Assessing geochemical and natural radioactivity impacts of Hamadat phosphatic mine through radiological indices.

The utilization of phosphorite deposits as an industrial resource is of paramount importance, and its sustainability largely depends on ensuring safe and responsible practices. This study aims to evaluate the suitability of phosphorite deposits for industrial applications such as the production of phosphoric acid and phosphatic fertilizers. To achieve this goal, the study meticulously examines the geochemical characteristics of the deposits, investigates the distribution of natural Radioactivity within them, and assesses the potential radiological risk associated with their use. The phosphorites are massive and collected from different beds within the Duwi Formation at the Hamadat mining area. They are grain-supported and composed of phosphatic pellets, bioclasts (bones), non-phosphatic minerals, and cement. Geochemically, phosphorites contain high concentrations of P2O5 (23.59-28.36 wt.%) and CaO (40.85-44.35 wt.%), with low amounts of Al2O3 (0.23-0.51 wt.%), TiO2 (0.01-0.03 wt.%), Fe2O3 (1.14-2.28 wt.%), Na2O (0.37-1.19 wt.%), K2O (0.03-0.12 wt.%), and MnO (0.08-0.18 wt.%), suggesting the low contribution of the detrital material during their deposition. Moreover, they belong to contain enhanced U concentration (55-128 ppm). They are also enriched with Sr, Ba, Cr, V, and Zn and depleted in Th, Zr, and Rb, which strongly supports the low detrital input during the formation of the Hamadat phosphorites. The high Radioactivity of the studied phosphorites is probably due to the widespread occurrence of phosphatic components (e.g., apatite) that accommodate U in high concentrations. Gamma spectrometry based on NaI (Tl) crystal 3×3 has been used to measure occurring radionuclides in the phosphorite samples. The results indicate that the radioactive concentrations' average values of 226Ra, 232Th, and 40K are 184.18±9.19, 125.82±6.29, and 63.82±3.19 Bq Kg-1, respectively. Additionally, evaluations have been made of the radiological hazards. The calculated risk indicators exceeded the recommended national and world averages. The data obtained will serve as a reference for follow-up studies to evaluate the effectiveness of the Radioactivity of phosphatic materials collected from the Hamdat mine area.

Timing of Postoperative Stroke and Risk of Mortality After Noncardiac Surgery: A Cohort Study.

Background: Postoperative stroke is a devastating complication of surgery, given its association with severe long-term disability and mortality. Previous investigators have confirmed the association of stroke with postoperative mortality. However, limited data exist regarding the relationship between the timing of stroke and survival. Addressing this knowledge gap will help clinicians develop tailored perioperative strategies to reduce the incidence, severity, and mortality associated with perioperative stroke. Therefore, our objective was to determine whether the timing of postoperative stroke influenced mortality risk. Methods: We performed a retrospective cohort study of patients > 18 years who underwent noncardiac surgery and developed postoperative stroke during the first 30 days of surgery (National Surgical Quality Improvement Program Pediatrics 2010 - 2021). Our primary outcome was 30-day mortality following the occurrence of postoperative stroke. We subdivided patients into two mutually exclusive groups: early and delayed stroke. Early stroke was defined as the occurrence within 7 days following surgery, consistent with a previous study. Results: We identified 16,750 patients who underwent noncardiac surgery and developed stroke within 30 days of surgery. Of these, 11,173 (66.7%) had an early postoperative stroke (≤ 7 days). Perioperative physiological status, operative characteristics, and preoperative comorbidities were generally comparable between patients with early and delayed postoperative stroke. Despite the comparability in these clinical characteristics, the mortality risk was 24.9% for early and 19.4% for delayed stroke. After adjusting for perioperative physiological status, operative characteristics, and preoperative comorbidities, early stroke was associated with an increased mortality risk (adjusted odds ratio: 1.39, confidence interval: 1.29 - 1.52, P-value < 0.001). In patients with an early postoperative stroke, the most common preceding complications were bleeding requiring transfusion (24.3%), followed by pneumonia (13.2%) and renal insufficiency (11.3%). Conclusions: Postoperative stroke tends to occur within 7 days following noncardiac surgery. Such timing of postoperative stroke carries a higher mortality risk, suggesting that targeted efforts to prevent stroke should focus on the first week following surgery to reduce the incidence and mortality associated with this complication. Our findings contribute to the growing understanding of stroke after noncardiac surgery and may help clinicians develop tailored perioperative neuroprotective strategies to prevent or improve treatment and outcomes of postoperative stroke.

Hypoxemia After Endobronchial Valve Deployment for Persistent Air Leak.

Endobronchial valves (EBVs) are a novel, minimally invasive bronchoscopic management technique for persistent air leaks that fail conservative therapy. Currently, 2 EBVs are available in the United States: the Spiration Valve System (Olympus, Redmond, WA) and the Zephyr Valve (Pulmonx, Redwood, CA). These valves are Food and Drug Administration-approved to reduce hyperinflation in emphysematous patients via bronchoscopic lung-volume reduction. However, more recently, the Spiration Valve has been granted a compassionate use exemption through the Food and Drug Administration for persistent postsurgical air leaks. Despite their popularity, these devices are not free from side effects. As an anesthesiologist, it is vital to be aware of the pathophysiology of this patient population so that safe and effective anesthetics may be provided during valve placement. Here, the use of EBVs is discussed in a patient who presented with a persistent air leak after a transthoracic needle aspiration that failed treatment due to persistent hypoxemia, warranting EBV removal.

Refractory Hypotension During Implantation of a 70 mL Total Artificial Heart in a Patient With Pectus Excavatum: A Case Report.

The Syncardia total artificial heart system is the only commercially approved durable device for treating biventricular heart failure patients awaiting heart transplantation. Conventionally, the Syncardia total artificial heart system is implanted based on the distance from the anterior aspect of the 10th thoracic vertebra to the sternum and the patient's body surface area. However, this criterion does not account for chest wall musculoskeletal deformities. This case report describes a patient with a pectus excavatum who developed compression of the inferior vena cava after Syncardia total artificial heart implantation and how transesophageal echocardiography guided chest wall surgery to accommodate the total artificial heart system.

Tracheal Bronchus and Successful Right-Sided Isolation With a Bronchial Blocker.

The presence of a tracheal bronchus, which is often incidentally discovered, complicates endotracheal intubation and lung isolation during thoracic surgery. Prior reports of successful right-sided lung isolation in the presence of tracheal bronchus required utilization of a double lumen tube. Although right-sided lung isolation was required in our case, due to other patient factors, it was determined that a double lumen tube of a suitable size would be unlikely to be placed safely and successfully. We describe the successful use of a Rüsch EZ-Blocker bronchial blocker in obtaining right-sided isolation in a patient with a difficult airway and tracheal bronchus.

Mouse Model of Spinal Cord Hypoperfusion with Immediate Paralysis Caused by Endovascular Repair of Thoracic Aortic Aneurysm.

BACKGROUND: A clinically relevant mouse model of thoracic endovascular aortic repair-induced ischemic spinal cord injury has been lacking since the procedure was first employed in 1991. The hypothesis was that ligation of mouse intercostal arteries would simulate thoracic endovascular aortic repair-induced ischemic spinal cord injury and behavioral deficit. The aim was to create a mouse model of thoracic endovascular aortic repair-induced spinal cord hypoperfusion by ligating five pairs of mouse intercostal vessels. METHODS: Mice were divided into sham (n = 53) and ligation (n = 60) groups. The procedures called for double ligation of three pairs and single ligation of two pairs of thoracic intercostal arteries in adult C57BL/6 mice. A laser Doppler probe was used in vivo on the spinal cords and intercostal arteries to document the extent of arterial ligation and spinal cord hypoperfusion. The Basso Mouse Scale for Locomotion, histological studies, and electron microscopy demonstrated postligation locomotive and histopathological changes. RESULTS: Ligation induced a significant and instantaneous drop in blood flow in the intercostal arteries (% change; mean = -63.81; 95% CI, -72.28 to -55.34) and the thoracic spinal cord (% change; mean = -68.55; 95% CI, -80.23 to -56.87). Paralysis onset was immediate and of varying degree, with behavioral deficit stratified into three groups: 9.4% exhibited severe paralysis, 37.5% moderate paralysis, and 53.1% mild paralysis at day 1 (n = 32; P < 0.001). Mild and moderate paralysis was transient, gradually improving over time. Severe paralysis showed no improvement and exhibited a higher mortality rate (83%; n = 15 of 18) compared to moderately (33%; n = 6 of 18) and mildly (24%; n = 6 of 25) paralyzed mice (P < 0.001). The overall ligation group survival rate (84%; n = 46 of 55) was significantly lower than the sham group (100%; n = 48 of 48) with P = 0.003. CONCLUSIONS: The mouse model generates reproducible spinal cord hypoperfusion and accompanying histopathological ischemic spinal cord damage. The resulting anatomical changes and variable behavioral deficits mimic the variability in radiological and clinical findings in human patients.

Distribution of Radionuclides and Radiological Health Assessment in Seih-Sidri Area, Southwestern Sinai.

The current contribution goal is to measure the distribution of the radionuclide within the exposed rock units of southwestern Sinai, Seih-Sidri area, and assess the radiological risk. Gneisses, older granites, younger gabbro, younger granites, and post granitic dikes (pegmatites) are the main rock units copout in the target area. Radioactivity, as well as radiological implications, were investigated for forty-three samples from gneisses (seven hornblende biotite gneiss and seven biotite gneiss), older granites (fourteen samples), and younger granites (fifteen samples of syenogranites) using NaI (Tl) scintillation detector. External and internal hazard index (Hex, Hin), internal and external level indices (Iα, Iγ), absorbed dose rates in the air (D), the annual effective dose equivalent (AED), radium equivalent activity (Raeq), annual gonadal dose (AGDE), excess lifetime cancer risk (ELCR), and the value of Upper Continental Core 232Th/238U mass fractions were determined from the obtained values of 238U, 232Th and 40K for the examined rocks of Seih-Sidri area. The average 238U mg/kg in hornblende biotite gneiss and biotite gneiss, older granites, and syenogranites is 2.3, 2.1, 2.7, and 8.4 mg/kg, respectively, reflecting a relatively higher concentration of uranium content in syenogranites. The results suggest that using these materials may pose risks to one's radiological health.

A Novel Triazole Schiff Base Derivatives for Remediation of Chromium Contamination from Tannery Waste Water.

Tannery industries are one of the extensive industrial activities which are the major source of chromium contamination in the environment. Chromium contamination has been an increasing threat to the environment and human health. Therefore, the removal of chromium ions is necessary to save human society. This study is oriented toward the preparation of a new triazole Schiff base derivatives for the remediation of chromium ions. 4,4'-((1E)-1,2-bis ((1H-1,2,4-triazol-3-yl) imino)ethane-1,2-diyl) diphenol was prepared by the interaction between 3-Amino-1H-1,2,4-triazole and 4,4'-Dihydroxybenzil. Then, the produced Schiff base underwent a phosphorylation reaction to produce the adsorbent (TIHP), which confirmed its structure via the different tools FTIR, TGA, 1HNMR, 13CNMR, GC-MS, and Phosphorus-31 nuclear magnetic resonance (31P-NMR). The newly synthesized adsorbent (TIHP) was used to remove chromium oxyanions (Cr(VI)) from an aqueous solution. The batch technique was used to test many controlling factors, including the pH of the working aqueous solution, the amount of adsorbent dose, the initial concentration of Cr(VI), the interaction time, and the temperature. The desorption behaviour of Cr(VI) changes when it is exposed to the suggested foreign ions. The maximum adsorption capacity for Cr(VI) adsorption on the new adsorbent was 307.07 mg/g at room temperature. Freundlich's isotherm model fits the adsorption isotherms perfectly. The kinetic results were well-constrained by the pseudo-second-order equation. The thermodynamic studies establish that the adsorption type was exothermic and naturally spontaneous.

Radiological Hazards and Natural Radionuclide Distribution in Granitic Rocks of Homrit Waggat Area, Central Eastern Desert, Egypt.

Natural radioactivity, radiological hazard, and petrological studies of Homrit Waggat granitic rocks, Central Eastern Desert, Egypt were performed in order to assess their suitability as ornamental stone. On the basis of mineralogical and geochemical compositions, Homrit Waggat granitic rocks can be subdivided into two subclasses. The first class comprises granodiorite and tonalite (I-type) and is ascribed to volcanic arc, whereas the second one includes alkali-feldspar granite, syenogranite, and albitized granite with high-K calc alkaline character, which is related to post-orogenic granites. 238U, 226Ra, 232Th, and 40K activities of natural radionuclides occurring in the examined rocks were measured radiometrically using sodium iodide detector. Furthermore, assessment of the hazard indices-such as: annual effective dose (AED) with mean values (0.11, 0.09, 0.07, 0.05, and 0.03, standard value = 0.07); gamma radiation index (Iγ) with mean values (0.6, 0.5, 0.4, 0.3, and 0.14, standard value = 0.5); internal (Hin) with mean values (0.6, 0.5, 0.4, 0.3, and 0.2, standard value = 1.0); external (Hex) index (0.5, 0.4, 0.3, 0.24, and 0.12, standard value = 1.0); absorbed gamma dose rate (D) with mean values (86.4, 75.9, 53.5, 43.6, and 20.8, standard value = 57); and radium equivalent activity (Raeq) with mean values (180, 154, 106.6, 90.1, and 42.7, standard value = 370)-were evaluated with the knowledge of the natural radionuclides. The result of these indices falls within the acceptable worldwide limits. Therefore, we suggest that these rocks are safe to be used in industrial applications.

Pulmonary artery pulsatility index as a predictor of right ventricular failure in left ventricular assist device recipients: A systematic review.

BACKGROUND: It is critical to identify patients at increased risk of right ventricular failure (RVF) before left ventricular assist device (LVAD) implantation. Pulmonary artery pulsatility index (PAPi) is a hemodynamic parameter that is a specific measure of right ventricular function and may better identify LVAD recipients at risk for RVF. This systematic review analyzes the predictive value of preoperative PAPi to RVF in the setting of LVAD implantation. METHODS: Databases were searched for all studies reporting on PAPi and RVF after LVAD implantation. Data collected included: number of patients, patient characteristics, incidences of RVF, PAPi, central venous pressure (CVP), CVP/pulmonary capillary wedge pressure, tricuspid annular plane systolic excursion, and right ventricular stroke work index. RESULTS: Thirty-two studies (4,756 patients) were included in this review. The incidence of RVF was found to be 27.48% (1,307 patients). The weighted mean (standard deviation) of preoperative PAPi associated with RVF vs No RVF was 2.17 (2.36) and 2.87 (3.21), respectively. When comparing LVAD recipients with RVF and No RVF, patients who developed RVF had a significantly lower preoperative PAPi by a WMD (95% CI) of -0.74 [-1.00, -0.49] (p < .001). The remaining variables (CVP; CVP/pulmonary capillary wedge pressure; tricuspid annular plane systolic excursion; and right ventricular stroke work index) were also confirmed as predictors of RVF after LVAD implantation. CONCLUSIONS: This systematic review demonstrates the utility of PAPi as a clinical predictor of RVF after LVAD implantation. Based on our findings, we recommend that PAPi be used in conjunction with traditional hemodynamic parameters when risk stratifying LVAD recipients for RVF.

Histologic, viral, and molecular correlates of heart disease in fatal COVID-19.

Cardiac manifestations are common in severe COVID-19. This study compared the histologic, viral, and molecular findings in cardiac tissue in fatal COVID-19 (n = 11) and controls (n = 11). In situ hybridization (SARS-CoV2 RNA) and immunohistochemistry for viral proteins and the host response were quantified for the samples and compared with qRTPCR and Western blot data. Control hearts showed a high resident population of macrophages that had variable ACE2 expression. Cardiac ACE2 expression was 10× greater in the heart tissues of cases and controls with obesity or type II diabetes. Multifocal endothelial cell swelling and degeneration, perivascular edema plus microvascular thrombi were unique to the cases. SARS-CoV2 RNA and nucleocapsid protein were rarely detected in situ in any COVID-19 heart. However, in each case abundant SARS-CoV-2 spike protein was evident. Co-expression experiments showed that the spike protein localized mostly to the ACE2+ interstitial macrophages/pericytes that were activated as evidenced by increased IL6 and TNFα expression. Western blots confirmed the presence of the viral spike protein, but not the nucleocapsid protein, in the cardiac homogenates. The intercalated disc proteins connexin 43, the primary cardiac gap junction protein, and NaV1.5, the predominant cardiac sodium channel, each showed marked lateral migration in the myocytes in the cases, which would increase the risk of reentrant arrhythmias. It is concluded that the viral spike protein, endocytosed by macrophages/pericytes, can induce a myocarditis with the possibility of conduction dysfunction due to abnormal localization of key intercalated disc proteins.

MicroRNA miR-155 Activity in Mouse Choline Acetyltransferase-Positive Neurons Is Critical for the Rate of Early and Late Paraplegia After Transient Aortic Cross-Clamping.

Aortic aneurism open repair surgery can cause spinal cord (SC) injury with 5-15% of patients developing paraparesis or paraplegia. Using a mouse model of transient aortic cross-clamping (ACC), we have previously found that the expression of proinflammatory microRNA miR-155 increases in motoneurons (MNs) and endothelial cells (ECs) of ischemic SCs, and that global miR-155 deletion decreases the percentage of paraplegia by 37.4% at 48-h post-ACC. Here, we investigated the cell-specific contribution of miR-155 in choline acetyltransferase-positive (ChAT+) neurons (that include all MNs of the SC) and ECs to SC injury after ACC. Mice lacking miR-155 in ChAT+ neurons (MN-miR-155-KO mice) developed 24.6% less paraplegia than control mice at 48-h post-ACC. In contrast, mice lacking miR-155 in ECs (ECs-miR-155-KO mice) experienced the same percentage of paraplegia as control mice, despite presenting smaller central cord edema. Unexpectedly, mice overexpressing miR-155 in ChAT+ neurons were less likely than control mice to develop early paraplegia during the first day post-ACC, however they reached the same percentage of paraplegia at 48-h. In addition, all mice overexpressing miR-155 in ECs (ECs-miR-155-KI mice) were paraplegic at 48-h post-ACC. Altogether, our results suggest that miR-155 activity in ChAT+ neurons protects the SC against ischemic injury during the first day post-ACC before becoming deleterious during the second day, which indicates that early and late paraplegias arise from different molecular malfunctions. These results point to the need to develop specific protective therapeutics aimed at inhibiting both the early and late deleterious events after open repair surgery of aortic aneurisms.