Granulation of hydrometallurgically synthesized spinel lithium manganese oxide using cross-linked chitosan for lithium adsorption from water.

A drastic increase in demand for electric vehicles and energy storage systems increases lithium (Li) need as a critical metal for the 21st century. Lithium manganese oxides stand out among inorganic adsorbents because of their high capacity, chemical stability, selectivity, and affordability for lithium recovery from aqueous media. This study investigates using hydrometallurgically synthesized lithium manganese oxide (Li1.6Mn1.6O4) in granular form coated with cross-linked chitosan for lithium recovery from water. Characterization methods such as SEM, FTIR, XRD, and BET reveal the successful synthesis of the composite adsorbent. Granular cross-linked chitosan-coated and delithiated lithium manganese oxide (CTS/HMO) adsorbent demonstrated optimal removal efficiency of 86 % at pH 12 with 4 g/L of adsorbent dosage. The Langmuir isotherm at 25 °C, which showed monolayer adsorption with a maximum capacity of 4.94 mg/g, a better fit for the adsorption behavior of CTS/HMO. Adsorption was endothermic and thermodynamically spontaneous. Lithium adsorption followed the pseudo-first-order kinetic model.

Insights into engineered graphitic carbon nitride quantum dots for hazardous contaminants degradation in wastewater.

Increased environmental pollution is a critical issue that must be addressed. Photocatalytic, adsorption, and membrane filtration methods are suitable in environmental governance because of their high selectivity, low cost, environment-friendly nature, and excellent treatment efficiency. Graphitic carbon nitride (g-C3N4) quantum dots (QDs) have been considered as photocatalysts, adsorbents, and membrane materials for wastewater treatments, owing to their stability, adsorption capacity, photochemical properties, and low toxicity and cost. This review summarizes g-C3N4 QD synthesis techniques, operating parameters affecting the removal performance in the treatment process, modification effects with other semiconductors, and benefits and drawbacks of g-C3N4 QD-based materials. Furthermore, this review discusses the practical applications of g-C3N4 QDs as adsorbents, photocatalysts, and membrane materials for organic and inorganic contaminant treatments and their value-added product formation potential. Modified g-C3N4 QD-based material adsorbents, photocatalysts, and membranes present potentially applicable effects, such as removal of most waterborne contaminants. Excellent results were obtained for the reduction of methyl orange, bisphenol A, tetracycline, ciprofloxacin, phenol, rhodamine B, E. coli, and Hg. Overall, this paper provides comprehensive background on g-C3N4 QD-based materials and their diverse applications in wastewater treatment, and it presents a foundation for the enhancement of similar unique materials in the future.

A review of boron removal from aqueous solution using carbon-based materials: An assessment of health risks.

Carbon-based compounds have gained attention of researchers for use in boron removal due to their properties, which make them a viable and low cost adsorbent with a high availability, as well as environmental friendliness and high removal efficiency. The removal of boron utilizing carbon-based materials, including activated carbon (AC), graphene oxide (GO), and carbon nanotubes (CNTs), is extensively reviewed in this paper. The effects of the operating conditions, kinetics, isotherm models, and removal methods are also elaborated. The impact of the modification of the lifetime of carbon-based materials has also been explored. Compared to unmodified carbon-based materials, modified materials have a significantly higher boron adsorption capability. It has been observed that adding various elements to carbon-based materials improves their surface area, functional groups, and pore volume. Tartaric acid, one of these doped elements, has been employed to successfully improve the boron removal and adsorption capabilities of materials. An assessment of the health risk posed to humans by boron in treated water utilizing carbon-based materials was performed to better understand the performance of materials in real-world applications. Furthermore, the boron removal effectiveness of carbon-based materials was evaluated, as well as any shortcomings, future perspectives, and gaps in the literature.

Carbonaceous materials for removal and recovery of phosphate species: Limitations, successes and future improvement.

The carbonaceous materials have gained significant interest for the phosphorus species remediation and recovery in the last decade. Carbonaceous materials present many unique features, such as cost effective, availability, environmentally friendly, and high removal efficiency that make them a promising adsorbent. In this review, the recent application of carbonaceous materials including activated carbon (AC), graphene and graphene oxide (GO), lignin, carbon nanotubes (CNTs), and gC3N4 for phosphate removal and recovery were comprehensively summarized. The kinetics and isotherm models, removal mechanisms, and effects of operating parameters are reported. The reusability, lifetime of carbonaceous materials, and impact of modification were also considered. The modified carbonaceous materials have significantly high phosphate adsorption capacity compared to unmodified adsorbents. Namely, MgO-functionalized lignin-based bio-charcoal exhibited a 906.8 mg g-1 of capacity as the highest one among other reviewed materials. The modification of carbonaceous materials with various elements has been presented to improve the surface functional groups, surface area and charge, and pore volume and size. Among these loaded elements, iron has been effectively used to provide a prospect for magnetic recovery of the adsorbent as well as increase phosphate adsorption. Furthermore, the phosphate recovery methods, phosphate removal efficiency of carbonaceous materials, the limitations, important gaps in the literature, and future studies to enhance applicability of carbonaceous materials in real scale are also discussed.

The prognostic role of D-dimer in hospitalized COVID-19 patients.

INTRODUCTION: In COVID-19 patients, the determination of the relationship between elevated D-dimer level and prognosis and the determination of thrombosis formation in the early stages of the disease are very important. The aim of this study was to investigate the prognostic role of D-dimer levels based on presentation in patients hospitalized with the diagnosis of COVID-19. METHOD: The study was conducted on patients hospitalized with the diagnosis of laboratory-confirmed COVID-19 between March 11 and April 20, 2020. Patients with diseases that could have caused an increase in D-dimer were excluded from the study. RESULTS: The evaluation was made across a total of 1,669 patients, comprising 782 (46.9 %) females and 887 (53.1 %) males. The effects of D-dimer, CRP, ferritin, and troponin on mortality were evaluated with Enter Logistic Regression Analysis, and the model was found to be significant, with an explanatory coefficient of the model at a very good level of 91.3 %. The D-dimer scores were determined to be higher in patients who did not survive. The risk of mortality was seen to be 7.325-fold higher in cases with D-dimer measurement ≥0.5. CONCLUSION: The study results showed that the D-dimer test was an independent risk factor showing mortality in COVID-19 patients (Tab. 6, Ref. 27). Text in PDF www.elis.sk Keywords: D-dimer, SARS-CoV-2, mortality.

The Systematic Effect of Mesenchymal Stem Cell Therapy in Critical COVID-19 Patients: A Prospective Double Controlled Trial.

The aim of this clinical trial was to control the cytokine storm by administering mesenchymal stem cells (MSCs) to critically-ill COVID-19 patients, to evaluate the healing effect, and to systematically investigate how the treatment works. Patients with moderate and critical COVID-19 clinical manifestations were separated as Group 1 (moderate cases, n = 10, treated conventionally), Group 2 (critical cases, n = 10, treated conventionally), and Group 3 (critical cases, n = 10, treated conventionally plus MSCs transplantation therapy of three consecutive doses on treatment days 0, 3, and 6, (as 3 × 106 cells/kg, intravenously). The treatment mechanism of action was investigated with evaluation markers of the cytokine storm, via biochemical parameters, levels of proinflammatory and anti-inflammatory cytokines, analyses of tissue regeneration via the levels of growth factors, apoptosis markers, chemokines, matrix metalloproteinases, and granzyme-B, and by the assessment of the immunomodulatory effects via total oxidant/antioxidant status markers and the levels of lymphocyte subsets. In the assessment of the overall mortality rates of all the cases, six patients in Group-2 and three patients in Group-3 died, and there was no loss in Group-1. Proinflammatory cytokines IFNγ, IL-6, IL-17A, IL-2, IL-12, anti-inflammatory cytokines IL-10, IL-13, IL-1ra, and growth factors TGF-ß, VEGF, KGF, and NGF levels were found to be significant in Group-3. When Group-2 and Group-3 were compared, serum ferritin, fibrinogen and CRP levels in Group-3 had significantly decreased. CD45 +, CD3 +, CD4 +, CD8 +, CD19 +, HLA-DR +, and CD16 + / CD56 + levels were evaluated. In the statistical comparison of the groups, significance was only determined in respect of neutrophils. The results demonstrated the positive systematic and cellular effects of MSCs application on critically ill COVID-19 patients in a versatile way. This effect plays an important role in curing and reducing mortality in critically ill patients.

Mesenchymal stem cells treatment in COVID-19 patient with multi-organ involvement.

The aim of this study is to evaluate the therapeutic effect of mesenchymal stem cells (MSCs) in a severe case of brain and multiple organ involvement in a patient with COVID-19. Here, a 51-year-old male patient with multi-organ involvement due to COVID-19 infection and developing cardiac arrest is presented. MSCs were transplanted to the patient four times systematically and once intrathecally. As a result, the application of MSCs has been found to have a healing effect on organs in this patient with severe COVID-19 infection. In addition, transplantation of MSCs both systematically and intrathecally is considered to be effective in the treatment of the central nervous system (Tab. 2, Fig. 2, Ref. 24). Keywords: mesenchymal stem cell, COVID-19, organ involvement.

Tetanus in adults: results of the multicenter ID-IRI study.

Tetanus is an acute, severe infection caused by a neurotoxin secreting bacterium. Various prognostic factors affecting mortality in tetanus patients have been described in the literature. In this study, we aimed to analyze the factors affecting mortality in hospitalized tetanus patients in a large case series. This retrospective multicenter study pooled data of tetanus patients from 25 medical centers. The hospitals participating in this study were the collaborating centers of the Infectious Diseases International Research Initiative (ID-IRI). Only adult patients over the age of 15 years with tetanus were included. The diagnosis of tetanus was made by the clinicians at the participant centers. Izmir Bozyaka Education and Research Hospital's Review Board approved the study. Prognostic factors were analyzed by using the multivariate regression analysis method. In this study, 117 adult patients with tetanus were included. Of these, 79 (67.5%) patients survived and 38 (32.5%) patients died. Most of the deaths were observed in patients >60 years of age (60.5%). Generalized type of tetanus, presence of pain at the wound area, presence of generalized spasms, leukocytosis, high alanine aminotransferase (ALT) and C-reactive protein (CRP) values on admission, and the use of equine immunoglobulins in the treatment were found to be statistically associated with mortality (p < 0.05 for all). Here, we describe the prognostic factors for mortality in tetanus. Immunization seems to be the most critical point, considering the advanced age of our patients. A combination of laboratory and clinical parameters indicates mortality. Moreover, human immunoglobulins should be preferred over equine sera to increase survival.

Predictors for limb loss among patient with diabetic foot infections: an observational retrospective multicentric study in Turkey.

We aimed to investigate the predictors for limb loss among patients with diabetes who have complicated skin/soft-tissue infections. In this observational study, consecutive patients with diabetic foot infection (DFI) from 17 centres in Turkey, between May 2011 and May 2013 were included. The Turkish DFI Working Group performed the study. Predictors of limb loss were investigated by multivariate analysis. In total, 455 patients with DFI were included. Median age was 61 years, 68% were male, 65% of the patients were hospitalized, 52% of the patients had used antibiotics within the last month, and 121 (27%) had osteomyelitis. Of the 208 microorganisms isolated, 92 (44.2%) were Gram-positive cocci and 114 (54.8%) were Gram-negative rods (GNR). The most common GNR was Pseudomonas; the second was Escherichia coli, with extended spectrum ß-lactamase positivity of 33%. Methicillin-resistant Staphylococcus species were found in 14% (29/208). Amputations were performed in 126/455 (28%) patients, 44/126 (34%) of these were major amputations. In multivariate analysis, significant predictors for limb loss were, male gender (OR 1.75, 95% CI 1.04-2.96, p 0.034), duration of diabetes >20 years (OR 1.9, 95% CI 1.18-3.11, p 0.008), infected ulcer versus cellulitis (OR 1.9, 95% CI 1.11-3.18, p 0.019), history of peripheral vascular disease (OR 2, 95% CI 1.26-3.27, p 0.004), retinopathy (OR 2.25, 95% CI 1.19-4.25, p 0.012), erythrocyte sedimentation rate >70 mm/hr (OR 1.6, 95% CI 1.01-2.68, p 0.05), and infection with GNR (OR 1.8, 95% CI 1.08-3.02, p 0.02). Multivariate analysis revealed that, besides the known risk factors such as male gender, duration of diabetes >20 years, infected ulcers, history of peripheral vascular disease and retinopathy, detection of GNR was a significant predictor of limb loss.

Evaluation of tularaemia courses: a multicentre study from Turkey.

In this multicentre study, which is the largest case series ever reported, we aimed to describe the features of tularaemia to provide detailed information. We retrospectively included 1034 patients from 41 medical centres. Before the definite diagnosis of tularaemia, tonsillitis (n = 653, 63%) and/or pharyngitis (n = 146, 14%) were the most frequent preliminary diagnoses. The most frequent clinical presentations were oropharyngeal (n = 832, 85.3%), glandular (n = 136, 13.1%) and oculoglandular (n = 105, 10.1%) forms. In 987 patients (95.5%), the lymph nodes were reported to be enlarged, most frequently at the cervical chain jugular (n = 599, 58%), submandibular (n = 401, 39%), and periauricular (n = 55, 5%). Ultrasound imaging showed hyperechoic and hypoechoic patterns (59% and 25%, respectively). Granulomatous inflammation was the most frequent histological finding (56%). The patients were previously given antibiotics for 1176 episodes, mostly with ß-lactam/ß-lactamase inhibitors (n = 793, 76%). Antituberculosis medications were provided in seven (2%) cases. The patients were given rational antibiotics for tularaemia after the start of symptoms, with a mean of 26.8 ± 37.5 days. Treatment failure was considered to have occurred in 495 patients (48%). The most frequent reasons for failure were the production of suppuration in the lymph nodes after the start of treatment (n = 426, 86.1%), the formation of new lymphadenomegalies under treatment (n = 146, 29.5%), and persisting complaints despite 2 weeks of treatment (n = 77, 15.6%). Fine-needle aspiration was performed in 521 patients (50%) as the most frequent drainage method. In conclusion, tularaemia is a long-lasting but curable disease in this part of the world. However, the treatment strategy still needs optimization.

The microbiological diagnosis of tuberculous meningitis: results of Haydarpasa-1 study.

We aimed to provide data on the diagnosis of tuberculous meningitis (TBM) in this largest case series ever reported. The Haydarpasa-1 study involved patients with microbiologically confirmed TBM in Albania, Croatia, Denmark, Egypt, France, Hungary, Iraq, Italy, Macedonia, Romania, Serbia, Slovenia, Syria and Turkey between 2000 and 2012. A positive culture, PCR or Ehrlich-Ziehl-Neelsen staining (EZNs) from the cerebrospinal fluid (CSF) was mandatory for inclusion of meningitis patients. A total of 506 TBM patients were included. The sensitivities of the tests were as follows: interferon-γ release assay (Quantiferon TB gold in tube) 90.2%, automated culture systems (ACS) 81.8%, Löwenstein Jensen medium (L-J) 72.7%, adenosine deaminase (ADA) 29.9% and EZNs 27.3%. CSF-ACS was superior to CSF L-J culture and CSF-PCR (p <0.05 for both). Accordingly, CSF L-J culture was superior to CSF-PCR (p <0.05). Combination of L-J and ACS was superior to using these tests alone (p <0.05). There were poor and inverse agreements between EZNs and L-J culture (κ = -0.189); ACS and L-J culture (κ = -0.172) (p <0.05 for both). Fair and inverse agreement was detected for CSF-ADA and CSF-PCR (κ = -0.299, p <0.05). Diagnostic accuracy of TBM was increased when both ACS and L-J cultures were used together. Non-culture tests contributed to TBM diagnosis to a degree. However, due to the delays in the diagnosis with any of the cultures, combined use of non-culture tests appears to contribute early diagnosis. Hence, the diagnostic approach to TBM should be individualized according to the technical capacities of medical institutions particularly in those with poor resources.

Volatiles and sensory evaluation of goat milk cheese Gokceada as affected by goat breeds (Gokceada and Turkish Saanen) and starter culture systems during ripening.

The effect of goat breed and starter culture on volatile composition and sensory scores in goat milk cheese was studied during 90d of ripening. Milk from 2 goat breeds (Gokceada and Turkish Saanen) and different starter culture systems (no starter, mesophilic and thermophilic starters) were used in the manufacture of goat milk cheeses (called Gokceada goat cheese). Volatile composition was determined by a solid-phase microextraction-gas chromatography-mass spectrometric method. Sixty compounds including esters (13), carboxylic acids (7), aldehydes (6), ketones (8), alcohols (14), and miscellaneous compounds (12) were identified. Esters, alcohols, and carboxylic acids were the main classes of volatile components in the cheeses. Both qualitatively and quantitatively, the use of different starter cultures and goat breeds significantly influenced the volatile fraction of goat milk cheese. Decanoic, hexanoic, and octanoic (commonly named capric, caproic, and caprylic) acids were indicator compounds to distinguish the goat breeds. Principal component analysis grouped the cheeses based on the use of starter culture and goat breed. Starter-free cheeses were separately located on the plot and age-related changes were present in all samples. Sensory evaluation of 90-d-old cheeses showed that the cheeses from the Gokceada breed received higher odor, flavor, and quality scores than those from the Turkish Saanen breed, and cheeses made using mesophilic starters resulted in the most satisfactory scores for flavor and quality attributes. In conclusion, goat milk cheeses made using milk from Gokceada goats and mesophilic starter culture had the best quality in terms of volatile composition and sensory attributes.

Successfully treated Mycobacterium abscessus mastitis: a rare cause of breast masses.

Rapidly growing mycobacteria are pathogens responsible for cutaneous or subcutaneous infections especially occurring after injection, trauma or surgery. We describe a patient with Mycobacterium abscessus mastitis that presented as a mass lesion and haemorrhagical discharge. It was initially diagnosed and treated as fibrocystic disease and non-specific abscess. Full recovery was obtained with combination therapy of clarithromycin, linezolid and amikacin without surgical debridement followed by several abscess aspirations. Atypical mycobacteria should be considered in diagnosis of chronic breast lesions in endemic areas. This is the first reported case of mastitis due to M. abscessus in Turkey.

Predictors of mortality in tuberculous meningitis: a multivariate analysis of 160 cases.

OBJECTIVE: To evaluate predictors of mortality in 160 patients with tuberculous meningitis (TBM). DESIGN: One hundred and sixty patients with TBM who had been followed for 11 years in a tertiary referral centre hospital were assessed retrospectively. Features considered as predictors of mortality in TBM were studied by multivariate logistic regression to develop a prognostic rule. RESULTS: Of 160 patients, 84% were in Stages II and III; 27 (17%) died. In univariate analysis, age, stage, altered sensorium, underlying comorbidities, pulmonary tuberculosis, leukocytosis and cerebrospinal fluid (CSF)/blood glucose < 0.30 and rise in CSF protein were associated with an increased risk of death. In multivariable analysis, age (OR 4.64, 95%CI 1.03-24.74, P = 0.046), altered sensorium (OR 8.62, 95%CI 1.25-110.0, P = 0.036), underlying comorbidity (OR 9.75, 95%CI 1.58-59.95, P = 0.014) and leukocytosis (OR 9.74, 95%CI 1.67-56.7, P = 0.011) were shown to be the best predictors of mortality in TBM. CONCLUSIONS: We observed that TBM patients who died were more likely to be older and have altered mental status on admission, underlying comorbidities and leukocytosis than TBM patients who survived. These factors were the most important predictors of mortality from TBM.

Characterization of aroma-active compounds, sensory properties, and proteolysis in Ezine cheese.

Ezine cheese is a white pickled cheese ripened in tinplate containers for at least 8 mo. A mixture of milk from goat, sheep, and cow is used to make Ezine cheese. Ezine cheese has geographical indication status. The purposes of this study were to determine and compare the changes in basic composition, aroma, and sensory characteristics, and proteolytic activity of Ezine cheese stored in tinplate containers and plastic vacuum packages during storage. Aroma-active compounds were determined by thermal desorption gas chromatography olfactometry. To evaluate the proteolytic activity, casein and nitrogen fractions were determined. The results indicated that compounds identified at high intensities were dimethyl sulfide, ethyl butyrate, hexanal, ethyl pentanoate, (Z)-4-heptenal, 1-octen-3-one, acetic acid, butyric acid, and p-cresol. Characteristic descriptive terms were cooked, whey, creamy, animal-like, sour, and salty. The level of proteolysis increased in Ezine cheese during storage. Ezine cheese can be ripened in small-size packaging after 3 mo of storage. Approximately 6 mo is sufficient to produce the characteristic properties of Ezine cheese.

[E-test susceptibility results of brucella strains for streptomycin, rifampicin, ciprofloxacin and tetracycline]. / Brucella suslarinin streptomisin, rifampisin, siprofloksasin ve tetrasiklin için E-test duyarlilik sonuçlari.

Although Brucella species are susceptible to many antimicrobial agents in vitro, the susceptibility tests for these bacteria are not well standardized and the break point values are not described yet clearly. The aim of this study was to investigate the minimum inhibitory concentration (MIC) values of 43 Brucella strains isolated from blood cultures by E-test. Streptomycin and rifampicin E-tests were performed for all of the strains, however, tetracycline and ciprofloxacin were tested for only 27 and 17 strains, respectively. The MIC interval for streptomycin was 0.025-1 mg/L, for rifampicin 0.19-1.5 mg/L, for tetracycline <0.016-0.032 mg/L, and for ciprofloxacin 0.094-0.64 mg/L. One strain was found intermediately susceptible to rifampicin. In may be concluded that development of resistance is not eligible against antibiotics which are currently used for brucellosis therapy.