Label-Free Identification of Carbonaceous Particles Using Nonlinear Optical Microscopy.

The adverse health effects of ambient carbonaceous particles (CPs) such as carbon black (CB), black carbon (BC), and brown carbon (BrC) are becoming more evident and depend on their composition and emission source. Therefore, identifying and quantifying these particles in biological samples are important to better understand their toxicity. Here, we report the development of a nonlinear optical approach for the identification of CPs such as CB and BrC using imaging conditions compatible with biomedical samples. The unique visible light fingerprint of CB and BrC nanoparticles (NPs) upon illumination with a femtosecond (fs) pulsed laser at 1300 nm excitation wavelength is an effective approach for their identification in their biological context. The emission from spectral features of these CPs was investigated with time-domain fluorescence lifetime imaging (FLIM) to further support their identification. This study is performed for different types of CPs embedded in agarose gel as well as in in vitro mammalian cells. The unique nonlinear emissive behavior of CP NPs used for their label-free identification is further complementary with fluorophores typically used for specific staining of biological samples thus providing the relevant bio-context.

Experience of surgical management of rare cases of choledochal cyst in last five years-tertiary care reflection.

Choledochal Cyst (CC), also known as the biliary cyst, is one of the rare inherited anomalies of intrahepatic and/or extrahepatic biliary system characterised by varying degrees of cystic dilatation of the biliary tract without acute obstruction. The prevalence ranges from 1 in 13,000 people to 1 in 2 million people with preponderance in Asia1, particularly in Japan. Moreover, the presentation also varies in children and adults, and is usually vaguer and non-specific in adults. The prevalence is even lower in males, with female to male ratio being 3:1-4:12. We present here three cases of adult choledochal cysts excised in our surgical unit in the last five years. We discuss the aetiopathogenesis, presentation, diagnosis, surgical treatment, and complications of choledochal cysts based on the available literature. It is crucial to establish a multidisciplinary group of professionals, that comprises paediatric surgeons, pathologists, paediatric gastroenterologists, physiotherapists, nutritionists, oncologists, and radiologists, to get acceptable outcomes in diagnosing and treating children with choledochal cysts.

Subcutaneous infiltration of carbon dioxide (carboxytherapy) for abdominal fat reduction: A randomized clinical trial.

BACKGROUND: Noninvasive fat removal is preferred because of decreased downtime and lower perceived risk. It is important to seek new noninvasive fat removal treatments that are both safe and efficacious. OBJECTIVE: To assess the extent to which carboxytherapy, which is the insufflation of carbon dioxide gas into subcutaneous fat, results in reduction of fat volume. METHODS: In this randomized, sham-controlled, split-body study, adults (body mass index, 22-29 kg/m2) were randomized to receive 5 weekly infusions of 1000 cm3 of CO2 to 1 side of the abdomen, and 5 sham treatments to the contralateral side. The primary outcome measures were ultrasound measurement of fat layer thickness and total circumference before and after treatment. RESULTS: A total of 16 participants completed the study. Ultrasound measurement indicated less fat volume on the side treated with carboxytherapy 1 week after the last treatment (P = .011), but the lower fat volume was not maintained at 28 weeks. Total circumference decreased nominally but not significantly at week 5 compared with baseline (P = .0697). Participant body weights did not change over the entire course of the study (P = 1.00). LIMITATIONS: Limitations included modest sample size and some sources of error in the measurement of circumference and fat layer. CONCLUSION: Carboxytherapy provides a transient decrease in subcutaneous fat that may not persist. Treatment is well tolerated.

Novel plasma microRNA biomarkers for the identification of colitis-associated carcinoma.

BACKGROUND: Ulcerative colitis is an established risk factor for colorectal cancer, also known as colitis-associated cancer. Existing colonoscopic-based surveillance has many disadvantages, so a new accurate, efficient, cost-effective screening test is needed. MicroRNAs (miRNAs) regulate gene expression and are dysregulated in a range of diseases, including ulcerative colitis and colorectal cancer. This study aimed to establish the miRNAs associated with colitis-associated cancer. METHODS: Blood samples were collected from 45 adult patients undergoing colonoscopic screening for ulcerative colitis at the Leicester General Hospital, Leicester, UK. Pool A and B TaqMan Array 384-well cards were used to quantify the expression of 754 miRNAs in the circulating plasma. 28 high priority miRNA candidates showing abnormal expression were validated with real-time quantitative PCR. FINDINGS: Patients were allocated to three disease groups (ulcerative colitis, n=37; dysplasia, n=2; colitis-associated cancer, n=6). Analysis of variance was used to assess differences between the groups. miR-375 was significantly upregulated in the colitis-associated cancer cohort (p=0·0061) compared with active ulcerative colitis. Combining several miRNAs in a panel increased the capacity of the test to distinguish between colitis-associated cancer and different ulcerative colitis activity states. INTERPRETATION: Our study suggests that miRNAs have the potential to act as blood-based biomarkers to monitor the activity and progression of disease in patients with ulcerative colitis. FUNDING: Royal College of Surgeons of England.

Emerging drugs for the treatment of acne.

INTRODUCTION: Acne is the most common skin condition in the US. The mainstay of acne therapy includes: topical retinoids, topical antibiotics, benzoyl peroxide (BP), and oral isotretinoin for severe cases. Although these treatment options are highly effective they do have certain drawbacks. Current acne treatment regimens often require patients to use multiple medications, some of which may have irritating side effects. Furthermore, Propionibacterium acnes resistance to antibiotics has become an increasing problem due to the rise in antibiotic use. AREAS COVERED: New therapies that have either been released onto the market or that are being developed include: adapalene-BP combination agent, dapsone 5% gel, minocycline foam, topical nitric oxide-releasing agent, cortexolone 17 α-propionate, and CIP isotretinoin. Some of these new therapies address the challenges faced with existing treatment options. For instance, the relatively new combination therapy, adapalene-BP, limits antibiotic resistance and also helps simplify treatment regimens. The newly developed topical nitric oxide-releasing agent also holds potential in limiting antibiotic resistance. EXPERT OPINION: Many of the new therapies discussed in this paper are still in early stages of testing so it is difficult to predict their outlook; however, based on preliminary findings, these therapies seem to be promising.

Effect of Electrocoagulation and Direct Pressure Application on Bleeding from Liver Bed During Laparoscopic Cholecystectomy.

OBJECTIVE: To compare the efficacy of electrocoagulation and direct pressure application in controlling haemorrhage from the liver bed during laparoscopic cholecystectomy. STUDY DESIGN: Randomized controlled trial. Place and Duration of the Study: Department of General Surgery, Sir Ganga Ram Hospital, Lahore, Pakistan, from July 2021 to December 2021. METHODOLOGY: A total of 218 patients of either gender, aged 18 to 60 years and with bleeding from the liver bed during laparoscopic cholecystectomy were randomly allocated to two groups of haemorrhage control techniques. In group A, electrocoagulation was used and in group B, direct pressure was applied to the bleeding area for 5 minutes. Efficacy in controlling bleeding was compared in both groups. RESULTS: The mean age of all study participants was 44.6 + 13.5 years. The majority of the patients were females (89%). The mean body mass index (BMI) of all participants was 25.3 ± 3.09 kg/m2. Intraoperative bleeding was secured in 86.2% of patients in Group A vs. 81.7% of patients in Group B. However, the difference was not statistically significant (p=0.356). In 27 (12.4%) cases, bleeding could not be controlled by both of these techniques. In these cases, endosuturing was applied in 19 (70.4%) cases, spongostan in 6 (22.2%) cases, and endo-clips in 2 (7.4%) cases. Intraoperative drain and conversion to open procedure was required in 1 patient each, both belonging to the direct pressure application group. CONCLUSION: The efficacy of electrocoagulation in securing haemorrhage from the liver bed is better than the direct pressure application technique. KEY WORDS: Laparoscopic cholecystectomy, Haemorrhage, Electrocoagulation, Surgical hemostasis, Liver bed.

Crystal phase engineering of Ru for simultaneous selective photocatalytic oxidations and H2 production.

Noble metal nanoparticles are often used as cocatalysts to enhance the photocatalytic efficiency. While the effect of cocatalyst nanoparticle size and shape has widely been explored, the effect of the crystal phase is largely overlooked. In this work, we investigate the effect of Ru nanoparticle crystal phase, specifically regular hexagonal close-packed (hcp) and allotropic face-centered cubic (fcc) crystal phases, as cocatalyst decorated onto the surface of TiO2 photocatalysts. As reference photocatalytic reaction the simultaneous photocatalytic production of benzaldehyde (BAD) and H2 from benzyl alcohol was chosen. Both the fcc Ru/TiO2 and hcp Ru/TiO2 composites exhibit enhanced BAD and H2 production rates compared to pristine TiO2 due to the formation of a Schottky barrier promoting the photogenerated charge separation. Moreover, a 1.9-fold photoactivity enhancement of the fcc Ru/TiO2 composite is achieved as compared to the hcp Ru/TiO2 composite, which is attributed to the fact that the fcc Ru NPs are more efficient in facilitating the charge transfer as compared to hcp Ru NPs, thus inhibiting the recombination of electron-hole pairs and enhancing the overall photoactivity.

Carbonaceous Nanoparticle Air Pollution: Toxicity and Detection in Biological Samples.

Among the different air pollutants, particulate matter (PM) is of great concern due to its abundant presence in the atmosphere, which results in adverse effects on the environment and human health. The different components of PM can be classified based on their physicochemical properties. Carbonaceous particles (CPs) constitute a major fraction of ultrafine PM and have the most harmful effects. Herein, we present a detailed overview of the main components of CPs, e.g., carbon black (CB), black carbon (BC), and brown carbon (BrC), from natural and anthropogenic sources. The emission sources and the adverse effects of CPs on the environment and human health are discussed. Particularly, we provide a detailed overview of the reported toxic effects of CPs in the human body, such as respiratory effects, cardiovascular effects, neurodegenerative effects, carcinogenic effects, etc. In addition, we also discuss the challenges faced by and limitations of the available analytical techniques for the qualitative and quantitative detection of CPs in atmospheric and biological samples. Considering the heterogeneous nature of CPs and biological samples, a detailed overview of different analytical techniques for the detection of CPs in (real-exposure) biological samples is also provided. This review provides useful insights into the classification, toxicity, and detection of CPs in biological samples.

Label-free detection and size estimation of combustion-derived carbonaceous particles in a microfluidic approach.

Detection and size estimation of combustion-derived carbonaceous particles (CDCPs) are important to understand their toxicity. Size determination of individual nano- and microparticles (NMPs) based on scattered light is a straightforward method. However, detection and sizing of CDCPs in biological samples based on scattering alone are not possible due to the compositional heterogeneity of NMPs present in biological samples. Label-free identification of CDCPs based on unique white light (WL) emission, using femtosecond (fs) pulsed near-infrared (NIR) lasers, has emerged as a reliable method even in complex biological samples. However, size estimation of CDCPs in biological samples using label-free techniques is still lacking. Here we report the development of a dual-channel multiphoton flow cytometry (DCMPFC) setup for label-free identification and size-determination of CDCPs in suspensions. Scattering intensity calibration with reference polystyrene (PS) nanoparticles (NPs) and Mie Theory allow us to determine the sizes of CDCPs in aqueous suspensions. Further, the relationship between particle sizes and WL emission intensity was determined, and the sizes of CDCPs in urine samples could also be estimated. This approach is believed to open new opportunities for the quantification and size determination of CDCPs, originating from exposure to air pollution, in liquid biopsies. This is an important step in determining the CDCP exposure of individual persons.

Kinetic and isotherms modeling of methyl orange and chromium (VI) onto hexagonal ZnO microstructures as a membrane for environmental remediation of wastewater.

Globally, contamination of water by dyes and heavy metals (HMs) is a serious environmental and public health problem due to their carcinogenic and mutagenic nature. It is incumbent to treat innocuously before discharge. It is the first time, hexagonal zinc oxide (ZnO) microstructure are being employeed as a membrane in the simultaneous removal of methyl orange (MO) and chromium (Cr (VI)) from the aqueous solution. The surface chemistry of hexagonal ZnO was characterized for morphology, surface functional groups, crystalline nature, and elemental composition by scanning electron microscope (SEM), Fourier transmission infrared spectroscopy (FTIR), X-ray diffraction (XRD) and energy dispersive X-ray spectroscopy (EDX). Adsorption capacity and removal efficiency was determined by the laboratory batch adsorption experiments, while nonlinear, linear kinetics and isotherm models were fitted to experimental data to investigate the adsorption process. The results exhibited that the maximum adsorption capacity (qmax) of hexagonal ZnO from the Langmuir isotherm model was 80.39 mg g-1 and 84.10 mg g-1 for MO and Cr (VI) respectively. According to the modeling findings, linear langmuir fitted to the experimental data with R2 0.967 and 0.971 for both MO and Cr (VI) which indicates monolayer physical adsorption of both pollutants has taken place. Whereas, kinetic study showed nonlinear pseudo-second order with R2 0.989 and 0.986 for MO and Cr (VI) model best fitted with the experimental data. The values of thermodynamics parameters Gibbs free energy change ΔG°, heat of enthalpy ΔH° and, heat of entropy ΔS° indicate that spontaneous, endothermic, and irreversible adsorption reactions occurred. Overall, it is concluded from our observations that hexagonal ZnO has the potential to be used as an eco-friendly, cost-effective adsorbent for simultaneous remaoval of both MO and Cr (VI) from water. Findings of the current investigation provide valuable insights for the development of an inexpensive, effective and sustainable filtration method for the treatment of MO and Cr (VI) synergistically.

Photothermal Suzuki Coupling Over a Metal Halide Perovskite/Pd Nanocube Composite Catalyst.

The development of improved catalysts capable of performing the Suzuki coupling reaction has attracted considerable attention. Recent findings have shown that the use of photoactive catalysts improves the performance, while the reaction mechanism and temperature-dependent performance of such systems are still under debate. Herein, we report Pd nanocubes/CsPbBr3 as an efficient catalyst for the photothermal Suzuki reaction. The photo-induced and thermal contribution to the overall catalytic performance has been investigated. Light controls the activity at temperatures around and below 30 °C, while thermal catalysis determines the reactivity at higher temperatures. The Pd/CsPbBr3 catalyst exhibits 11 times higher activity than pure CsPbBr3 at 30 °C due to reduced activation barrier and facilitated charge carrier dynamics. Furthermore, the alkoxide radicals (R-O-) for the Suzuki reaction are experimentally and theoretically confirmed, and photogenerated holes are proven to be crucial for cleaving C-B bonds of phenylboronic acids to drive the reaction. This work prescribes a general strategy to study photothermal catalysis and offers a mechanistic guideline for photothermal Suzuki reactions.

Truly combining the advantages of polymeric and zeolite membranes for gas separations.

Mixed-matrix membranes (MMMs) have been investigated to render energy-intensive separations more efficiently by combining the selectivity and permeability performance, robustness, and nonaging properties of the filler with the easy processing, handling, and scaling up of the polymer. However, truly combining all in one single material has proven very challenging. In this work, we filled a commercial polyimide with ultrahigh loadings of a high-aspect ratio, CO2-philic Na-SSZ-39 zeolite with a three-dimensional channel system that precisely separates gas molecules. By carefully designing both zeolite and MMM synthesis, we created a gas-percolation highway across a flexible and aging-resistant (more than 1 year) membrane. The combination of a CO2-CH4 mixed-gas selectivity of ~423 and a CO2 permeability of ~8300 Barrer outperformed all existing polymer-based membranes and even most zeolite-only membranes.

Unique emissive behavior of combustion-derived particles under illumination with femtosecond pulsed near-infrared laser light.

Exposure to combustion-derived particles (CDPs), such as carbonaceous particulate matter (PM), has adverse effects on human health. Hence, selective detection of these particles in biological environments is required to understand their toxicity. The optical detection of carbonaceous PM is possible in biological samples based on white light (WL) emission under illumination with a femtosecond (fs) pulsed near-infrared (NIR) laser. However, it is unclear if common non-CDPs in ambient PM, such as silica and metal oxides, can interfere with CDP detection when illuminated using a fs-pulsed NIR laser. Here, we show that WL emission, when illuminated with a fs-pulsed NIR laser, is observed only for CDPs amongst other common air pollution particles. We report that the intense WL emission from CDPs spanning over the whole visible spectrum is not observed from non-CDPs. This observation is made for four different CDPs and five different, relevant non-CDPs, in wet and dried samples using biologically relevant imaging conditions. This investigation confirms the uniqueness of WL emission as a selective detection mechanism of CDPs using a multiphoton microscopy platform, commonly available in research laboratories. Furthermore, some relevant signatures for the non-CDPs are provided that could potentially lead to the selective monitoring of pollution related nanoparticles (NPs).

Monitoring indoor exposure to combustion-derived particles using plants.

Indoor plants can be used to monitor atmospheric particulates. Here, we report the label-free detection of combustion-derived particles (CDPs) on plants as a monitoring tool for indoor pollution. First, we measured the indoor CDP deposition on Atlantic ivy leaves (Hedera hibernica) using two-photon femtosecond microscopy. Subsequently, to prove its effectiveness for using it as a monitoring tool, ivy plants were placed near five different indoor sources. CDP particle area and number were used as output metrics. CDP values ranged between a median particle area of 0.45 × 102 to 1.35 × 104 µm2, and a median particle number of 0.10 × 102 to 1.42 × 10³ particles for the indoor sources: control (greenhouse) < milling machine < indoor smokers < wood stove < gas stove < laser printer. Our findings demonstrate that Atlantic ivy, combined with label-free detection, can be effectively used in indoor atmospheric monitoring studies.

Mortality Prediction in Patients Admitted in Surgical Intensive Care Unit by Using APACHE IV.

OBJECTIVE: To predict the mortality by the mean Acute Physiology and Chronic Health Evaluation (APACHE) IV score of all the patients admitted in a Surgical Intensive Care Unit (ICU) and comparing the score of the survivors and non-survivors. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Surgical Intensive Care Unit, Mayo Hospital, Lahore, from June 2013 to November 2014. METHODOLOGY: All adult patients admitted in the Surgical ICU were included in this study. The demographics and other data of the patients were recorded. The APACHE IV scores of all patients were calculated at the time of admission. The scores of the survivors and the non-survivors were compared for prediction of survival and mortality. RESULTS: The age of these patients ranged from 13 to 70 (mean 38.39) years with 86 (55.48%) males and 69 (44.52%) females. The mean APACHE IV score of these patients was 34.96 ±14.93 ranging from 11 to 63 years. Eighty-three (53.55%) patients survived and 72 (46.45%) died. With respect to gender, 41 (47.67%) males out of 86 and 31 (44.92%) females out of 69 did not survive. The mortality increased with an increase in APACHE IV score and all the patients with score more than 39 did not survive. CONCLUSION: The predicted mortality can be assessed by APACHE IV score, so it is good for application among the surgical ICU patients.

A Review of Patient Lifting Interventions to Reduce Health Care Worker Injuries.

Health care workers suffer from musculoskeletal disorders at a significantly higher rate than workers in other industries. Consequently, a growing demand for patient handling devices to reduce worker injury has evolved. This article reviews the literature regarding interventions designed to reduce injuries among health care workers. A PubMed search was conducted using the terms "occupational health [Mesh Terms] patient lifting." Fourteen articles were identified that assessed interventions to improve worker safety. Of the 14 articles, 7 discussed technological interventions, 4 educational approaches, and 3 policy change. All three types of interventions were generally effective at improving worker safety, with the ideal intervention consisting of elements of all three types. Although adopting a new intervention may be expensive, the reduction in workers' compensation costs associated with injured nurses can easily outweigh the costs of interventions.

Bilateral chylothorax: an unusual complication of cervical rib resection.

Bilateral chylothorax is a rare cause of pleural effusions. Here we report an unusual acute presentation of bilateral chylothorax following thoracic outlet surgery. Unique to this case was the disparate characteristics of pleural fluid analyses with an exudate on the left and a transudate on the right. This report describes the recognition and management of bilateral chylothoraces, an uncommon but potentially serious complication of this frequently performed surgical procedure.

One Dimensional Graphitic Carbon Nitrides as Effective Metal-Free Oxygen Reduction Catalysts.

To explore the effect of morphology on catalytic properties of graphitic carbon nitride (GCN), we have studied oxygen reduction reaction (ORR) performance of two different morphologies of GCN in alkaline media. Among both, tubular GCN react with dissolved oxygen in the ORR with an onset potential close to commercial Pt/C. Furthermore, the higher stability and excellent methanol tolerance of tubular GCN compared to Pt/C emphasizes its suitability for fuel cells.

Adverse Event Reporting in Clinical Trials of Finasteride for Androgenic Alopecia: A Meta-analysis.

IMPORTANCE: Two meta-analyses conclude that finasteride treatment of androgenic alopecia (AGA) is safe but do not assess quality of safety reporting. OBJECTIVE: To assess safety reporting for clinical trial reports of finasteride for AGA. DATA SOURCES: MEDLINE, ClinicalTrials.gov, and a clinical data repository for an academic medical center. STUDY SELECTION: Published clinical trial reports for finasteride treatment of AGA. DATA EXTRACTION AND SYNTHESIS: For each trial, we assessed quality of adverse event reporting, extracted the number and type of adverse events in treatment and placebo groups, and assessed duration of safety evaluation and adequacy of blinding. Two observers independently extracted the data; differences were resolved by consensus. We assessed generalizability in a large cohort of men prescribed finasteride, 1.25 mg/d or less, by assessing for eligibility in the finasteride-AGA pivotal trials. MAIN OUTCOMES AND MEASURES: Quality was assessed as adequate, partially adequate, inadequate, or no events reported. We used funnel plots of the hazard ratio to assess bias. RESULTS: Of 34 clinical trials, none had adequate safety reporting, 19 were partially adequate, 12 were inadequate, and 3 reported no adverse events. Funnel plots were asymmetric with a bias toward lower odds ratio for sexual adverse effects, suggesting systematic underdetection. No reports assessed adequacy of blinding, 18 (53%) disclosed conflicts of interest, and 19 (56%) received funding from the manufacturer. Duration of drug safety evaluation was 1 year or less for 26 of 34 trials (76%). Of 5704 men in the clinical data repository who were treated for AGA with finasteride, 1.25 mg/d or less, for AGA, only 31% met inclusion criteria for the pivotal trials referenced in the manufacturer's full prescribing information and 33% took finasteride for more than 1 year. CONCLUSIONS AND RELEVANCE: Available toxicity information from clinical trials of finasteride in men with AGA is very limited, is of poor quality, and seems to be systematically biased. In a cohort of men prescribed finasteride for routine treatment of AGA, most would have been excluded from the pivotal studies that supported US Food and Drug Administration approval for AGA. Published reports of clinical trials provide insufficient information to establish the safety profile for finasteride in the treatment of AGA.