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BACKGROUND: Primary total hip arthroplasty (THA) often requires blood transfusion. Transfusions are undesirable due to risks of infectious and noninfectious complications. This systematic review therefore studied the effectiveness of erythropoietin (EPO) in reducing allogeneic transfusion rate during THA. METHODS: Using the MESH terms "Erythropoietin" AND "Total Hip" with restrictions to 'Randomized Controlled Trial', 'Clinical Trial', 'Humans', and 'English', a literature search was performed in PubMed and CINAHL. Articles were scanned by both authors and retained for further review if eligibility was met according to the inclusion criteria defined by the PICOS (population, intervention, comparator, outcomes, study design) configuration. Risk of bias was assessed using the Cochrane risk of bias criteria. Data extracted include patient demographics, intervention versus comparator arm, outcomes, laboratory data, and individual study characteristics. The primary outcome of focus was rate or amount of allogeneic blood transfusions intra- or postoperatively. In 6/8 studies, data permitted calculations of absolute risk reduction (ARR) in transfusion rate (%) and number needed to treat (NNT) to evade transfusions. RESULTS: A total of 8 studies met all eligibility criteria and were retained for data extraction; risk of bias was low-moderate in 7/8 and high in 1/8. Allogeneic transfusion exposure was lowered by the intervention in 7/8 studies with ARR from 9.6% to 33.5% and NNT from 4 to 10. CONCLUSIONS: In the blood conservation systems described, the addition of EPO was effective in reducing allogeneic transfusions. The studies included spanned a nearly 30-year period. Earlier studies incorporated preoperative autologous donation, a now outdated modality.
Assuntos
Artroplastia de Quadril , Eritropoetina , Humanos , Transfusão de Sangue , Transfusão de Eritrócitos , Ensaios Clínicos Controlados Aleatórios como Assunto , Eritropoetina/uso terapêuticoRESUMO
In the future, industrial CO2 electroreduction using renewable energy sources could be a sustainable means to convert CO2 and water into commodity chemicals at room temperature and atmospheric pressure. This study focuses on the electrocatalytic reduction of CO2 on polycrystalline Au surfaces, which have high activity and selectivity for CO evolution. We explore the catalytic behavior of polycrystalline Au surfaces by coupling potentiostatic CO2 electrolysis experiments in an aqueous bicarbonate solution with high sensitivity product detection methods. We observed the production of methanol, in addition to detecting the known products of CO2 electroreduction on Au: CO, H2 and formate. We suggest a mechanism that explains Au's evolution of methanol. Specifically, the Au surface does not favor C-O scission, and thus is more selective towards methanol than methane. These insights could aid in the design of electrocatalysts that are selective for CO2 electroreduction to oxygenates over hydrocarbons.
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Fuels and industrial chemicals that are conventionally derived from fossil resources could potentially be produced in a renewable, sustainable manner by an electrochemical process that operates at room temperature and atmospheric pressure, using only water, CO2, and electricity as inputs. To enable this technology, improved catalysts must be developed. Herein, we report trends in the electrocatalytic conversion of CO2 on a broad group of seven transition metal surfaces: Au, Ag, Zn, Cu, Ni, Pt, and Fe. Contrary to conventional knowledge in the field, all metals studied are capable of producing methane or methanol. We quantify reaction rates for these two products and describe catalyst activity and selectivity in the framework of CO binding energies for the different metals. While selectivity toward methane or methanol is low for most of these metals, the fact that they are all capable of producing these products, even at a low rate, is important new knowledge. This study reveals a richer surface chemistry for transition metals than previously known and provides new insights to guide the development of improved CO2 conversion catalysts.
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The electrochemical reduction of CO2 could allow for a sustainable process by which renewable energy from wind and solar are used directly in the production of fuels and chemicals. In this work we investigated the potential dependent activity and selectivity of the electrochemical reduction of CO2 on metallic silver surfaces under ambient conditions. Our results deepen our understanding of the surface chemistry and provide insight into the factors important to designing better catalysts for the reaction. The high sensitivity of our experimental methods for identifying and quantifying products of reaction allowed for the observation of six reduction products including CO and hydrogen as major products and formate, methane, methanol, and ethanol as minor products. By quantifying the potential-dependent behavior of all products, we provide insights into kinetics and mechanisms at play, in particular involving the production of hydrocarbons and alcohols on catalysts with weak CO binding energy as well as the formation of a C-C bond required to produce ethanol.
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This work explores surface changes and the Hg capture performance of brominated activated carbon (AC) pellets, sulfur-treated AC pellets, and sulfur-treated AC fibers upon exposure to simulated Powder River Basin-fired flue gas. Hg breakthrough curves yielded specific Hg capture amounts by means of the breakthrough shapes and times for the three samples. The brominated AC pellets showed a sharp breakthrough after 170-180 h and a capacity of 585 µg of Hg/g, the sulfur-treated AC pellets exhibited a gradual breakthrough after 80-90 h and a capacity of 661 µg of Hg/g, and the sulfur-treated AC fibers showed no breakthrough even after 1400 h, exhibiting a capacity of >9700 µg of Hg/g. X-ray photoelectron spectroscopy was used to analyze sorbent surfaces before and after testing to show important changes in quantification and oxidation states of surface Br, N, and S after exposure to the simulated flue gas. For the brominated and sulfur-treated AC pellet samples, the amount of surface-bound Br and reduced sulfur groups decreased upon Hg capture testing, while the level of weaker Hg-binding surface S(VI) and N species (perhaps as NH4(+)) increased significantly. A high initial concentration of strong Hg-binding reduced sulfur groups on the surface of the sulfur-treated AC fiber is likely responsible for this sorbent's minimal accumulation of S(VI) species during exposure to the simulated flue gas and is linked to its superior Hg capture performance compared to that of the brominated and sulfur-treated AC pellet samples.