Production of renewable diesel from Jatropha curcas oil via pyrolytic-deoxygenation over various multi-wall carbon nanotube-based catalysts

Jatropha curcas is a highly toxic plant that produces seed containing viscous oil with productivity (2 ton/ha), it grows in tropical and sub-tropical regions and offer greater adaptability to a wide range of climatic and soil conditions. Its oils have been noted as an important alternative to produce green diesel via deoxygenation reaction. This study, deoxygenation of jatropha curcas oil (JCO) was carried out over NiO–Fe2O3 and NiO–ZnO catalysts that supported onto multi-walled carbon nanotube (MWCNT). It had found that high Fe and Zn dosages were ineffective in deoxygenation and greatest activity was observed on NiO(20) Fe2O3(5)/MWCNT catalyst. Structure-activity correlations revealed that low metal loading, large density of weak + medium acidic sites and strong basic sites play key role in enhancing the catalytic activities and n-(C15+C17) selectivity. Comparing carbon nanostructures and carbon micron size supported NiO-Fe2O3 revealed that green diesel obtained from NiO–Fe2O3/MWCNT catalysed deoxygenation had the highest heating value and the lowest amounts of oxygen content. Thereby, it confirmed the importance of carbon nanostructure as the catalyst support in improving the diesel quality. Considering the high reusability of NiO-Fe2O3/MWCNT (6 consecutive runs) and superior green diesel properties (flash point, cloud properties and cetane index) demonstrated the NiO–Fe2O3/MWCNT catalyst offers great option in producing excellent properties of green diesel for energy sector

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

SARS-CoV-2 susceptibility and COVID-19 disease severity are associated with genetic variants affecting gene expression in a variety of tissues

Variability in SARS-CoV-2 susceptibility and COVID-19 disease severity between individuals is partly due to genetic factors. Here, we identify 4 genomic loci with suggestive associations for SARS-CoV-2 susceptibility and 19 for COVID-19 disease severity. Four of these 23 loci likely have an ethnicity-specific component. Genome-wide association study (GWAS) signals in 11 loci colocalize with expression quantitative trait loci (eQTLs) associated with the expression of 20 genes in 62 tissues/cell types (range: 1:43 tissues/gene), including lung, brain, heart, muscle, and skin as well as the digestive system and immune system. We perform genetic fine mapping to compute 99% credible SNP sets, which identify 10 GWAS loci that have eight or fewer SNPs in the credible set, including three loci with one single likely causal SNP. Our study suggests that the diverse symptoms and disease severity of COVID-19 observed between individuals is associated with variants across the genome, affecting gene expression levels in a wide variety of tissue types

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

A first update on mapping the human genetic architecture of COVID-19

peer reviewe

Significance of Pyrolytic Temperature, Particle Size, and Application Rate of Biochar in Improving Hydro-Physical Properties of Calcareous Sandy Soil

Water management and irrigation conservation in calcareous sandy soil are of significant importance for sustaining agricultural production, especially in arid and semi-arid region that facing scarcity of water resources. The changes in hydro-physical characteristics of calcareous sand soil were investigated after date palm waste-derived biochar application in column trials. Significance of pyrolysis temperature (300 &deg;C, 500 &deg;C, and 700 &deg;C), particle size [&lt;0.5 mm (D0.5), 0.5&ndash;1 mm (D1), and 1&ndash;2 mm (D2)], and application rate (1%, 2.5%, and 5%) were studied. Variations in infiltration rate, intermittent evaporation, and saturated hydraulic conductivity as a function of aforementioned factors were investigated. After amending the top 10-cm soil layer with different biochar and application rates, the columns were subjected to six wetting and drying cycles by applying 25 cm3 tap water per week over a 6-week period. Overall, biochar application resulted in decreased saturated hydraulic conductivity, while improved cumulative evaporation. Specifically, biochar produced at 300 &deg;C and 500 &deg;C demonstrated 10.2% and 13.3% higher cumulative evaporation, respectively., whereas, biochar produced at 700 &deg;C with 5% application rate resulted in decreased cumulative evaporation. Cumulative evaporation increased by 5.0%, 7.7% and, 7.8% for D0.5, D1 and D2 (mm) on average, respectively, as compared with the untreated soil. Thus, biochar with particle size 0.5&ndash;1 mm significantly improved hydro-physical properties when applied at 1%. Generally, using biochar produced at medium temperature and small particle size with appropriate application rates could improve the soil hydro-physical properties

Efficient Remediation of Cadmium- and Lead-Contaminated Water by Using Fe-Modified Date Palm Waste Biochar-Based Adsorbents

Heavy metals pollution of water resources is an emerging concern worldwide and seeks immediate attention. Date palm waste was transformed into biochar (BC), which was further modified through Fe-intercalation for the production of magnetic biochar (Fe-BC) in this study. The produced BC and Fe-BC were analyzed for chemical, proximate, surface, and elemental composition. The efficiency of the produced adsorbents to decontaminate the water from Cd2+ and Pb2+ ions was investigated through kinetics and an isotherm adsorption batch trial. Kinetics adsorption data fit well with the pseudo-second order and power function model, while equilibrium data were described well with the Langmuir and Freundlich isotherms. The maximum adsorption capacity as shown by the Langmuir model was the highest for Fe-BC for both Cd2+ (48.44 mg g&minus;1) and Pb2+ (475.14 mg g&minus;1), compared with that of BC (26.78 mg g&minus;1 Cd2+ and 160.07 mg g&minus;1 Pb2+). Both materials showed higher removal of Pb (36.34% and 99.90% on BC and Fe-BC, respectively) as compared with Cd (5.23% and 12.28% on BC and Fe-BC, respectively) from a binary solution. Overall, Fe-BC was more efficient in adsorbing both of the studied metals from contaminated water. The application of Fe-BC resulted in 89% higher adsorption of Cd2+ and 197% higher adsorption of Pb2+ from aqueous media as compared to BC. Kinetics and isotherm models as well as SEM&ndash;EDS analysis of the post-adsorption adsorbents suggested multiple adsorption mechanisms including chemisorption, pore-diffusion, and electrostatic interactions