Biogenic volatile compounds of activated sludge and their application for metal bioremediation

Heavy metals pollution is nowadays one of the most important environmental concerns. This paper illustrates the employment of the biogenic volatile compounds generated during the aerobic growth of activated sludge on raw domestic wastewater for heavy metals removal. Most of the tested metals even as individual or mixed metal species (Co, Cu, Cd, Fe, Hg, Ni, Mn, Pb and Zn) were potentially transformed into insoluble precipitates and then separated out of their solutions. The Fourier-transform infrared (FTIR) analysis has identified some organosulfur groups (thiol, disulfide and thiocarbonyl), in addition to amine group in the metal precipitates. This study highlighted the application of the microbial volatile metabolites for heavy metals bioremediation in a powerful, cost effective and eco-friendly bioprocess.Key words: Application, activated sludge, biogas, metals, bio-precipitatio

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Characterization of Thermophilic Bacteria Isolated from Two Hot Springs in Jazan, Saudi Arabia

The capability of thermophilic microorganisms to flourish at high temperatures makes their enzyme systems ideal for various biotechnological applications. Based on the proteolytic and amylolytic activities, two thermophilic bacteria were isolated from hot springs in Jazan, Saudi Arabia. The antibiotic and heavy metals susceptibility patterns of the bacterial isolates were performed. According to the metabolic fingerprint, the bacterial isolates were identified as Brevibacterium linens and Bacillus subtilis. Moreover, the impact of temperature, substrate concentration, and some metal ions on the production of proteases and amylases from the bacterial strains was investigated. The maximum protease production was achieved at 50°C while the greatest amylase production was recorded at 30°C for both strains at a constant pH of 7.5. The highest enzyme production was recorded at 5% skimmed milk for protease of B. linens and 10% for B. subtilis while 0.6% starch was the optimum substrate concentration of amylase production of the two strains. Furthermore, Ca2+ showed a simulative influence on protease production from the two strains whereas Mg2+ and Mn2+ demonstrated minor effect. On the other hand, Ca2+, Mg2+ and Mn2+ demonstrated a positive effect on the amylase production from both strains

Relation between postmenopausal osteoporosis and coronary and peripheral arterial disease

Objectives: To study the relation between coronary artery disease (CAD) and peripheral arterial disease (PAD) with osteoporosis in postmenopausal women. Patients and methods: A 100 postmenopausal women were studied for evidence of osteoporosis by measurement of lumbar spine and femoral neck bone mineral density (BMD) and calculation of T score. From these cases; two groups were selected, group I included 30 cases with osteoporosis and group II included a matching 30 cases without osteoporosis or osteopenia as control group. Both groups were studied for prevalence of CAD using noninvasive tests including ECG, echocardiography and CT angiography, and prevalence of PAD using noninvasive tests including ankle brachial index (ABI) and color duplex study (CDS) of lower limb arteries. Results: Using CT angiogram, 17 cases (56.7%) had CAD in group I versus 6 cases (20%) in group II (p = 0.003). Prevalence of three vessel disease was significantly higher in group I than in group II (23.3% vs 3.3%, p = 0.022). In group I, there was a significant positive correlation between patients’ age with prevalence and severity of CAD in group I; and a significant negative correlation between T score with prevalence and severity of CAD. Presence of significant stenosis or occlusion in CDS of lower limb arteries was found in 6 cases (20%) in group I versus one case (3.3%) in group II (p = 0.044). Conclusion: Because of the increased prevalence of CAD and PAD in postmenopausal women with osteoporosis the severity of CAD and PAD in osteoporotic postmenopausal women is positively correlated to the severity of osteoporosis. Thus, in osteoporotic postmenopausal women, cardiovascular status evaluation should be done in order to identify candidate patients for preventive and therapeutic cardiovascular interventions

Mercury Resistance Determinants Related to Tn21, Tn1696, and Tn5053 in Enterobacteria from the Preantibiotic Era

Three mer transposons from the Murray collection of preantibiotic enterobacteria show >99% sequence identity to current isolates. Tn5073 is most closely related to Tn5036 and Tn1696, and Tn5074 is most closely related to Tn5053. Tn5075 is most closely related to Tn21 but lacks integron In2 and is flanked by insertion elements