Does Performing Endoscopy Sooner Have an Impact on Outcomes in Patients With Acute Nonvariceal Upper Gastrointestinal Hemorrhage? A Systematic Review.

Background Endoscopy is the cornerstone for the diagnosis and treatment of nonvariceal upper gastrointestinal bleeding. Regarding the management of nonvariceal bleeding, the administration of crystalloid solution and proton pump inhibitors before endoscopy is well established, but the optimal timing of endoscopy has been a matter of debate and a subject of many investigational studies. The need for urgent endoscopy arises to provide prompt redress to acute bleeding, decrease the length of stay, and lower mortality from ongoing bleeding. Objective This study aimed to determine if endoscopy performed within 24 hours of presentation improves outcomes in terms of mortality, hospital length of stay, and rebleeding in individuals presenting with nonvariceal upper gastrointestinal bleed with any risk. Methodology We performed a systematic review of two large databases (PubMed and Google Scholar) to incorporate all studies published after 2000. We included studies with nonvariceal upper gastrointestinal bleeding and excluded those reporting variceal gastrointestinal hemorrhage. Results We reviewed eight studies that qualified after meeting our inclusion and exclusion criteria. We divided these studies into three separate groups based on the timing of endoscopy. Only two studies found a difference in mortality that was statistically significant in patients who underwent endoscopy within 24 hours of presentation. One study showed lower mortality in a patient who underwent urgent endoscopy, but it did not reach statistical significance. Other studies did not show any statistical difference in mortality, hospital length of stay, and rebleeding rates. The studies showed conflicting evidence on the amount of blood transfusion, though urgent endoscopy was found to be difficult in few studies due to blood obscuring the lesion. Conclusions While data suggest that there is a potential benefit in performing endoscopy sooner, there is no concrete evidence to point to a particular time range. Before performing endoscopy, the American Society for Gastrointestinal Endoscopy (2012) recommends adequate resuscitation with crystalloid solutions, blood transfusions, and antisecretory and prokinetic agent therapy. More investigational studies are needed to formulate a time-sensitive flow sheet to approach endoscopy in patients with nonvariceal upper gastrointestinal bleeding. A strict criterion is also needed to delineate patients into low-risk and high-risk groups. Doing so would provide a systematic approach to help with mortality, rebleeding, and healthcare resource utilization

Biosorption potential of natural, pyrolysed and acid-assisted pyrolysed sugarcane bagasse for the removal of lead from contaminated water

Lead (Pb) is a ubiquitous pollutant which poses serious threats to plants, animals and humans once entered into the food chain via contaminated industrial effluents on their discharge into the surface of water bodies and/or geological materials. This study aimed to examine and compare the biosorption potential of natural sugarcane bagasse (NB), pyrolysed sugarcane bagasse (PB) and acid assisted pyrolysed sugarcane bagasse (APB) for the removal of Pb from contaminated water. To explore this objective, a series of batch experiments were conducted at various adsorbent mass (0.25, 0.5, 0.75, 1.0 g per 100 ml contaminated water), initial Pb concentration (7, 15, 30, 60 and 120 ppm), and contact time (7, 15, 30, 60 and 120 min). Results revealed that all the tested bio-sorbents have potential to adsorb and remove Pb ions from the contaminated water. In this regard, APB proved more effective since it removed 98% of Pb from aqueous solution at initial Pb concentration of 7 ppm and mass of 0.25 g per 100 ml of aqueous solution. The respective values in case of NB and PB were 90 and 95%. For a given adsorbent type, Pb adsorption decreased by increasing the mass from 0.25 to 1.0 g per 100 ml of aqueous solution. However, the greatest Pb removal occurred at adsorbent mass of 1.0 g per 100 ml of aqueous solution. Initial Pb concentration had a great impact on Pb adsorption and removal by adsorbent. The former increased and the latter decreased with the increase in initial Pb concentration from seven to 120 ppm. At seven ppm Pb concentration, maximum Pb removal took place irrespective to the adsorbent type. Out of the total Pb adsorption and removal, maximum contribution occurred within 15 min of contact time between the adsorbate and adsorbent, which slightly increased till 30 min, thereafter, it reached to equilibrium. Application of equilibrium isotherm models revealed that our results were better fitted with Freundlich adsorption isotherm model. Overall, and for the reasons detailed above, it is concluded that sugarcane bagasse has capabilities to adsorb and remove Pb ions from contaminated water. Its bio-sorption potential was considerably increased after pyrolysis and acid treatment

Transition metal doped CeO2 for photocatalytic removal of 2-chlorophenol in the exposure of indoor white light and antifungal activity

Besides natural sunlight and expensive artificial lights, economical indoor white light can play a significant role in activating a catalyst for photocatalytic removal of organic toxins from contaminated water. In the current effort, CeO2 has been modified with Ni, Cu, and Fe through doping methodology to study the removal of 2-chlorophenol (2-CP) in the illumination of 70 W indoor LED white light. The absence of additional diffractions due to the dopants and few changes such as reduction in peaks’ height, minor peak shift at 2θ (28.525°) and peaks’ broadening in XRD patterns of modified CeO2 verifies the successful doping of CeO2. The solid-state absorption spectra revealed higher absorbance of Cu-doped CeO2 whereas a lower absorption response was observed for Ni-doped CeO2. An interesting observation regarding the lowering of indirect bandgap energy of Fe-doped CeO2 (∼2.7 eV) and an increase in Ni-doped CeO2 (∼3.0 eV) in comparison to pristine CeO2 (∼2.9 eV) was noticed. The process of e-– h+ recombination in the synthesized photocatalysts was also investigated through photoluminescence spectroscopy. The photocatalytic studies revealed the greater photocatalytic activity of Fe-doped CeO2 with a higher rate (∼3.9 × 10−3 min-1) among all other materials. Moreover, kinetic studies also revealed the validation of the Langmuir-Hinshelwood kinetic model (R2 = 0.9839) while removing 2-CP in the exposure of indoor light with a Fe-doped CeO2 photocatalyst. The XPS analysis revealed the existence of Fe3+, Cu2+ and Ni2+ core levels in doped CeO2. Using the agar well-diffusion method, the antifungal activity was assessed against the fungus M. fructicola and F. oxysporum. Compared to CeO2, Ni-doped CeO2, and Cu-doped CeO2 nanoparticles, the Fe-doped CeO2 nanoparticles have outstanding antifungal properties

Pravastatin-Induced Acute Pancreatitis: A Case Report and Literature Review

Pancreatitis is inflammation of pancreas associated most commonly with chronic alcoholism and gallstones. Other less common causes of pancreatitis are hyperlipidemia, infections, surgery, trauma, post endoscopic retrograde cholangiopancreatography, and drugs. Drugs are now increasingly recognized as a cause of pancreatitis, and high suspicion and exclusion of other most common causes is required before considering drug-induced pancreatitis. There are few case reports of acute pancreatitis in the literature after statin use, but out of these, only 3 are after starting pravastatin. We are reporting a case of 49-year-old male who presented with nausea, vomiting, and abdominal pain. His laboratory findings were significant for lipase more than 10 000 on admission, and computed tomography scan of abdomen was showing peripancreatic fat stranding and inflammation. After exclusion of most common causes of pancreatitis, pravastatin was found probable culprit for his symptoms, which he started taking 2 weeks ago. We also reviewed the literature on statins-induced acute pancreatitis. With increased uses of statins, physician need to be vigilant to suspect statins as a culprit in cases of pancreatitis with unknown etiology. Prompt discontinuation of statins is required in these cases

Optimization of neural-network model using a meta-heuristic algorithm for the estimation of dynamic Poisson’s ratio of selected rock types

Abstract This research focuses on the predictive modeling between rocks' dynamic properties and the optimization of neural network models. For this purpose, the rocks' dynamic properties were measured in terms of quality factor (Q), resonance frequency (FR), acoustic impedance (Z), oscillation decay factor (α), and dynamic Poisson’s ratio (v). Rock samples were tested in both longitudinal and torsion modes. Their ratios were taken to reduce data variability and make them dimensionless for analysis. Results showed that with the increase in excitation frequencies, the stiffness of the rocks got increased because of the plastic deformation of pre-existing cracks and then started to decrease due to the development of new microcracks. After the evaluation of the rocks’ dynamic behavior, the v was estimated by the prediction modeling. Overall, 15 models were developed by using the backpropagation neural network algorithms including feed-forward, cascade-forward, and Elman. Among all models, the feed-forward model with 40 neurons was considered as best one due to its comparatively good performance in the learning and validation phases. The value of the coefficient of determination (R2 = 0.797) for the feed-forward model was found higher than the rest of the models. To further improve its quality, the model was optimized using the meta-heuristic algorithm (i.e. particle swarm optimizer). The optimizer ameliorated its R2 values from 0.797 to 0.954. The outcomes of this study exhibit the effective utilization of a meta-heuristic algorithm to improve model quality that can be used as a reference to solve several problems regarding data modeling, pattern recognition, data classification, etc

Damage Characteristics of Thermally Deteriorated Carbonate Rocks: A Review

This review paper summarizes the recent and past experimental findings to evaluate the damage characteristics of carbonate rocks subjected to thermal treatment (20–1500 °C). The outcomes of published studies show that the degree of thermal damage in the post-heated carbonate rocks is attributed to their rock fabric, microstructural patterns, mineral composition, texture, grain cementations, particle orientations, and grain contact surface area. The expressive variations in the engineering properties of these rocks subjected to the temperature (>500 °C) are the results of chemical processes (hydration, dehydration, deionization, melting, mineral phase transformation, etc.), intercrystalline and intergranular thermal cracking, the separation between cemented particles, removal of bonding agents, and internal defects. Thermally deteriorated carbonate rocks experience a significant reduction in their fracture toughness, static–dynamic strength, static–dynamic elastic moduli, wave velocities, and thermal transport properties, whereas their porous network properties appreciate with the temperature. The stress–strain curves illustrate that post-heated carbonate rocks show brittleness below a temperature of 400 °C, brittle–ductile transformation at a temperature range of 400 to 500 °C, and ductile behavior beyond this critical temperature. The aspects discussed in this review comprehensively describe the damage mechanism of thermally exploited carbonate rocks that can be used as a reference in rock mass classification, sub-surface investigation, and geotechnical site characterization

Zinc in soil-plant-human system: A data-analysis review

Zinc (Zn) plays an important role in the physiology and biochemistry of plants due to its established essentiality and toxicity for living beings at certain Zn concentration i.e., deficient or toxic over the optimum range. Being a vital cofactor of important enzymes, Zn participates in plant metabolic processes therefore, alters the biophysicochemical processes mediated by Zn-related enzymes/proteins. Excess Zn can provoke oxidative damage by enhancing the levels of reactive radicals. Hence, it is imperative to monitor Zn levels and associated biophysicochemical roles, essential or toxic, in the soil-plant interactions. This data-analysis review has critically summarized the recent literature of (i) Zn mobility/phytoavailability in soil (ii) molecular understanding of Zn phytouptake, (iii) uptake and distribution in the plants, (iv) essential roles in plants, (v) phyto-deficiency and phytotoxicity, (vi) detoxification processes to scavenge Zn phytotoxicity inside plants, and (vii) associated health hazards. The review especially compares the essential, deficient and toxic roles of Zn in biophysicochemical and detoxification processes inside the plants. To conclude, this review recommends some Zn-related research perspectives. Overall, this review reveals a thorough representation of Zn bio-geo-physicochemical interactions in soil-plant system using recent data

Revealing of Core Shell Effect on Frequency-Dependent Properties of Bi-based Relaxor/Ferroelectric Ceramic Composites

Abstract In this study, electromechanical characteristics of (1-x) Bi0.5Na0.5TiO3–xSrTiO3 (ST26, x = 0.26)/(1-y) Bi0.5Na0.5TiO3–ySrTiO3 (ST10, y = 0.1) (matrix/seed) composites were studied. The ST26 (high relaxor phase) and ST10 (a relaxor ferroelectric (RF), high ferroelectric phase) composite with large (r-ST26-ST10) and small (t-ST26-ST10) grains exhibited frequency-related dielectric properties and large strain response at a low triggering electric field (an incipient piezoelectricity). It is ascribed to a matrix-seed effect originating from the inhomogeneous composition due to the presence of two phases. The r-ST26-ST10 composite sintered at 4 h, prominent material, showed a high normalized dynamic strain (d33*) of ~700 pm/V (large grains) with stable frequency dependence properties at a low field of 40 kV/cm. The properties of the r-ST26-ST10 composite exhibit less decay with frequency-related polarization and strain compared to those of t-ST26-ST10 composite. The increase in soaking time promotes the diffusion and homogenization of the microstructure in composites, leading to changes in the core-shell structure in the solid solution. The polarization and strain of the ST26-ST10 composites with the frequency are linked to the stability of the internal random fields created by non-ergodic relaxor phase of seed and the amount of phase change in the ergodic relaxor matrix