Bleomycin electrosclerotherapy (BEST) for the treatment of vascular malformations

Biomedical applications of electroporation are expanding out of the field of oncology into vaccination, treatment of arrhythmias and now in the treatment of vascular malformations. Bleomycin is a widely used sclerosing agent in the treatment of various vascular malformations. The application of electric pulses in addition to bleomycin enhances the effectiveness of the drug, as demonstrated by electrochemotherapy, which utilizes bleomycin in the treatment of tumors. The same principle is used in bleomycin electrosclerotherapy (BEST). The approach seems to be effective in the treatment of low-flow (venous and lymphatic) and, potentially, even high-flow (arteriovenous) malformations. Although there are only a few published reports to date, the surgical community is interested, and an increasing number of centers are applying BEST in the treatment of vascular malformations. Within the International Network for Sharing Practices on Electrochemotherapy (InspECT) consortium, a dedicated working group has been constituted to develop standard operating procedures for BEST and foster clinical trials. By treatment standardization and successful completion of clinical trials demonstrating the effectiveness and safety of the approach, higher quality data and better clinical outcomes may be achieved

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Are complication rates lower with 4-Fr versus 6-Fr transfemoral arterial access – prospective audit at a single interventional radiology centre

Abstract Background Femoral arterial access constitutes the first step in a significant proportion of interventional endovascular procedures. Whilst existing reports describe sheath size as an independent risk factor for bleeding complications in radial arterial access for coronary intervention, the influence of sheath size on overall complication rates and morbidity following femoral arterial access is not well described. This prospective single centre study reports our experience of vascular sheath size, patient and procedural factors in influencing complication rates following femoral arterial access. From April 2010 to May 2013, data was collected prospectively for all femoral arterial access procedures performed in the Interventional Radiology department of a tertiary hospital. For vascular sheath size <6-Fr, haemostasis was achieved by manual compression. For 6-Fr sheath size, a closure device was used in the absence of any contraindication. Results Of the 320 femoral access cases with eligible inclusion criteria, 52.5% had 4-Fr whilst 47.5% had 6-Fr vascular sheaths inserted. Overall post procedure complications rates were significantly higher following 6-Fr sheath (17/152 (11.2%)) versus 4-Fr systems (3/168 (1.8%)) (p=0.0007) mostly comprising self-limiting hematoma. There was no significant difference in major complications that required escalation of treatment. Conclusion No significant difference has been demonstrated between the use of either sheath systems for major complications. The practical limitations of a smaller system, combined with existing body of evidence, may not justify the routine use of 4-Fr sheath systems as the primary sheath size for all endovascular procedures

Effect of Nano Potassium and Nano Zinc on Growth and Yield Enhancement in Wheat (Triticum aestivum L.)

The field experiment was conducted during Rabi season 2022 at experimental field of Crop Research Farm, Department of Agronomy, Naini Agricultural Institute, Sam Higginbottom University of Agriculture, Technology And Sciences, Prayagraj, Uttar Pradesh, India. The soil of experimental plot was sandy loam in texture, nearly neutral in soil reaction (pH 7.3), low in organic carbon (0.48%), available nitrogen (230 kg/ha), available phosphorus (13.60 kg/ha) and available potassium (215.4 kg/ha). The treatment consists of 3 levels of Nano potassium 25, 40, 55 ppm and Nano zinc 60, 80, 120 ppm along with control. The experiment was layout in Randomized Block Design with ten treatments each replicated thrice. Higher plant height (93.43 cm), plant dry weight (26.99 g), tillers/running row meter (73.57) and the yield attributes namely spike length (11.93 cm), grains/spike (51.67), spikes/running row meter (62.90), effective tillers/running row meter (60.10), grain yield (6.61 t/ha) and straw yield (8.90 t/ha were obtained highest in the treatment 9 [Nano potassium 55ppm + Nano zinc 120ppm]

Sulphated zirconia catalyzed acylation of phenols, alcohols and amines under solvent free conditions

International audienceSulphated zirconia prepared by the treatment of a high surface area zirconia (320m2 g−1) with 1N H2SO4 shows a strong acidity after calcination at 893 K. It is comparable to that of zeolites, with an enthalpy of adsorption of NH3 close to 130 kJ mol−1. The isotherm of N2 adsorption at 77K on the sulphated zirconia shows characteristic of mesoporous solid having surface area about 125m2 g−1, and pores of 4 nm as determined applying the BJH method. The sulphated zirconia obtained by sulphation has 14.5 wt.% S just after oven drying and 1.8 wt.% S after calcination at 893 K. The X-ray diffraction pattern of the calcined sample shows the presence of an intensive peak at 2θ = 30 characteristic of the tetragonal structure. This solid acid has been applied to the acylation of a variety of phenols, alcohols and amines with acetic anhydride as an acylating agent under solvent free conditions. The yields reach about 95% in 10 min, and the catalyst can be recycled several times, so that this process could find useful applications

Stratospheric Aerosol Characteristics from the 2017–2019 Volcanic Eruptions Using the SAGE III/ISS Observations

In recent years (2017–2019), several moderate volcanic eruptions and wildfires have perturbed the stratospheric composition and concentration with distinct implications on radiative forcing and climate. The Stratospheric Aerosol and Gas Experiment III instruments onboard the International Space Station (SAGE III/ISS) have been providing aerosol extinction coefficient (EC) profiles at multiple wavelengths since June 2017. In this study, a method to invert the spectral stratospheric aerosol optical depth (sAOD) or EC values from SAGE III/ISS (to retrieve the number/volume size distributions and other microphysical properties) is presented, and the sensitivity of these retrievals is evaluated. It was found that the retrievals are strongly dependent on the choices of wavelengths, which in turn determine the shapes of the calculated curves. Further, we examine the changes in stratospheric aerosol spectral behavior, size distribution properties, time evolution (growth/decay) characteristics associated with subsequent moderate volcanic eruptions, namely, Ambae (15∘S, 167∘E; April and July 2018), Raikoke (48∘N, 153∘E; June 2019), and Ulawun (5∘S, 151∘E; June and August 2019), in different spatial regions. The observational period was classified with reference to Ambae eruptions into four phases (pre-Ambae, Ambae1, Ambae2, and post-Ambae). The pre-Ambae and post-Ambe periods comprise the 2017 Canadian fires and 2019 Raikoke/Ulawun eruptions, respectively. The spectral dependence of sAOD was comparable and lowest during the pre-Ambae and Ambae1 periods in all regions. The number concentration at the principal mode radius (between 0.07 and 0.2 μm) was observed to be higher during the Ambae2 period over the Northern Hemisphere (NH). The rate of change (growth/decay) in the sAOD on a global scale resembled the changes in the Southern Hemisphere (SH), unlike the time-lag-associated changes in the NH. These differences could be attributed to the prevailing horizontal and vertical dispersion mechanisms in the respective regions. Lastly, the radiative forcing estimates of Ambae and Raikoke/Ulawun eruptions, as reported in recent studies, was discussed by taking clues from other major and moderate eruptions to gain insight on their role in climate change

The first example of bromination of aromatic compounds with unprecedented atom economy using molecular bromine

Bromination of organic compounds is usually effected using equimolar ratios of bromine with the substrate. The generated HBr is used either in the preparation of value added brominated products or is disposed aswaste, causing serious environmental problems.Acatalyst for an inbuilt recycle of HBr by oxidation and subsequent bromination of the organic compounds has been designed and developed. The efficacy is demonstrated in the production of tetrabromobisphenol-A (TBBA) in an integrated approach of bromination coupled with oxybromination of bisphenol-A (BA), aimed at utilisation of both bromine atoms of the bromine molecule. Here 2.05 mol of bromine and 2.1 mol of H2O2 as an oxidant were used per mol of BA catalysed by tungstate-exchanged Mg-Al layered double hydroxide (LDH-WO4) with unprecedented atom economy in a biphase system comprising dichloroethane and water under auto-reflux for the first time. This is quite impressive when compared with the currently used process, in which &gt; 4 mol of bromine per mol of BA is being used. The TBBA thus obtained allows in-process control of pollutants in the integrated process and conforms to all the 14 specifications that include American Public Health Administration (APHA) colour values and hydrolysable bromide, very important specifications for marketability. Effects of mole ratios of H2O2/BA and Br2/BA, concentration of the catalyst, solvent and temperature on yields and quality of the product were studied in an effort to optimise the parameters. Environmental and economical factors of the process evolved are highlighted. The Mg-Al and Ni-Al-LDH-WO4 catalysts used in the above process and their precursors were characterised bymeans of powder-XRD, TGA-DTA, FT-IR spectroscopy, scanning electron microscopy (SEM), and particle size distribution.The heterogeneity and reusability of the Mg-Al-LDH-WO4 were well established. The catalyst displayed consistent activity and selectivity for four recycles

Impact of the 2018 Ambae Eruption on the Global Stratospheric Aerosol Layer and Climate

POPS measurements have to be re-425quested from the PI ([email protected])International audienceDuring an extended volcanic unrest starting in 2017, two main moderate stratospheric eruptions occurred at the Ambae volcano (15°S and 167°E), Vanuatu, in April and July 2018. Observations from a geostationary orbit show that the April and July eruptions injected a volcanic plume into the lower stratosphere. While aerosol enhancements from the April eruption have only had an impact on the Southern Hemisphere, the plume from the July eruption was distributed within the lower branch of the Brewer–Dobson circulation to both hemispheres. Satellite, ground‐based and in situ observations show that the background aerosol is enhanced throughout the year after the July eruption on a global scale. A volcanic‐induced perturbation of the global stratospheric aerosol optical depth up to 0.011 is found, in the ultraviolet/visible spectral range. This perturbation is comparable to that of recent moderate stratospheric eruptions like from Kasatochi, Sarychev, and Nabro. Top of the atmosphere radiative forcing values are estimated between −0.45 and −0.6 W/m2 for this event, showing that the Ambae eruption had the strongest climatic impact of the year 2018. Thus, the Ambae eruption in 2018 has to be taken into account when studying the decadal lower stratospheric aerosol budget and in climate studies