Reversible magnetic mercury extraction from water

A facile and efficient way to decontaminate mercury(II) polluted water with the aid of magnetic, highly stable and recyclable carbon coated cobalt (Co/C) nanoparticles is reported. Comparing non-functionalised Co/C nanomagnets with particles that were functionalised with amino moieties, the latter one proved to be more effective for scavenging mercury with respect to extraction capacity and recyclability. A novel nanoparticle–poly(ethyleneimine) hybrid (Co/C–PEI) prepared by direct ring opening polymerization of aziridine initiated by an amine functionalised nanoparticle surface led to a high capacity material (10 mmol amino groups per g nanomaterial) and thus proved to be the best material for scavenging toxic mercury at relevant concentrations (mg L−1/μg L−1) for at least 6 consecutive cycles. On a large-scale, 20 L of drinking water with an initial Hg2+ concentration of 30 μg L−1 can be decontaminated to the level acceptable for drinking water (≤2 μg L−1) with just 60 mg of Co/C–PEI particles

Effectiveness and safety of opicapone in Parkinson's disease patients with motor fluctuations: The OPTIPARK open-label study

BACKGROUND: The efficacy and safety of opicapone, a once-daily catechol-O-methyltransferase inhibitor, have been established in two large randomized, placebo-controlled, multinational pivotal trials. Still, clinical evidence from routine practice is needed to complement the data from the pivotal trials. METHODS: OPTIPARK (NCT02847442) was a prospective, open-label, single-arm trial conducted in Germany and the UK under clinical practice conditions. Patients with Parkinson’s disease and motor fluctuations were treated with opicapone 50 mg for 3 (Germany) or 6 (UK) months in addition to their current levodopa and other antiparkinsonian treatments. The primary endpoint was the Clinician’s Global Impression of Change (CGI-C) after 3 months. Secondary assessments included Patient Global Impressions of Change (PGI-C), the Unified Parkinson’s Disease Rating Scale (UPDRS), Parkinson’s Disease Questionnaire (PDQ-8), and the Non-Motor Symptoms Scale (NMSS). Safety assessments included evaluation of treatment-emergent adverse events (TEAEs) and serious adverse events (SAEs). RESULTS: Of the 506 patients enrolled, 495 (97.8%) took at least one dose of opicapone. Of these, 393 (79.4%) patients completed 3 months of treatment. Overall, 71.3 and 76.9% of patients experienced any improvement on CGI-C and PGI-C after 3 months, respectively (full analysis set). At 6 months, for UK subgroup only (n = 95), 85.3% of patients were judged by investigators as improved since commencing treatment. UPDRS scores at 3 months showed statistically significant improvements in activities of daily living during OFF (mean ± SD change from baseline: − 3.0 ± 4.6, p < 0.0001) and motor scores during ON (− 4.6 ± 8.1, p < 0.0001). The mean ± SD improvements of − 3.4 ± 12.8 points for PDQ-8 and -6.8 ± 19.7 points for NMSS were statistically significant versus baseline (both p < 0.0001). Most of TEAEs (94.8% of events) were of mild or moderate intensity. TEAEs considered to be at least possibly related to opicapone were reported for 45.1% of patients, with dyskinesia (11.5%) and dry mouth (6.5%) being the most frequently reported. Serious TEAEs considered at least possibly related to opicapone were reported for 1.4% of patients. CONCLUSIONS: Opicapone 50 mg was effective and generally well-tolerated in PD patients with motor fluctuations treated in clinical practice. TRIAL REGISTRATION: Registered in July 2016 at clinicaltrials.gov (NCT02847442)

Manganrockbridgeite, Mn²⁺₂Fe³⁺₃(PO₄)₃(OH)₄(H₂O), a new member of the rockbridgeite group, from the Hagendorf-Süd pegmatite, Oberpfalz, Bavaria

Manganrockbridgeite, Mn22+Fe33+(PO4)3(OH)4(H2O), is a new member of the rockbridgeite group, from the Hagendorf-Süd pegmatite, Oberpfalz, Bavaria. It occurs in association with frondelite, kenngottite, hureaulite and hematite. It forms compact intergrowths and clusters of shiny greenish black blades up to 200 µm long and 20 µm wide but only a few micrometres thick. The crystals are elongated on [100] and flattened on {001}, with perfect cleavage parallel to {001}. Individual thin blades are green in transmitted light and red under crossed polars. The calculated density is 3.40 g cm−3. Manganrockbridgeite is biaxial (+/-), with α= 1.795(5), β= 1.805(calc), γ=1.815(5) (white light) and 2V(meas.) = 90(2)∘. The empirical formula from electron microprobe analyses, Mössbauer spectroscopy and crystal structure refinement is (Mn1.072+Fe0.692+Fe0.163+)Σ1.92(Fe3+)2.88(PO4)3(OH)3.64(H2O)1.44. Manganrockbridgeite has monoclinic symmetry with space group P21/m and unit-cell parameters a=5.198(2), b=16.944(5), c=7.451(3) Å, β=110.170(9)∘, V=616.0(4) Å3 and Z=2. The crystal structure was refined using both laboratory and synchrotron single-crystal diffraction data. Whereas other rockbridgeite-group minerals have orthorhombic symmetry with a statistical distribution of 50 % Fe3+ / 50 % vacancies in M3-site octahedra forming face-shared chains along the 5.2 Å axis, monoclinic manganrockbridgeite has full ordering of Fe3+ and vacancies in alternate M3 sites along the 5.2 Å axis.</p

High prevalence of fluoroquinolone-resistant UTI among US emergency department patients diagnosed with urinary tract infection, 2018–2020

Background: Uropathogen resistance, fluoroquinolone-resistance (FQR), and extended spectrum beta-lactamase (ESBL), has been observed to be emerging worldwide with prevalences above recommended thresholds for routine empirical treatment. The primary aim of our study was to determine the prevalence of FQR from a geographically diverse sample of United States emergency departments (EDs). Methods: We conducted a multi-center, observational cohort study using a network of 15 geographically diverse US EDs. All patients ≥18 years of age with the primary or secondary diagnosis of urinary tract infection (UTI) in the ED identified using International Classification of Diseases (ICD-10) diagnosis code of cystitis, pyelonephritis, or UTI from 2018 to 2020 were included. We calculated descriptive statistics for uropathogens and susceptibilities. Logistic regression analysis was used to identify antimicrobial resistance risk factors associated with FQR Escherichia coli. Results: Among 3779 patients who met inclusion criteria, median age was 62.9 years (interquartile range [IQR]: 41–77.6) and 76.3% were female. The most common diagnoses were complicated (41.2%) and uncomplicated cystitis (40.3%). E. coli was the most common pathogen (63.2%), followed by Klebsiella pneumoniae (13.2%) and Enterococcus species (5.8%). Across all sites, overall E. coli FQ-resistance prevalence was 22.1%, ranging from 10.5 to 29.7% by site. The prevalence of ESBL-producing uropathogen was 7.4%, ranging from 3.6% to 11.6% by site. Previous IV or oral antimicrobial use in the past 90-days and history of a multi-drug resistant pathogen were associated with FQ-resistant E. coli (odds ratio [OR] 2.68, 95% confidence interval [CI]: 2.04–3.51, and OR 6.93, 95% CI: 4.95–9.70, respectively). Of the patients who had FQ-resistant E. coli or an ESBL-producing uropathogen isolated, 116 (37.1%) and 61 (36.7%) did not have any documented risk factors for resistance. Conclusion: FQ-resistant E. coli is widely prevalent across US sites highlighting the need for ongoing monitoring of antimicrobial resistance and, at some locations, modification of empirical treatments

PHarmacist Avoidance or Reductions in Medical Costs in Patients Presenting the EMergency Department: PHARM-EM Study

Objectives:. To comprehensively classify interventions performed by emergency medicine clinical pharmacists and quantify cost avoidance generated through their accepted interventions. Design:. A multicenter, prospective, observational study was performed between August 2018 and January 2019. Setting:. Community and academic hospitals in the United States. Participants:. Emergency medicine clinical pharmacists. Interventions:. Recommendations classified into one of 38 intervention categories associated with cost avoidance. Measurements and Main Results:. Eighty-eight emergency medicine pharmacists at 49 centers performed 13,984 interventions during 917 shifts that were accepted on 8,602 patients and generated $7,531,862 of cost avoidance. The quantity of accepted interventions and cost avoidance generated in six established categories were as follows: adverse drug event prevention (1,631 interventions;$2,225,049 cost avoidance), resource utilization (628; $310,582), individualization of patient care (6,122;$1,787,170), prophylaxis (24; $22,804), hands-on care (3,533;$2,836,811), and administrative/supportive tasks (2,046; $342,881). Mean cost avoidance was$538.61 per intervention, $875.60 per patient, and$8,213.59 per emergency medicine pharmacist shift. The annualized cost avoidance from an emergency medicine pharmacist was $1,971,262. The monetary cost avoidance to pharmacist salary ratio was between$1.4:1 and $10.6:1. Conclusions:. Pharmacist involvement in the care of patients presenting to the emergency department results in significant avoidance of healthcare costs, particularly in the areas of hands-on care and adverse drug event prevention. The potential monetary benefit-to-cost ratio for emergency medicine pharmacists is between$1.4:1 and $10.6:1