Silica-based monodisperse PdCo nanohybrids as highly efficient and stable nanocatalyst for hydrogen evolution reaction

Addressed herein, a highly active and stable nanohybrid has been synthesized for hydrogen production. The newly prepared nanocatalysts are silica-based palladium-cobalt nanohybrid structures (PdCo@SiO2 nanohybrid) (3.82 ± 0.37 nm). The prepared nanohybrids were fully identified with the help of different analytical techniques such as UV-Vis (Ultraviolet-Visible spectroscopy), XPS (X-ray photoelectron spectroscopy), TEM (Transmission electron microscopy), XRD (X-ray diffraction) and HR-TEM (High-resolution transmission electron microscopy) analyses. This prepared nanohybrid was quite successful in the production of hydrogen from DMAB in ambient conditions (TOF: 108.27 h?1). By the way, it was observed that the DMAB was converted entirely to the product at room temperature with the help of PdCo@SiO2 nanohybrid. Moreover, monodisperse PdCo@SiO2 nanohybrid has shown outstanding reusability performance even after 4th usage in the same reaction. As a result, it can be said that the prepared nanohybrid is highly efficient, stable and durable nanocatalyst for the dehydrocoupling of dimethylamine-borane. © 2018 Hydrogen Energy Publications LLCThe authors would like to thank Dumlupinar and Usak University for funding. Appendix

Düşük Seviyedeki Karbon Monoksit Zehirlenmesinde Asemptomatik Miyokardiyal Hasarlanma

Karbon monoksit zehirlenmesi önemli bir morbidite ve mortalite nedenidir. Klinikle daima korele olmasa da nörolojik belirtiler düşük, kardiyak belirtiler ise yüksek CO seviyelerinde görülebilmektedir. Düşük düzeydeki CO maruziyeti çok nadiren miyokardiyal hasarlanma nedenidir fakat imkânsız değildir. Bu vaka raporunda kardiyak belirti ve bulguları olmaksızın troponin seviyesi yüksek olan ve karbon monoksit seviyesi %20 olan hastayı sunmayı amaçladık. 26 yaşında erkek hasta acil servise bulantı kusma yakınması ile başvurdu. İlk bakılan EKG'de DII, DIII ve aVF'de 1 mm ST segment depresyonu ve DI-aVL'de ST segment elevasyonu mevcuttu. Hastanın laboratuvar değerlerinde; Troponin I 1.5 ng/mL, FCOHb 20.7% idi. İlk bakılan ekokardiyografide sol ventrikülde global hipokinezi vardı. Hastanın koroner anjiyografisi normaldi. CO zehirlenmesi düşünülen tüm hastalar CO seviyesine, kardiyak semptom ve bulguların olup olmadığına bakılmaksızın miyokardiyal hasarlanma için EKG, kardiyak nekroz markerleri ve ekokardiyografi ile değerlendirilmelidir.Carbon monoxide (CO) poisoning is an important cause of mortality and morbidity. Although measured in CO levels are not always correlated with clinical symptoms, neurological symptoms may present in lower CO levels, and cardiac signs and symptoms may occur in high CO levels. Low levels of CO exposure are very rare causes of myocardial injury. In this case presentation, we aimed to report on a patient who had a 20% level of CO and high troponin level without cardiac signs and symptoms. A 26-year-old male presented to the emergency department with headache, nausea, and vomiting. The initial electrocardiogram showed ST-segment depression of 1 mm in Lead II(II)-Lead III(III) - Lead augmented vector foot (aVF) and ST-segment elevation in Lead I(I)- Lead augmented vector left (aVL). The patient's laboratory values were as follows: troponin I: 1.5 ng/mL and FCOHb: 20.7%. The first echocardiogram of the patient demonstrated global hypokinesia of the left ventricle. The coronary angiogram of the patient was normal. All patients considered to have CO poisoning should be evaluated with electrocardiograms, cardiac necrosis marker measurements, and an echocardiogram for myocardial injury regardless of the level of CO or the absence of cardiac symptoms and signs

30-Day morbidity and mortality of bariatric metabolic surgery in adolescence during the COVID-19 pandemic – The GENEVA study

Background: Metabolic and bariatric surgery (MBS) is an effective treatment for adolescents with severe obesity. Objectives: This study examined the safety of MBS in adolescents during the coronavirus disease 2019 (COVID-19) pandemic. Methods: This was a global, multicentre and observational cohort study of MBS performed between May 01, 2020, and October 10,2020, in 68 centres from 24 countries. Data collection included in-hospital and 30-day COVID-19 and surgery-specific morbidity/mortality. Results: One hundred and seventy adolescent patients (mean age: 17.75 ± 1.30 years), mostly females (n = 122, 71.8%), underwent MBS during the study period. The mean pre-operative weight and body mass index were 122.16 ± 15.92 kg and 43.7 ± 7.11 kg/m2, respectively. Although majority of patients had pre-operative testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (n = 146; 85.9%), only 42.4% (n = 72) of the patients were asked to self-isolate pre-operatively. Two patients developed symptomatic SARS-CoV-2 infection post-operatively (1.2%). The overall complication rate was 5.3% (n = 9). There was no mortality in this cohort. Conclusions: MBS in adolescents with obesity is safe during the COVID-19 pandemic when performed within the context of local precautionary procedures (such as pre-operative testing). The 30-day morbidity rates were similar to those reported pre-pandemic. These data will help facilitate the safe re-introduction of MBS services for this group of patients

Epidemiology of surgery associated acute kidney injury (EPIS-AKI): a prospective international observational multi-center clinical study

Purpose: The incidence, patient features, risk factors and outcomes of surgery-associated postoperative acute kidney injury (PO-AKI) across different countries and health care systems is unclear. Methods: We conducted an international prospective, observational, multi-center study in 30 countries in patients undergoing major surgery (> 2-h duration and postoperative intensive care unit (ICU) or high dependency unit admission). The primary endpoint was the occurrence of PO-AKI within 72 h of surgery defined by the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Secondary endpoints included PO-AKI severity and duration, use of renal replacement therapy (RRT), mortality, and ICU and hospital length of stay. Results: We studied 10,568 patients and 1945 (18.4%) developed PO-AKI (1236 (63.5%) KDIGO stage 1500 (25.7%) KDIGO stage 2209 (10.7%) KDIGO stage 3). In 33.8% PO-AKI was persistent, and 170/1945 (8.7%) of patients with PO-AKI received RRT in the ICU. Patients with PO-AKI had greater ICU (6.3% vs. 0.7%) and hospital (8.6% vs. 1.4%) mortality, and longer ICU (median 2 (Q1-Q3, 1-3) days vs. 3 (Q1-Q3, 1-6) days) and hospital length of stay (median 14 (Q1-Q3, 9-24) days vs. 10 (Q1-Q3, 7-17) days). Risk factors for PO-AKI included older age, comorbidities (hypertension, diabetes, chronic kidney disease), type, duration and urgency of surgery as well as intraoperative vasopressors, and aminoglycosides administration. Conclusion: In a comprehensive multinational study, approximately one in five patients develop PO-AKI after major surgery. Increasing severity of PO-AKI is associated with a progressive increase in adverse outcomes. Our findings indicate that PO-AKI represents a significant burden for health care worldwide

30-Day Morbidity and Mortality of Bariatric Surgery During the COVID-19 Pandemic: a Multinational Cohort Study of 7704 Patients from 42 Countries.

BACKGROUND There are data on the safety of cancer surgery and the efficacy of preventive strategies on the prevention of postoperative symptomatic COVID-19 in these patients. But there is little such data for any elective surgery. The main objectives of this study were to examine the safety of bariatric surgery (BS) during the coronavirus disease 2019 (COVID-19) pandemic and to determine the efficacy of perioperative COVID-19 protective strategies on postoperative symptomatic COVID-19 rates. METHODS We conducted an international cohort study to determine all-cause and COVID-19-specific 30-day morbidity and mortality of BS performed between 01/05/2020 and 31/10/2020. RESULTS Four hundred ninety-nine surgeons from 185 centres in 42 countries provided data on 7704 patients. Elective primary BS (n = 7084) was associated with a 30-day morbidity of 6.76% (n = 479) and a 30-day mortality of 0.14% (n = 10). Emergency BS, revisional BS, insulin-treated type 2 diabetes, and untreated obstructive sleep apnoea were associated with increased complications on multivariable analysis. Forty-three patients developed symptomatic COVID-19 postoperatively, with a higher risk in non-whites. Preoperative self-isolation, preoperative testing for SARS-CoV-2, and surgery in institutions not concurrently treating COVID-19 patients did not reduce the incidence of postoperative COVID-19. Postoperative symptomatic COVID-19 was more likely if the surgery was performed during a COVID-19 peak in that country. CONCLUSIONS BS can be performed safely during the COVID-19 pandemic with appropriate perioperative protocols. There was no relationship between preoperative testing for COVID-19 and self-isolation with symptomatic postoperative COVID-19. The risk of postoperative COVID-19 risk was greater in non-whites or if BS was performed during a local peak

Safety of Bariatric Surgery in ≥ 65-Year-Old Patients During the COVID-19 Pandemic

Background Age >= 65 years is regarded as a relative contraindication for bariatric surgery. Advanced age is also a recognised risk factor for adverse outcomes with Coronavirus Disease-2019 (COVID-19) which continues to wreak havoc on global populations. This study aimed to assess the safety of bariatric surgery (BS) in this particular age group during the COVID-19 pandemic in comparison with the younger cohort.Methods We conducted a prospective international study of patients who underwent BS between 1/05/2020 and 31/10/2020. Patients were divided into two groups - patients >= 65-years-old (Group I) and patients < 65-years-old (Group II). The two groups were compared for 30-day morbidity and mortality.Results There were 149 patients in Group 1 and 6923 patients in Group II. The mean age, preoperative weight, and BMI were 67.6 +/- 2.5 years, 119.5 +/- 24.5 kg, and 43 +/- 7 in Group I and 39.8 +/- 11.3 years, 117.7 +/- 20.4 kg, and 43.7 +/- 7 in Group II, respectively. Approximately, 95% of patients in Group 1 had at least one co-morbidity compared to 68% of patients in Group 2 (p = < 0.001). The 30-day morbidity was significantly higher in Group I ( 11.4%) compared to Group II (6.6%) (p = 0.022). However, the 30-day mortality and COVID-19 infection rates were not significantly different between the two groups.Conclusions Bariatric surgery during the COVID-19 pandemic is associated with a higher complication rate in those >= 65 years of age compared to those < 65 years old. However, the mortality and postoperative COVID-19 infection rates are not significantly different between the two groups

Effect of BMI on safety of bariatric surgery during the COVID-19 pandemic, procedure choice, and safety protocols - An analysis from the GENEVA Study

Background: It has been suggested that patients with a Body Mass Index (BMI) of > 60 kg/m2 should be offered expedited Bariatric Surgery (BS) during the Coronavirus Disease-2019 (COVID-19) pandemic. The main objective of this study was to assess the safety of this approach. Methods: We conducted a global study of patients who underwent BS between 1/05/2020 and 31/10/2020. Patients were divided into three groups according to their preoperative BMI -Group I (BMI < 50 kg/m2), Group II (BMI 50-60 kg/m2), and Group III (BMI > 60 kg/m2). The effect of preoperative BMI on 30-day morbidity and mortality, procedure choice, COVID-19 specific safety protocols, and comorbidities was assessed. Results: This study included 7084 patients (5197;73.4 % females). The mean preoperative weight and BMI were 119.49 & PLUSMN; 24.4 Kgs and 43.03 & PLUSMN; 6.9 Kg/m2, respectively. Group I included 6024 (85 %) patients, whereas Groups II and III included 905 (13 %) and 155 (2 %) patients, respectively.The 30-day mortality rate was higher in Group III (p = 0.001). The complication rate and COVID-19 infection were not different. Comorbidities were significantly more likely in Group III (p = < 0.001). A significantly higher proportion of patients in group III received Sleeve Gastrectomy or One Anastomosis Gastric Bypass compared to other groups. Patients with a BMI of > 70 kg/m2 had a 30-day mortality of 7.7 % (2/26). None of these patients underwent a Roux-en-Y Gastric Bypass. Conclusion: The 30-day mortality rate was significantly higher in patients with BMI > 60 kg/m2. There was, however, no significant difference in complications rates in different BMI groups, probably due to differences in procedure selection