Pancreatitis with arthropathy and subcutaneous fat necrosis

The occurrence of peripheral fat necrosis in exceptional cases of pancreatic disease is not well understood. We report studies on such a patient with arthropathy and subcutaneous nodules. Examination of serial serum samples demonstrated striking elevations of the pancreatic enzymes phospholipase A, 3–3.4 units/ml (normal 0.17–0.41); lipase, 7–39 Sigma-Tietz units/ml (normal < 1); immunoreactive trypsin, 912–3,207 ng/ml (normal 12–41). The distinguishing characteristic of the patient's synovial fluid was a marked elevation of hydrolized fatty acids (680 mg/dl versus 19 ± 19 in control inflammatory joint fluids). Synovial fluid fatty acid distribution was identical to values for tissue fat. In contrast, serum fatty acid levels and distribution were normal. No associated proteinase inhibitor or significant immunologic abnormality was detected. Certain properties of adipose cells and lipolytic enzymes may help explain the characteristically selective necrosis of fat cells observed in this syndrome.     

Thoracic surgery in United Arab Emirates

The United Arab Emirates (UAE) has undergone a significant change in its population and economy in the last decades and in parallel its healthcare system has evolved rapidly to provide advanced, innovative and world-leading care. At the forefront of this revolution in healthcare is the development of a multidisciplinary multimodality thoracic service provision, offered at quaternary referral hospitals amalgamating academics, training, research and innovation. Previously, thoracic service care was limited to single providers at various public and private hospitals, usually performing lower complexity cases. Most complex thoracic cases were repatriated outside the UAE. This practice was replaced with the opening of Cleveland Clinic Abu Dhabi (CCAD), in 2015, which created a multidisciplinary thoracic program. This included the start of a mini-invasive surgical and lung transplantation program. Since that time other public and private hospitals have emerged providing care in a similar model. The impact of these programs has been a decreased transfer of patients abroad for treatment. Under the umbrella of the Emirates Thoracic Society (ETS) a platform for greater collaboration aimed at improving patient care, potential research and physician education has been created. Direct links have been established with world-leading Thoracic surgery and Respiratory Medicine Centers facilitating this development and offering support and guidance. This article charts these changes in thoracic care in the recent past, present, and delineates plans for the future in the UAE.     

Transfer hydrogenation of nitroarenes using cellulose filter paper-supported Pd/C by filtration as well as sealed methods

A reductive filter paper for selective nitro reduction has been prepared by modification of a pristine cellulose filter paper by Pd/C nanoparticles, as a portable catalyst. The reaction was performed in two different set-ups including (i) filtration and (ii) sealed systems, in the presence of ammonium formate and ex situ generated hydrogen gas reducing agents, respectively. In the sealed system in the presence of H₂ gas, the halogenated nitroarenes were completely reduced, while in the filtration system, different derivatives of the nitroarenes were selectively reduced to aryl amines. In both systems, the reduction of nitroarenes to aryl amines was performed with high efficiency and selectivity, comparable to a heterogeneous system. Reaction parameters were comprehensively designed using Design Expert software and then studied. The properties of the catalytic filter paper were studied in detail from the points of view of swellability, shrinkage, reusability, and stability against acidic, alkaline, and oxidative reagents.

A novel and efficient catalytic filtration has been developed for the selective reduction of nitro compounds on a Pd/C-doped cellulose filter paper.     

Increased Circulating Copeptin Levels Are Associated with Vaso-Occlusive Crisis and Right Ventricular Dysfunction in Sickle Cell Anemia

ObjectiveVaso-occlusive crisis (VOC) is a common clinical manifestation of sickle cell anemia (SCA) and is associated with increased proinflammatory mediators. Copeptin is the C-terminal part of the prohormone for provasopressin and seems clinically relevant in various clinical conditions. Right ventricular (RV) dysfunction significantly appears in SCA patients due to pulmonary hypertension. This study aimed to investigate the association of copeptin levels in VOC patients and evaluate RV dysfunction.Materials and MethodsA total of 108 patients were enrolled in the study. Twenty-eight SCA patients in steady state (30.2 ± 0.9 years), 25 SCA patients in VOC (36.8 ± 11.8 years), and 55 healthy individuals (31.9 ± 9.4 years) with HbAA genotype were included. Clinical, echocardiographic, and laboratory data were recorded. ELISA was used for the determination of serum levels of copeptin.ResultsVOC patients had significantly higher copeptin level compared both with controls and SCA subjects in steady state (22.6 ± 13.0 vs. 11.3 ± 5.7 pmol/L, 22.6 ± 13.0 vs. 12.4 ± 5.8 pmol/L, p = 0.009 for both). Additionally, the copeptin level was significantly higher in SCA patients with RV dysfunction than those without RV dysfunction (23.2 ± 12.2 vs. 15.3 ± 9.5 pmol/L, p = 0.024). Multiple logistic regression analysis revealed that high-sensitivity C-reactive protein and copeptin levels were found to be associated with VOC.ConclusionThis study showed that copeptin and hs-CRP levels were increased in patients with VOC, and it was found that RV dysfunction was more common in SCA patients with VOC than in the control group. Copeptin can be considered for use as a potential biomarker in predicting VOC crisis in SCA patients and in the early detection of patients with SCA who have the potential to develop RV dysfunction.     

Effects of Graphene Oxide and Crumb Rubber on the Fresh Properties of Self-Compacting Engineered Cementitious Composite Using Response Surface Methodology

Graphene oxide-modified rubberized engineered cementitious composite (GO-RECC) is attracting the attention of researchers because of the reported benefits of the GO and crumb rubber (CR) on the strength and deformation properties of the composite. While it is well established that GO negatively affects the workability of cementitious composites, its influence on the attainment of the desired self-compacting (SC) properties of ECC has not yet been thoroughly investigated, especially when combined with crumb rubber (CR). In addition, to simplify the number of trial mixes involved in designing SC-GO-RECC, there is a need to develop and optimize the process using Design of Experiment (DOE) methods. Hence, this research aims to investigate and model using response surface methodology (RSM), the combined effects of the GO and CR on the SC properties of ECC through the determination of T₅₀₀, slump flow, V-funnel, and L-box ratio of the SC-GORECC as the responses, following the European Federation of National Associations Representing for Concrete (EFNARC) 2005 specifications. The input factors considered were the GO by wt.% of cement (0.02, 0.04, 0.06, and 0.08) and CR as a replacement of fine aggregate by volume (5, 10, and 15%). The results showed that increasing the percentages of GO and CR affected the fresh properties of the SC-GORECC adversely. However, all mixes have T₅₀₀ of 2.4 to 5.2 s, slump flow of 645 to 800 mm, V-funnel time of 7.1 to 12.3 s, and L-box ratio (H2/H1) of 0.8 to 0.98, which are all within acceptable limits specified by EFNARC 2005. The developed response prediction models were well fitted with R² values ranging from 91 to 99%. Through the optimization process, optimal values of GO and CR were found to be 0.067% and 6.8%, respectively, at a desirability value of 1.0.     

A Review of X-ray Photoelectron Spectroscopy Technique to Analyze the Stability and Degradation Mechanism of Solid Oxide Fuel Cell Cathode Materials

Nondestructive characterization of solid oxide fuel cell (SOFC) materials has drawn attention owing to the advances in instrumentation that enable in situ characterization during high-temperature cell operation. X-ray photoelectron spectroscopy (XPS) is widely used to investigate the surface of SOFC cathode materials because of its excellent chemical specificity and surface sensitivity. The XPS can be used to analyze the elemental composition and oxidation state of cathode layers from the surface to a depth of approximately 5–10 nm. Any change in the chemical state of the SOFC cathode at the surface affects the migration of oxygen ions to the cathode/electrolyte interface via the cathode layer and causes performance degradation. The objective of this article is to provide a comprehensive review of the adoption of XPS for the characterization of SOFC cathode materials to understand its degradation mechanism in absolute terms. The use of XPS to confirm the chemical stability at the interface and the enrichment of cations on the surface is reviewed. Finally, the strategies adopted to improve the structural stability and electrochemical performance of the LSCF cathode are also discussed.     

Characteristics of Conventional and Microwave Sintered Iron Ore Preform

In this study, compacted hematite (Fe₂O₃) preforms were made and sintered at various temperatures, such as 1250 °C and 1300 °C, using both conventional and microwave sintering methods. The density, porosity, microhardness, cold crushing strength, microphotographs, and X-ray diffraction (XRD) analysis of the sintered preforms were used to evaluate the performance of the two sintering methods. It was found that microwave sintered preforms possessed lesser porosity and higher density than conventionally sintered preforms owing to uniform heating of the powdered ore in microwave sintering method. Furthermore, it was also observed that microwave sintered preforms exhibited relatively higher cold crushing strength and hardness than conventionally sintered preforms. Thus, the overall results revealed that microwave sintering yielded better properties considered in the present study.     

Combined experimental and computational study of Al2O3 catalyzed transamidation of secondary amides with amines

Amides are the most extensively used substances in both synthetic organic and bioorganic chemistry. Unfortunately, the traditional synthesis of amides suffers from some important drawbacks, including low atom efficiency, high catalyst loading, separation of products from the reaction mixture and production of byproducts. Al₂O₃ is an amphoteric catalyst that activates the carbonyl carbon of the secondary amide group and helps the C–N cleavage of the reactant amide group by attacking the N–H hydrogen. By using the concepts of amphoteric properties of Al₂O₃, amides were synthesized from secondary amides and amines in the presence of triethylamine solvent. Several aliphatic and aromatic amines were used for the transamidation of N-methylbenzamide in the presence of the Al₂O₃ catalyst. Moreover, using the Gaussian09 software at the DFT level, HUMO, LUMO and the intrinsic reaction coordinates (IRCs) have also been calculated to find out the transition state of the reaction and energy. In this study, five successful compounds were synthesized by the transamidation of secondary amides with amines using a reusable Al₂O₃ catalyst. The catalyst was reused several times with no significant loss in its catalytic activity. The products were purified by recrystallization and column chromatography techniques. This catalytic method is effective for the simultaneous activation of the carbonyl group and N–H bond by using the Al₂O₃ catalyst.

Amides are the most extensively used substances in both synthetic organic and bioorganic chemistry.     

Complication and cost analysis of transbronchial lung cryobiopsy and awake video-assisted thoracic surgery in diagnosis of interstitial lung disease

Aim and introduction:Diagnosing of interstitial lung disease (ILD) is difficult and expensive. The standard diagnostical approaches to ILD are bronchoalveolar lavage, transbronchial lung biopsy, transbronchial lung cryobiopsy (TBLC) and surgical lung biopsy (SLB). SLB is gold standard for the confident diagnosis of ILD but because of the poor performance of the patients it’s use is limited. We conducted a retrospective study to point out that TBLC plays an important role in diagnosis of ILD and has fewer complications and lower cost than awake video-assisted thoracic surgery (AVATS).Material and methods:132 patients who underwent TBLC and AVATS with a pre-diagnosis of ILD in our hospital between 2015 and 2020 were evaluated retrospectively. Diagnosis rates, complications and costs were recorded.Results:There were no non-diagnostic materials in 44 patients in AVATS arm. Prolonged air leak was observed in 11(25.0%) of the patients, and six of them (13.6%) were discharged with Heimlich Valve (HV). Median length of stay in the hospital was 8 days, while average patient cost was $515.9 (415.2-2662.9) in the AVATS arm. Non-diagnostic material was obtained from 10 (11.3%) of 88 patients in TBLC arm. Six (6.8%) of them had pneumothorax, only one of them required a chest tube. No patient was discharged with HV (p=0.001). Median cost for each patient with a median hospital stay of 2.0 (1.0-21.0) (p<0.001) days was $171.9 (80.8-1493.3) (p<0.001).Discussion:Although TBLC is behind AVATS in terms of diagnostic accuracy, it may be an alternative diagnostic tool in the diagnosis of interstitial lung disease due to its acceptable safety profile and cost-effectiveness.