Early prediction and prevention of infected pancreatic necrosis

Approximately 20%-30%of patients with acute necrotizing pancreatitis develop infected pancreatic necrosis(IPN),a highly morbid and potentially lethal complication.Early identification of patients at high risk of IPN may facilitate appropriate preventive measures to improve clinical outcomes.In the past two decades,several markers and predictive tools have been proposed and evaluated for this purpose.Conventional biomarkers like C-reactive protein,procalcitonin,lymphocyte count,interleukin-6,and interleukin-8,and newly developed biomarkers like angiopoietin-2 all showed significant association with IPN.On the other hand,scoring systems like the Acute Physiology and Chronic Health Evaluation II and Pancreatitis Activity Scoring System have also been tested,and the results showed that they may provide better accuracy.For early prevention of IPN,several new therapies were tested,including early enteral nutrition,anti-biotics,probiotics,immune enhancement,etc.,but the results varied.Taken together,several evidence-supported predictive markers and scoring systems are readily available for predicting IPN.However,effective treatments to reduce the incidence of IPN are still lacking apart from early enteral nutrition.In this editorial,we summarize evidence concerning early prediction and prevention of IPN,providing insights into future practice and study design.A more homo-geneous patient population with reliable risk-stratification tools may help find effective treatments to reduce the risk of IPN,thereby achieving individualized treatment.

Multiple chemical warfare agent simulant decontamination by self-driven microplasma

Low-temperature plasma is a green and high-efficiency technology for chemical warfare agent(CWA)decontamination.However,traditional plasma devices suffer from the problems of highpower composition and large power-supply size,which limit their practical applications.In this paper,a self-driven microplasma decontamination system,induced by a dielectric-dielectric rotary triboelectric nanogenerator(dd-r TENG),was innovatively proposed for the decontamination of CWA simulants.The microplasma was characterized via electrical measurements,optical emission spectra and ozone concentration detection.With an output voltage of-3460 V,the dd-r TENG can successfully excite microplasma in air.Reactive species,such as OH,O(1D),Hαand O3were detected.With input average power of 0.116 W,the decontamination rate of 2-chloroethyl ethyl sulfide reached 100%within 3 min of plasma treatment,while the decontamination rates of malathion and dimethyl methylphosphonate reached(65.92±1.65)%and(60.88±1.92)%after 7 min of plasma treatment,respectively.In addition,the decontamination rates gradually decreased with the increase in the simulant concentrations.Typical products were identified and analyzed.This study demonstrates the broad spectrum and feasibility of the dd-r TENG-microplasma for CWA elimination,which provides significant guidance for their practical applications in the future.

Interaction between macroalgae and microplastics:Caulerpa lentillifera and Gracilaria tenuistipitata as microplastic bio-elimination vectors

The pollution of microplastics(MPs)in the ocean has become a serious matter of concern.The farmed seaweeds(Caulerpa lentillifera and Gracilaria tenuistipitata)were selected to study their ability of adsorption with two typical classes of MPs(polyamides and polystyrene),thereby revealing the interaction between MPs and macroalgae and exploring novel methods of removing MPs from macroalgae.The results demonstrate that polyamides(PA)fibers had no effect on the various physiological parameters of both seaweeds(e.g.,relative growth rate,photosynthetic oxygen evolution rate,the contents of malondialdehyde and extracellular polymeric substances)after 7 days of exposure,except for the chlorophyll-a concentration.However,the effects of polystyrene(PS)particles on the algae were strongly associated with the concentration of MPs exposure.Exposed to the high concentration(100 mg/L)of PS particles,the relative growth rate of C.lentillifera and G.tenuistipitata decreased by 54.56% and 30.62%,respectively,compared to the control,while no significant(P>0.05)harmful effect of PS particles on seaweeds was observed in an environment with a low content of PS particles(25 mg/L).The PS particles in concentration of 100 mg/L significantly(P<0.05)inhibited photosynthetic oxygen evolution rate and extracellular polymeric substances(EPS)contents in both seaweeds,but increased malondialdehyde(MDA)contents.When exposed for 72 h,the MPs adhesion rate of G.tenuistipitata is higher than that of C.lentillifera,which might be due to the higher EPS content of G.tenuistipitata.The MPs desorption experiment indicated that the combination of dewatering and washing had the highest desorption rate of MPs which could reach to 91.45%and 87.23%for C.lentillifera and G.tenuistipitata,respectively.This research demonstrates the potential of macroalgae as a vector for MPs in aquatic environment and provides methodological insights into decontamination procedures for removing the MPs from macroalgae.

Insights into remediation technology for malachite green wastewater treatment

Malachite green (MG) dye is a common industrial dye and organic contaminant that can be found in (waste)water. Textile and food industries make use of MG as dyeing and food coloring agents, respectively. However, MG is both genotoxic and mutagenic. Hence, the elimination of MG from MG-laden-wastewater is germane. This review summarizes up-to-date researches that have been reported in literature as regards the decontamination of toxic MG wastewater. Various removal methods (adsorption, membrane, Fenton system, and heterogenous and homogeneous photodegradation) were discussed. Of the two basic technologies that are comprehensively explored and reviewed, chemical treatment methods are not as viable as physical removal methods, such as the adsorption technology, due to the lack of secondary pollutant production, simple design, low operation costs, and resource availability. This review also presents various practical knowledge gaps needed for large-scale applications of adsorptive removal methods for MG. It concludes by recommending further research on the techniques of cheap and simple decontamination of MG to get clean water.

Optimization of Technical Parameters for Detecting Mycobacteria in Hospital Wastewater in Tropical Urban Areas: The Case of the City of Abidjan (Côte d’Ivoire)

The loads of organic matter, microorganisms, detergents and antibiotics in liquid hospital effluents make them complex environments, raising numerous health and ecological questions. Investigations of mycobacteria in water lack adequate techniques. This study is the first part of a pilot project aimed at developing an optimized protocol for the isolation of mycobacteria from hospital effluents, as a prelude to more in-depth investigation in this matrix. The aim was to compare the performance of two decontamination methods, three culture media and two incubation temperatures generally proposed in the literature, in order to identify the most effective methods in each case, as well as possible areas for improvement in the isolation of these germs from this environmental matrix. The results show that liquid hospital effluent can be decontaminated using both the NaOH method (4%;for 30 min.) and the CPC method (0.05%;for 30 min.), with the same mycobacteria recovery efficiency. Despite the low concentration, decontamination with CPC killed more mycobacteria and sufficiently eliminated contaminating germs. In contrast, decontamination with NaOH was less harmful to mycobacteria, but did not remove many contaminating germs. On the other hand, LJG medium performed better than LJGF medium and LJGP medium for the growth of mycobacteria in hospital waters. Finally, there was no difference in performance between the two incubation temperatures of 30℃ and 37℃. The results of this study show that further evaluation of existing protocols is required in order to optimize methods for the pre-treatment of hospital effluent for the isolation of mycobacteria.

Design and Characterization of an Aerosol Test Chamber for Emergency Response Patient Contamination Control Simulation and Research

Contaminated or infected patients present a risk of cross-contamination for emergency responders, attending medical personnel and medical facilities as they enter a treatment facility. The controlled conditions of an aerosol test chamber are required to examine factors of contamination, decontamination, and cross-contamination. This study presents the design, construction, and a method for characterizing an aerosol test chamber for a full-sized manikin on a standard North Atlantic Treaty Organization litter. The methodology combined air velocity measurements, aerosol particle counts and size distributions, and computational fluid dynamics modeling to describe the chamber’s performance in three dimensions. This detailed characterization facilitates future experimental design by predicting chamber performance for a variety of patient-focused research.

Facile Preparation of Silver Halide Nanoparticles for Biological Application and Waste Water Treatment

Highly efficient silver halide nanoparticles (AgX, X = Cl, Br NP’s) were successfully synthesized by facile and template-free direct-precipitation method using potassium chloride, potassium bromide and silver nitrate as reactive sources. The as-prepared AgX NP’s were characterized by FTIR, thermogravimetric analysis, XRD, EDX and HRTEM. The antimicrobial susceptibilities against two Gram-positive bacteria (Bacillus cereus, Staphylococcus aureus) and four Gram-negative bacteria (Salmonella typhi, Escherichia coli, P. aeruginosa and Klebsiella pneumoniae) in addition to five fungi (Aspergillus flavus, A. carbonarus, Penicillium verrucosum, Fusarium verticelloides and A. niger) were tested by the disk diffusion technique. The antibacterial and antifungal results suggest that the prepared AgX NP’s show high activity against the tested organisms compared to tetracycline and Nystatin taken as standard drugs. As an application, the use of the prepared AgX NP’s as photo catalyst for the decontamination of malathion as VX chemical warfare agent (CWA) stimulant from water sample was extensively studied.

Facile Preparation of Silver Halide Nanoparticles for Biological Application and Waste Water Treatment

Highly efficient silver halide nanoparticles (AgX, X = Cl, Br NP’s) were successfully synthesized by facile and template-free direct-precipitation method using potassium chloride, potassium bromide and silver nitrate as reactive sources. The as-prepared AgX NP’s were characterized by FTIR, thermogravimetric analysis, XRD, EDX and HRTEM. The antimicrobial susceptibilities against two Gram-positive bacteria (Bacillus cereus, Staphylococcus aureus) and four Gram-negative bacteria (Salmonella typhi, Escherichia coli, P. aeruginosa and Klebsiella pneumoniae) in addition to five fungi (Aspergillus flavus, A. carbonarus, Penicillium verrucosum, Fusarium verticelloides and A. niger) were tested by the disk diffusion technique. The antibacterial and antifungal results suggest that the prepared AgX NP’s show high activity against the tested organisms compared to tetracycline and Nystatin taken as standard drugs. As an application, the use of the prepared AgX NP’s as photo catalyst for the decontamination of malathion as VX chemical warfare agent (CWA) stimulant from water sample was extensively studied.

Gut-liver axis in liver cirrhosis: How to manage leaky gut and endotoxemia

A "leaky gut" may be the cutting edge for the passage of toxins, antigens or bacteria into the body, and may play a pathogenic role in advanced liver cirrhosis and its complications. Plasma endotoxin levels have been admitted as a surrogate marker of bacterial translocation and close relations of endotoxemia to hyperdynamic circulation, portal hypertension, renal, cardiac, pulmonary and coagulation disturbances have been reported. Bacterial overgrowth, increased intestinal permeability, failure to inactivate endotoxin,activated innate immunity are all likely to play a role in the pathological states of bacterial translocation. Therapeutic approach by management of the gut-liver axis by antibiotics, probiotics, synbiotics, prebiotics and their combinations may improve the clinical course of cirrhotic patients. Special concern should be paid on anti-endotoxin treatment. Adequate management of the gut-liver axis may be effective for prevention of liver cirrhosis itself by inhibiting the progression of fibrosis.

Selective intestinal decontamination for the prevention of early bacterial infections after liver transplantation

Bacterial infection in the first month after liver transplantation is a frequent complication that poses a serious risk for liver transplant recipients as contributes substantially to increased length of hospitalization and hospital costs being a leading cause of death in this period. Most of these infections are caused by gramnegative bacilli, although gram-positive infections, especially Enterococcus sp. constitute an emerging infectious problem. This high rate of early postoperative infections after liver transplant has generated interest in exploring various prophylactic approaches to surmount this problem. One of these approaches is selective intestinal decontamination(SID). SID is a prophylactic strategy that consists of the administration of antimicrobials with limited anaerobicidal activity in order to reduce the burden of aerobic gram-negative bacteria and/or yeast in the intestinal tract and so prevent infections caused by these organisms. The majority of studies carried out to date have found SID to be effective in the reduction of gram-negative infection, but the effect on overall infection is limited due to a higher number of infection episodes by pathogenic enterococci and coagulase-negative staphylococci. However, difficulties in general extrapolation of the favorable results obtained in specific studies together with the potential risk of selection of multirresistant microorganisms has conditioned controversy about the routinely application of these strategies in liver transplant recipients.

Hybrid electric discharge plasma technologies for water decontamination:a short review

Electric discharge plasma(EDP)can efficiently degrade aqueous pollutants by its in situ gen erated strong oxidative species(OH,0,H2O2.O.etc)“nd other physiochemical effects(UV irradiation,shockwaves,local high temperature,etc),but a high energy consumptions limit the application of EDP in water treatment.Some adsorbents,catalysts,and oxida nts have been employed for en hanci ng the degradation of pollutants by discharge plasma.These hybrid plasma technologies offer improved water treatment performance compared to dischai'ge plasma alone.This paper reviews the water decontamination performance and mechanisms of these hybrid plasma technologies,and some suggestions on future water treatment technologies based on discharge plasma are also proposed.

Cold Plasma:A Potential Alternative for Rice Grain Postharvest Treatment Management in Malaysia

Use of pesticides,herbicides and fertilizers is among the techniques to control insect pests and fungal pathogens.However,the technique is the major contributor to severe environmental implications in terms of air,water and soil pollution.Besides,variable inconsistency becomes an important issue in the implementation of inclined bed dryers,leading to significant rice grain loss.Cold plasma technology has been widely proposed as a potential alternative for rice grain postharvest treatment management due to the presence of generated ionised gas that eventually produces reactive oxygen species or reactive nitrogen species.These species are used to decontaminate foodborne pathogens,mycotoxins and bacterial diseases.This review explores the current literature regarding cold plasma treatment technology,focusing on its efficiency as the microbial decontamination medium and insect pest mortality medium,and on the enhancement functional,nutritional and cooking properties,especially in rice grains.Previous studies have successfully demonstrated the ability of cold plasma treatment to significantly reduce the microbial count of foodborne pathogens,detoxify mycotoxins,and control seedborne rice seedling bacterial diseases.Previous studies have also proved that the implementation of cold plasma technology in postharvest management should be seriously considered for improving rice grain quantity and quality in Malaysia.

Surface Decontamination of Chemical Agent Surrogates Using an Atmospheric Pressure Air Flow Plasma Jet

An atmospheric pressure dielectric barrier discharge （DBD） plasma jet generator using air flow as the feedstock gas was applied to decontaminate the chemical agent surrogates on the surface of aluminum, stainless steel or iron plate painted with alkyd or PVC. The experi- mental results of material decontamination show that the residual chemical agent on the material is lower than the permissible value of the National Military Standard of China. In order to test the corrosion effect of the plasma jet on different material surfaces in the decontamination pro-cess, corrosion tests for the materials of polymethyl methacrylate, neoprene, polyvinyl chloride （PVC）, polyethylene （PE）, phenolic resin, iron plate painted with alkyd, stainless steel, aluminum, etc. were carried out, and relevant parameters were examined, including etiolation index, chroma- tism, loss of gloss, corrosion form, etc. The results show that the plasma jet is slightly corrosive for part of the materials, but their performances are not affected. A portable calculator, computer display, mainboard, circuit board of radiogram, and a hygrometer could work normally after being treated by the plasma jet.

Effect of different treatments on electrokinetic remediation of Zn, Pb and Cd from a contaminated calcareous soil

Electrokinetic remediation is a promising method to decontamination of the heavy metals from soils.In this paper,the remediation of a contaminated calcareous soil with Zn,Cd and Pb sampled from around Zanjan province of Iran,was investigated using electrokinetic method.In this paper,the soil contain a high concentration of Zn(1400 mg·kg^(-1)),Cd(15 mg·kg^(-1))and Pb(250 mg·kg^(-1)).Electrokinetic decontamination consists of two series of experiments as follows:(1)the effect of five treatments including the use of distilled water,acetic acid and EDTA electrolyte solutions,and approaching anodes systems,and the circulation flow of electrolyte at two different voltage gradient(i.e.1.33 and 2.66 V·cm^(-1)),and(2)the effect of moisture content(saturated,FC and 0.7 FC,FC indicated soil moisture at "Field Capacity")with a voltage gradient of 1.33 V·cm^(-1).After applying electric current for 5 days,the results of experiments indicated that the removal efficiency of heavy metals can be increased by raising the voltage gradient.In this matter,the highest remediation can be observed among different treatments in EDTA(Ethylene diamine tetra acetic acid)treatment(40.11%,43.10%and 24.7%for Zn,Cd and Pb,respectively).Moreover,the heavy metals removal at the saturated moisture was at the highest level so that 32.62%cadmium,31.33%zinc and 18.82%lead being removed after 120 h of electric current application.By decreasing moisture to 0.7 FC,the removal percentage for the three heavy metals obtained 20.97%,18.44%and 12.25%,respectively.Furthermore,Cd had the highest removal,and Zn and Pb were next among the three heavy metals in question.

Inactivation of Staphylococcus aureus by the synergistic action of charged and reactive plasma particles

In this paper,a low-pressure capacitively coupled plasma discharge sustained in an argonoxygen mixture was studied in order to evaluate its properties in terms of inactivation of Staphylococcus aureus.The plasma parameters as electron temperature and plasma density were measured by the Langmuir probe(Ne≈1015 m^-3,Te≈1.5 eV),while the neutral atom density was in the range of 1021 m^-3.In the plasma phase,oxygen radicals were taken as reference of the reactive species with antimicrobial activity,and oxygen spectral lines,over a range of plasma process parameters,were investigated by the optical emission spectroscopy.Optimal plasma conditions were found,and a count reduction of 4 log in a few minutes of the bacterium proves the potentiality of an industrial grade plasma reactor as a sterilization agent.

Protection of armoured vehicles against chemical, biological and radiological contamination

The article presents problems related to mechanical protection of vehicles with different add-on armours against chemical,biological and radiological contamination.This applies to vehicles with additional passive,reactive and hybrid protection in the form of cassettes against piercing with anti-tank projectiles,piercing with their kinetic energy of impact,and as a result of chemical energy of shaped charges as well as explosively formed projectiles.It has been shown how increased ballistic protection of these vehicles at the same time reduces their decontaminability in various places of the vehicle due to the increased additional surface of the vehicle with cassettes.Prevention of contamination of these cassettes has been presented as a way of reducing hard to reach surface for decontamination and a method of insulating construction elements(stands),fixing these cassettes to the vehicle,from the environment to prevent contact with contaminated liquids and dusts.The selection of appropriate materials is shown,which may affect the improvement of the decontamination efficiency of the vehicle with such cassettes.This applies to the use of materials with low absorption of chemical warfare agents,which prevent the accumulation of large amounts of these agents on contaminated surfaces and improve the effectiveness of decontamination.It also shows how to ensure better access of the disinfectant to as much of the vehicle surface as possible,covered with cassettes that have been contaminated.It shows how a vehicle,in particular with such cassettes,can provide protection against radar detection when Radar Absorbent Material is used on vehicle cassettes.

Medical errors, infection-control breaches and the use of adulterated and misbranded medical devices

Several well-publicized cases of improper cleaning,disinfection or sterilization of contaminated reusable medical equipment that posed an increased risk of patientto-patient disease transmission were reported within the past few years,resulting in the notification of approximately 20 000 patients.These medical errors,the specific infection-control standards they breached,and assessments of the risk of infection associated with each are discussed.Other topics discussed include the Food and Drug Administration’s(FDA)regulation of medical devices and infection-control products;the use of adulterated,misbranded,and investigational devices;consent decrees and associated Certificates of Medical Necessity;and informed patient consent.Focus is placed on liquid chemical sterilization,its history,and the FDA’s recent censure and discontinuation of a medical device labeled with this claim,namely,the STERIS System 1 processor.Recommendations are provided for healthcare facilities,regulatory agencies,manufacturers of reusable medical devices,and professional healthcare organizations and administrations to improve public health and prevent healthcareassociated infections.

Decontamination of 2-Chloroethyl Ethyl Sulfide by Pulsed Corona Plasma

Decontamination of 2-chloroethyl ethyl sulfide （2-CEES, CH_3CH_2SCH_2CH_2C1） by pulsed corona plasma was investigated. The results show that 212.6 mg/m^3 of 2-CEES, with the gas flow rate of 2 m^3/h, can be decontaminated to 0.09 mg/m^3. According to the variation of the inlet and outlet concentration of 2-CEES vapor with retention time, it is found that the reaction of 2-CEES in a pulsed corona plasma system follows the first order reaction, with the reaction rate constant of 0.463 s^-1. The decontamination mechanism is discussed based on an analysis of the dissociation energy of chemical bonds and decontamination products. The C-S bond adjacent to the C1 atom will be destroyed firstly to form CH3CH2S. and .CH2CH2C1 radicals. CH3CH2S. can be decomposed to .C_2H_5 and .S..S can be oxidized to SO_2, while .C_2H_5 can be finally oxidized to CO_2 and H_2O. The C-Cl bond in the .CH_2CH_2C1 radical can be destroyed to form .CH_2CH_2. and .C1, which can be mineralized to CO_2, H_2O and HCl. The H atom in the .CH_2CH_2C1 radical can also be substituted by -C1 to form CHCl_2-CHCl_2.

Sterilization of Turmeric by Atmospheric Pressure Dielectric Barrier Discharge Plasma

In this study atmospheric pressure dielectric barrier discharge （DBD） plasma has been employed for sterilizing dry turmeric powders. A 6 kV, 6 kHz frequency generator was used to generate plasma with Ar, Ar/Ou, He, and He/O2 gases between the 5 mm gap of two quartz covered electrodes. The complete sterilization time of samples due to plasma treatment was measured. The most important contaminant of turmeric is bacillus subtilis. The results show that the shortest sterilization time of 15 rain is achieved by exposing the samples to Ar/O2 plasma. Survival curves of samples are exponential functions of time and the addition of oxygen to plasma leads to a significant increase of the absolute value of time constant of the curves. Magnitudes of protein and DNA in treated samples were increased to a similar value for all samples. Taste, color, and solubility of samples were not changed after the plasma treatment.

Earthworms: Charles Darwin’s ‘Unheralded Soldiers of Mankind’: Protective &Productive for Man &Environment

Earthworms promises to provide cheaper solutions to several social, economic and environmental problems plaguing the human society. Earthworms can safely manage all municipal and industrial organic wastes including sewage sludge and divert them from ending up in the landfills. Their body work as a ‘biofilter’ and they can ‘purify’ and also ‘disinfect’ and ‘detoxify’ municipal and several industrial wastewater. They reduce the BOD & COD loads and the TDSS of wastewater significantly. They can even remove the EDCs (endocrine disrupting chemicals) from sewage which is not removed by the conventional sewage treatments plants. Earthworms can bio-accumulate and bio-transform many chemical contaminants including heavy metals and organic pollutants in soil and clean-up the contaminated lands for re-development. Earthworms restore & improve soil fertility by their secretions (growth hormones) and excreta (vermicast with beneficial soil microbes) & boost ‘crop productivity’. They have potential to replace the environmentally destructive chemical fertilizers from farm production. The ‘protein rich’ earthworm biomass is being used for production of ‘nutritive feed materials’ for fishery, dairy & poultry industries. They are also being used as ‘raw materials’ for rubber, lubricant and detergent industries. The bioactive compounds isolated from earthworms are finding new uses in production of ‘life saving medicines’ for cardiovascular diseases and cancer cure.