Ni/H-ZSM-5 as a stable and promising catalyst for COx free H2 production by CH4 decomposition

Catalytic decomposition of methane for COx free hydrogen production is carried out over Ni supported on H-ZSM-5 catalysts with different Si/Al ratios (i.e. 40, 150, 300 and 485) at 550 °C and atmospheric pressure. Methane decomposition activity of Ni/H-ZSM-5 is decreased with time on stream and finally deactivated completely. The fresh and reduced catalysts are characterized by BET-SA, XRD, FT-IR, UV-DRS, TPR, pulse chemisorption of H2 and N2O and some of the used catalysts are characterised by CHNS, SEM, TEM and Raman spectroscopy. Raman spectra of the used catalysts showed both ordered and disordered carbon at 1580 cm-1 and 1320 cm-1. The 20 wt% Ni/H-ZSM-5 (Si/Al = 150) exhibited a higher H2 production rate over the other Ni loadings. The superior performance of 20 wt% Ni/H-ZSM-5 (Si/Al = 150) is rationalized by the physico-chemical properties of the various Ni loaded H-ZSM-5 catalysts

Suicide Prevention

Suicide, or intentional self-harm, is one of the leading causes of death in the United States. Suicide rates among Hoosiers have increased from 12.6 per 100,000 in 2008 to 16.3 per 100,000 in 2017, a nearly 30% increase over the 10-year period. One in ten Indiana high school students attempted and survived suicide; those who identified as gay, lesbian, or bisexual had significantly higher rates of suicide-related thoughts and behaviors compared to students who identified as heterosexual. A variety of factors contribute to a person’s likelihood to engage in suicidal thoughts and behaviors. Though anyone can be affected by suicide, there are some groups within the population that are at a particularly high risk due to the stresses they experience. The purpose of this report is to provide an overview of suicide risks, trends, and current interventions in Indiana. To accomplish this, we (1) reviewed the literature and existing data, (2) conducted key informant interviews with state experts, and (3) synthesized the information to provide recommendations for suicide prevention

Cetuximab and anemia prevention in head and neck cancer patients undergoing radiotherapy

BACKGROUND: Epidermal growth factor receptor (EGFR) activation is associated with increased production of interleukin 6 (IL6), which is intensified by radiotherapy (RT) induced inflammatory response. Elevated IL6 levels intensifies RT-induced anemia by upregulating hepcidin causing functional iron deficiency. Cetuximab, an EGFR inhibitor, has been associated with lower rates of anemia for locally advanced head and neck squamous cell carcinoma (HNSCC). We hypothesized that concomitant cetuximab could prevent RT-induced anemia. METHODS: We queried our institutional head and neck cancers database for non-metastatic HNSCC cases that received RT with concomitant cetuximab or RT-only between 2006 and 2018. Cetuximab was administered for some high-risk cases medically unfit for platinum agents per multidisciplinary team evaluation. We only included patients who had at least one complete blood count in the 4 months preceding and after RT. We compared the prevalence of anemia (defined as hemoglobin (Hb) below 12 g/dL in females and 13 g/dL in males) and mean Hb levels at baseline and after RT. Improvement of anemia/Hb (resolution of baseline anemia and/or an increase of baseline Hb ≥1 g/dL after RT), and overall survival (OS) in relation to anemia/Hb dynamics were also compared. RESULTS: A total of 171 patients were identified equally distributed between cetuximab-plus-RT and RT-only groups. The cetuximab-plus-RT group had more locally-advanced stage, oropharyngeal and high grade tumors (p \u3c 0.001 for all). Baseline anemia/Hb were similar, however anemia after RT conclusion was higher in the cetuximab-plus-RT vs RT-only (63.5% vs. 44.2%; p = 0.017), with a mean Hb of 11.98 g/dL vs. 12.9 g/dL; p = 0.003, for both respectively. This contributed to significantly worse anemia/Hb improvement for cetuximab-plus-RT (18.8% vs. 37.2%; p = 0.007). This effect was maintained after adjusting for other factors in multivariate analysis. The prevalence of iron, vitamin-B12 and folate deficiencies; and chronic kidney disease, was non-different. Baseline anemia was associated with worse OS (p = 0.0052) for the whole study cohort. Nevertheless, improvement of anemia/Hb was only marginally associated with better OS (p = 0.068). CONCLUSIONS: In contrast to previous studies, cetuximab was not associated with lower rates of anemia after RT for nonmetastatic HNSCC patients compared to RT-alone. Dedicated prospective studies are needed to elucidate the effect of cetuximab on RT-induced anemia

Factors predictive of persistent fistulas in EUS-directed transgastric ERCP: a multicenter matched case-control study

Background and Aims: EUS-directed transgastric ERCP (EDGE) is an established method for managing pancreaticobiliary pathology in Roux-en-Y gastric bypass patients, with high rates of technical success and low rates of serious adverse events (AEs). However, widespread adoption of the technique has been limited because of concerns about the development of persistent gastrogastric or jejunogastric fistulas. Gastrogastric and jejunogastric fistulas have been reported in up to 20% of cases in some series, but predictive risk factors and long-term management and outcomes are lacking. Therefore, our aims were to assess factors associated with the development of persistent fistulas and the technical success of endoscopic fistula closure. Methods: This is a case-control study involving 9 centers (8 USA, 1 Europe) from February 2015 to September 2021. Cases of persistent fistulas were defined as endoscopic or imaging evidence of fistula more than 8 weeks after lumen-apposing metal stent (LAMS) removal. Control subjects were defined as endoscopic or imaging confirmation of no fistula more than 8 weeks after LAMS removal. AEs were defined and graded according to the American Society for Gastrointestinal Endoscopy lexicon. Results: Twenty-five patients identified to have evidence of a persistent fistula on follow-up surveillance (cases) were matched with 50 patients with no evidence of a persistent fistula on follow-up surveillance (control subjects) based on age and sex. Mean LAMS dwell time was 74.7 ± 106.2 days. After LAMS removal, argon plasma coagulation (APC) ablation of the fistula was performed in 46 patients (61.3%). Primary closure of the fistula was performed in 26.7% of patients (20: endoscopic suturing in 17, endoscopic tacking in 2, and over-the-scope clips + endoscopic suturing in 1). When comparing cases with control subjects, there was no difference in baseline demographics, fistula site, LAMS size, or primary closure frequency between the 2 groups (P > .05). However, in the persistent fistula group, the mean LAMS dwell time was significantly longer (127 vs 48 days, P = .02) and more patients had ≥5% total body weight gain (33.3% vs 10.3%, P = .03). LAMS dwell time was a significant predictor of persistent fistula (odds ratio, 4.5 after >40 days in situ, P = .01). The odds of developing a persistent fistula increased by 9.5% for every 7 days the LAMS was left in situ. In patients with a persistent fistula, endoscopic closure was attempted in 19 (76%) with successful resolution in 14 (73.7%). Conclusions: Longer LAMS dwell time was found to be associated with a higher risk of persistent fistulas in EDGE patients. APC or primary closure of the fistula on LAMS removal was not found to be protective against developing a persistent fistula, which, if present, can be effectively managed through endoscopic closure in most cases. © 2023 American Society for Gastrointestinal Endoscop

Marijuana Use in Indiana: A Look at Cannabis Laws in and Around Indiana

Though under federal law marijuana is still considered an illicit drug, many states have enacted policies decriminalizing and/or legalizing marijuana to some degree. In 14 states (including Indiana), possession, use, cultivation, sale or distribution of marijuana is illegal. Indiana is bordered by states with varying marijuana policies: Kentucky (illegal), Ohio (medical use), and Michigan and Illinois (medical and recreational use). One emerging trend of concern is the use of marijuana products (THC) in e-cigarettes, especially among young people

Life Orientation Method: MGE 412

Examination on Life Orientation Method: MGE 412, June 2011