Maternal hypoxia decreases capillary supply and increases metabolic inefficiency leading to divergence in myocardial oxygen supply and demand

Maternal hypoxia is associated with a decrease in left ventricular capillary density while cardiac performance is preserved, implying a mismatch between metabolism and diffusive exchange. We hypothesised this requires a switch in substrate metabolism to maximise efficiency of ATP production from limited oxygen availability. Rat pups from pregnant females exposed to hypoxia (FIO2=0.12) at days 10-20 of pregnancy were grown to adulthood and working hearts perfused ex vivo. 14 C-labelled glucose and 3 H-palmitate were provided as substrates and metabolism quantified from recovery of 14CO2 and 3 H2O, respectively. Hearts of male offspring subjected to Maternal Hypoxia showed a 20% decrease in cardiac output (P<0.05), despite recording a 2-fold increase in glucose oxidation (P<0.01) and 2.5-fold increase (P<0.01) in palmitate oxidation. Addition of insulin to Maternal Hypoxic hearts, further increased glucose oxidation (P<0.01) and suppressed palmitate oxidation (P<0.05), suggesting preservation in insulin signalling in the heart. In vitro enzyme activity measurements showed that Maternal Hypoxia increased both total and the active component of cardiac pyruvate dehydrogenase (both P<0.01), although pyruvate dehydrogenase sensitivity to insulin was lost (NS), while citrate synthase activity declined by 30% (P<0.001) and acetyl-CoA carboxylase activity was unchanged by Maternal Hypoxia, indicating realignment of the metabolic machinery to optimise oxygen utilisation. Capillary density was quantified and oxygen diffusion characteristics examined, with calculated capillary domain area increased by 30% (P<0.001). Calculated metabolic efficiency decreased 4-fold (P<0.01) for Maternal Hypoxia hearts. Paradoxically, the decline in citrate synthase activity and increased metabolism suggest that the scope of individual mitochondria had declined, rendering the myocardium potentially more sensitive to metabolic stress. However, decreasing citrate synthase may be essential to preserve local PO2, minimising regions of hypoxia and hence maximising the area of myocardium able to preserve cardiac output following maternal hypoxia

Laying waste to mercury: inexpensive sorbents made from sulfur and recycled cooking oils

Mercury pollution threatens the environment and human health across the globe. This neurotoxic substance is encountered in artisanal gold mining, coal combustion, oil and gas refining, waste incineration, chloralkali plant operation, metallurgy, and areas of agriculture in which mercury-rich fungicides are used. Thousands of tonnes of mercury are emitted annually through these activities. With the Minamata Convention on Mercury entering force this year, increasing regulation of mercury pollution is imminent. It is therefore critical to provide inexpensive and scalable mercury sorbents. The research herein addresses this need by introducing low-cost mercury sorbents made solely from sulfur and unsaturated cooking oils. A porous version of the polymer was prepared by simply synthesising the polymer in the presence of a sodium chloride porogen. The resulting material is a rubber that captures liquid mercury metal, mercury vapour, inorganic mercury bound to organic matter, and highly toxic alkylmercury compounds. Mercury removal from air, water and soil was demonstrated. Because sulfur is a by-product of petroleum refining and spent cooking oils from the food industry are suitable starting materials, these mercury-capturing polymers can be synthesised entirely from waste and supplied on multi-kilogram scales. This study is therefore an advance in waste valorisation and environmental chemistry.Max J. H. Worthington, Renata L. Kucera, Inês S. Albuquerque, Christopher T. Gibson, Alexander Sibley, Ashley D. Slattery, Jonathan A. Campbell, Salah F. K. Alboaiji, Katherine A. Muller, Jason Young, Nick Adamson, Jason R. Gascooke, Deshetti Jampaiah, Ylias M. Sabri, Suresh K. Bhargava, Samuel J. Ippolito, David A. Lewis, Jamie S. Quinton, Amanda V. Ellis, Alexander Johs, Gonçalo J.L. Bernardes and Justin M. Chalke

Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study

Background Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications. Methods We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC). Findings In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683–0·717]). Interpretation In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required. Funding British Journal of Surgery Society

Mercury vapor sensor enhancement by nanostructured gold deposited on nickel surfaces using galvanic replacement reactions

Anthropogenic mercury emission is a serious global environmental problem because of its toxicity to humans, plants and wildlife. In order to control these emissions, accurate and reliable online continuous mercury monitoring systems (CMMs) are critical. Such systems can notify appropriate authorities or provide feedback signals to a process control system in time, thus making them an integral part of monitoring and controlling Hg emissions. We demonstrate how nanostructured gold can easily be deposited in small quantities on nickel electrode based QCMs using galvanic replacement (GR) reactions with the resultant surface having excellent Hg monitoring properties. The developed GR surfaces were observed to have higher sensitivity and selectivity in the presence of interfering gas species (NH3 and H2O), as well as to have ∼80% higher mercury sorption capacity than the most efficient mercury sorbents reported to date. Investigations towards the Hg-sensing capabilities of the resultant Ni–Au surface based Hg sensors showed ∼50% better sensitivity and detection limit over control Au films. Furthermore, the GR based QCMs were found to self-regenerate without changing the operating temperature of the sensor, undergoing Hg desorption with sensor recoveries of 93.7–99.3% following Hg exposure at an operating temperature of 90 °C. Surface depth profile analysis of the Ni–Au electrode surfaces showed that the high recovery rate of the sensors was primarily due to the Ni–Au structures, which unlike continuous Au thin-films more commonly used for Hg sensing applications, do not accumulate Hg at the sensitive-layer–substrate interface. Furthermore, the GR Ni–Au surfaces were found to be highly selective towards Hg vapor in the presence of NH3 and H2O interfering gas species which makes them potentially suitable for operating in harsh industrial effluent environments.© The Royal Society of Chemistry 201

Proof of concept for a passive sampler for monitoring of gaseous elemental mercury in artisanal gold mining

Abstract Mercury emissions from artisanal gold mining operations occurring in roughly 80 developing countries are a major workplace health hazard for millions of people as well as the largest contributor to global mercury pollution. There are no portable, cheap, and rapid methods able to inform workers or health practitioners of mercury exposure on site in remote locations. In this work, a proof of concept for a miniaturized mercury sampler, prepared by the direct reduction of gold into the porous nanostructures of Vycor glass (PVG), is introduced. Mercury retention on the PVG/Au sampler induces significant color changes, due to the formation of Au-Hg amalgam that affects the surface plasmon resonance characteristics of the material. The color change can potentially be quantified by the analysis of pictures obtained with a cell phone camera rapidly and onsite. Laboratory experiments showed the viability of using PVG/Au as passive sampler for monitoring of Hg°. PVG/Au samplers were then deployed in an artisanal and small-scale gold mining (ASGM) operations in Burkina Faso and it was able to indicate personal mercury exposures. The amount of mercury quantified in the samplers for all miners was higher than the current personal exposure limit set by the US Occupational Safety & Health Administration (OSHA)