High Chloride Levels Research Articles

Hyperchloremic metabolic acidosis potentially benefiting sodium bicarbonate therapy: A multi-center cohort study

BackgroundThe use of sodium bicarbonate for metabolic acidosis has been a topic of debate, primarily due to the lack of clinical efficacy evidence. This study aims to identify which types of patients with various acid-base balance parameters can benefit from sodium bicarbonate therapy. MethodsPatients diagnosed with metabolic acidosis were screened from a large multi-center critical care database to form a retrospective cohort. Mortality curves, logistic regression analysis, simulation methods, and propensity scores were used to compare data between sodium bicarbonate (SOB group) and non-treated (Non-SOB group) patients. ResultsThere was an interaction between baseline chloride, anion gap levels and sodium bicarbonate therapy on patients' in-hospital death. As chloride levels increased, the in-hospital mortality curves of the SOB group and Non-SOB group gradually converged, with the difference narrowing from approximately 20 % to 10 %, and then gradually widened with the increase of the anion gap. Furthermore, when patients had high chloride levels (≥112 mmol/L), those in the SOB group exhibited a higher incidence of hypernatremia, hypokalemia, and hypocalcemia at 24 h, and a lower incidence of hyperchloremia. Patients in SOB group also had a lower simulated mortality. Among patients treated with sodium bicarbonate, those with low chloride had more difficulty in normalizing pH compared to those with high chloride. ConclusionsThis study identified an interaction between baseline chloride and sodium bicarbonate therapy on patient survival. Hyperchloremic metabolic acidosis may potentially benefit from sodium bicarbonate therapy. Further prospective randomized controlled studies are warranted.

Situational Analysis of Groundwater Resources in Kenyan Drylands, Case study of Turkana County

Recent climate changes have increased the incidences of severe droughts and floods, which have increased the vulnerability of pastoralists in the Kenyan drylands. Thus, there is a need to carry out a situational analysis of groundwater as it is the main source of water which provides baseline information useful for planning Analysis of results indicates that Turkana County is dominated by shallow wells and boreholes with the shallowest wells located along the seasonal rivers and Lake Turkana. The borehole depth was found to range between 20 to 200m. Most of the boreholes located near Lake Turkana were shallower compared to those far away from the lake with a depth ranging between 0 to 52m. Most of the boreholes had a low yield that ranged between 1.2 to 4.6m3/hr be attributed to the basement rocks which are prevalent in the county and are classified as poor aquifers. The water points were mainly dense in urban areas, which was mainly the central region where the water demand was high and this was attributed to the high population. The groundwater levels occurred mostly at 13m indicating that Turkana County has mostly shallow aquifers that predominantly occurred along the river valleys and at the edge of the volcanic deposits. The groundwater quality is mainly saline as most of the boreholes had high TDS, EC and chloride levels. The presence of high fluoride levels indicates the presence of high volcanic rocks that have high fluoride ions that are largely prevalent in the study region. The Sulphate, Nitrite and Nitrate Levels in all the water samples analyzed were below the EU, WHO and KEBs standards indicating the low anthropogenic activities carried out in the drylands as most farmers are pastoralists. The most prevalent cation was sodium in some of the boreholes indicating why the groundwater was saline.

Kinetics and mechanisms of non-radically and radically induced degradation of bisphenol A in a peroxymonosulfate-chloride system

Bisphenol A, a hazardous endocrine disruptor, poses significant environmental and human health threats, demanding efficient removal approaches. Traditional biological methods struggle to treat BPA wastewater with high chloride (Cl−) levels due to the toxicity of high Cl− to microorganisms. While persulfate-based advanced oxidation processes (PS-AOPs) have shown promise in removing BPA from high Cl− wastewater, their widespread application is always limited by the high energy and chemical usage costs. Here we show that peroxymonosulfate (PMS) degrades BPA in situ under high Cl− concentrations. BPA was completely removed in 30 min with 0.3 mM PMS and 60 mM Cl−. Non-radical reactive species, notably free chlorine species, including dissolved Cl2(l), HClO, and ClO− dominate the removal of BPA at temperatures ranging from 15 to 60 °C. Besides, free radicals, including •OH and Cl2•−, contribute minimally to BPA removal at 60 °C. Based on the elementary kinetic models, the production rate constant of Cl2(l) (32.5 M−1 s−1) is much higher than HClO (6.5 × 10−4 M−1 s−1), and its degradation rate with BPA (2 × 107 M−1 s−1) is also much faster than HClO (18 M−1 s−1). Furthermore, the degradation of BPA by Cl2(l) and HClO were enlarged by 10- and 18-fold at 60 °C compared to room temperature, suggesting waste heat utilization can enhance treatment performance. Overall, this research provides valuable insights into the effectiveness of direct PMS introduction for removing organic micropollutants from high Cl− wastewater. It further underscores the critical kinetics and mechanisms within the PMS/Cl⁻ system, presenting a cost-effective and environmentally sustainable alternative for wastewater treatment.

Study on improvement of impermeability of strongly weathered phyllite by microorganisms

The technology of strengthening weakness rock based on microbial mineralization has been widely concerned by researchers and engineers in recent years. The uniaxial compressive strength, permeability and microscopic physical properties of strongly weathered phyllite treated by microorganisms were investigated in this study. The microstructure study were conducted using nuclear magnetic resonance (NMR), scanning electron microscope (SEM) and X-ray diffraction (XRD). The results show that effective cementation is generated in weathered phyllite due to the microbial induced carbonate precipitation in the process of microbial modified weathering of phyllite, which can increase the strength up to 39 % of treated phyllite. The NMR results proved that the stone content can significantly affects the pore distribution of improved phyllite samples. The porosity is significantly reduced after adding microorganisms for improvement, the permeability changes from 0.019 to 0.022 md with different treatments in this study. A high stone content can promote the adhesion of microorganisms, which is conducive to the formation of calcium carbonate. Both excessively high or low levels of calcium chloride and urea can significantly affect on microbial and enzyme activities. The XRD results confirm the calcite which generated by the microbe-induced carbonate precipitation. Although the calcite content is low but with a wide distribution range, which can effectively decrease the porosity and permeability. That is to say, the wide distribution of calcite can improve the strength of weathered phyllite.

Assessment of the Spatial Distribution of Water Quality for Surface and Groundwater at Bonny Island, Nigeria

The aim of the study was to assess the spatial distribution of water quality for surface and ground water at Bonny Island in Rivers State, Nigeria. Surface and Groundwater samples were collected from 9 sampling locations and analyzed for physicochemical parameters, heavy metals, and petroleum hydrocarbons. The contaminants in the surface and groundwater were measured using a variety of methods. Heavy metals in the water were measured using gas chromatography, PAHs were measured using Atomic Absorption Spectrophotometry (ASS) while THC were measured using HACH DR/890 colorimeter. The water quality index (WQI) was calculated using the Weighted Arithmetic Index Method while Principal Component Analysis was used to understand the distribution of the physicochemical parameters, heavy metals, and petroleum hydrocarbons. The results showed that the WQI for both surface and groundwater samples ranged from 55.22 – 125.39, indicating poor to unfit water quality for consumption. In contrast, a control location away from the industrial activities had good water quality with WQI between 35.19 and 45.77. Principal component analysis revealed that the surface water in the industrial area were contaminated with lead, Poly Aromatic Hydrocarbon (PAHs), Total Petroleum Hydrocarbon which indicate oil and gas activities. High chloride, nitrate and sulphate levels were also observed in surface water close to the NLNG plant. Limiting further contamination of the surface and groundwater can be achieved by constant effluent and plume stack monitoring by regulatory agencies. Industrial stakeholder should set up subsidized clinics to provide treatment for any gastrointestinal illnesses or renal damage suffered by residents.

Water resources and physicochemical properties of the Mio-Pliocene aquifer complex in the M’leta Plain, Western Algeria

The aquifers in the M’léta Plain are crucial for supplying drinking water and supporting industrial and agricultural water needs. However, they are facing a pollution risk and environmental degradation. The present study aims to assess the groundwater quality in the M’léta Plain, focusing on its physicochemical properties, statistics of the aquifer, pollution risks, and factors influencing the water mineralisation process. The analysis of 16 samples reveals that the water contains high levels of sulphates and chlorides, often accompanied by sodium, calcium, or magnesium. This suggests two distinct water types or facies: one characterised by sodium chloride or calcium chloride, and the other with calcic or sodic sulphate waters, sometimes including magnesium sulphate. These facies may be attributed to the influence of different formations at the outcrop. Statistical analyses reveal a strong correlation between electrical conductivity and the majority of chemical elements, indicating the impact of freshwater interacting with the underlying rock formations on mineralisation. Some results also show undersaturation of certain minerals. Furthermore, the study evaluates the water's suitability for irrigation in the M’léta Plain in accordance with Richards’ classification.

Measurement report: Hygroscopicity of size-selected aerosol particles in the heavily polluted urban atmosphere of Delhi: impacts of chloride aerosol

Abstract. Recent research has revealed the crucial role of wintertime, episodic high chloride (H-Cl) emissions in the Delhi region, which significantly impact aerosol hygroscopicity and aerosol-bound liquid water, thus contributing to the initiation of Delhi fog episodes. However, these findings have primarily relied on modeled aerosol hygroscopicity, necessitating validation through direct hygroscopicity measurements. This study presents the measurements of non-refractory bulk aerosol composition of PM1 from an Aerodyne aerosol chemical speciation monitor and for first-time size-resolved hygroscopic growth factors (nucleation, Aitken, and accumulated mode particles) along with their associated hygroscopicity parameters at 90 % relative humidity using a hygroscopic tandem differential mobility analyzer at the Delhi Aerosol Supersite. Our observations demonstrate that the hygroscopicity parameter for aerosol particles varies from 0.00 to 0.11 (with an average of 0.03 ± 0.02) for 20 nm particles, 0.05 to 0.22 (0.11 ± 0.03) for 50 nm particles, 0.05 to 0.30 (0.14 ± 0.04) for 100 nm particles, 0.05 to 0.41 (0.18 ± 0.06) for 150 nm particles, and 0.05 to 0.56 (0.22 ± 0.07) for 200 nm particles. Surprisingly, our findings demonstrate that the period with H-Cl emissions displays notably greater hygroscopicity (0.35 ± 0.06) in comparison to spans marked by high biomass burning (0.18 ± 0.04) and high hydrocarbon-like organic aerosol (0.17 ± 0.05) and relatively cleaner periods (0.27 ± 0.07). This research presents initial observational proof that ammonium chloride is the main factor behind aerosol hygroscopic growth and aerosol-bound liquid water content in Delhi. The finding emphasizes ammonium chloride's role in aerosol–water interaction and related haze/fog development. Moreover, the high chloride levels in aerosols seem to prevent the adverse impact of high organic aerosol concentrations on cloud condensation nuclei activity.

Meconium Peritonitis in the Newborn with Cystic Fibrosis and Negative Neonatal Screening for Immunoreactive Trypsinogen: Clinical Case

Background. Meconium ileus is one of the manifestations of cystic fibrosis. It is characterized by intestinal obstruction with viscous meconium leading to perforation and peritonitis. The issues of early diagnosis of cystic fibrosis, management of newborns with meconium ileus and negative neonatal screening for immunoreactive trypsinogen (IRT), as well as IRT decrease causes and mechanisms in patients with meconium ileus require further study. Clinical case description. Routine ultrasound examination at the 33rd week of gestation has shown signs of colon obstruction and meconium peritonitis in the intrauterine child. Surgical treatment of peritonitis was performed urgently on the 1st day after birth. The child was on mechanical ventilation from the 1st day of life. The child has shown signs of intrahepatic cholestasis with direct hyperbilirubinemia (up to 100 μmol/L) and signs of hemorrhagic syndrome (bleeding from injection sites) on the 8th day of life. Negative IRT blood test was received (21.6 ng/mL, normal value < 70 ng/mL) on the 10th day. The fecal elastase concentration was 45 μg/g (normal value > 200 μg/g) (on the same day). Sweat tests were performed on the 21st and 23rd days of life. They have shown high levels of sweat chlorides (112 mmol/L in both samples, normal value — 30–59 mmol/L). The diagnosis of «cystic fibrosis» was established, thus, dornase alfa (dosage — 2.5 mg/day) was added to the therapy. Conclusion. Meconium ileus is one of the specific intestinal manifestations of cystic fibrosis and it commonly can be complicated with intestinal perforation in the intrauterine child with further peritonitis. Children with meconium ileus require sweat tests regardless the neonatal screening results.

Microbial Quality and Mineral Content of Water Consumed in Ho Municipality of Volta Region, Ghana

Background: Water quality and safety are fundamental to human development and well-being. Therefore, the purpose of this study was to determine the bacteriological and mineral content of water in Ho, the capital city of the Volta Region of Ghana.
 Methods: Sachet, bottled, and tap water were sampled from January to February in 2019 due to the high rate of consumption and their presumed quality which were taken at random from five different locations throughout the municipality. Water quality assessment protocols were utilized to ascertain the bacteriological as well as mineral contents of the samples, whilst ANOVA was used to determine statistical difference and significance at p<0.05.
 Results: The maximum Heterotrophic Plate Count for tap water was 9.95±0.64×105 Colony Forming Unit (CFU)/ml, for sachet water was 7.46±0.09×106 CFU/ml, and for bottled water was 1.10±0.56×105 CFU/ml, all obtained on nutrient agar. For MacConkey agar, maximum growth was 2.94±0.03×106, 9.42±1.67×106, and 2.31±0.77×105 CFU/ml for tap, sachet, and bottled water, respectively. The Xylose Lysine Deoxycholate Agar indicated maximum growth of 1.84±0.34×103, 5.72±0.06×106, and 5.50±2.12×104 CFU/ml for tap, sachet, and bottled water, respectively.
 The physical parameters such as pH, turbidity, color, and conductivity were within the recommended limits set by the Ghana Standards Authority. However, tap water recorded the highest turbidity, bottled water recorded the highest and least pH and turbidity, respectively. Moreover, the mineral analysis revealed high levels of phosphate (PO₄³⁻), chloride (Cl-), and sodium (Na) in bottled water, and total iron (Fe) was relatively high in several tap and sachet water samples, the latter item also recorded the highest for ammonia (NH3).
 Conclusions: Overall, the tap, sachet, and bottled water samples exhibited varied levels of microbial, and mineral contents whilst the physical parameters were relatively within the recommended levels. The sachet and tap

Appraisement of groundwater quality status within Enugu, Nigeria, using physicochemical evaluation and water quality indices

Enugu state is notorious for potable water scarcity which forces residents to depend on polluted water sources. In this study, an appraisement of the quality status of groundwater from some areas within Enugu was conducted. Physicochemical characteristics of groundwater sampled from 15 boreholes that supply domestic water to Aninri, Awgu, Ezeagu, Udi and Oji River Areas of Enugu, Nigeria, were determined. A total of 45 water samples were obtained across both rainy and dry seasons. Standard methods were used to determine the physicochemical parameters and trace metals. The physicochemical results showed values within the WHO safe limits, except sulphate (1670 ± 21.5 mg L−1) in Mpu water samples, and high chloride levels in Ndeaboh and Mpu (18088 ± 29.4 and 1095 ± 23.9 mg L−1 for dry and rainy seasons, respectively). The pH values were predominantly slightly acidic, ranging from 5 to 8.2. Groundwater within Ukaete, Ndeaboh, Oduma and Amankpunato had very high levels of electrical conductivity (2897.80 ± 173.38, 31000 ± 45.9, 1672 ± 9.3 and 1222 ± 8.1) in the dry season, respectively; and 1665.06 ± 326.6, 5410 ± 2.4, 4860 ± 9.4, 1872 ± 19.3 in the rainy season, respectively. The higher chloride values observed, possibly due to a geogenic origin, could also be responsible for the higher values of the electrical conductivity. There were traces of copper and lead in the samples during the dry season; however, lead was not detected in most borehole water samples during the wet season. Fe was the only metal that recorded values above the WHO standard. Traces of copper in the samples may have resulted from corrosion in the copper pipelines, reservoirs or other metallic fittings used in the construction of the boreholes. The water quality index (WQI) of the borehole water examined was above 100 in all except Ogugu Awgu samples, indicating that borehole water was generally not potable and therefore unsuitable for domestic application or drinking. The observed results revealed that the groundwaters from the study area were contaminated with chloride and lead, causing the water parameters to be above standard limits. Lead at any concentration is deemed toxic according to USEPA. There is a need to treat borehole water supplies in the area before its application for domestic use.

Chloride as a Prognostic Factor in Children with Diabetic Ketoacidosis: A Retrospective Cohort Study

Introduction: In the management of Diabetic Ketoacidosis (DKA), importance is given to electrolytes such as sodium and potassium, but not chloride. There is evidence that high chloride levels can lead to Acute Kidney Injury (AKI). However, chloride as a prognostic factor has not been thoroughly investigated. Aim: To evaluate the role of chloride as a prognostic factor in the treatment of children with DKA. Materials and Methods: This retrospective cohort study collected data from 22 children with severe DKA, aged under 14 years, admitted to the Department of Paediatrics, SRM Medical College Hospital and Research Centre, Chennai, Tamil Nadu, India, between January 2016 and October 2020. Data included demographic details, blood glucose, arterial blood gas, renal function tests, serum electrolytes at admission and at 24 hours, and outcome parameters. All children received regular monitoring and standard treatment as per the International Society for Paediatric and Adolescent Diabetes (ISPAD) guidelines. The children were divided into two groups: Recovery within 48 hours (Group-A) and more than 48 hours (Group-B). Electrolyte and renal parameters after 24 hours of treatment were compared. Univariate analysis was performed using Statistical Package for Social Sciences (SPSS) version 21.0. Student's t-test, Chisquare test, and odds ratio were used for statistical analysis. A p-value of <0.05 was considered significant. Results: Among the 22 children, 50% recovered within 48 hours, while the remaining half took more than 48 hours. A total of 13 had hyperchloraemia at 24 hours (59%). The mean serum chloride at 24 hours was 115.91 mmol/L in Group-B compared to 106.09 mmol/L in Group-A (p=0.0079*). Two developed AKI, requiring renal replacement therapy and ventilatory support, and eventually died. Conclusion: In the present study, children with severe DKA who developed hyperchloraemia after 24 hours of admission, following fluid resuscitation with 0.9% normal saline and subsequent standard treatment, took a longer time to recover

Effect of hyperchloremia on mortality of pediatric trauma patients: a retrospective cohort study.

Hyperchloremia is often encountered due to the frequent administration of intravenous fluids in critically ill patients with conditions such as shock or hypotension in the pediatric intensive care unit, and high serum levels of chloride are associated with poor clinical outcomes. This study aimed to determine the association between hyperchloremia and in-hospital mortality in pediatric patients with major trauma. This retrospective cohort study was conducted at a tertiary university hospital in Turkey. Data were collected between March 2020 and April 2022. Patients aged 1 month to 18 years with major trauma who received intravenous fluids with a concentration > 0.9% sodium chloride were enrolled. Hyperchloremia was defined as a serum chloride level > 110 mmol/L. Clinical and laboratory data were compared between the survivors and nonsurvivors. The mortality rate was 23% (n = 20). The incidence of hyperchloremia was significantly higher in nonsurvivors than in survivors (P = 0.05). In multivariate logistic analysis, hyperchloremia at 48 h was found to be an independent risk factor for mortality in pediatric patients with major trauma. In pediatric patients with major trauma, hyperchloremia at 48-h postadmission was associated with 28-day mortality. This parameter might be a beneficial prognostic indicator.

Clinical efficacy of sodium bicarbonate in treating pediatric metabolic acidosis with varying level of acid–base balance parameters: a real-world study

BackgroundSodium bicarbonate (SB) infusion is commonly used to correct metabolic acidosis, but its clinical efficacy remains controversial. This study aims to investigate whether acid–base balance parameters should be a consideration for administering SB treatment.MethodsChildren with metabolic acidosis (pH < 7.35 and bicarbonate < 22 mmol/L) who were treated with or without 50 mg/ml SB injection were grouped and extracted from a retrospective cohort database of the Pediatric Intensive Care Unit. The interaction between acid–base balance parameters and SB treatment on mortality was analyzed through mortality curves and cross-effect models. Logistic regression was conducted to estimate the risk of death following SB treatment in the overall children as well as in subgroups, and potential confounding factors were adjusted for. After employing propensity score matching to account for confounding factors, further analysis was performed to evaluate the effectiveness of SB treatment within each chloride subgroup.ResultsA total of 5865 children with metabolic acidosis were enrolled, of which 2462 (42.0%) received SB treatment. In the overall population, it was found that SB treatment did not reduce hospital mortality or 28-day mortality. Interactions between acid–base balance parameters (chloride and anion gap) and SB treatment on mortality were observed. Subgroup analysis clarified that when chloride levels were below 107 mmol/L, children treated with SB had higher in-hospital mortality (29.8% vs 14.9%) and 28-day mortality (26.5% vs 13.4%), with adjusted ORs of 2.065 (95% CI, 1.435–2.97) and 1.947 (95% CI, 1.332–2.846), respectively. In contrast, when chloride levels were greater than or equal to 113 mmol/L, children treated with SB had a shorter stay in the PICU (median: 1.1 days vs 5.1 days, adjusted p = 0.004) and lower in-hospital mortality (4.3% vs 10.3%) and 28-day mortality (4.0% vs 8.4%), with adjusted ORs of 0.515 (95% CI, 0.337–0.788) and 0.614 (95% CI, 0.391–0.965), respectively. After controlling for confounding factors through matching, the impact of SB treatment on the risk of death in each chloride subgroup was consistent with the aforementioned results. However, treatment with SB did not significantly increase the risk of death in newborns or children with moderate to severe metabolic acidosis when chloride levels were below 107 mmol/L (p > 0.05).ConclusionsThe use of sodium bicarbonate for treating metabolic acidosis has been found to increase mortality in children with low chloride levels but decrease mortality in those with high chloride levels in this study. Further prospective multi-center clinical studies and basic research are needed to validate these findings.

Chloride-induced corrosion patterns of reinforcements in simulated pore solutions of calcium sulfoaluminate cement concrete: An analytical study

The widespread use of calcium sulfoaluminate cement (CSA) for rapidly repairing marine structures exposed to high chloride levels has spurred limited investigation into the corrosion behavior of reinforcements in low-pH CSA systems. To address this knowledge gap, researchers conducted a comprehensive study on the impact of primary ions within CSA (OH−, SO42−, and Al(OH)4-) on steel rebars in simulated pore solutions (SPSs). The investigation employed various analytical methods such as Mott-Schottky/cyclic polarization curves, corrosion current, impedance spectrum analyses, and microstructural examinations. The results demonstrate that SO42− diminishes the corrosion resistance of reinforcements by depassivating them, consequently reducing the critical chloride concentration (Ccrit). However, this influence is mitigated with elevated OH− or Al(OH)4− concentrations. Furthermore, the presence of Al(OH)4- in the pore solution contributes to an increased Ccrit by stabilizing alkalinity via OH− hydrolysis. Based on the empirical findings, the researchers developed an empirical formula for Ccrit, offering insights into estimating the service life of CSA-based concrete structures in real marine environments.

Process optimization and mechanism for removal of high-concentration chlorine from municipal solid waste incineration fly ash washing wastewater by Friedel's salt

Waterwashing is an important pretreatment method for the reuse of municipal solid waste incineration (MSWI) fly ash. However, the presence of high levels of chlorides and small amounts of sulfides in the waterwashing solution makes it difficult to treat and reuse. Therefore, in this study, a calcium sulfate- Friedel's salt precipitation method was used to dechlorinate and desulfurize in the MSWI fly ash washing solution. This paper mainly focused on the chloride removal, and the effects of factors such as reagent ratios, temperature, and reaction time on chloride removal rate and the two-stage dechlorination and desulfurization process were optimized. The experimental results indicated that when the ratio in the first stage was n(Ca):n(Al):n(Cl) = 3:1.5:1, and in the second stage, n(Ca):n(Al):n(Cl) = 8:4:1, a chloride removal rate of up to 90.5% and a sulfide removal rate of over 99.88% could be obtained. The deposited particles were analyzed by using FE-SEM, XRD, and FTIR to investigate their size, morphology, phase composition, and functional groups. The study revealed that excessively high or low reagent ratios could reduce the interlayer spacing of Friedel's salt. Additionally, high temperatures led to the decomposition of Friedel's salt, and the dechlorination efficiency was affected.

Salivary elemental signature of dental caries: a systematic review and meta-analysis of ionomics studies.

Trace- and macro-chemical elements are crucial for cellular physiological functioning, and their alterations in biological fluids might be associated with an underlying pathological state. Hence, this study aimed to examine and summarize the published literature concerning the application of salivary ionomics for caries diagnosis. An extensive search of studies was conducted using PubMed, EMBASE, Web of Science, and Scopus, without any language and year restriction for answering the following PECO question: "In subjects (i.e., children, adolescents, or adults) with good systematic health, are there any variations in the salivary concentrations of trace- or macro-elements between caries-free (CF) individuals and caries-active (CA) subjects?" A modified version of the QUADOMICS tool was used to assess the quality of the included studies. The Review Manager Version 5.4.1. was used for data analyses. The analysis of salivary chemical elements that significantly differed between CF and CA subjects was also performed. Thirty-four studies were included, involving 2299 CA and 1669 CF subjects, having an age range from 3 to 64years in over 16 countries. The meta-analysis revealed a statistically significant difference (p < 0.05) in the salivary levels of calcium, phosphorus, chloride, magnesium, potassium, sodium, and zinc between CA and CF subjects, suggesting higher levels of calcium, phosphorus, potassium, and sodium in CF subjects while higher levels of chloride, magnesium, and zinc in CA patients. Half of the included studies (17/34) were considered high quality, while the remaining half were considered medium quality. Only zinc and chloride ions were found to be higher significantly and consistent in CF and CA subjects, respectively. Conflicting outcomes were observed for all other salivary chemical elements including aluminum, bromine, calcium, copper, fluoride, iron, potassium, magnesium, manganese, sodium, ammonia, nitrite, nitrate, phosphorus, lead, selenium, and sulfate ions.

Use of monosodium glutamate as alternative to reduce sodium in cooking affects the physicochemical, phytochemical, and sensory attributes of pigmented and non-pigmented rice

The increased consumption of processed foods makes diets more susceptible to high levels of sodium chloride (NaCl) and foods of low nutritional value. With this, the objective was to evaluate the influence of different contents of sodium chloride (NaCl) and monosodium glutamate (MSG) during the cooking of brown, black, and red rice, in order to reduce the concentration of NaCl in the rice preparation, since it toward public health concern. Replacing NaCl with 100% MSG in the preparation of pigmented and non-pigmented cooked rice resulted in reduced cooking time (up to 25.44%), rice hardness (up to 24.32%) and improved free phenolics. In addition, black rice showed an 8.60% increase in anthocyanins, while in red rice 55% of proanthocyanidins remained after cooking with 100% MSG. On the other hand, an increase in the content of leached compounds during cooking was mainly represented by amylose, proteins and proanthocyanidins. Regarding sensory attributes, MSG improved the appearance and texture, increasing the acceptability of cooked brown, black and red rice.

Replacing Mineral Fertilizer with Nitrified Human Urine in Hydroponic Lettuce (Lactuca sativa L.) Production

Source-separated, nitrified, and decontaminated human urine constitutes a promising plant fertilizer that contains a large share of the nitrogen and phosphorus in household wastewater, and other plant nutrients. However, human urine contains high levels of sodium and chloride that can affect salt-sensitive greenhouse crops. Replacing mineral fertilizer with nitrified urine fertilizer could reduce the environmental impact of lettuce production in hydroponic systems, if marketable yield, appearance, and produce quality are not affected. In the present study, a treatment combination of a nitrified urine fertilizer and mineral fertilizers was used to grow lettuce through the nutrient film technique. This was compared to a conventionally fertilized control treatment. No significant differences were observed regarding yield, phenotype, and contents of nitrate, heavy metals, phenolic acids, and chlorophyll in leaf tissue. Calcium content was significantly reduced and sodium was elevated in nitrified urine treatment. For the elements nitrogen, phosphorous, and potassium, a saving of 48%, 13%, and 15% was calculated, respectively. The calculated carbon footprint from the total fertilizer production was reduced by 34.25%, caused by the nitrified urine treatment. Based on these results, a nutrient solution composed of nitrified urine fertilizer combined with mineral fertilizer may be a promising alternative for growers to produce lettuce with a reduced environmental impact without loss of plant quantity and quality.

Using red blood cell distribution width to predict death after abdominal aortic aneurysm rupture

BackgroundAn abdominal aortic aneurysm is a life-threatening enlargement in the major vessel at the abdomen level. This study investigated the associations between different levels of red blood cell distribution width and all-cause mortality among patients with abdominal aortic aneurysm rupture. It developed predictive models for all-cause mortality risk.MethodsThis was a retrospective cohort study using 2001 to 2012 MIMIC-III dataset. The study sample included 392 U.S. adults with abdominal aortic aneurysms who were admitted to ICU after the aneurysm rupture. Then we used two single-factor and four multivariable logistic regression models to examine the associations between different levels of red blood cell distribution and all-cause mortality (30 days and 90 days), controlling for demographics, comorbidities, vital signs, and other laboratory measurements. The receiver operator characteristic curves were calculated, and the areas under the curves were recorded.ResultsThere were 140 (35.7%) patients with an abdominal aortic aneurysm in the red blood cell distribution width range between 11.7 and 13.8%, 117 (29.8%) patients in the range between 13.9 and 14.9%, and 135 (34.5%) patients in the range between 15.0 and 21.6%. Patients with higher red blood cell distribution width level (> 13.8%) tended to have a higher mortality rate (both 30 days and 90 days), congestive heart failure, renal failure, coagulation disorders, lower hemoglobin, hematocrit, MCV, red blood cell count, higher levels of chloride, creatinine, sodium, and BUN (All P < 0.05). Results of multivariate logistic regression models indicated that patients with higher red blood cell distribution width levels (> 13.8%) had the highest statistically significant odd ratios of 30 days and 90 days of all-cause mortality than lower red blood cell distribution width levels. The area under the RDW curve was lower (P = 0.0009) than that of SAPSII scores.ConclusionsOur study found that patients with abdominal aortic aneurysm rupture with a higher blood cell distribution had the highest risk of all-cause mortality. Using the blood cell distribution width level in patients with abdominal aortic aneurysm rupture to predict mortality should be considered in future clinical practice.

Community-based serum chloride abnormalities predict mortality risk.

This population-based study aimed to investigate the prognostic value of ambulatory serum chloride abnormalities, often ignored by physicians. The study population included all non-hospitalized adult patients, insured by "Clalit" Health Services in Israel's southern district, who underwent at least 3 serum chloride tests in community-based clinics during 2005-2016. For each patient, each period with low (≤97 mmol/l), high (≥107 mmol/l) or normal chloride levels were recorded. A Cox proportional hazards model was used to estimate the mortality risk of hypochloremia and hyperchloremia periods. 664,253 serum chloride tests from 105,655 subjects were analyzed. During a median follow up of 10.8 years, 11,694 patients died. Hypochloremia (≤ 97 mmol/l) was independently associated with elevated all-cause mortality risk after adjusting for age, co-morbidities, hyponatremia and eGFR (HR 2.41, 95%CI 2.16-2.69, p<0.001). Crude hyperchloremia (≥107 mmol/L) was not associated with all-cause mortality (HR 1.03, 95%CI 0.98-1.09 p = 0.231); as opposed to hyperchloremia ≥108 mmol/l (HR 1.14, 95%CI 1.06-1.21 p<0.001). Secondary analysis revealed a dose-dependent elevated mortality risk for chloride levels of 105 mmol/l and below, well within the "normal" range. In the outpatient setting, hypochloremia is independently associated with an increased mortality risk. This risk is dose-dependent where the lower the chloride level, the higher is the risk.