Prevalence and Impact of Acute Pancreatitis on Hospitalization Outcomes in a Cohort of Patients With Crohn's Disease.

Background: Few studies evaluated the risk of acute pancreatitis (AP) in patients with Crohn's disease (CD). It's controversial if AP can be considered as an extraintestinal manifestation of CD. We studied this potential association in a retrospective cohort of patients with CD. Methods: We draw our cohort from the Nationwide Readmission Databases 2016 - 2018. We used the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes to identify all adult patients admitted with a diagnosis of CD. Patient with a comorbid AP were identified. We analyzed the significant impact of AP on hospitalization outcomes. A multivariate regression analysis was used to identify factors associated with AP. Results: We included 214,622 patients discharged from an index hospitalization for CD, 1.1% had AP. AP was independently associated with higher odds of inpatient mortality (odds ratio (OR): 1.831; 95% confidence interval (CI): 1.345 - 2.492, P < 0.001), gallstone disease (OR: 4.047; 95% CI: 3.343 - 4.9, P < 0.001), nonalcoholic fatty liver disease (NAFLD) (OR: 3.568; 95% CI: 3.08 - 4.133, P < 0.001), and hypercalcemia (OR: 1.964; 95% CI: 1.302 - 2.965, P = 0.001). Thirty-day readmission analysis showed that CD patients with AP were more commonly to be readmitted for AP than for any other reason. Conclusions: In our nationwide cohort of CD patients, there was a significant association between AP and worse hospitalization outcomes. Additionally, we found independent associations for having AP that may help identify patients at high risk.

Fate and removal of silver nanoparticles during sludge conditioning and their impact on soil health after simulated land application.

The growing use of silver nanoparticles (AgNPs) in personal care products and clothing has increased their concentrations in wastewater and subsequently in sludge raising concerns about their fate and toxicity during wastewater treatment and after land application of sludge. This research investigated the fate and removal of AgNPs during chemical conditioning of anaerobically digested sludge and their impact on soil bacteria and health after land application. Ferric chloride (FeCl3), alum (Al2 (SO4)3 • (14-18) H2O), and synthetic (polyacrylamide) polymer were used for sludge conditioning. All conditioners effectively removed AgNPs from the liquid phase and concentrated them in sludge solids. Concentration analyses showed that out of 53.0 mg/L of silver in the sludge, only 0.1 to 0.003 mg/L of silver remained in the sludge supernatant after conditioning and 12 to 20% of this value were particulates. Morphological analyses also showed that AgNPs went through physical, chemical, and morphological changes in sludge that were not observed in nanopure water and the resulting floc structures and the incorporation of nanoparticles were different for each conditioner. The impact of conditioned AgNPs on the biological activities of soil was evaluated by investigating its impact on the presence of five important phyla (Acidobacteria, Actinobacteria, Bacteroidetes, Firmicutes and Proteobacteria). The results showed that AgNPs at a concentration of 20 mg AgNPs/g soil had a minimal impact on the presence and diversity of the assessed phyla. Also, using different chemicals for sludge conditioning resulted in different growth behavior of studied phyla. This study provides new insight into how the presence of AgNPs and different chemicals used for sludge conditioning might impact the soil biological activities and hence plant growth. The study also provides a solid basis for further research in the risk assessment of nanoparticle toxicity in biosolids amended soils.

Transformation of Silver Nanoparticles (AgNPs) during Lime Treatment of Wastewater Sludge and Their Impact on Soil Bacteria.

This study investigated the impact of lime stabilization on the fate and transformation of AgNPs. It also evaluated the changes in the population and diversity of the five most relevant bacterial phyla in soil after applying lime-stabilized sludge containing AgNPs. The study was performed by spiking an environmentally relevant concentration of AgNPs (2 mg AgNPs/g TS) in sludge, applying lime stabilization to increase pH to above 12 for two hours, and applying lime-treated sludge to soil samples. Transmission electron microscopy (TEM) and energy-dispersive X-ray spectroscopy (EDS) were used to investigate the morphological and compositional changes of AgNPs during lime stabilization. After the application of lime stabilized sludge to the soil, soil samples were periodically analyzed for total genomic DNA and changes in bacterial phyla diversity using quantitative polymerase chain reaction (qPCR). The results showed that lime treatment effectively removed AgNPs from the aqueous phase, and AgNPs were deposited on the lime molecules. The results revealed that AgNPs did not significantly impact the presence and diversity of the assessed phyla in the soil. However, lime stabilized sludge with AgNPs affected the abundance of each phylum over time. No significant effects on the soil total organic carbon (TOC), heterotrophic plate count (HPC), and percentage of the live cells were observed.

Impact of anaerobically digested silver and copper oxide nanoparticles in biosolids on soil characteristics and bacterial community.

This study investigated whether 2 and 30 mg AgNPs or CuONPs/g TS present in treated sludge (biosolids) may impact the soil health by monitoring the soil characteristics and soil bacterial community for 105 days after the application of biosolids. AgNPs or CuONPs/g TS were first anaerobically digested with mixed primary and secondary sludge rather than adding pristine nanoparticles to biosolids directly. Both environmentally relevant (under the USEPA ceiling concentration limits) and high concentrations of AgNPs and CuONPs were tested. Soil tests included TOC, TN, TP, pH, cell viability and heterotrophic plate counts (HPC). Metagenomic data was generated by high-throughput sequencing of the 16S rRNA gene to explore bacterial populations and diversity. AgNPs and CuONPs at 2 and 30 mg NPs/g TS of sludge could impact soil health factors such as bacterial diversity, community structure, and the population of plant growth-promoting rhizobacteria (PGPR). The population of the highly abundant bacteria that have important physiological roles in soil decreased, while the less important bacteria for soil function were able to thrive. CuONPs exhibited a higher level of toxicity than the AgNPs at both phylum and genus taxonomic levels, and the HPC decreased with higher concentrations of AgNPs and CuONPs. Initially, most of the studied phyla abundance was affected, but the control and other reactors approached similar levels by the end of the experiments, which may be explained by the decrease in toxicity due to the transformation of nanoparticles and the defence mechanisms of bacteria, and indicates the need for long-term field studies.