The use of faecal microbiota transplant as treatment for recurrent or refractory Clostridioides difficile infection and other potential indications: second edition of joint British Society of Gastroenterology (BSG) and Healthcare Infection Society (HIS) guidelines.

The first British Society of Gastroenterology (BSG) and Healthcare Infection Society (HIS)-endorsed faecal microbiota transplant (FMT) guidelines were published in 2018. Over the past 5 years, there has been considerable growth in the evidence base (including publication of outcomes from large national FMT registries), necessitating an updated critical review of the literature and a second edition of the BSG/HIS FMT guidelines. These have been produced in accordance with National Institute for Health and Care Excellence-accredited methodology, thus have particular relevance for UK-based clinicians, but are intended to be of pertinence internationally. This second edition of the guidelines have been divided into recommendations, good practice points and recommendations against certain practices. With respect to FMT for Clostridioides difficile infection (CDI), key focus areas centred around timing of administration, increasing clinical experience of encapsulated FMT preparations and optimising donor screening. The latter topic is of particular relevance given the COVID-19 pandemic, and cases of patient morbidity and mortality resulting from FMT-related pathogen transmission. The guidelines also considered emergent literature on the use of FMT in non-CDI settings (including both gastrointestinal and non-gastrointestinal indications), reviewing relevant randomised controlled trials. Recommendations are provided regarding special areas (including compassionate FMT use), and considerations regarding the evolving landscape of FMT and microbiome therapeutics.

Experimental and computational approach on the development of a new Green corrosion inhibitor formulation for N80 steel in 20% formic acid.

Organic acids are employed as scale dissolvers in the oil & gas industry during production to stimulate oil recovery by pumping in the formations. Corrosion of metallic surfaces in organic acid solutions poses a significant issue in the oil and gas sector. In recent years, considering the stringent environmental regulations, there has been a growing research interest in environmentally safe inhibitors. This paper explores the synthesis of 2-(3-(carboxymethyl)-1H-imidazol-3-ium-1-yl) acetate (IZ) and its first-time application for corrosion mitigation of N80 steel in 20% formic acid. A detailed experimental study involving gravimetric, electrochemical, and surface analytical techniques is reported herein. The electrochemical impedance spectroscopy (EIS) and potentiodynamic polarization (PDP) analyses suggest a rise of impedance with IZ and a mixed-type inhibition behavior, respectively. The inhibition efficiency (IE) is 99.54% at 200 mg/L at 308 K, reaching 99.4% at 363 K with the introduction of KI as a synergistic agent. Computational studies revealed that the inhibitor IZ gets protonated in the experimental environment. The protonated form shows a tendency to receive electrons from the metal surface and shows a greater energy of adsorption compared to that of the neutral form.

Metal/metal oxide-carbohydrate polymers framework for industrial and biological applications: Current advancements and future directions.

Recently, the development and consumption of metal/metal oxide carbohydrate polymer nanocomposites (M/MOCPNs) are withdrawing significant attention because of their numerous salient features. Metal/metal oxide carbohydrate polymer nanocomposites are being used as environmentally friendly alternatives for traditional metal/metal oxide carbohydrate polymer nanocomposites exhibit variable properties that make them excellent prospects for a variety of biological and industrial uses. In metal/metal oxide carbohydrate polymer nanocomposites, carbohydrate polymers bind with metallic atoms and ions using coordination bonding in which heteroatoms of polar functional groups behave as adsorption centers. Metal/metal oxide carbohydrate polymer nanocomposites are widely used in woundhealing, additional biological uses and drug delivery, heavy ions removal or metal decontamination, and dye removal. The present review article features the collection of some major biological and industrial applications of metal/metal oxide carbohydrate polymer nanocomposites. The binding affinity of carbohydrate polymers with metal atoms and ions in metal/metal oxide carbohydrate polymer nanocomposites has also been described.

Greenly synthesized zeolites as sustainable materials for corrosion protection: Design, technology and application.

The progress and use of effective and economic anticorrosive resources are in high mandate due to huge safety and economic concerns about corrosion. Significant advancements have already been achieved that help in minimizing corrosion costs up to US $375 to US $875 billion annually. The use of zeolites in anticorrosive and self-healing coatings is well-studied and documented in many reports. The self-healing property of zeolite-based coatings is attributed to their ability to provide anticorrosive protection in the defected areas through forming protective oxide films i.e. passivation. The synthesis of zeolites from the traditional hydrothermal method is associated with several drawbacks including their high cost and discharge of harmful gases such as oxides of nitrogen (NOx) and greenhouse gases (CO2 and CO). In view of this, some green approaches such as solvent-free, organotemplate-free, use of safer organic templates, green solvents (e.g. ILs) and energy efficient (MW and US) heating, one-step reactions (OSRs) etc. are adopted in the green synthesis of zeolites. Recently, the self-healing properties of greenly synthesized zeolites are documented along with their mechanism of corrosion inhibition.

Heteropolysaccharides in sustainable corrosion inhibition: 4E (Energy, Economy, Ecology, and Effectivity) dimensions.

Carbohydrate polymers (polysaccharides) and their derivatives are widely utilized in sustainable corrosion inhibition (SCI) because of their various fascinating properties including multiple adsorption sites, high solubility and high efficiency. Contrary to traditional synthetic polymer-based corrosion inhibitors, polysaccharides are related to the 4E dimension, which stands for Energy, Economy, Ecology, and Effectivity. Furthermore, they are relatively more environmentally benign, biodegradable, and non-bioaccumulative. The current review describes the SCI features of various heteropolysaccharides, including gum Arabic (GA), glycosaminoglycans (chondroitin-4-sulfate (CS), hyaluronic acid (HA), heparin, etc.), pectin, alginates, and agar for the first time. They demonstrate impressive anticorrosive activity for different metals and alloys in a variety of corrosive electrolytes. Through their adsorption at the metal/electrolyte interface, heteropolysaccharides function by producing a corrosion-protective film. In general, their adsorption follows the Langmuir isotherm model. In their molecular structures, heteropolysaccharides contain several polar functional groups like -OH, -NH2, -COCH3, -CH2OH, cyclic and bridging O, -CH2SO3H, -SO3OH, -COOH, -NHCOCH3, -OHOR, etc. that serve as adsorption centers when they bind to metallic surfaces.

Colloidal and interface aqueous chemistry of dyes: Past, present and future scenarios in corrosion mitigation.

The most effective corrosion inhibitors are organic compounds, especially heterocyclic ones with a certain balance of hydrophilicity, hydrophobicity, and conjugation. Most dyes develop the critical characteristics of a substance that can be utilized as an effective corrosion inhibitor. These include the presence of polar functional groups, nonbonding electrons and multiple bonds of the aromatic ring(s) and side chains. In aqueous electrolytes, dyes efficiently bind to metal surfaces through their electron-rich spots, known as adsorption centers. Literature studies show that many dye series have excellent anticorrosive properties for many metal/electrolyte combinations. They contain many electron-donating sites and behave as polydentate and chelating ligands. The polar functional for instance -OH, -CONH2, -NH2, -OR, -SO3H, -COOH, -NMe2, -N=N-, -CHO, -N=C < etc. also help in solubilizing relatively complex dye molecules in aqueous electrolytes. This review work seeks to explain the interfacial adsorption of dye molecules and how that negatively affects metallic corrosion. Through their adsorption, dye molecules block the active sites. They mainly achieved this by employing the Langmuir isotherm model. Additionally, the mechanism of corrosion inhibition is investigated, with a special emphasis on dyes.

Green surfactants for corrosion control: Design, performance and applications.

Surfactants enjoy an augmented share of hydrophilicity and hydrophobicity and are well-known for their anticorrosive potential. The use of non-toxic surfactants is gaining growing interest because of the scaling demands of green chemistry. Green surfactants have successfully replaced traditional toxic surfactant-based corrosion inhibitors. Recently, many reports described the corrosion inhibition potential of green surfactants. The present article aims to describe the recent advancements in using green surfactants in corrosion mitigation. They create a charge transfer barrier through their adsorption at the interface of the metal and the environment. Their adsorption is well explained by the Langmuir adsorption isotherm. In the adsorbed layer, their hydrophilic polar heads orient toward the metal side and their hydrophobic tails orient toward the solution side. They block the active sites and retard the anodic and cathodic and act as mixed-type inhibitors. Their adsorption and bonding nature are fruitfully supported by surface analyses. They can form mono- or multilayers depending upon the nature of the metal, electrolyte and experimental conditions. The challenges and opportunities of using green surfactants as corrosion inhibitors have also been described.

Hydrophilicity and hydrophobicity consideration of organic surfactant compounds: Effect of alkyl chain length on corrosion protection.

Organic compounds have been recognized as one of the utmost operative corrosion protective measures. However, their usage and synthesis are allied with the consumption and release of malignant materials. More so, out of various manufactured and settled compounds, only a few are effective. Therefore, the high mandate is to design and formulate effective compounds based on literature outcomes. Literature outcomes suggest that surfactant molecules having alkyl substituent of neither too small nor too large act as effective aqueous phase corrosion inhibitors. The present review describes the effect of alkyl/hydrocarbon chain length on the corrosion inhibition potential of some series of surfactant molecules. Generally, an increase in the alkyl chain length favors inhibition performance due to enhancing the packing of surfactant molecules at the interface of metal and electrolyte, but a very high level of hydrophobicity disfavors the inhibition performance. Hydrophilicity and hydrophobicity can be suitably tailored by varying the number and size of the hydrocarbon chain. Organic compounds containing the hydrocarbon chain length of C12-C16 exhibit the best inhibition efficiency (%IE). The molecules become effective by adsorbing on the metal surface. They behave as mixed- and interface-type corrosion inhibitors.

Molecular modelling of compounds used for corrosion inhibition studies: a review.

Molecular modelling of organic compounds using computational software has emerged as a powerful approach for theoretical determination of the corrosion inhibition potential of organic compounds. Some of the common techniques involved in the theoretical studies of corrosion inhibition potential and mechanisms include density functional theory (DFT), molecular dynamics (MD) and Monte Carlo (MC) simulations, and artificial neural network (ANN) and quantitative structure-activity relationship (QSAR) modeling. Using computational modelling, the chemical reactivity and corrosion inhibition activities of organic compounds can be explained. The modelling can be regarded as a time-saving and eco-friendly approach for screening organic compounds for corrosion inhibition potential before their wet laboratory synthesis would be carried out. Another advantage of computational modelling is that molecular sites responsible for interactions with metallic surfaces (active sites or adsorption sites) and the orientation of organic compounds can be easily predicted. Using different theoretical descriptors/parameters, the inhibition effectiveness and nature of the metal-inhibitor interactions can also be predicted. The present review article is a collection of major advancements in the field of computational modelling for the design and testing of the corrosion inhibition effectiveness of organic corrosion inhibitors.

Gum Arabic as an environmentally sustainable polymeric anticorrosive material: Recent progresses and future opportunities.

Gum Arabic (GA) is a plant exudate, consisting of glycoproteins (proteins with carbohydrate co-factor or prosthetic group) and polysaccharides mainly consisting of galactose and arabinose. Because of its polymeric nature and tendency to dissolve in water, GA is widely used as anticorrosive materials, especially in the aqueous electrolytes. GA contains various electron rich polar sites through which they easily get adsorbed on metallic surface and behaves as effective anticorrosive materials. Because of its natural and biological origin, GA is regarded as one of the environmental sustainable and edible alternatives to traditional toxic corrosion inhibitors. Present review piece of writing aims to illustrate the assortment of literatures on gum Arabic as a corrosion inhibitor. Limitation of traditional organic corrosion inhibitors and advantages of using GA as an environmental sustainable alternative have also been described along with the mechanism of corrosion inhibition.

Corrosion inhibition potential of chitosan based Schiff bases: Design, performance and applications.

Chemically, chitosan is a linear polysaccharide constituted of arbitrarily distributed D-glucosamine and N-acetyl-D-glucosamine constituents combined together via ß-1,4-glycosidic linkage. Because of increasing ecological awareness and strict environmental regulations, species of natural and biological origin such as chitosan can be identified as ideal environmental sustainable alternative to replace traditional heterocyclic (toxic) corrosion inhibitors. Although, chitosan contains numerous electron rich sites however chitosan itself is not highly effective aqueous phase corrosion inhibitors. Aqueous phase application of chitosan is limited because of its limited solubility. However, chemically modified chitosan derivatives, such as chitosan based Schiff bases (CSBs) exhibit remarkable solubility in such electrolytes. Therefore, recently various reports dealing with the anticorrosion potential of CSBs have been reported. Present review article describes the collections on CSBs as aqueous phase corrosion inhibitors. Nature of CSBs adsorption through chelation (coordination) has also been discussed based on literature outcomes.

Bioinspired Heterocyclic Compounds as Corrosion Inhibitors: A Comprehensive Review.

Corrosion is a phenomenon that devastatingly affects innovative, industrial, and mechanical applications, especially in the oil and gas industries. The corrosion conceivably influences industrial equipment; it deteriorates the environment and lessens the equipment/infrastructure's lifetime. Considering the significant impact of corrosion in our daily lives, this review article aims to briefly discuss the significance of corrosion and different control methods with special attention on corrosion inhibitors. The classification of corrosion inhibitors based on types and their advantage/limitations, and heterocyclic compounds as potential corrosion inhibitors, mainly nitrogen-based compounds (pyridine (1N), pyrimidine (2N), and triazines (3N) fused ring benzimidazole, etc.), and their biological significance has been discussed in detail. The mechanism, challenges, and applications of heterocyclic compounds as corrosion inhibitors in various industrial relevant corrosive environments such as acid pickling, descaling operation in the desalination plant, oil gas industry, etc., have also been highlighted in the review.

Efficacy of Oral, Topical, or Combined Oral and Topical 5-Aminosalicylates, in Ulcerative Colitis: Systematic Review and Network Meta-analysis.

BACKGROUND: 5-Aminosalicylates [5-ASAs] are the mainstay of treatment for ulcerative colitis [UC]. The optimum preparation, dose, and route of administration for UC remain unclear. We conducted a network meta-analysis to examine this issue. METHODS: We searched MEDLINE, EMBASE, EMBASE Classic, and the Cochrane central register of controlled trials from inception to December 2020. We included randomised controlled trials [RCTs] comparing oral, topical, or combined oral and topical 5-ASAs, with each other or placebo for induction of remission or prevention of relapse of UC. Results were reported as pooled relative risks [RRs] with 95% confidence intervals [CIs] to summarise effect of each comparison tested, with treatments ranked according to P-score. RESULTS: We identified 40 RCTs for induction of remission and 23 for prevention of relapse. Topical mesalazine [P-score 0.99], or oral and topical mesalazine combined [P-score 0.87] ranked first and second for clinical and endoscopic remission combined. Combined therapy ranked first in trials where ≥50% of patients had left-sided/extensive disease, and topical mesalazine first in trials where ≥50% of patients had proctitis/proctosigmoiditis. High-dose [≥3.3 g/day] oral mesalazine ranked third in most analyses, with the most trials and most patients. For relapse of disease activity, combined therapy and high-dose oral mesalazine ranked first and second, with topical mesalazine third. 5-ASAs were safe and well tolerated, regardless of regimen. CONCLUSIONS: Our results support previous evidence; however, higher doses of oral mesalazine had more evidence for induction of remission than combined therapy and were significantly more efficacious than lower doses. Future RCTs should better establish the role of combined therapy for induction of remission, as well as optimal doses of oral 5-ASAs to prevent relapse.

Chromeno-carbonitriles as corrosion inhibitors for mild steel in acidic solution: electrochemical, surface and computational studies.

Three novel N-hydrospiro-chromeno-carbonitriles namely, 2-amino-7,7-dimethyl-1',3',5-trioxo-1',3',5,6,7,8-hexahydrospiro[chromene-4,2'-indene]-3-carbonitrile (INH-1), 3-amino-7,7-dimethyl-2',5-dioxo-5,6,7,8-tetrahydrospiro[chromene-4,3'-indoline]-2-carbonitrile (INH-2) and 3'-amino-7',7'-dimethyl-2,5'-dioxo-5',6',7',8'-tetrahydro-2H-spiro[acenaphthylene-1,4'-chromene]-2'-carbonitrile (INH-3) were synthesized using the principles of green chemistry and applied as corrosion inhibitors for mild steel in acidic medium using computational simulations and experimental methods. Experimental and computational studies revealed that inhibition effectiveness of the INHs followed the sequence: INH-3 (95.32%) > INH-2 (93.02%) > INH-1 (89.16%). The investigated compounds exhibit mixed-type corrosion inhibition characteristics by blocking the active sites on the surface of mild steel. EIS study revealed that the INHs behave as interface-type corrosion inhibitors. EDX analyses supported the adsorption mechanism of corrosion inhibition. A DFT study carried out for gaseous and aqueous forms of inhibitor molecules indicated that interactions of INHs with the mild steel surface involve charge transfer phenomenon or donor-acceptor interactions. A Monte Carlo (MC) simulation study revealed that only a fractional segment of the molecule lies parallel to the steel surface, since the INH molecules are not completely planar. The results of computational studies and experimental analyses were in good agreement.

Design and application of submental island flap to reconstruct non-circumferential defect after hypopharyngeal carcinoma resection: a prospective study of 27 cases.

BACKGROUND: This study investigated the effects of reconstruction of hypopharyngeal non-circumferential defects with a submental island flap after ablation of hypopharyngeal carcinoma. OBJECTIVES: The purpose of our study was to identify advantages and limitations of the submental flap for reconstruction of non-circumferential hypopharyngeal defects. METHODS: A total of 27 patients who had stage II-IV hypopharyngeal cancer and underwent pharyngeal reconstruction with a submental flap by the senior author in both Department of Otolaryngology Head Neck Surgery, Chinese PLA General Hospital and Department of Otolaryngology Head Neck Surgery, Beijing Friendship Hospital, Capital Medical University. RESULTS: 96.3% (26/27) cases of submental island flap survived. There were two pharyngocutaneous fistulas, one recovered spontaneously, and the other was associated with flap necrosis, underwent neck debridement and flap removal. All except for one patient had decannulation of their nasogastric tube 2 weeks postoperatively. There was no evidence of a stricture or stenosis of the laryngopharynx, nor any sign of aspiration, except for one with esophageal inlet stricture caused by radiotherapy. There were two cases of obvious paraesthesia pharynges due to beard growth at the submental flap after reconstruction. 63.0% (17/27) patients are alive and 37% (10/27) have died of disease. The 3-year survival rate is 56.3% and the 5-year survival rate is 50.0%. CONCLUSION: The submental flap reconstruction for moderately sized non-circumferential hypopharyngeal defects is a recommended treatment option.

Cinnamaldehyde-modified chitosan as a bio-derived corrosion inhibitor for acid pickling of copper: Microwave synthesis, experimental and computational study.

Chitosan (CS) was cross-linked using cinnamaldehyde (Cinn) in a single step procedure following microwave irradiation to produce cinnamaldehyde-modified chitosan (Cinn-CS). The synthesized Cinn-CS was used as a novel corrosion inhibitor for copper in 1 M hydrochloric acid. A comprehensive electrochemical investigation using the impedance measurements, and potentiodynamic polarization was undertaken, supported with surface analysis and computational studies. The inhibitor Cinn-CS functioned by adsorption on the copper surface and showed an inhibition efficiency of >89% at a dose of 1000 mgL-1. The charge transfer resistance showed a rise with increase in inhibitor dosage to the corrosive medium, and the corrosion currents showed a significant decrease with the addition of the inhibitor. The Cinn-CS displayed a mixed type of inhibition performance with cathodic nature. The study of the copper surface using scanning electron microscopy depicted a considerably smooth morphology in the presence of the adsorbed Cinn-CS. The computational studies indicated that the Cinn-CS Schiff base shows better adsorption behavior compared to the parent molecules of chitosan and cinnamaldehyde and can show an inhibition performance in the neutral, and the protonated form.

Results from the first English stool bank using faecal microbiota transplant as a medicinal product for the treatment of Clostridioides difficile infection.

BACKGROUND: Faecal Microbiota Transplant (FMT) has improved outcomes for the treatment of Clostridioides difficile infection (CDI) compared to antibiotic therapy. FMT is classified as a medicinal product in the United Kingdom, similar to the USA and Canada, limiting supply via stool banks without appropriate licencing. In the largest UK cohort to date, we describe the clinical outcomes for 124 patients receiving FMT for recurrent or refractory CDI and present a framework to produce FMT as a licenced medicinal product. METHODS: Anonymous unrelated healthy donors, screened via health assessment and microbiological testing donated stool. In aerobic conditions FMT aliquots were prepared for immediate use or frozen storage, following a production framework developed to comply with Good Manufacturing Practice. Outcome measures were clinical response to FMT defined as resolution of diarrhoea within seven days and clinical cure defined as response without diarrhoea recurrence at 90 days. FINDINGS: Clinical response was 83·9% (95% CI 76·0%-90·0%) after one treatment. Clinical cure was 78·2% (95% CI 67·4%-89·0%) across the cohort. Refractory cases appeared to have a lower initial clinical response rate compared to recurrent cases, however at day 90 there were no differences observed between these groups. INTERPRETATION: The methodology developed here enabled successful licencing of FMT by The Medicines and Healthcare products Regulatory Agency as a medicinal product. This has widened the availability of FMT in the National Health Service via a stool bank and can be applied in other centres across the world to improve access to safe and quality assured treatments.

Chitosan-cinnamaldehyde Schiff base: A bioinspired macromolecule as corrosion inhibitor for oil and gas industry.

A Schiff base of chitosan with cinnamaldehyde (Cinn-Cht) was synthesized in a single step using microwave irradiation and characterized using spectroscopic techniques. The synthesized Schiff base was used for the mitigation of carbon steel corrosion in 15% HCl. The corrosion evaluation was performed using weight loss tests, electrochemical impedance measurements, and polarization studies. The corrosion inhibition efficiency increased with inhibitor dosage and achieved a high value of 85.16% at 400 mgL-1. The inhibitor adsorption followed the Langmuir isotherm and displayed a mixed physical and chemical adsorption behavior. To further improve the corrosion inhibition efficiency, potassium iodide (KI) was incorporated in the corrosive solution, which increased the inhibition efficiency further to 92.45% at a concentration of 10 mM. Surface studies carried out via SEM analyses indicated the inhibitor adsorption and protective film formation on the steel surface. The computational studies carried out via DFT revealed that mainly the protonated form of inhibitor adsorbs on the metal surface. Monte Carlo simulation studies also showed that the protonated form of the inhibitor molecule exhibited higher adsorption energy than the neutral inhibitor.

Microwave-assisted synthesis of a new Piperonal-Chitosan Schiff base as a bio-inspired corrosion inhibitor for oil-well acidizing.

A new Schiff base of chitosan, namely Piperonal-chitosan (Pip-Cht), was synthesized for the first time, using a microwave irradiation method and characterized using spectroscopic techniques. The corrosion inhibition behavior of the new Schiff base was evaluated on carbon steel in 15% HCl medium via gravimetric and electrochemical techniques. This is the first work on the application of chemically functionalized chitosan as a corrosion inhibitor in the oil-well acidizing environment. The Pip-Cht inhibitor exhibited a high corrosion inhibition efficiency of 85.16% at a moderate dose of 600 mg L-1. Further, the addition of potassium iodide as a synergistic agent to the corrosive electrolyte produced a significant improvement in the inhibition efficiency to 91.15% at a low dosage of 10 mM of KI. At a higher temperature of 65 °C, the combination of both the inhibitor and KI yielded a high inhibition efficiency. The results of the gravimetric and electrochemical experiments were corroborated using AFM and SEM studies. The DFT calculations indicated that corrosion inhibition behavior of the Schiff base mainly occurs in the protonated form.