erythropoietin (Epocain / Epokine)

Preparation of Vanadium Tailings-Based Ceramsite and Evaluation of Its Adsorption Performance for High-Fluoride Wastewater.

Fan Jiangke J, Huang Jing J, Zhang Yimin Y, Wan Qian Q et al.

Vanadium tailings-based ceramsite (VT-Ceramsite), a type of porous ceramsite synthesized from vanadium tailings, was employed for the adsorption of fluoride ions from high-fluoride wastewater. This approach not only mitigates environmental pollution caused by industrial solid waste but also effectively removes fluoride contaminants from wastewater. The effects of vanadium tailings content, sintering temperature, and sintering time on the adsorption performance of the VT-Ceramsite were systematically investigated. Comprehensive characterizations via XRD, SEM, BET, and adsorption modeling reveal that fluoride sequestration by VT-Ceramsite is governed by the synergy between physical diffusion and chemical interactions. While the porous architecture provides essential transport pathways, the chemically active sites facilitate stable bonding. Future research will prioritize surface functionalization and tailoring strategies to augment the density of these active sites, thereby maximizing the adsorption potential for treating complex industrial effluents. The optimal preparation conditions were determined to be a ratio of 6.5:2.5:1 for vanadium tailings, fly ash, and kaolin, with a preheating temperature of 300 °C for 20 min and a sintering temperature of 900 °C for 20 min. In these conditions, the adsorption capacity for fluorine ions can reach 43.59 mg/g. VT-Ceramsite exhibited a specific surface area of 3.61 m2/g, hydrochloric acid solubility of 1.2%, and a void fraction of 48.68%, all parameters met national industrial standards. In addition, the leaching concentrations of heavy metals were found to be well below the limits specified in CJ/T 299-2008, indicating that the material poses no risk of secondary pollution. The study provides an economical, safe, and environmentally friendly route for the utilization of solid waste, and it offers a promising adsorbent for treating high-fluoride wastewater.

Unilateral Versus Bilateral Fronto-Orbital Advancement in Non-Syndromic Unicoronal Craniosynostosis: A Systematic Review and Pooled Data Analysis.

Şibar Serhat S, Uygur Halil Şafak HŞ, Kuzucu Pelin P

Nonsyndromic unicoronal craniosynostosis (NS-UCS) is characterized by asymmetric craniofacial deformity and remains one of the most challenging entities in craniofacial surgery. Fronto-orbital advancement (FOAR) may be performed either unilaterally or bilaterally, yet the optimal approach remains controversial. The present study aims to compare surgical outcomes, complication profiles, and long-term stability between unilateral and bilateral FOAR to clarify selection criteria for surgical technique. A systematic review was conducted using the PubMed, Web of Science, and Cochrane databases, following PRISMA guidelines. Studies involving nonsyndromic anterior plagiocephaly treated by unilateral or bilateral FOAR with ≥12 months of follow-up were included. Twenty studies encompassing 511 patients met the inclusion criteria. Data were pooled, and statistical analyses were performed using (IBM SPSS Statistics version 29.0; IBM Corp., Armonk, NY) and Python-based analytical tools. Of the included patients, 315 (61.6%) underwent bilateral FOAR and 196 (38.4%) underwent unilateral FOAR. Contour deformity was significantly more frequent after unilateral FOAR (75.0% vs. 27.5%, P<0.05). Due to heterogeneous reporting across studies, postoperative strabismus outcomes could not be reliably compared using pooled analysis. Bilateral procedures required longer operative times (213 vs. 162 min, P<0.05), though no significant differences were found in overall complication rate, hospital stay, or relapse incidence between the 2 groups. Both unilateral and bilateral FOARs provide effective correction of craniofacial asymmetry in NS-UCS, but they differ in their complication profiles. Unilateral FOAR offers reduced surgical exposure and shorter operative duration but has a higher rate of contour irregularities. Bilateral FOAR achieves more comprehensive orbital and forehead correction, albeit with longer operative times and broader surgical exposure. These results suggest that the choice of technique should be guided by deformity severity, contralateral asymmetry, and surgeon experience. The analysis identifies critical data gaps in reporting relapse and revision rates, underscoring the need for prospective studies with standardized outcome measures to refine surgical algorithms for anterior plagiocephaly.

First Successful Bloodless Combined Heart-Liver Transplantation in a Jehovah's Witness.

Konidala Chamanthi C, Perrone Juan J, Miranda Carlos C, Balazs Zsolt Z et al.

Combined heart-liver transplantation (CHLT) represents an infrequent and highly intricate surgical intervention characterized by substantial risk. While isolated cases documenting bloodless heart transplantation or transfusion-free liver transplantation exist, a successful bloodless CHLT had not previously been recorded. This case report details the inaugural instance of such a procedure performed for a Jehovah's Witness patient. A 67-year-old male Jehovah's Witness with severe multi-vessel coronary artery disease and refractory angina, heart failure with preserved ejection fraction, and metabolic dysfunction-associated steatohepatitis (MASH)-related cirrhosis (stage III-IV) was admitted for transplant evaluation at Tampa General Hospital. Listed as UNOS Status 2e, he underwent bloodless CHLT. Preoperative hemoglobin was 15 g/dL, and platelet count was 157 000/µL, optimized with erythropoietin and iron supplementation. Intraoperative blood conservation strategies included meticulous surgical techniques, acute normovolemic hemodilution (ANH, two units), cell salvage (675 mL), cryoprecipitate (600 mL), aminocaproic acid, and FEIBA (factor eight inhibitor bypassing activity). Both transplantations were uneventful. The patient was extubated on postoperative day 1 (POD 1). Endomyocardial biopsy on POD 16 showed no rejection. An echocardiogram on POD 18 confirmed preserved biventricular function (LVEF 60-65%). The patient was discharged on POD 24 with hemoglobin of 9.6 g/dL and platelet count of 227 000/µL. At POD 60, he exhibited excellent function of both transplanted organs. This report expands the scope of bloodless medicine, offering a model for managing complex multi-organ transplants in patients with religious restrictions to blood products, with the patient continuing to exhibit excellent recovery approximately ten months post-transplant.

Anti-erythropoietin antibody-mediated pure red cell aplasia in a patient with chronic kidney disease.

Lowyim Devon D, Stevenson Matthew M