Master of Veterinary Bioscience / Department of Diagnostic Medicine/Pathobiology / Deon Van Der Merwe / Every year thousands of domestic animals are poisoned by ethylene glycol. Exposure is normally orally, but may be dermal, and poisonings are usually accidental and not malicious. Antifreeze, overwhelmingly the source of the ethylene glycol poisoning, is responsible for over 99% of reported cases. Storage, handling and proper disposal of ethylene glycol is extremely important in limiting access to this deadly product. Ethylene glycol exposures were involved in 1737 calls made to the American Society for the Prevention of Cruelty to Animals call center between 2006 and 2011. Dogs were involved in approximately 87% of exposures and cats in 13%. There were no seasonal or breed patterns. The most common clinical signs reported were neurological and gastrointestinal for both cats and dogs. Urinary calcium oxalate crystals were reported in 28.6% of exposed cats, and 21% of dogs. Attenuated total reflectance Fourier transform infrared spectroscopy (ATR-FTIR) was used to detect calcium oxalate crystals in wax-mounted kidneys from twenty total cases, ten of which were suspected ethylene glycol poisoning submitted to the Kansas State Veterinary Diagnostic Laboratory, and ten samples deemed negative by a pathologist using light microscopy. Pure calcium oxalate monohydrate was used as a reference, and a unique absorption peak was detected between wavenumbers 1290 cm[superscript]-1 and 1320 cm[superscript]-1. The drying of kidney tissues resulted in increased sensitivity for calcium oxalate. Crystal detection by the ATR-FTIR was compared to light microscopy. Bi-fringence of crystals allowed microscopic detection, but the ATR-FTIR specificity for the test was 100%, and sensitivity was 80% compared to traditional microscopy for ca-oxalate crystal identification. ATR-FTIR was also used to detect un-metabolized ethylene glycol in vomitus using wavenumbers 1084 cm[superscript]−1, 1039 cm[superscript]−1, and 882 cm[superscript]−1, but ethylene glycol was not detectable. Ethylene glycol concentrations in samples were much too low to be detected as ethylene glycol on the ATR-FTIR, as the limit of detection was not distinguishable until 5000 ppm using a serial dilution. These methods presented simple, reliable, quick, sensitive, stable, and highly adaptable tests for detection, diagnosis and treatment of ethylene glycol poisoning.

Typescript (photocopy). / Digitized by Kansas Correctional Industries

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published_or_final_version / Environmental Management / Master / Master of Science in Environmental Management

published_or_final_version / Environmental Management / Master / Master of Science in Environmental Management

A potential route for converting different carbon sources (coal, natural gas and biomass) into synthetic fuels is the transformation of these raw materials into synthesis gas (CO and H2), followed by a catalytic step which converts this gas into the desired fuels. The present thesis has focused on two catalytic steps: Fischer-Tropsch synthesis (FTS) and methanation. The Fischer-Tropsch synthesis serves to convert synthesis gas into liquid hydrocarbon-based fuels. Methanation serves instead to produce synthetic natural gas (SNG). Cobalt catalysts have been used in FTS while nickel catalysts have been used in methanation.             The catalyst lifetime is a parameter of critical importance both in FTS and methanation. The aim of this thesis was to investigate the deactivation causes of the cobalt and nickel catalysts in their respective reactions.             The resistance to carbonyl-induced sintering of nickel catalysts supported on different carriers (γ-Al2O3, SiO2, TiO2 and α-Al2O3) was studied. TiO2-supported nickel catalysts exhibited lower sintering rates than the other catalysts. The effect of the catalyst pellet size was also evaluated on γ-Al2O3-supported nickel catalysts. The use of large catalyst pellets gave considerably lower sintering rates. The resistance to carbon formation on the above-mentioned supported nickel catalysts was also evaluated. Once again, TiO2-supported nickel catalysts exhibited the lowest carbon formation rates. Finally, the effect of operating conditions on carbon formation and deactivation was studied using Ni/TiO2 catalysts. The use of higher H2/CO ratios and higher pressures reduced the carbon formation rate. Increasing the temperature from 280 °C to 340 °C favored carbon deposition. The addition of steam also reduced the carbon formation rate but accelerated catalyst deactivation.             The decline in activity of cobalt catalysts with increasing sulfur concentration was also assessed by ex situ poisoning of a cobalt catalyst. A deactivation model was proposed to predict the decline in activity as function of the sulfur coverage and the sulfur-to-cobalt active site ratio. The results also indicate that sulfur decreases the selectivity to long-chain hydrocarbons and olefins. / <p>QC 20160817</p>

Introduction: Opioid poisoning has been rapidly increasing in the past decade, and has been driven in large part due to increases in opioid prescribing. This has been accompanied by intervention efforts aimed at preventing and reversing opioid poisoning through naloxone prescription programs. Current literature have not quantified the economic burden of opioid poisoning. Understanding this information can help inform these efforts and bring light to this growing problem. In addition understanding various determinants of increased costs can help to identify the types of populations more likely to have greater costs. Main Objectives: The objectives are 1) to quantify the economic burden of opioid poisoning, 2) to evaluate differences in costs, LOS, and in-hospital mortality depending on opioid type, 3) to identify opioids most likely to result in hospitalization for opioid-related ED visits and 4) to determine differences in the odds of admission to various hospital admission categories with respect to opioid type. Methods: A cost-of-illness approach was used to estimate the economic burden of opioid poisoning. Direct costs and prevalence estimates were obtained from nationally representative databases. Other sources of direct costs were obtained from the literature. Indirect costs were measured using the human capital method. Differences in costs, LOS, and in-hospital mortality were measured through generalized linear models using the National Inpatient Sample in 2009 from the Healthcare Cost and Utilization Project. The Drug Abuse Warning Network database was used to evaluate opioids most likely to result in hospitalization and to evaluate the likelihood of different opioids to cause admission into different types of hospital settings. Results: Opioid poisoning resulted in an economic burden approximately $20.4 billion dollars in 2009. Productivity losses were associated with 89% of this total. Direct medical costs were associated with $2.2 billion. Methadone was associated with the greatest inpatient costs and LOS, while heroin was associated with a greater likelihood of in-patient mortality compared to prescription opioids. Heroin, methadone, and morphine were associated with the greatest odds of hospitalization. Among admitted patients, methadone, morphine, and fentanyl were each associated with the greatest odds of ICU admission compared with other opioids. Conclusions: Opioid poisoning results in a significant economic burden to society. Costs, length of stay, in-patient mortality and the odds of hospitalization and admission type depend on the type of opioid involved. The results from this study can be used to inform policy efforts in providing interventions to reduce opioid poisoning and help focus efforts on populations at highest risk for increased costs.

Lead is a central nervous system poison. Healthy People 2010 established a target blood lead level (BLL) for children of 0 μg/dL by 2010, but is silent with regard to any changes in BLLs standards for working age adults. In this paper, the relation of BLL to performance on two neurobehavioral tests was assessed in working age adults (N = 4909; Age 20 to 59 years; 51.4% Female) employing data from the Third National Health and Nutrition Survey (NHANES 111). Multiple linear regression analyses indicated a significant effect of BLL on time taken to complete an attention demanding cognitive task (Symbol Digit Substitution Task, SDST) but not accuracy of performance of the SDST or simple reaction time, after controlling for confounding variables of age, sex, race-ethnicity, and education. Persons with BLL ≥5 μg /dL took longer (multivariate adjusted mean = 23.6 Sec, SE = 0.30) compared to individuals with BLLs <5 μg /dL (mean = 22.5 Sec, SE = 0.14). The results suggest that lead burden in working age persons impairs central nervous processes involving executive mental functions (decision speed and attention). The findings, if confirmed by case control and or cohort studies would indicate a need to reconsider currently accepted lead levels in working age adults.

Background – An increase in opioid prescribing has led to an increase in opioid overdoses.1,2 No study has estimated the incremental costs subsequent to an opioid overdose event in prescription opioid users, or the prevalence and costs of overdose events in family members of prescription opioid users and in overdose victims with no identifiable source of prescription opioid. The latter group will be referred to as “others”. Objectives – The first objective of this study was to estimate the prevalence of opioid overdoses in aforementioned groups. The second objective was to estimate the incremental costs and resource utilization associated with opioid overdoses in these groups. Methods – This study is a retrospective analysis using claims data from SelectHealth, a not-for-profit health insurance organization in Utah and southern Idaho. We estimated the prevalence of opioid overdoses in the sample population, as well as in each group, by year. For the cost estimation we collapsed family members and others into one category – “non-medical users”. To estimate costs we used an incremental cost approach whereby we used propensity scores to match cases (patients who suffered from an opioid overdose) to appropriate controls (patients who did not suffer from an opioid overdose) and estimated the direct medical costs incurred in each group in the year following an overdose. Generalized Linear Models were used to estimate incremental costs and resource utilization. Sensitivity analyses were conducted to measure the robustness of the estimates. Results – The prevalence of opioid overdoses increased by 84.8% in prescription opioid users (from 55.6 per 100,000 in 2011 to 102.8 per 100,000 in 2014), increased by 37.9% in family members of prescription opioid users (from 5.9 per 100,000 in 2011 to 8.2 per 100,000 in 2014) and increased by 179.9% in others (from 8.2 per 100,000 in 2011 to 23.1 per 100,000 in 2014). The prevalence of opioid overdoses in acute users increased by 14.7% (from 43.8 per 100,000 in 2011 to 50.3 per 100,000 in 2014) as compared to 165.9% in chronic users (from 187.0 per 100,000 in 2011 to 497.3 per 100,000 in 2014). The incremental direct medical costs per patient per year were estimated to be $65,277 (p-value<0.05) in prescription opioid users who suffered from an overdose and $41,102 (p-value<0.05) in non-medical users who suffered from an overdose. Overdose-specific costs were estimated to be $12,111 for prescription opioid users and $11,070 in non-users. Conclusions – Our study found that the prevalence of opioid overdoses increased steadily from 2011 to 2014 in the sample population. The prevalence of overdoses was much higher in chronic opioid users as compared to acute users. Differences between overdose-specific costs and total incremental costs may suggest that overdoses are associated with substantial costs in addition to costs for the initial treatment of the overdose. While the cost to payers due to overdoses in prescription opioid users is substantial, payers also incur costs from diversion of opioids.

This thesis focuses on cognitive functions in patients after methanol poisoning. The theoretical part consists of a description of methanol, characteristics of methanol poisoning and its neurological sequelae. Methanol poisoning affects the basal ganglia, therefore we describe them and their role in cognitive processes. The theoretical part also describes a case of mass methanol poisoning in the Czech Republic in 2012-2013. The practical part compares results of a control group and a group of patients poisoned with methanol in cognitive assessment. Results show that the patients after methanol poisoning have significantly lower scores in tasks testing memory and executive functions than the control group.