RANDOMIZED COMPARATIVE STUDY OF DEFINITIVE EXTERNAL FIXATION VERSUS ORIF IN PILON FRACTURES: AN EARLY CLINICAL OUTCOME REPORT

Repairing Pilon fractures remains challenging. ORIF allows direct anatomical reduction, but at the expense of soft tissues dissection which are associated with recovery. On the other hand, External Fixation allows indirect reduction and causes less soft tissue damage. However, a few studies conclude that External Fixation is associated with high rates of malunion.The objectives were to evaluate and compare: primary outcome measure: ankle hindfoot function (AOFAS at 9 months) and secondary outcome measures: quality of reduction, bone union, arthritic changes, other potential complications and ultimately the optimum management for pilon fractures.A prospective randomized comparative clinical study. 40 Patients were included in the study with comminuted closed Pilon fracture. Patients were randomized by closed envelope technique into two groups: Group (1) Included 20 patients managed by external fixation with limited internal fixation. Group (2) Included 20 patients managed by open reduction and internal fixation. Skeletally immature, type 43A AO/OTA, Open fractures, compartment syndrome, Pathological fractures were excluded.There was no significant difference between External fixation and ORIF as methods of fixation for Pilon fracture in the functional activity of the patient after 9 months as evidenced by AOFAS score (P=0.547) and the development of complications (P=0.227). However, there was statistically significant difference (P<0.001) regarding the time to weight bearing between both groups, and statistically significant difference (P=0.042) regarding time to union.The best surgical modality to treat Pilon fractures is still debatable. While external fixation is used by many to avoid major complications, it has been associated with high rates of malunion, and osteoarthritis.

A case report of two Moroccan patients with hereditary neurological disorders and molecular modeling study on the S72L de novo PMP22 variant

Hereditary neurological disorders represent a wild group of hereditary illnesses affecting mainly the nervous system, the majority of which have a Mendelian inheritance pattern. Here we present the case of two Moroccan patients each affected by a different hereditary neurological disorder. In the first patient WES analysis revealed the presence of the p.Ser72Leu de novo mutation in the PMP22 gene reported for the first time in Africa, specifically in Morocco. This variant is predicted to be in a mutation "hot-spot" region causing Dejerine-Sottas syndrome called also Charcot-Marie-Tooth type 3. The molecular modeling study suggests an important alteration of hydrogen and hydrophobic interactions between the residue in position 72 of the PMP22 protein and its surrounding amino acids. On the other hand, the p.Ala177Thr mutation on the RNASEH2B gene, responsible of Aicardi-Goutières syndrome 2, was carried in a homozygous state by the second patient descending from a consanguineous family. This mutation is common among the Moroccan population as well as in other North African countries. The present results contributed to a better follow-up of both cases allowing better symptom management with convenient treatments.

Facile and Sustainable Synthesis of ZnO Nanoparticles: Effect of Gelling Agents on ZnO Shapes and Their Photocatalytic Performance

The present work involves investigating an unexplored soft-chemical method for synthesizing nanostructured ZnO through biopolymer gelation. Our objective was to exploit (i) the difference in the gelation mechanism of four tested biopolymers, namely, alginate, chitosan, carboxymethylcellulose (CMC), and pectin and (ii) numerous experimental parameters that govern this process in order to allow the control of the growth of nanostructured ZnO, with a view to using the prepared oxides as photocatalysts for the oxidation of the Orange G dye. So, the effect of biopolymer's nature on the microstructural, morphological, and textural properties was examined by thermogravimetric analysis (TGA), X-ray diffraction (XRD), Fourier transform infrared (FTIR) spectroscopy, field-emission gun-scanning electron microscopy-high resolution (FEG-SEM) with energy-dispersive spectrometry (SEM-EDS), ultraviolet-visible (UV-vis) spectroscopy, and N₂ adsorption/desorption. As-prepared oxides were crystallized in a hexagonal wurtzite structure, with a clear difference in their morphologies. The sample prepared by using chitosan has a specific surface area of around 36.8 m²/g in the form of aggregated and agglomerated nanostructured minirods and thus shows the best photocatalytic performance with 99.3% degradation of the Orange G dye in 180 min.

Current concepts in the management of radial head fractures: a national survey and review of the literature

INTRODUCTION

This study aims to report on current practice in the management of radial head fractures (RHFs) in the United Kingdom and to review the literature to identify areas for future investigation.

METHODS

A 12-question online survey was sent to 500 surgeon members of the British Elbow and Shoulder Society in 2021. Questions focused on clinical assessment, indications for surgical treatment and willingness to participate in future studies. Descriptive statistical analysis summarised the responses.

RESULTS

The response rate was 20.4% (n = 102). For minimally displaced RHFs, non-operative management with immediate mobilisation was reported by 90.2% (n = 92) as opposed to 9.8% (n = 10) for initial immobilisation in plaster or brace. The most cited indication for radial head arthroplasty as opposed to fixation was increased patient age or low functional demand in 69.9% of responses (n = 71). In total, 41.2% (n = 42) indicated the need for a future randomised controlled trial (RCT) concerning the management of RHF. Only five RCTs were returned by the literature review.

DISCUSSION

There is considerable variability in the management of RHF among an experienced cohort of surgeons. With the interest declared by the participating surgeons, there is a call for a well-designed sufficiently powered RCT.

The current status and challenges of biomass biorefineries in Africa: A critical review and future perspectives for bioeconomy development

Africa benefits from diverse biomasses that are rich in high-added value materials and precursors for energy, food, agricultural, cosmetic and medicinal applications. Many African countries are interested in valorizing biomasses to develop efficient and integrated biorefinery processes and their use for local and regional economic development. Thus, this report critically reviews the current status of African biomass richness, its diversity, and potential applications. Moreover, particular attention is given to bioenergy production, mainly by biological and thermochemical conversion processes. This also includes biomass valorization in agriculture, particularly for the production of plant-based biostimulants, which are a potential emerging agri-input sector worldwide. This study points out that even though several processes for biofuel, biogas, biofertilizer and biostimulant production have already been established in Africa, their development on a larger scale remains limited. This study also reports the different socioeconomic and political aspects of biomass applications, along with their challenges, opportunities, and future research perspectives, to promote concrete technologies transferable into an industrial level.

Screening of potential phosphate solubilizing bacteria inoculants should consider the contrast in phosphorus bio-solubilization rate along with plant growth promotion and phosphorus use efficiency

AIMS

Although phosphate solubilizing bacteria (PSB) have been globally reported to improve soil phosphorus (P) availability and plant growth, technical gaps such as the lack of an ideal screening approach, is yet to be addressed. The potential of non-halo-forming PSB remains underestimated because of the currently adopted screening protocols that exclusively consider halo-forming and PSB with high phosphorus solubilization (PS) capacities. Yet, caution should be taken to properly assess PSB with contrasting PS rates regardless of the presence or absence of the solubilization halo.

METHODS AND RESULTS

This study sought to examine the PS rate and plant growth promotion ability of 12 PSB categorized as high PSB (H-PSB), medium PSB (M-PSB), and low PSB (L-PSB) based on their PS rates of rock phosphate (RP). The non-halo-forming PSB Arthrobacter pascens was categorized as H-PSB, which might have been eliminated during the classical screening process. In addition, induction of organic acids and phosphatase activity in rhizosphere soils by H-, M-, and L-PSB was proportional to increased wheat P content by 143.22, 154.21, and 77.76 mg P g-1 compared to uninoculated plants (18.1 mg P g-1).

CONCLUSIONS

Isolates considered as M- and L-PSB could positively influence wheat above-ground physiology and root traits as high as H-PSB. In addition, non-halo-forming PSB revealed significant PS rates along with positive effects on plant growth as high as halo-forming PSB.

Role of biochar in anaerobic microbiome enrichment and methane production enhancement during olive mill wastewater biomethanization

The current research work attempted to investigate, for the first time, the impact of biochar addition, on anaerobic digestion of olive mill wastewater with different initial chemical oxygen demand loads in batch cultures (10 g/L, 15 g/L, and 20 g/L). Methane yields were compared by applying one-way analysis of variance (ANOVA) followed by post-hoc Tukey's analysis. The results demonstrated that adding at 5 g/L biochar to olive mill wastewater with an initial chemical oxygen demand load of 20 g/L increased methane yield by 97.8% and mitigated volatile fatty acid accumulation compared to the control batch. According to the results of microbial community succession revealed by the Illumina amplicon sequencing, biochar supplementation significantly increased diversity of the microbial community and improved the abundance of potential genera involved in direct interspecies electron transfer, including Methanothrix and Methanosarcina. Consequently, biochar can be a promising alternative in terms of the recovery of metabolic activity during anaerobic digestion of olive mill wastewater at a large scale.

Improved rock phosphate dissolution from organic acids is driven by nitrate assimilation of bacteria isolated from nitrate and CaCO3-rich soil

Until now, the solubilization capacities of insoluble mineral P by soil microorganisms have been screened in vitro with media containing NH4+ as a nitrogen source. This presence of NH4+ will lead to an acidification of the medium responsible for the solubilization of the insoluble P. However, besides proton release, the production of organic acids can play a very important role in the release of free P. This physiological mechanism can largely depend on the source of nitrogen (NH4+vs NO3-) assimilated by the bacteria but the influence of the N source on the production of organic acids has yet to be studied. Our aim was to investigate if the N source assimilated by bacteria and the soil characteristics such as the dominant N source (NH4+vs NO3-) and CaCO3 contents might influence the bacterial capacities to solubilize rock phosphate. To fill this objective, we screened the capacity of bacteria isolated from 3 soils to solubilize rock phosphate in vitro in presence of NH4+or NO3-. Then, we selected the most efficient bacterial strains to identify and quantify the release of organic anions into the medium. Among the two hundred and forty-three bacterial strains isolated from the 3 soils, nine and seven isolates were identified with the highest % rock phosphate-solubilization values with NH4+ or NO3- as the sole N-source. Only one strain was able to release free Pi with NH4+ or NO3- as the sole N-source. The most predominant organic acids released by almost all isolates were gluconic acid, lactic acid, glycolic acid, acetic acid, formic acid and pyruvic acid regardless the N-source. However, with NO3- as source of N, the highest concentrations on those acids were found together with the highest release of free Pi into the medium. Molecular analysis of 16S rRNA indicated that almost all strains belonged to Bacillus and Paenibacillus genera. The PCA analysis between soil properties and bacterial capacities to release organic acids and free Pi also revealed that soil factors such as CaCO3 and soil NO3- content positively influenced the release of organic acids by bacteria grown in vitro. Our results concluded that the bacterial rock phosphate-solubilization was intimately related to organic acids production which in turn seemed to be driven by the assimilation of NO3- by bacteria. Therefore, the N-source might be considered a key factor to take into consideration during the screening and selection of suitable strains involved in the P-solubilization.

Use of photosensitizers activated by photodynamic therapy on the canal disinfection of radicular dentin bonded to Dimethacrylate-based glass fiber post: an assessment of pushout bond strength

OBJECTIVE

The present lab-based investigation aimed at evaluating the canal disinfectants using photodynamic therapy (PDT) using different photosensitizers, conventional NaOCl, a mixture of doxycycline, citric acid, and a detergent (MTAD) and their impact on the bond strength of glass fiber post to radicular dentin.

MATERIALS AND METHODS

Forty extracted human premolars were gathered and disinfected. The decoration was performed up to the cementoenamel junction. Using the crown down technique cleaning of the canal was done following rinse with distilled water. All canals were dried with paper points and obturated with gutta-percha. Post space was prepared using peso reamers and samples were randomly allocated into four groups following different disinfection regimes: Group 1 - Methylene blue photosensitizer (MBP) + MTAD; Group 2 - RBP (Rose Bengal photosensitizer) + MTAD; Group 3 - CP (curcumin photosensitizer) + MTAD and Group 4 - 2.25% NaOCl + MTAD (control). Following disinfection, the canals were dried and the post was placed and cemented within the canal. Samples were dissected at coronal, middle, and apical third and placed in a universal testing machine for push-out bond strength (PBS). Debonded surfaces were evaluated for failure modes. PBS was examined using a one-way analysis of variance (ANOVA). The means of PBS were compared using Tukey multiple comparison tests with a significance threshold of (p<0.05).

RESULTS

Group 3 canals disinfected with CP and MTAD had the highest PBS at two levels: cervical (9.57±1.21 MPa), middle (6.37±0.79 MPa), and group 2 canal space disinfected by RBP and MTAD had the maximum PBS in apical portion (5.35±0.42 MPa). No significant difference at all root levels between group 2 (RBP + MTAD) and group 3 (p>0.05). Canal irrigation with group 1 (MBP + MTAD) and group 4 control (2.25% NaOCl + MTAD) exhibited comparable PBS at all three levels of the root.

CONCLUSIONS

CP, MTAD, RBP and MTAD for canal disinfection and bonding of glass fiber post to radicular dentin demonstrated comparable bond values at all three root levels and can be recommended in clinical settings after further investigations.

Sulfated Well-Defined Mesoporous Nanostructured Zirconia for Levulinic Acid Esterification

Well-organized zirconia (ZrO₂) nanoparticles forming mesoporous materials have been successfully synthesized via a facile micelle-templating method using cetyltrimethylammonium bromide as a structure-directing template to control the nucleation/growth process and porosity. The systematic use of such a surfactant in combination with a microwave-assisted solvothermal (cyclohexane/water) reaction enabled the control of pore size in a narrow-size distribution range (3-17 nm). The effect of solvent mixture ratio on the porosity of the synthesized oxide was determined, and the controlled growth of zirconia nanoparticles was confirmed by means of powder X-ray diffraction, small-angle X-ray scattering, transmission electron microscopy, selected area electron diffraction, high-resolution transmission electron microscopy, X-ray photoelectron spectroscopy, thermogravimetric analysis, and Fourier transform infrared spectroscopy as well as N₂ physisorption isotherm analysis. Then, the as-prepared nanostructured zirconia oxides were treated with sulfuric acid to have sulfated samples. The catalytic performances of these mesoporous zirconia nanoparticles and their sulfated samples were tested for levulinic acid (LA) esterification by ethanol, with quantitative conversions of LA to ethyl levulinate after 8 h of reaction.

Hybrid Alginate-Brushite Beads Easily Catalyze the Knoevenagel Condensation On-Water

An innovative hybrid organic-inorganic material composed of alginate-brushite xerogel beads was successfully applied for the catalysis of the Knoevenagel condensation. The catalyst was derived from phosphated alginate xerogel microspheres formed from the ionotropic gelling effect of phosphated alginate. To this end, alginate was phosphated by the addition of diammonium hydrogen phosphate in a 1% w/w alginate gel. The phosphated alginate was subsequently precipitated by chelation of Ca²⁺ cations, generating a phosphated alginate hydrogel microsphere, which was washed and dried, forming hybrid organic-inorganic xerogel beads as a crystalline phosphate-rich mineral fraction covered by alginate. X-ray diffraction analysis revealed that the crystalline inorganic matrix of the material was composed predominantly of brushite. SEM analysis revealed plate-like, ribbon-like, or needle-like morphologies in the hybrid alginate-brushite beads. The hybrid material was tested as a catalyst for Knoevenagel condensation, which was performed ″on-water″ under mild conditions with aromatic aldehydes and activated methylene compounds, giving high yields (up to 97%). The reaction rate and product yield increased together with the reaction temperature for all reagents. The recyclable solid catalyst was effective for three runs, revealing the potential of the innovative hybrid catalyst as an eco-friendly heterogeneous catalyst.

Phosphate solubilizing bacteria can significantly contribute to enhance P availability from polyphosphates and their use efficiency in wheat

Rhizosphere microbes significantly enhance phosphorus (P) availability from a variety of unavailable P pools in agricultural soils. However, little is known about the contribution of root-associated microorganisms, notably P solubilizing bacteria (PSB), to enhance the use of polyphosphate (PolyP) fertilizers as well as the key mechanisms involved. This study assesses the ability of four PSB (Bacillus siamensis, Rahnella aceris, Pantoea hericii, Bacillus paramycoides) and their consortium (Cs) to enhance the release rate of available P from two types of PolyP ("PolyB" and "PolyC") with a focus on the key role of phosphatase enzyme activities and organic acids production. Wheat growth performance and P acquisition efficiency were evaluated in response to co-application of PSB and PolyP. Results showed that inoculation with PSB, notably Cs, significantly enhanced available P from PolyC, PolyB and tri-calcium P. Increased available P in response to inoculation with PSB significantly correlated with medium acidification, organic acids production (notably glycolic acid) and induced activities of acid phosphatase and pyrophosphatase. In planta, the co-application of PSB-PolyP improved wheat plant biomass, root growth and P acquisition, with best results obtained from Cs-PolyP co-application as compared to uninoculated and unfertilized plants. At seedling stage, the co-application of Cs-PolyP (PolyB and PolyC) enhanced root hairs length (125 % and 131 %), root length (26 % and 37 %) and root inorganic P (Pi) content (160 % and 182 %), respectively compared to uninoculated plants. Similarly, at tillering stage, plant biomass (35 % and 47 %), Pi content (43 % and 253 %), P translocation (215 % and 315 %) and soil phosphatases (213 % and 219 %) significantly improved under PolyB and PolyC application, respectively. Findings from this study demonstrate the key role of PSB to enhance the use of PolyP through production of organic acids and phosphatases, exhibiting differential traits patterns between the two PolyP. Improved wheat growth and root P acquisition in response to PSB-PolyP co-application can be attributed to induced rhizosphere processes leading to enhanced available P taken up by roots.

The correlation between coronary artery disease and left ventricular filling pressure: which correlates more LVEDP or LV pre-A wave?

Funding Acknowledgements

Type of funding sources: Public hospital(s). Main funding source(s): Al-mouwasat University Hospital and Uneversity Heart Surgery Center, Damascus, Syrian Arab Republic.

Background

Coronary artery disease (CAD) affects left ventricular (LV) systolic and diastolic function. This  results in high filling pressure which expressed by different waves and may be assessed by invasive and noninvasive methods. Validation and comparing the correlation between CAD and different LV filling pressure waves may add a step forward in CAD diagnosis, prognosis and treatment.

Purpose

This study invasively validates the correlation between coronary artery disease (CAD) and left ventricular end-diastolic pressure (LVEDP) as well as left ventricular pre-A wave (LV pre-A wave) and compare the results.

Methods

124 patients who accepted to participate for this study underwent left heart catheterization for medical indications. This study obtained the results of LV filling pressures (LVEDP and LV pre-A wave), as well as, coronary angiography results with assessing the severity and extents (if CAD presents) by vessels number and Gensini Score (GS). Spearman r correlation were used for continuous/continuous or continuous/ordinal variables and Chi square test for nominal/nominal variables. Then we compared the results.

Results

CAD presence with elevated LVEDP incidence (OR = 4.29, relative risk = 1.85 P = 0.0123). Vessel number, plaque number and Gensini score correlations with LVEDP were (P = 0.0038 r = 0.34, P = 0.0002 r = 0.44, p = 0.0002 r = 0.43 and p = 0.0622 r = 0.22) respectively. In the same way, CAD presence with LV pre-a wave (OR = 2.75, relative risk = 1.5, P = 0.0447). Vessels number, plaque numbers and Gensini score relations with LV pre-A wave were (P = 0.0379 r = 0.23, P = 0.0004 r = 0.39, p = 0.0002 r = 0.40 and p = 0.0568 r = 0.21) respectively. All the results are summarized in Tables (1 + 2+3).

Conclusions

LV filling pressure had a significant correlation with CAD presence, vessel number and plaque number but it did not have a correlation with Gensini score. LVEDP had a stronger correlation with CAD presence, severity, sensitivity and extent but lower specificity than LV pre-A wave. Abstract Tables of results (1 + 2)  Abstract Table of result 3

A check of the grading system among the 2009 and 2016 EACVI/ASE left ventricular diastolic function guidelines statistically and invasively

Funding Acknowledgements

Type of funding sources: Public hospital(s). Main funding source(s): Al-mouwasat University Hospital and University Heart Surgery Center in Damascus, Syrian Arab Republic.

Background

Left ventricular diastolic function assessment undergoes continuous updates. EACVI/ASE 2016 guidelines handles with this case, which is an expert consensus and simplified update of the 2009 recommendations. As stated in the latest guidelines, studies need to check that the simplicity does not affect much the accuracy.

Aim

This study compares the corresponding subgroups between the 2009 and 2016 EACVI/ASE guidelines, for the assessment of left ventricular diastolic function statistically. Furthermore, it invasively validates of the relation between the grading results of each guidelines and  the measured LV filling pressure during catheterization lab.

Methods

124 patients underwent transthoracic echocardiography just before angiography. A trained echo cardiographer obtained E/A mitral flow, Av E/e", LAVI, TR, septal and lateral e" and other supportive parameters to assess LV diastolic function and filling pressure according to 2009 and 2016 EACVI/ASE guidelines algorithms and we compared the results with LV pre-a wave during catheterization with a cut-off &gt;12mmhg considered elevated.

Results

EACVI/ASE 2016 resulted in {normal (46.77%), Grade I (29.03%), Grade II (10.48%), Grade III  (7.26%) and indeterminate (6.45%)}, while EACVI/ASE 2009 resulted in {normal (39.52%), Grade I (25%), Grade II (13.71%), Grade III  (7.26%) and indeterminate (14.52%)} with no statically significant difference between subgroups. EACVI/ASE 2016 vs. 2009 in assessment LV filling pressure (odds ratio =0.51 and p value = 0.034. EACVI/ASE 2016 sensitivity and specificity were (0.36, 0.94 ) respectively and EACVI/ASE 2009 sensitivity and specificity were (0.63, 0.80) respectively. All results are summarized in (tables: 1 + 2+3 + 4+5 + 6).

Conclusion

This study found that the updated and simplified 2016 EACVI/ASE guidelines algorithm did not affect statistically the grading results of 2009 EACVI/ASE. Even more, 2016 had a higher relation between diastolic subgroups and invasively measured LV filling pressure which reflects the higher specificity than 2009. On the other hand 2016 was less able to detect elevated LV filling pressure which reflects a lower sensitivity than 2009. 2016 was more specific but less sensitive than 2009. There were no statistically significant difference between the means of invasively measured LV filling pressures among both guidelines. Abstract Figure.  Abstract Figure.

Invasive validation of the different echo parameters and cut-offs among the trilogy of left ventricular filling pressure assessment guidelines: EACVI/ASE 2016, ESC 2016, HFA 2019

Funding Acknowledgements

Type of funding sources: Public hospital(s). Main funding source(s): Al-mouwasat University Hospital and University Heart Surgery Center in Damascus, Syrian Arab Republic.

Background

Left ventricular filling pressure assessment is a challenge. Three guidelines concerned about this are: EACVI/ASE 2016, ESC 2016 and the HFA 2019 guidelines. Echo assessment is a corner stone in their algorithms with different cutoffs and different parameters used depending on expert consensus that should be validated in an invasive manner as the authors stated.

Aims

This study validates and tests the accuracy of the different cutoffs and parameters used in echo LV filling pressure assessment in the three guidelines: EACVI/ASE 2016, ESC 2016 and HFA 2019 by direct measure in the catheterization lab.

Methods

82 patients with EF ≥ 50%, signs and symptoms of HF underwent transthoracic echocardiography immediately before catheterization. Av E/e", TR, LAVI, LVMI, RWT, LV wall thickness, Septal, lateral and mean e" were used to assess LV filling pressure with respect to EACVI/ASE 2016, ESC 2016 and HFA guidelines algorithms" different cutoffs and  parameters used. This study used LV pre-A wave with a cutoff &gt;12mmhg defined high as a reference and then we compared the results.

Results

all the results of functional and structural echo parameters" diagnostic criteria (sensitivity, specificity, NPV, PPV and accuracy) are summarized in (Table:1 + 2).

Conclusion

From an echo view, each algorithm depends on  modest to high specific but low to modest sensitive echo parameters. There is no single parameter makes a guidelines superior to others. Although that the fact of combining more echo indices make the diagnosis and eventually the algorithm more reliable as in HFA 2019, that was for the cost of simplicity and ease of application. Av E/e"&gt;13 was the best cutoff (ESC 2016). Orientation for the cause of use (sensitivity, specificity, NPV or PPV) should employ the echo indices and cutoffs in best benefit, as for mitral (e"), although that septal &lt; 7 and lateral e"&lt;10 (EACVI/ASE 2016 and HFA 2019) had an overall more accuracy than mean e"&lt;9 (ESC 2016), sub analysis showed that the first is better used for specificity and NPV but the latter better for sensitivity and PPV. Same idea for LVMI≥145/122 (m/f)+RWT &gt; 0.42 (HFA 2019 major criteria) which had more specificity than LVMI≥115/95 (m/F) cutoffs (HFA2019 minor criteria and ESC2016) but in the cost of lower sensitivity, furthermore, sub analysis showed this LVMI high cutoffs were more benefit in female than in men after taking the NPV, PPV and accuracy in consideration. Abstract Figure.  Abstract Figure.

The correlation of ESC 2016 diastolic guidelines with invasively measured left ventricular filling pressure

Funding Acknowledgements

Type of funding sources: Public hospital(s). Main funding source(s): Al-mouwasat University Hospital, University Heart Surgery Center in Damascus, Syrian Arab Republic.

Background

left ventricular (LV) diastolic function and filling pressure assessment is a challenge. ESC 2016 diastolic guidelines handles with this issue. Validation of and comparing the correlation between this guidelines and invasively measured different waves may add a step forward in the assessment, prognosis and treatment of LV diastolic function by echo.

Purpose

this study validates of the correlation of ESC 2016 left ventricular filling pressure echo guidelines with invasively measured left ventricular end-diastolic pressure and left ventricular pre-a.

Methods

124 patients who accepted to participate for this study underwent transthoracic echocardiography immediately before left heart catheterization. This study obtained echo parameters to assess LV filling pressure according to ESC 2016 algorithms. It also obtained left ventricular end-diastolic pressure (LVEDP) and LV pre-a waves during catheterization. It analyzed the data and compared the results.

Results

Correlations of grading system (normal, abnormal parameters 1,2 and 3 present) with LV pre-a and LVEDP waves were (P= &lt; 0.0001 r = 0.47, P = 0.0027 r = 0.41), respectively. After excluding group of patients with only one abnormal parameter as indeterminate group, pressure assessment guidelines correlations with the presence of LV pre-a and LVEDP waves were (P = 0.0009 OR = 31.76, p= 0.0170 OR = 36.00), respectively. Means difference of LV pre-a and LVEDP waves between pressure guidelines presence and absence two groups were (LV pre-a: 12.72, 7.52, P &lt; 0.0001and LVEDP: 21.03 10.36, P = 0.0043), respectively. All results are summarized in (Table:1 + 2+3 + 4+5).

Conclusion

ESC 2016 guidelines pressure assessment correlated strongly with both LV pre-a and LVEDP waves which means that the higher the number of abnormal echo parameters is resulted by echo guidelines, the higher the LV pre-a or LVEDP is presented invasively. Different approaches had different diagnostic accuracy, the best specific was cutoff≥ 2 abnormal echo parameters and the best sensitive and overall accuracy was still cutoff≥2 but after excluding only one abnormal echo parameter group as indeterminate group. The difference between means between echo guidelines pressure assessment was more significant statistically in LV pre-a wave than in LVEDP. Abstract Figure. Abstract Figure.

A comparison between left ventricular filling pressure two waves: end-diastolic and pre-a for the correlation with echocardiographic parameters

Funding Acknowledgements

Type of funding sources: Public hospital(s). Main funding source(s): Al-mouwasat University Hospital, University Heart Surgery Center Damascus, Syrian Arab Republic.

Background

left ventricular (LV) filling pressure has an important prognostic and therapeutic role. Echocardiography plays an essential noninvasive role in its assessment and diagnosis. Checking of the correlation between echo parameters and different LV filling pressure wave invasively measure may add a step forward in its diagnosis, prognosis and treatment.

Purpose

this study invasively measures left end-diastolic pressure (LVEDP) and left ventricular pre-a wave (LV pre-a wave) and validates the correlation of each wave with echo parameters obtained immediately before angiography.

Methods

124 patients who accepted to participate for this study underwent transthoracic echocardiography just before catheterization. E/A, Av E/e", lateral and septal e", TR. LAVI, S/D, AR-A and other parameters were obtained to validate and compare the correlation with LVEDP and LV pre-a wave.

Results

  Correlation of different echo parameters with LVEDP and LV pre-a wave are summarized in table.

Conclusion

Among these echo parameters of this study, there was a significant correlation between LVEDP and E, E/A, TR, S velocity, S/D, AR duration, AR-A duration and LVMI. LV pre-a wave had a significant correlation with LAVI, EF, FS, Av E/e", E velocity, A velocity, E/A, TR, S velocity, S/D, AR duration, AR-A duration, LVDd, RWT, LVDs and LVMI. LVEDP correlated more than LV pre-a wave with S velocity, S/D, AR duration, AR-A duration and LVMI. LV pre-a wave correlated more than LVEDP with TR and E velocity. E/A was equally correlated with LVEDP and LV pre-a wave. Abstract Table of results 1  Abstract Table of results 2

An echocardiographic algorithm for predicting coronary artery disease: is it time to establish one?

Funding Acknowledgements

Type of funding sources: Public hospital(s). Main funding source(s): Al-mouwasat University Hospital and University Heart Surgery Center in Damascus, Syrian Arab Republic.

Background

Coronary artery disease (CAD) is a major clinical issue. CAD affects left ventricular systolic, diastolic function and LV filling pressure. Echocardiography has been known as the best noninvasive way for the assessment of systolic, diastolic function and LV filling pressure. Finding a correlation between CAD and echocardiographic parameters may help in the early assessment, prognosis and treatment of CAD.

Purpose

Finding a correlation between coronary artery disease and echocardiographic parameters with cutoffs to use in a diagnostic algorithm.

Methods

124 patients who accepted to participate for this study underwent transthoracic echocardiography immediately before their medically indicated left heart catheterization . An experienced echo cardiographer obtained mitral flow E velocity, A velocity, E/A, A duration, Av E/e", septal, lateral and mean e", pulmonary veins S velocity, D velocity, S/D, AR velocity, AR duration, AR-A duration, left atrial volume index (LAVI), tricuspid regurgitation (TR), inter ventricular septum (IVS), left inter ventricular diameter (LIVD), posterior wall diameter (PW) and some other echo parameters and assessed LV diastolic function and filling pressure according to EACVI/ASE 2016 guidelines. This study obtained angiography results and then analyzed and compared the results.

Results

Echo parameters that correlated with CAD were: EDT ≥ 160 (P = 0.0012 OR = 5.46), Av E/e" ≥ 7 (P = 0.0066 OR = 3.67), E ≥ 44 cm/s (P = 0.0026 OR = 10.00), A duration &gt; 140 (P = 0.0256 OR = 10.50), E/A ≥ 1 (P = 0.0036 OR = 4.17) and AR duration ≥ 210 (P = 0.0001 OR = 85.00). When Cutoffs ≥ 3 present, the correlation with CAD was (P= &lt; 0.0001 OR = 8.80) with diagnostic accuracy of (sensitivity = 0.76, specificity = 0.74, NPV = 0.68, PPV = 0.81). All the results are summarized in (Picture1:Tables 1 and 2).

Conclusion

Echo parameters (EDT, Av E/e", E velocity, A duration, E/A, AR duration) had strong correlations with the presence of coronary artery disease. The presence of three or more abnormal parameters had a significant diagnostic accuracy for CAD, and the more the abnormal parameters were positive, the higher the specificity and positive predictive value were for the diagnosis of CAD. The presence of only two abnormal parameters had a low specificity for CAD and the presence of 2016 EACVI/ASE diastolic dysfunction correlated with CAD with modest specificity which needs further assessment for the differential diagnosis. Furthermore, one or no abnormal parameters ruled out CAD with strong negative predictive value. Depending on the results of this study we kindly propose a resting echocardiographic algorithm for the diagnosis of CAD in (picture2: a proposed algorithm). Further studies should validate this algorithm and find other echo parameters especially strain echocardiography wether for resting or exercise algorithms. Abstract Tables of results  Abstract Figure. A proposed algorithm

Industrial symbiosis of anaerobic digestion and pyrolysis: Performances and agricultural interest of coupling biochar and liquid digestate

The sustainability of the anaerobic digestion industry is closely related to proper digestate disposal. In this study, an innovative cascading biorefinery concept coupling anaerobic digestion and subsequent pyrolysis of the digestate was investigated with the aim of enhancing the energy recovery and improving the fertilizers from organic wastes. Continuous anaerobic co-digestion of quinoa residues with wastewater sludge (45/55% VS) exhibited good stability and a methane production of 219 NL CH₄/kg VS. Subsequent pyrolysis of the solid digestate was carried out (at 500 °C, 1 h, and 10 °C/min), resulting in a products distribution of 40 wt% biochar, 36 wt% bio-oil, and 24 wt% syngas. The organic phase (OP) of bio-oil and syngas exhibited higher and lower heating values of 34 MJ/kg and 11.8 MJ/Nm³, respectively. The potential synergy of coupling biochar with liquid digestate (LD) for agronomic purposes was investigated. Interestingly, coupling LD (at 170 kg N/ha) with biochar (at 25 tons/ha) improved the growth of tomato plants up to 25% compared to LD application alone. In parallel, co-application of biochar with LD significantly increased the ammonia volatilization (by 64%) compared to LD application alone, although their simultaneous use did not impact the C and N mineralization rates.

Comparison between the British and the American/European guidelines for the assessment of left ventricular diastolic function with invasive validation of left ventricular filling pressure

Background

Left ventricle diastolic function and filling pressures assessment is still a major challenge to echocardiographer. There are two echo guidelines regarding this issue: the British Society of Echocardiography (BSE 2013) and the American Society of Echocardiography/European Association of Cardiovascular Imaging (ASE/EACVI 2016). The 2016 guidelines, which is an expert consensus and simplified update of 2009 guidelines, needs an invasive validation according to its authors. Recent studies raised questions about the diagnostic accuracy as sensitivity results varied very widely (34% to 87%) and also that of 2009 (43% to 79%). This study validated the diastolic pressure invasively in the cath lab and compared the results with the echo guidline algorithms were done immediately before the catheterization. When possible, it included additional assessment of S/D and Ar-A duration.

Purpose

Validation of the diagnostic accuracy of the 2009, the updated 2016 ASE/EACVI and 2013 BSE echocardiographic LV filling pressure predicting algorithms, as well as pulmonary veins flow (S/D) and (Ar-A) durations with invasively measured LV-pre-A wave.

Methods

124 patients (58.06% males) underwent transthoracic echocardiography immediately before left heart catheterization. A trained echocardiographer obtained E/A mitral flow, E/e', left atrial volume index, TR, EDT, lateral and septal e' to estimate LV filling pressure as normal, elevated or indeterminate using the 2009, 2016

ASE/EACVI algorithms and 2013 BSE algorithm. He also obtained Secondary parameters as (S/D) and (Ar-A) duration. Invasive LV pre-A pressure was the reference of this study, with &gt;12 mm Hg defined as elevated.

Results

Invasive LV pre-A pressure was elevated in 60 (48.38%) patients. When they could determine LV filling pressure, 2016 sensitivity was 0.36 and specificity 0.94, 2009 had 0.56 sensitivity and 0.90 specificity and 2013 resulted in 0.63 sensitivity and 0.80 specificity. Results of diagnostic accuracy of each algorithm as well as (S/D) and (Ar-A) summarized in tables associated in (picture 1: Tables of results). EDT≥150 msec raised NPV in normal, grade one diastolic dysfunction and indeterminate pressure.

Conclusion

2016 was the most specific but the least sensitive with modest NPV and PPV between the 2013 and 2009. 2013 was the most sensitive with the highest indeterminate pressure rate to execlude. Adding S/D or Ar-A duration markedly improved the sensitivity and reduced class indeterminate among all algorithms with more benefit when both combined. EDT had a rule out role in normal, grade one diastolic dysfunction and indeterminate pressure patients. We kindly propose a modification of 2016 algorithm by adding S/D, Ar-A and EDT as optional parameters to increase sensitivity and reduce indeterminate class without affecting simplicity or specificity (picture 2: Proposed algorithms A+B). We recommend future studies to validate the diagnostic accuracy of the proposed algorithms.

Funding Acknowledgement

Type of funding sources: Public hospital(s). Main funding source(s): Al mouwasat University Hospital and University Heart Surgery Center at Damascus, Syrian Arab Republic. Tables of resultsProposed Algorithms A+B

Anaerobic digestion and agronomic applications of microalgae for its sustainable valorization

Microalgae are considered potential candidates in biorefinery processes, and due to their biochemical properties, they can be used in the production of biofuels such as biogas, as well as for bioremediation of liquid effluents. The objective of this review is to study the current status of microalgae anaerobic digestion and agricultural uses (as bio-stimulants and biofertilizers), starting from microalgae cultivation. Indeed, the efficiency of these processes necessarily depends on the evaluation of different biotic and abiotic factors that affect the growth of microalgae. However, the adaptation and the optimization of process parameters on a large scale is also limited by energy and economic constraints. Moreover, the integration of biogas production processes with microalgae cultivation allows a nutrients and CO2 virtuous loop, thus promoting the sustainability of the process. Finally, this paper provides a general overview of biogas and biofertilizers production combination, as well as the related challenges and recommended future research perspectives to complement the gap in the literature.

Phosphate bacterial solubilization: A key rhizosphere driving force enabling higher P use efficiency and crop productivity

•

Phosphate bacteria bio-solubilization significantly increase crop P acquisition and productivity.

•

Phosphate solubilizing bacteria increase RP agronomic efficiency as well as P fertilizers efficiency.

•

This process can be optimized through a rational bacterial screening to assure efficient PSB are selected.

•

Appropriate formulation of PSB is a sustainable approach to enhance P-fertilizers efficiency.

•

Development of innovative PSB-Phosphate formulations is likely to sustain crop production.

Background

Increasing crop production to feed a growing population has driven the use of mineral fertilizers to ensure nutrients availability and fertility of agricultural soils. After nitrogen, phosphorus (P) is the second most important nutrient for plant growth and productivity. However, P availability in most agricultural soils is often limited because P strongly binds to soil particles and divalent cations forming insoluble P-complexes. Therefore, there is a constant need to sustainably improve soil P availability. This may include, among other strategies, the application of microbial resources specialized in P cycling, such as phosphate solubilizing bacteria (PSB). This P-mediating bacterial component can improve soil biological fertility and crop production, and should be integrated in well-established formulations to enhance availability and efficiency in use of P. This is of importance to P fertilization, including both organic and mineral P such as rock phosphate (RP) aiming to improve its agronomic efficiency within an integrated crop nutrition system where agronomic profitability of P and PSB can synergistically occur.

Aim of Review

The purpose of this review is to discuss critically the important contribution of PSB to crop P nutrition in concert with P fertilizers, with a specific focus on RP. We also highlight the need for PSB bioformulations being a sustainable approach to enhance P fertilizer use efficiency and crop production.

Key Scientific Concepts of Review

We first recognize the important contribution of PSB to sustain crop production, which requires a rational approach for both screening and evaluation of PSB enabling an accurate assessment of the bacterial effects both alone and in intertwined interaction with plant roots. Furthermore, we propose new research ideas about the development of microbial bioformulations based on PSB with a particular focus on strains exhibiting synergetic effects with RP.

DSPECT-specific normal limits for LV measurements: a new approach to derivation

Funding Acknowledgements

Type of funding sources: None.

Background

Differences in spatial resolution and image filtering between the solid-state DSPECT and traditional Anger SPECT (A-SPECT) cameras are likely to result in differences in LV measurements. However, DSPECT- specific normal values have not been systematically derived. We used healthy organ-donor subjects from our high-volume solid organ transplant center for derivation of normal values.

Purpose

To report DSPECT-specific LV measurements normal limits derived from a unique cohort of donor subjects.

Methods

Subjects were 92 consecutive kidney or liver donors who underwent single day rest (5 mCi)- stress (15mCi) Tc-99m sestamibi gated SPECT myocardial perfusion imaging (MPI) on the DSPECT for pre-operative evaluation. Exclusion criteria included any cardiac disease or medications. LV measurements were made on the post-stress supine stress images using QGS®.

Results

Of 92 subjects (mean age 54.4 ± 15.0 and 39% men), mean EF for women and men were 77.2 ± 14.1% and 70.0 ± 14.7%, respectively. Mean end-diastolic volume for women and men were 67.0 ± 32.2 ml and 99.6 ± 51.6 ml (indexed 38.3 ± 17.2 ml/m2 and 48.1 ± 25.9 ml/m2), respectively. Mean LV wall volume for women and men were 95.9 ± 26.0 ml and 112.0 ± 48.8 ml (indexed 55.0 ± 13.8 ml/m2 and 54.1 ± 24.6 ml/m2), respectively.

Conclusion

We report DSPECT-specific LV measurements from normal subjects from which limits of normality can be derived for clinic use. Organ-donors who undergo pre-operative MPI are a suitable cohort for the derivation of normal values.

Thalamic versus midbrain tremor; two distinct types of Holmes' Tremor: a review of 17 cases

INTRODUCTION

Holmes Tremor (HT) is a unique and debilitating movement disorder. It usually results from lesions of the midbrain and its connection but can also result from posterior thalamic injury. Clinical examination can help lesion localization between these two areas. We studied the clinical features and their radiological correlations to distinguish midbrain HT (HT-m) from thalamic HT (HT-t).

METHODS

Retrospective review of 17 patients with a HT-type presentation was conducted. Tremor characteristics, associated clinical signs and radiological findings were studied.

RESULTS

Eleven patients had a myorythmic rest tremor, large amplitude proximal tremor with goal-directed worsening, with or without mild distal dystonic posturing, representing HT-m. Six patients had slow, large amplitude proximal tremors and distal choreathetoid movements, significant proximal/distal dystonic posturing, associated with proprioceptive sensory loss, representing HT-t. Haemorrhagic lesions were the predominant cause of HT-m; whereas, ischaemia was more commonly associated with HT-t.

CONCLUSION

When assessing patients with HT, attentiveness to the presence of associated signs in the affected limb, such as a proprioceptive sensory deficits and additional movement disorders, can aid lesion localisation, which can have implications for management.

Management of peri-prosthetic joint infection and severe bone loss after total hip arthroplasty using a long-stemmed cemented custom-made articulating spacer (CUMARS)

Background

There is little evidence on techniques for management of peri-prosthetic infection (PJI) in the context of severe proximal femoral bone loss. Custom-made articulating spacers (CUMARS) utilising cemented femoral stems as spacers was described providing better bone support and longer survival compared to conventional articulating spacers. We retrospectively report our experience managing PJI by adaptation of this technique using long cemented femoral stems where bone loss precludes use of standard stems.

Methods

Patients undergoing 1st stage revision for infected primary and revision THA using a cemented long stem (> 205 mm) and standard all-polyethylene acetabulum between 2011 and 2018 were identified. After excluding other causes of revision (fractures or aseptic loosening), Twenty-one patients remained out of total 721 revisions. Medical records were assessed for demographics, initial microbiological and operative treatment, complications, eradication of infection and subsequent operations. 2nd stage revision was undertaken in the presence of pain or subsidence.

Results

Twenty-one patients underwent 1st stage revision with a cemented long femoral stem. Mean follow up was 3.9 years (range 1.7–7.2). Infection was eradicated in 15 (71.4%) patients. Two patients (9.5%) required repeat 1st stage and subsequently cleared their infection. Three patients (14.3%) had chronic infection and are on long term suppressive antibiotics. One patient (4.8%) was lost to follow up before 2 years. Complications occurred in seven patients (33%) during or after 1st stage revision. Where infection was cleared, 2nd stage revision was undertaken in 12 patients (76.5%) at average of 9 months post 1st stage. Five (23.8%) CUMARS constructs remained in-situ at an average of 3.8 years post-op (range 2.6–5.1).

Conclusions

Our technique can be used in the most taxing of reconstructive scenarios allowing mobility, local antibiotic delivery, maintenance of leg length and preserves bone and soft tissue, factors not afforded by alternative spacer options.

Intensive home treatment in comparison with care as usual: Cost-utility analysis from a pre-randomized controlled trial in the netherlands

Introduction

The implementation of Intensive Home Treatment (IHT) aims to decrease the pressure on acute inpatient services that could lead to prevent hospitalization and reduce the number of hospitalization days and, ultimately, reduce cost in the mental health services. Although there are studies assessing the effectiveness of IHT, there is a shortage of research studying the cost-effectiveness.

Objectives

The aim of this study is to present an cost-utility analysis of IHT compared to care as usual (CAU)

Methods

Patients between 18 and 65 years of age whose mental health professionals considered hospitalization were included. These patients were pre-randomized in either IHT or CAU and followed up for 12-months. For this study, the base case analysis was performed from the societal and healthcare perspective. For the cost-utility analyses the Euroqol 5D was used to calculate quality adjusted life years (QALYs) as a generic measure of health gains.

Results

Data of 198 patients were used. From a sociatal perspective, the cost-utility analysis resulted in an incremental cost-effectiveness ratios (ICERs) of €58 730, and a 37% likelihood that IHT leads to higher QALYs at lower costs. The probability of IHT being cost-effective was >50% if there was no willingness to pay more for extra QALY than in the current situation under CAU.

Conclusions

Professionals working in crisis care are able to offer IHT with the same effect as other crisis care interventions at lower costs. IHT seem to be cost-effective compared with CAU over 52 weeks follow-up for patients who experience psychiatric crises.

Disclosure

No significant relationships.

Evaluation of rice straw biopowder from alkaline-mechanical pretreatment by hydro-textural approach

Apretreatment step forlignocelluloses is responsible to alter the complex structure which allows enhancingenzymatic accessibility and bioconversion of the materials.However, there is a gap on the methods to characterize physicalevolutions of the material throughout its pretreatment.The aim of this study is to evaluate the physical changes in rice straw (RS)pretreated with alkaline followed by grinding to produce biopowders.A hydro-textural approach was applied to evaluate the physical changes of RS pretreated byimpregnation and soaking in NaOH.The results indicated that the volume deformation increased by 110%, whilethe energy consumptiondecreased by 11.3% compared to unpretreated RS.Moreover, the cellulose content and glucose were 66.8 and 212 mg/gRS obtained by RSsoaking. Thealkaline-mechanicalpretreatment was shown asan effective process to providehigh glucosereadily converted to bioethanol.Additionally, the hydro-textural approach can be considered an alternative method for biomass structural characterization.

Coupling anaerobic digestion and pyrolysis processes for maximizing energy recovery and soil preservation according to the circular economy concept

After press separation of the liquid and solid digestate from an agricultural biogas plant, pyrolysis of solid anaerobic digestate was carried out (i.e., at 500 °C, 1h, and 10 °C/min) to produce biochar (37.6 wt%), bio-oil (33.7 wt%) and syngas (29.3 wt%). The organic phase of bio-oil and syngas exhibited high and low heating values of 28.4 MJ/kg and 12.9 MJ/Nm³, respectively. Then, the synergy of coupling biochar with liquid digestate for agronomic purposes was investigated by leaching experiment and growth plant tests on wheat. Leaching experiments using combination of liquid digestate (170 kg N/ha) and biochar demonstrated that biochar addition increases the cumulative leaching of all nutrients, except nitrate, that have a significant decrease of 82% and 91%, respectively at 50 and 100 t/ha, compared to soil treated only with liquid digestate. The co-application of biochar with liquid digestate on growth wheat plant tests demonstrated that biochar application at 50 t/ha did not exhibit a negative impact on the relative seed germination and improved aerial dry biomass production (up to 27.5%) compared to soil with only liquid digestate addition.

Production and Dry Mechanochemical Activation of Biochars Derived from Moroccan Red Macroalgae Residue and Olive Pomace Biomass for Treating Wastewater: Thermodynamic, Isotherm, and Kinetic Studies

This study aimed to produce activated biochars (BCs) from Moroccan algae residue (AG) and olive pomace (OP) using mechanochemical activation with NaOH and ball milling (BM) for treating artificial textile wastewater containing methylene blue (MeB). The produced OP-activated BC by BM showed the highest absolute value of ζ-potential (-59.7 mV) and high removal efficiency of MeB compared to other activated BCs. The nonlinear pseudo-first-order kinetic model was the most suitable model to describe the kinetics of adsorption of MeB onto biochars produced from AG and the NaOH-activated BC from OP, whereas the nonlinear pseudo-second-order kinetic model suits the OP raw biochar and BM-activated BC. The nonlinear Langmuir isotherm model was the most suitable model for describing MeB adsorption onto BCs, compared to the nonlinear Freundlich isotherm model. The maximum adsorption capacities of AG-activated BCs with NaOH and BM were 13.1 and 9.1 mg/g, respectively, while those of OP-activated BCs were 2.6 and 31.8 mg/g, respectively. The thermodynamic study indicates the spontaneous and endothermic nature of the adsorption process of most activated BCs. In addition, ΔS° values indicate the increase of randomness at the solid-liquid interface during MeB sorption onto BC.

In vitro haemostatic efficacy of aqueous, methanol and ethanol plant extracts of three medicinal plant species in Palestine

Abstract The haemostatic efficacy of different extract types of Satureja thymbra L., Thymbra spicata L. (Lamiaceae) and Verbascum fruticulosum Post. (Scrophulariaceae) was evaluated in this study via the Prothrombin time (PT) and Activated partial thromboplastin time (aPTT) analysis. Aqueous, methanol and ethanol extracts of the examined plant species leaves were prepared to a final concentration 50 mg/mL. In vitro PT and aPTT assays were conducted on normal platelet poor plasma blood samples by a digital coagulation analyzer. The obtained results revealed anticoagulation activity of all investigated plant species with observed variations among them. The aqueous and ethanol extracts of T. spicata as well as the aqueous extract of S. thymbra prolonged PT values significantly (p < 0.05). While, all V. fruticulosum extract types have had no significant effect on the PT values. The recorded aPTT data showed that all aqueous extracts have had a significant effect on the blood haemostasis as they increased aPTT values in all plant species under study. Out of which, both the ethanol and methanol extracts of T. spicata and methanol extract of S. thymbra showed similar effect. Of great concern, it was clearly noticed that the aqueous and ethanol extract of T. spicata and the aqueous extract of S. thymbra possess the strongest anticoagulation effect as they increased both PT and aPTT values significantly relative to the control (p < 0.05). The variable anticoagulation bioactivity among the studied plant species could be referred to the various solvents degrees of solubility of different phyto-constituents. Thus, the efficacy of the plant species extracts evaluation as anticoagulants or coagulants were related to the plant species and to the solvent of extraction.

Effect of coupling alkaline pretreatment and sewage sludge co-digestion on methane production and fertilizer potential of digestate

This study aims at investigating how organic waste co-digestion coupled with alkaline pretreatment can impact the methane production and agronomic value of produced digestates. For this purpose, sludge alone and mixed with olive pomace or macroalgal residues were subjected to anaerobic digestion with and without alkaline pretreatment. In addition, co-digestion of pretreated sludge with raw substrates was also carried out and compared to the whole mixture pretreatment. KOH pretreatment enhanced methane production by 39%, 15% and 49% from sludge, sludge mixed with olive pomace and sludge mixed with macroalgal residues, respectively. The digestates were characterised according to their physico-chemical and agronomic properties. They were then applied as biofertilizers for tomato growth during the first vegetative stage (28 days of culture). Concentrations in chlorophyll a and carotenoids in tomato plants, following sludge digestate addition, rose by 46% and 41% respectively. Sludge digestate enhanced tomato plant dry weight by 87%, while its nitrogen content increased by 90%. The impact of nitrogen and phosphorus contents in the digestate was strongest on tomato plant dry weight, thus explaining the efficiency of sludge digestate relative to other types of digestate. However, when methane production is considered, the combination of pre-treatment with co-digestion of macroalgal residues and sludge appears most beneficial for maximizing energy recovery and for biofertilizer generation.

Are positive-pressure ventilation lobby rooms effective for protective and source isolation?

High-efficiency particulate air supplied to a positive-pressure ventilation lobby (PPVL) in isolation rooms offers the dual advantage of protective and source isolation. This study demonstrates the in-use validity of PPVL rooms for protective isolation of patients. Of the 48 PPVL air samples investigated, Aspergillus fumigatus was detected from only one (2%) sample. Local and remote monitoring of the PPVL rooms is essential for the safety of patients and healthcare workers. Remote and point-of-use engineering controls are essential for ongoing ventilation monitoring, but this should be complemented by visual inspection of the isolation suite. Periodic microbiological monitoring should also be considered with other control measures.

Evaluation of agronomic properties of digestate from macroalgal residues anaerobic digestion: Impact of pretreatment and co-digestion with waste activated sludge

The aim of this paper is to investigate the impact of pretreating macroalgal residue (MAR) from agar-agar extraction and its co-digestion with sewage sludge on methane production and the agronomic quality of the digestates produced. First, different pretreatments were assessed on BMP tests. Among milling technologies used, knife milling with a 4 mm-screen improved methane production by 25%. The MAR was then knife milled before alkaline, acid and thermal pretreatment. KOH pretreatment (5% TS basis, 25 °C for 2 days) led to the highest methane improvement. It was applied to semi-continuous anaerobic digestion and methane production achieved 237 Nml/gVS which was 20% higher than the control (198 Nml/gVS). In comparison to MAR mono-digestion, co-digestion with thickened activated sludge produced less methane (184 Nml/gVS) but reduced H₂S emission by 91%. None of the digestates was toxic for the germination or growth of wheat and tomato plants. Particularly, co-digestion had the highest impact on tomato plant dry weight (+94% compared to soil alone) mainly due to the phosphorous brought by sludge. However, the impact of alkaline pretreatment on plant growth was not significant.

Mild microwaves, ultrasonic and alkaline pretreatments for improving methane production: Impact on biochemical and structural properties of olive pomace

This study aims to investigate the effects of microwaves, ultrasonic and alkaline pretreatments on olive pomace properties and its biomethane potential. Alkaline pretreatment was found to reduce lipid and fiber contents (especially lignin) and to increase soluble matter. The alkali pretreatment at a dose of 8% (w/w TS) under 25 °C and for 1 day removed 96% of initial lipids from the solid olive pomace. Unlike NaOH addition, mild microwaves and ultrasonic pretreatments had no impact on lignin. However, in the case of long microwaves pretreatment (450 W-10 min), cellulose and lignin contents were reduced by 50% and 26% respectively. Similarly, the combination of ultrasonic and alkali reagent showed a positive effect on fiber degradation and lipid solubilization as well as a positive impact on methane production. Statistical analysis highlighted the correlation between NaOH dose, solubilization and methane production. The alkaline pretreatment at ambient temperature appeared the most energetically efficient.

Effective Catalytic Delignification and Fractionation of Lignocellulosic Biomass in Water over Zn3V2O8 Mixed Oxide

The conversion of poplar wood biomass to highly value-added chemicals and molecular building blocks was achieved by using the dispersed mixed oxide Zn₃V₂O₈ (ZVO) in water under 100 kPa of 10% O₂/N₂ at 160, 180, and 200 °C for 4 h. This nanostructured mixed oxide was prepared via the precipitation process and then characterized by several techniques. The results showed that this mixed oxide has interesting catalytic properties and is a versatile catalyst for biomass delignification and lignin and hemicellulose depolymerization. ZVO exhibited high activity on poplar biomass delignification and fractionation (degree of delignification > 97%) and lignin and holocellulose conversion with high yield into aromatic and furan compounds (80 mg/g initial wood at 200 °C), with high selectivities for 5-hydroxymethylfurfural (HMF) (25 mg/g of initial wood), vanillin, and syringaldehyde.

Controlling the growth of nanosized titania via polymer gelation for photocatalytic applications

Nanocrystalline titania was synthesized by a simple, innovative and eco-friendly gelation method by using biopolymers (polysaccharides).

Influence of Rice Husk and Wood Biomass Properties on the Manufacture of Filaments for Fused Deposition Modeling

Additive manufacturing or 3D printing has the potential to displace some of the current manufacturing techniques and is particularly attractive if local renewable waste resources can be used. In this study, rice husk, and wood powders were compounded in polylactic acid (PLA) by twin screw extrusion to produce filaments for fused-deposition modeling 3D printing. The biomasses were characterized in terms of physical features (e.g., particle size, density) and chemical compositions (e.g., solid state nuclear magnetic resonance, ash content). The two biomasses were found to have a different impact on the rheological behavior of the compounds and the extrusion process overall stability. When comparing the complex viscosity of neat PLA to the biomass/PLA compounds, the integration of wood powder increased the complex viscosity of the compound, whereas the integration of rice husk powder decreased it. This significant difference in rheological behavior was attributed to the higher specific surface area (and chemical reactivity) of the rice husk particles and the presence of silica in rice husks compared to the wood powder. Color variations were also observed. Despite the biomass filler and rheological behavior differences, the mechanical properties of the 3D printed samples were similar and predominantly affected by the printing direction.

Comparison of Dry Versus Wet Milling to Improve Bioethanol or Methane Recovery from Solid Anaerobic Digestate

Biogas plants for waste treatment valorization are presently experiencing rapid development, especially in the agricultural sector, where large amounts of digestate are being generated. In this study, we investigated the effect of vibro-ball milling (VBM) for 5 and 30 min at a frequency of 20 s⁻¹ on the physicochemical composition and enzymatic hydrolysis (30 U g⁻¹ total solids (TS) of cellulase and endo-1,4-xylanase from Trichoderma longibrachiatum) of dry and wet solid separated digestates from an agricultural biogas plant. We found that VBM of dry solid digestate improved the physical parameters as both the particle size and the crystallinity index (from 27% to 75%) were reduced. By contrast, VBM of wet solid digestate had a minimal effect on the physicochemical parameters. The best results in terms of cellulose and hemicelluloses hydrolysis were noted for 30 min of VBM of dry solid digestate, with hydrolysis yields of 64% and 85% for hemicelluloses and cellulose, respectively. At the condition of 30 min of VBM, bioethanol and methane production on the dry solid separated digestate was investigated. Bioethanol fermentation by simultaneous saccharification and fermentation resulted in an ethanol yield of 98 g_eth kg⁻¹ TS (corresponding to 90% of the theoretical value) versus 19 g_eth kg⁻¹ TS for raw solid digestate. Finally, in terms of methane potential, VBM for 30 min lead to an increase of the methane potential of 31% compared to untreated solid digestate.

Computational studies of 2-(4-oxo-3-phenylthiazolidin-2-ylidene)malononitrile

The molecular structure of the 2-(4-oxo-3-phenylthiazolidin-2-ylidene) malononitrile (3) is calculated using DFT B3LYP/6-311G(d, p) method. The calculated geometric parameters are in good agreement with the experimental data. The NBO calculations were performed to predict the natural atomic charges at the different atomic sites and study the different intramolecular charge transfer (ICT) interactions occurring in the studied system. The BD(2)C17-C19 → BD*(2)C14-C15, LP(2)O2 → BD*(1)N5-C9 and LP(1)N5 → BD*(2)C10-C11 ICT interactions causing stabilization of the system by 23.30, 30.63 and 52.48 kcal/mol, respectively. The two intense electronic transition bands observed experimentally at 249 nm and 296 nm are predicted using the TD-DFT calculations at 237.9 nm (f = 0.1618) and 276.4 nm (f = 0.3408), respectively. These electronic transitions are due to H-3 → L (94%) and H → L (95%) excitations, respectively.