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Cardiac myxomas are extremely rare in infants, but many times are life endangering. We report a case of giant right atrial myxoma in a 7-month-old child obstructing tricuspid valve inflow, causing severe metabolic acidosis and near cardiac arrest. The child was treated with emergency surgical excision of intracardiac myxoma saving her life. [ABSTRACT FROM AUTHOR]

Waste disposal is a challenging environmental concern worldwide. Carbon-rich waste materials can be transformed into adsorbent and/or catalyst support to reduce treatment costs and promote waste recycling. In the present study, three waste materials—sewage sludge, black liquor (from pulp and paper mills), and sugar mill press mud—were converted into activated carbons which were used as support for the iron-impregnated heterogeneous Fenton-type photo catalysts. These materials were characterized and tested on synthetic wastewater containing 4-chlorophenol (4-CP) as the model compound and simulated pulp-bleaching effluent. The oxidation runs were performed at an initial reaction pH of 4.4 with stoichiometric H2O2 dose and catalyst mass loading of 1 g/L for 2 h duration. The maximum total organic carbon removal of 69% and 32% was observed for 4-CP and simulated bleaching effluent, respectively, during photocatalytic oxidation with black liquor–derived catalyst. Thus, the use of black liquor–derived catalyst for bleaching effluent can help paper mill operators handle liquid as well as solid waste in a very efficient manner. [ABSTRACT FROM AUTHOR]

• HTC pretreatment greatly improved resource recovery from sewage sludge. • The properties of hydrochar formed after HTC at 200 °C resembled with peat coal. • TGA kinetics of hydrochar combustion showed great reduction in activation energy. • 60–70% HA and 80% PO 4 3−-P (struvite) were recovered from process wastewater. • The recovered HA showed improvement in seed growth. Safe disposal of the sludge generated from sewage treatment plant is a major challenge worldwide. Hydrothermal carbonization (HTC) is considered a potential pretreatment alternative for sewage sludge to facilitate the improved resource recovery. In the present study, the mixed centrifuged sewage sludge (CSS) was subjected to the HTC pretreatment to determine characteristics of the solid hydrochar (HC) and liquid fraction (LF) with a purpose of energy recovery and extraction of value-added compounds, respectively. HTC was performed in a high pressure batch reactor at 200 °C temperature for 1–8 h duration. The HC produced after HTC resembled with the low quality peat coal whereas the LF contained value-added chemicals such as humic acid (HA) and phosphate phosphorous (PO 4 3—P). Using ammonium sulphate as 'salting out' agent, ~70% of the total HA (~15–16 g/L) could be recovered from the LF. Using the recovered HA, an improvement in the root and shoot lengths of the seeds could be observed. In the subsequent step, the total PO 4 3−-P recovery of ~80% was obtained as struvite from the residual wastewater. [ABSTRACT FROM AUTHOR]

With the rise in living standards and evolution of science, there is a rise in life expectancy world over. This demographic transition has led to a rise in older persons, increasing the dependency ratios and "demographic burden." Management of such old patients requires special considerations and understanding as aging is a physiological phenomenon in which the functional capacity of organs decreases due to degenerative changes in the structure. An important aspect to remember in Geriatric Anesthesia is that in spite of adequate compensatory mechanisms for age-related changes, there is a limitation of physiological reserve, especially in stressful circumstances like perioperative period. Geriatric patients are more sensitive to all medications and anesthetic agents. Lesser amount of drug is required to achieve the desired clinical effect, but have a prolonged effect. This elderly but well-preserved patient, possibly a case of small gut obstruction was posted for emergency laparoscopy and proceed. Seeing his age and easy friability, a well-planned preoperative assessment and optimization was done prior to wheeling him into operation theater. Administration of short-acting anesthetic drugs in titrated quantities and awareness about postoperative cognitive dysfunction (POCD) helped us to get better and faster recovery in the patient. [ABSTRACT FROM AUTHOR]

To determine the efficacy of repeat selective laser trabeculoplasty (SLT) in medication-naive open-angle glaucoma (OAG) and ocular hypertensive (OHT) patients requiring repeat treatment for early to medium-term failure during the Laser in Glaucoma and Ocular Hypertension (LiGHT) trial. Post hoc analysis of SLT treatment arm of a multicenter prospective randomized controlled trial. Treatment-naive OAG or OHT requiring repeat 360-degree SLT within 18 months. Retreatment was triggered by predefined IOP and disease-progression criteria (using objective individualized target IOPs). After SLT at baseline, patients were followed for a minimum of 18 months after second (repeat) SLT. A mixed-model analysis was performed with the eye as the unit of analysis, with crossed random effects to adjust for correlation between fellow eyes and repeated measures within eyes. Kaplan–Meier curves plot the duration of effect. Initial (early) IOP lowering at 2 months and duration of effect after initial and repeat SLT. A total of 115 eyes of 90 patients received repeat SLT during the first 18 months of the trial. Pretreatment IOP before initial SLT was significantly higher than before retreatment IOP of repeat SLT (mean difference, 3.4 mmHg; 95% confidence interval [CI], 2.6–4.3 mmHg; P < 0.001). Absolute IOP reduction at 2 months was greater after initial SLT compared with repeat SLT (mean difference, 1.0 mmHg; 95% CI, 0.2–1.8 mmHg; P = 0.02). Adjusted absolute IOP reduction at 2 months (adjusting for IOP before initial or repeat laser) was greater after repeat SLT (adjusted mean difference, −1.1 mmHg, 95% CI, −1.7 to −0.5 mmHg; P = 0.001). A total of 34 eyes were early failures (retreatment 2 months after initial SLT) versus 81 later failures (retreatment >2 months after initial SLT). No significant difference in early absolute IOP reduction at 2 months after repeat SLT was noted between early and later failures (mean difference, 0.3 mmHg; 95% CI, −1.1 to 1.8 mmHg; P = 0.655). Repeat SLT maintained drop-free IOP control in 67% of 115 eyes at 18 months, with no clinically relevant adverse events. These exploratory analyses demonstrate that repeat SLT can maintain IOP at or below target IOP in medication-naive OAG and OHT eyes requiring retreatment with at least an equivalent duration of effect to initial laser. [ABSTRACT FROM AUTHOR]

[Display omitted] • Hydrothermal pretreatment of press mud (PM) improved resource recovery options. • The combustion properties of hydrochar (HC) were superior than PM. • No phytotoxicity was found with PM and HC for the germination of mung bean seeds. • Significant biogas generation from process water was observed. In the present study, press mud (PM), a major waste by-product from sugar industries, was subjected to hydrothermal pretreatment (HTP) to create resource recovery opportunities. The HTP process was performed with the PM samples in a laboratory scale high pressure batch reactor (capacity = 0.7 L) at 160 °C and 200 °C temperatures (solids content = 5 % and 30 %). The pretreatment resulted in separation of solid and liquid phases which are termed as solid hydrochar (HC) and process water (PW), respectively. High heating value (HHV) of HC was ∼14–18 MJ kg−1, slightly higher than that of PM (14 MJ kg−1). The thermogravimetric analysis showed about 1.5–1.7 times higher heat release from HC burning compared to that observed from combustion of PM. Apart from this, the HC and PM showed no phytotoxicity during germination of mung bean (Vigna radiata). Moreover, the biochemical methane potential test on the PW showed a generation of 167–245 mL biogas per gram of chemical oxygen demand added. Hence, the HTP offers several resource recovery opportunities from PM which may also reduce the risks of environmental degradation. [ABSTRACT FROM AUTHOR]

Sulphidic spent caustic (SSC) is an alkaline waste stream which is generated during caustic scrubbing of liquefied petroleum gas and ethylene products. Due to presence of high concentrations of sulphides and phenols, the waste stream requires proper treatment before mixing with the low strength wastewater streams produced from other refinery operations. Electrochemical process is an emerging treatment method that can work efficiently at ambient conditions. The present study reports performance of electro-Fenton (EF) process for the treatment of synthetic SSC wastewater (sulphides = 10 g L−1, phenol = 2 g L−1 and pH = 12.9). The EF runs were carried out for 2 h duration in a reactor equipped with iron electrodes. The effects of H 2 O 2 dose (0.26–1.3 M), current density (1–20 mA cm−2), pH (4.5–12.9) and stirring speed (100–1000 rpm) were investigated on removal of pollutants. The H 2 O 2 was rapidly consumed in initial 30 min during which the significant fraction of the pollutants was degraded or removed. The optimum conditions for EF process were found to be as follows: pH = 4.5, H 2 O 2 dose = 1.05 M, current density = 5 mA cm−2 and stirring speed = 500 rpm. At these conditions, the maximum sulphide and phenol removals from the wastewater were 98% and 91%, respectively. The results will be helpful to the wastewater treatment plant operators worldwide dealing with high concentrations of such pollutants. [Display omitted] • EF process showed 98% sulphide and 90% COD removals from synthetic wastewater. • The maximum pollutant removal rate was found to occur in initial 30 min. • During EF, the Fe2+ concentration in the solution was ∼200 mg L−1. • Pollutants' removal pathways were oxidation, volatilization and solid precipitate. • Thiosulphates, and organic acids were detected as intermediates during EF process. [ABSTRACT FROM AUTHOR]

To report clinical efficacy, predictors of success, and safety of primary selective laser trabeculoplasty (SLT) used in treatment-naive patients with open-angle glaucoma (OAG) or ocular hypertension (OHT). Post hoc analysis of a multicenter, prospective, randomized, controlled trial. Treatment-naive patients with OAG or OHT. Patients randomized to SLT or topical medication and treated to predefined target intraocular pressures (IOPs) requiring ≥20% IOP reduction from baseline for all disease severity levels. Initial (early) absolute IOP-lowering at 2 months. Achievement of drop-free disease-control: meeting target IOP without disease progression or need for additional topical medication over 36 months after SLT. Predictors of early absolute IOP-lowering and drop-free disease-control after single initial SLT. Frequency of laser-related complications. A total of 611 eyes (195 OHT and 416 OAG) of 355 patients received SLT, and 622 eyes (185 OHT and 437 OAG) of 362 patients received topical medication at baseline. Early absolute IOP-lowering after SLT was no different between OHT and OAG eyes (adjusted mean difference = −0.05 mmHg; 95% confidence interval [CI], −0.6 to 0.5 mmHg; P = 0.85). No difference was noted in early absolute IOP-lowering between topical medication and primary SLT (adjusted mean difference = −0.1 mmHg; 95% CI, −0.6 to 0.4 mmHg; P = 0.67). Early absolute IOP-lowering with primary SLT was positively associated with baseline IOP (coefficient 0.58; 95% CI, 0.53–0.63; P < 0.001) and negatively with female gender (coefficient −0.63; 95% CI, −1.23 to −0.02; P = 0.04). At 36 months, 536 eyes (87.7% of 611 eyes) of 314 patients (88.5% of 355 patients) were available for analysis. Some 74.6% of eyes (400 eyes) treated with primary SLT achieved drop-free disease-control at 36 months; 58.2% (312 eyes) after single SLT. Total SLT power and 2-month IOP were predictors of drop-free disease-control at 36 months after single SLT. Six eyes of 6 patients experienced immediate post-laser IOP spike (>5 mmHg from pretreatment IOP) with 1 eye requiring treatment. Primary SLT achieved comparable early absolute IOP-lowering in OHT versus OAG eyes. Drop-free disease-control was achieved in approximately 75% eyes at 36 months after 1 or 2 SLTs, the majority of these after single SLT. These analyses are exploratory but support primary SLT to be effective and safe in treatment-naive OAG and OHT eyes. [ABSTRACT FROM AUTHOR]

Abstract Land disposal of waste activated sludge pose environmental risks due to the presence of heavy metals, pathogens and organic pollutants. Anaerobic digestion (AD) is one of the preferred treatment methods for sludge treatment. However, sludge hydrolysis is often found the rate-limiting step thereby reducing the biogas generation potential. Therefore, an effort was made to determine the optimum conditions for sludge solubilization by means of hydrothermal pretreatment. In this study, response surface methodology using Box Behnken design approach was used to optimize four hydrothermal reaction variables (i.e., initial pH, time, temperature, and oxidation coefficient) for sludge solubilization and total chemical oxygen demand (tCOD) reduction. Temperature and pH were found to be the most significant parameters. The maximum tCOD reduction and volatile suspended solids solubilization of 58% and 52%, respectively, were obtained at the following optimum conditions: temperature = 180 °C, time = 5 h, pH = 3.3 and oxidation coefficient = 0.5. Under similar conditions and alkaline pH, Maillard's reaction occurs which may have adverse impact on the performance of downstream AD process. The highest NH 4 + N and volatile fatty acids (VFAs) concentrations were detected in the treated sludge at the optimum conditions. The future studies should be aimed at the recovery of proteins, VFAs and biogas using appropriate methods. Graphical abstract Image 1 Highlights • Box Behnken design approach was used to optimize conditions for WO and TH. • TH treatment of sludge in acidic pH range eliminates the Maillard's compounds. • Alkaline conditions resulted in poor dewatering of treated sludge. • WO causes the degradation of molecules to form volatile fatty acids. • Hydrothermal pretreatment can improve resource recovery from sewage sludge. [ABSTRACT FROM AUTHOR]

Background: Supraglottic airway devices are used for anesthesia in elective surgical procedures circumventing the need for intubation. We investigated the efficacy and safety of Baska® mask in comparison to an I-Gel® device. Methods: In this cross-sectional, observational study, we randomized 100 female patients (age 18–45 years, American Society of Anaesthesiologists grade I or II) undergoing elective short gynecological procedures into two groups, to receive ventilation with either Baska mask® (group 1, n = 50) or an I-Gel® device (group 2, n = 50). We excluded patients with obesity, short neck, and known systemic and upper airway disorders. The primary outcome was the oropharyngeal airway seal pressure, and the secondary outcomes were the ease of insertion and the complication rate. The results were analyzed using Mann–Whitney U-test and Fisher's exact test, and correlation analysis was done by Spearman's correlation test. Results: A total of 56 patients underwent dilatation and curettage, whereas the remaining had hysteroscopy in the study. The airway seal pressure achieved was higher with Baska® mask than I-Gel® device (35.8 ± 10.3 and 26.9 ± 7.5 of cm H2O, respectively; P < 0.0001). The ease of insertion (P < 0.0001) was better in group 1 and the complication rates were similar in both the groups (P > 0.05). Conclusion: Baska® mask offers a superior airway seal pressure with minimum complications in comparison to an I-Gel® device. Further studies with a large number of patients in different surgical settings are required to confirm our findings. [ABSTRACT FROM AUTHOR]

Graphical abstract Highlights • Optimization of photo-catalytic oxidation parameters for CPs in wastewater. • Quantification of intermediates/by-products during photo-catalytic process. • Around 90% of total chlorine atoms were dissolved as Cl− in the treated wastewater. • Even low concentrations of accelerators and inhibitors affect the degradation rate. • TOC removal of 78% was obtained from simulated bleaching effluent. Abstract In a pulp and paper mill, chlorine bleaching of pulp generates toxic aqueous stream containing various chlorophenols (CPs) which are not removed easily by biological process. The objective of the study was to optimize photo-catalytic oxidation reaction for synthetic wastewater containing mixture of mono-, di-, tri- and penta-CPs (i.e., 4-CP; 2,4-DCP; 2,4,6-TCP, and PCP) and evaluate its performance for simulated bleaching effluents produced during pulp bleaching stages. The experimental runs were performed in a glass reactor (capacity = 500 ml) with UV lamp (200–390 nm). A maximum TOC reduction of 93% was achieved for synthetic wastewater (initial TOC = 42 mg/L) at the following conditions: pH = 4.4 (unadjusted), H 2 O 2 dose = 6.8 mM (stoichiometric), [H 2 O 2 ]:[Fe2+] = 65 and run time = 37 min. Under these conditions, ∼90% of the chlorine atoms were dissolved as chloride ions in the treated wastewater. High performance liquid chromatography analysis on liquid samples extracted during the oxidation reaction revealed no accumulation of carboxylic acids in treated wastewater. At similar operating conditions, TOC removal from simulated bleaching effluent was 78% during photo-catalytic process compared to ∼50% obtained after Fenton's oxidation. [ABSTRACT FROM AUTHOR]

Purpose: We report two cases of endogenous meningococcal endophthalmitis in immunocompetent adults presenting with unilateral ocular disease and joint involvement.Methods: A retrospective review of two patients with endogenous endophthalmitis due to Neisseria meningitidis with associated arthropathy was conducted. The clinical presentation, investigations, treatment, and outcomes are presented.Results: Vitreous sampling confirmed Neisseria meningitidis via polymerase chain reaction (PCR) in both cases. PCR was positive from the knee aspirate of our second case. Both patients received topical steroids and topical, intravitreal and intravenous antibiotics. Despite this, visual outcomes were poor.Conclusions: This atypical combination of endogenous meningococcal endophthalmitis associated with meningococcal joint involvement could represent a novel pattern for the presentation of metastatic meningococcal endophthalmitis not previously described. We suggest joint aspirate PCR could be a useful adjunctive test to identify potential causative organisms in such cases where there is concurrent joint involvement in the absence of systemic features. [ABSTRACT FROM AUTHOR]

Ciprofloxacin (CPX), a fluoroquinolone antibiotic, is found in the bulk effluents emerged from pharmaceutical industries. Its presence in the effluent may lead to toxicity to the aquatic life and antimicrobial resistance. Hence, the oxidative degradation of CPX by classical Fenton's process was investigated for the present study. The maximum CPX and total organic carbon (TOC) removal from the synthetic wastewater (initial CPX concentration = 100 mg L −1 ) were 70% and 55%, respectively, under the best reaction conditions ([H 2 O 2 ]:[Fe 2+ ] = 10, stoichiometric H 2 O 2 concentration = 14.2 mM and initial wastewater pH = 3.0). Five major degradation products could be identified by high resolution liquid chromatography–mass spectrometry (HR LC-MS) which could have resulted by the occurrence of decarboxylation, defluorination, hydroxylation and cleavage of the piperazine ring. The time based detection of ferrous and ferric ions in aqueous phase confirmed the CPX degradation by hydroxyl radicals. A pathway has been proposed for CPX degradation by Fenton's process based on the kinetic decay and/or evolution profiles of CPX and intermediates as well as the release of inorganic ions into the aqueous solution. It was indicated from the rapid respirometric test that the wastewater toxicity was lowered after Fenton's treatment. [ABSTRACT FROM AUTHOR]

In the present study, activated carbon (AC) supported bi-metallic catalyst (3.3Cu/2.2Ce/4.4AC) was subjected to catalytic wet oxidation (CWO) of simulated pulping effluent at moderate operating conditions (temperatures = 120–190 °C and oxygen partial pressures = 0.5–1.2 MPa). The oxidation reaction was performed in a high pressure reactor (capacity = 0.7 l) with catalyst concentration of 1–5 g/l for 3 h duration. During CWO at 190 °C temperature and 0.9 MPa oxygen pressure, the chemical oxygen demand (COD), total organic carbon (TOC), lignin and color removals from the wastewater were 79%, 77%, 88% and 89%, respectively, while the wastewater biodegradability was enhanced to 0.52 from an initial value of 0.16. TOC mass balance suggested that nearly 86–97% of the degraded TOC was mineralized whereas copper and cerium leaching from the catalyst were in the range of 1–15% and 0.7–1% with respect to their initial amounts. Metal leaching was reduced with increase in the reaction temperature. Global kinetic rate model was also developed using TOC degradation data and the activation energies of two step (rapid followed by slower TOC removal) CWO reaction were determined as 34.2 kJ/mol and 28.5 kJ/mol, respectively. [ABSTRACT FROM AUTHOR]

Effluent arising from kraft or soda pulping section of a pulp and paper mill is difficult to treat due to the presence of recalcitrant organics such as lignin. In this study, FeCl3 pretreated pulping effluent was subjected to Fenton-like oxidation. Residual dissolved iron from pretreatment step and H2O2 were utilized as catalyst and oxidant, respectively while the initial wastewater pH was 4.0 (unadjusted). The maximum lignin and total organic carbon (TOC) removals of 85% and 48% could be achieved within 2 h of reaction. The oxidation reaction was mediated by hydroxyl radicals (HO) which were detected by electron spin resonance (ESR) spectroscopy. Moreover, the addition of tertiary butyl alcohol and chloroform (both radical scavengers) as well hydroxyl amine (a ferrous ion recycler) affected TOC removal significantly. The TOC degradation data could adequately be fit in a lumped kinetic model (LKM) and the activation energy was calculated as 50.85 kJ/mol. The nature of chemical compounds in treated wastewater was also predicted using Fourier transforms infrared (FTIR) spectroscopy. [ABSTRACT FROM AUTHOR]

The present study deals with the treatment of simulated pulping effluent (pH = 11, and total organic carbon (TOC) = 1900 mg/L) by acid precipitation and coagulation-flocculation processes. The maximum TOC removal (= 4845 mg/g Al3+) from the effluent was found with Al2(SO4)3coagulant. Addition of sufloc (a flocculant) improved the sludge settling significantly. Hydrolyzed mono- and polynuclear species generated from Fe and Al coagulants could have resulted in TOC removal. Thermal analysis of sludge showed release of gases like CO, CO2, HCHO, CH3SH and SO2during combustion. Afterwards, the dissolved metal species in treated wastewater samples should be removed. [ABSTRACT FROM AUTHOR]

The azo dye reactive yellow 145 (RY145) is inherently recalcitrant due to the presence of azo, ethyl sulfone and monochlorotriazine groups. This study explored removal of RY145 using zero valent aluminum (ZVAl) treatment under alkaline conditions followed by aerobic degradation using the bacterial strains Pseudomonas aeruginosa (RS1) and Thiosphaera pantotropha. During pretreatment using 1 g L−1 ZVAl at pH 11, 59% decolorization was observed after 30 min for 50 mg L−1 dye. However, even after carbon source supplementation, the supernatant could not support microbial activity due to the high aluminum concentration in solution at pH 11. After pH adjustment to neutral and Al(OH) 3 precipitation, complete decolorization occurred and subsequently microbial degradation of the intermediates could be achieved. ZVAl pretreatment followed by biological treatment could cause an overall TOC reduction of 65% within 96 h. Sorption of dye on the precipitate only contributed to 13% dye removal. The bacterial cultures could utilize nitrogen from the dye intermediates formed after alkaline ZVAl treatment. The sequential treatment also reduced the concentration of total amines and phytotoxicity to Vigna radiata seeds. When a simulated textile wastewater containing 200 mg L−1 of RY145 was subjected to this sequential treatment, complete dye decolorization and 99.2% overall TOC reduction was observed in 30.5 h. The other compounds present in the synthetic wastewater facilitated decolorization as well as mineralization of the dye. [Display omitted] • Zero valent aluminum could decolorize 59% RY145 dye under alkaline condition. • Neutralization caused complete decolorization by adsorption of dye on Al(OH) 3. • Sequential ZVAl and bacterial treatment caused 65% TOC removal due to dye. • The bacterial strains could utilize nitrogen from the dye intermediates. • The sequential treatment showed 99.2% TOC removal from simulated textile wastewater. [ABSTRACT FROM AUTHOR]

The azo dye reactive yellow 145 (RY145) is inherently recalcitrant due to the presence of azo, ethyl sulfone and monochlorotriazine groups. This study explored removal of RY145 using zero valent aluminum (ZVAl) treatment under alkaline conditions followed by aerobic degradation using the bacterial strains Pseudomonas aeruginosa (RS1) and Thiosphaera pantotropha. During pretreatment using 1 g L−1 ZVAl at pH 11, 59% decolorization was observed after 30 min for 50 mg L−1 dye. However, even after carbon source supplementation, the supernatant could not support microbial activity due to the high aluminum concentration in solution at pH 11. After pH adjustment to neutral and Al(OH) 3 precipitation, complete decolorization occurred and subsequently microbial degradation of the intermediates could be achieved. ZVAl pretreatment followed by biological treatment could cause an overall TOC reduction of 65% within 96 h. Sorption of dye on the precipitate only contributed to 13% dye removal. The bacterial cultures could utilize nitrogen from the dye intermediates formed after alkaline ZVAl treatment. The sequential treatment also reduced the concentration of total amines and phytotoxicity to Vigna radiata seeds. When a simulated textile wastewater containing 200 mg L−1 of RY145 was subjected to this sequential treatment, complete dye decolorization and 99.2% overall TOC reduction was observed in 30.5 h. The other compounds present in the synthetic wastewater facilitated decolorization as well as mineralization of the dye. [Display omitted] • Zero valent aluminum could decolorize 59% RY145 dye under alkaline condition. • Neutralization caused complete decolorization by adsorption of dye on Al(OH) 3. • Sequential ZVAl and bacterial treatment caused 65% TOC removal due to dye. • The bacterial strains could utilize nitrogen from the dye intermediates. • The sequential treatment showed 99.2% TOC removal from simulated textile wastewater. [ABSTRACT FROM AUTHOR]

Voice is one of the advanced features of natural evolution that differentiates human beings from other primates. The human voice is capable of conveying the thoughts into spoken words along with a subtle emotion to the tone. This extraordinary character of the voice in expressing multiple emotions is the gift of God to the human beings and helps in effective interpersonal communication. Voice generation involves close interaction between cerebral signals and the peripheral apparatus consisting of the larynx, vocal cords, and trachea. The human voice is susceptible to the hormonal changes throughout life right from the puberty until senescence. Thyroid, gonadal and growth hormones have tremendous impact on the structure and function of the vocal apparatus. The alteration of voice is observed even in physiological states such as puberty and menstruation. Astute clinical observers make out the changes in the voice and refer the patients for endocrine evaluation. In this review, we shall discuss the hormonal influence on the voice apparatus in normal and endocrine disorders. [ABSTRACT FROM AUTHOR]

In the present study, the performance of sewage sludge based adsorbents was examined for the removal of two recalcitrant pollutants (i.e. lignin and amoxicillin) from synthetic wastewater solutions (adsorbate concentration = 50–250 mg/l). The effect of various reaction parameters such as wastewater pH, adsorbent dosage and temperature was studied. Possible mechanisms for the adsorption process have been proposed which depends upon the behaviour of adsorbent surface and adsorbate molecules under specific reaction conditions. Three-parameter Redlich–Peterson isotherm model was found the best fit to the equilibrium data. Pseudo first and second order models validated the kinetic data for lignin and amoxicillin adsorption systems, respectively and the corresponding activation energy was 3.5–4.5 and 12–22 kJ/mol. The nature of adsorption was elucidated from the thermodynamic parameters. [ABSTRACT FROM AUTHOR]

Highlights: [•] Synthesis and characterization of non-noble metal based supported catalysts. [•] Catalytic wet oxidation of ferulic acid (lignin model compound) at mild conditions. [•] Theoretical estimation of the mineralization of ferulic acid (in terms of CO2). [•] HPLC analysis and determination of reaction kinetics. [•] Catalyst thermal regeneration, characterization and reuse in the oxidation process. [ABSTRACT FROM AUTHOR]

Various environmental regulationsimply that it is important to minimize the cost associated with treatmentof different industrial wastes prior to its discharge to the environment.In this paper, an algebraic methodology, based on the principles ofprocess integration, is proposed to target the minimum waste treatmentflow rate to satisfy an environmentally acceptable discharge limit.In the proposed methodology, treatment units with fixed outlet concentrationsare considered. It is observed that it is not necessary to maximizethe usage of the treatment unit with the minimum specific cost. Hence,a prioritized cost for each treatment unit is devised to select appropriatetreatment units that minimize the overall operating cost. Applicabilityof the proposed methodology is demonstrated through examples. [ABSTRACT FROM AUTHOR]

Pulpmill effluents are not suitable for conventional biologicaltreatment processes due to the presence of lignin which is found incellulosic raw materials. The present study was undertaken to removeferulic acid (a lignin model compound) from synthetic wastewater usinga catalytic wet air oxidation (CWAO) process. The hydrothermal processwas performed in the presence of three heterogeneous catalysts, namely,60% CuO/40% CeO2, 60% CuO/40% Al2O3, and 60% CuO/40% 13X, in a temperature range of 90–160 °C,while the total pressure was maintained in the range of 0.55–0.8MPa. CuO and CeO2mixture (prepared by the sol gel peroxomethod) exhibited the best performance and removed ca.70% chemical oxygen demand (COD) from the wastewater at 120 °Ctemperature. The spent catalyst showed appreciable decline in theCOD removal during reuse. The detailed results obtained from the catalystcharacterization (fresh and used) and WAO studies are presented inthe paper. [ABSTRACT FROM AUTHOR]

Abstract: The effectiveness of coagulation (using aluminium-based chemicals and ferrous sulfate) and acid precipitation (using H2SO4) processes for the pre-treatment of diluted black liquor obtained from a pulp and paper mill is reported. Commercial alum was found to be the most economical among all the aluminium and ferrous salts used as a coagulant. A maximum removal of chemical oxygen demand (COD) (ca. 63%) and colour reduction (ca. 90%) from the wastewater (COD=7000mgl−1) at pH 5.0 was obtained with alum. During the acid precipitation process, at pH<5.0, significant COD reductions (up to 64%) were observed. Solid residue obtained from the alum treatment at a temperature of 95°C showed much better (3 times) settling rate than that for the residue obtained after treatment with the same coagulant at a temperature of 25°C. The settling curves had three parts, namely, hindered, transition and compression zones. Tory plots were used to determine the critical height of suspension–supernatant interface that is used in the design of a clarifier–thickener unit. High heating values and large biomass fraction of the solid residues can encourage the fuel users to use this waste derived sludge as a potential renewable energy source. [Copyright &y& Elsevier]

Introduction: Eosinophilic mucin rhinosinusitis is an inflammatory pathological condition of the nose and paranasal sinuses. It is rare, occurs in immunocompetent patients and is characterised by peripheral eosinophilia and extensive bilateral sinus disease. To the best of our knowledge, visual loss with this condition has not been previously reported.Case Presentation: We present the case of a 26-year-old Asian woman with a background history of chronic sinusitis who presented with acute left-sided visual loss. Imaging showed significant opacification in the frontal, ethmoidal and sphenoidal sinuses as well as evidence of a unilateral optic neuritis. Histological analysis of sinus mucin revealed dense eosinophilic infiltrate and, despite medical and surgical intervention, vision was not restored in her left eye.Conclusion: We introduce visual loss as a complication of eosinophilic mucin rhinosinusitis. This adds further evidence to previous reports in the literature that optic neuropathy in sinusitis can occur secondary to non-compressive mechanisms. We also describe a rare finding: the vision in this patient did not improve following steroid therapy, antifungal therapy or surgical intervention. There are very few such cases described in the literature. We conclude that chronic sinusitis is an indolent inflammatory process which can cause visual loss and we reiterate the importance of recognizing and considering sinusitis as a cause of visual loss in patients in order that prompt medical and surgical treatment of the underlying disease can be initiated. [ABSTRACT FROM AUTHOR]

An 85-year-old man developed chronic postoperative endophthalmitis after complicated cataract surgery. Visual acuity in the affected eye was hand movements. Slitlamp biomicroscopy showed a hypopyon, superonasal iris nodule, and marked vitritis. An anterior chamber washout, iris biopsy, and intravitreal amphotericin injection were performed. Panfungal polymerase chain reaction of anterior chamber and vitreous samples were positive for Penicillium citrinum . The iris biopsy showed hyphae on Grocott staining. Despite treatment, the patient's acuity deteriorated to light perception and he developed severe intractable pain requiring evisceration. Histological analysis showed diffuse infiltration of hyphae. Penicillium species are fungal organisms that are ubiquitous in the environment and can cause chronic endophthalmitis. They are commonly dismissed as culture contaminants. True infection is confirmed by histological demonstration of fungal invasion. Diagnosis can be aided by iris biopsy if iris nodules are present. Polymerase chain reaction testing was beneficial in identifying the causative organism and should be considered early in endophthalmitis cases. Despite intravitreal and systemic antifungal treatment, the visual prognosis for this condition is variable. Financial Disclosure None of the authors has a financial or proprietary interest in any material or method mentioned. [ABSTRACT FROM AUTHOR]

Wet-air oxidation of diluted black liquor (chemical oxygen demand [COD] approximately 3250 to 14 500 mg/L) was performed at mild operating conditions (temperature = 388 to 423 K and total pressure = 0.6 MPa) in the presence of heterogeneous 60% copper oxide (CuO)/40% cerium oxide (CeO2) catalyst. Maximum COD reduction of 77.3% was obtained at 423 K at pH 3.0, which was marginally higher than that obtained at 413 K temperature (77.1%). In the acidic environment (pH ≤3), most of the COD was removed in the form of settleable solids during the transient heating of the wastewater from room temperature to the desired one. The solid residue obtained after the reaction has a heating value of 20.1 MJ/kg, which is comparable with that of Indian coal. Thermal degradation kinetic determination suggested that thermal characteristics of the solid residue are well represented by a power law model with Agarwal and Sivasubramanian approximation (Sail et a1.,2004). Water Environ. Res., 80, 136 (2008). [ABSTRACT FROM AUTHOR]

This paper proposes the use of a multicriteria assessment technique to evaluate the methane flow during gas extraction from a sanitary landfill. A number of parameters determine the gas generation and the feasibility for its extraction from a landfill. These parameters form a complex set of information with unknown mathematical interrelationships making potential gas flow evaluations difficult and elusive. In addition, the data available for a particular landfill are very often imprecise, uncertain, or subjective, making it even more difficult to evaluate the potential for gas extraction without conducting pilot tests. The method proposed in this paper uses fuzzy composite programming that allows for the use of imprecise information. A landfill gas potential index has been defined, which can be determined by easily obtainable climatological, geological, and landfill parameters. The landfill gas (LFG) potential index is related to the landfill gas flow using an empirical equation. The LFG potential model was calibrated and verified using data obtained from 61 landfills where gas extraction is being conducted. A sensitivity analysis was done to study the impact of variations in the input data on model output. [ABSTRACT FROM AUTHOR]

European Union (EU) member states are adopting the mechanical-biological treatment (MBT) of municipal solid waste (MSW) to comply with EU Landfill Directive (LD) targets on landfill diversion. We reviewthe policy framework for MSW-derived solid recovered fuel (SRF), composed of paper, plastic, and textiles, in the energy-intensive industries. A comparatively high calorific value (15-18 MJ/kg) fuel, SRF has the potential to partially replace fossil fuel in energy-intensive industries, alongside MSW in dedicated combustion facilities. Attempts by the European standards organization (CEN) to classify fuel properties consider net calorific value (CV) and chlorine and mercury content. However, the particle size, moisture content, and fuel composition also require attention and future studies must address these parameters. We critically review the implications of using SRF as a co-fuel in thermal processes. A thermodynamic analysis provides insight into the technical and environmental feasibility of co-combusting SRF in coal-fired power plants and cement kilns. Results indicate the use of SRF as co-fuel can reduce global warming and acidification potential significantly. This policy analysis is of value to waste managers, policy specialists, regulators, and the waste management research community. [ABSTRACT FROM AUTHOR]

Abstract: In the present study, catalytic wet oxidation (CWO) was investigated for the destruction of organic pollutants in the thermally pretreated effluent from a pulp and paper mill under moderate temperature and pressure conditions. The thermal pretreatment studies were conducted at atmospheric pressure and 368K using copper sulfate as a catalyst. The thermal pretreatment reduced COD by about 61%. The filtrate of the thermal pretreatment step was used at pH 8.0 for CWO at 383–443K temperature and a total pressure of 0.85MPa for 4h. Catalysts used for the reaction include copper sulfate, 5% CuO/95% activated carbon, 60% CuO/40% MnO2, and 60% CuO/40% CeO2. Maximum COD reduction was found to be 89% during CWO step using 5% CuO/95% activated carbon with a catalyst loading of 8gl−1 at 443K and 0.85MPa total pressure. Overall COD reduction for the pretreatment and the CWO was found to be 96%. Besides this, 60% CuO/40% CeO2 catalyst also exhibited the similar activity as that of obtained with 5% CuO/95% activated carbon catalyst at 423K temperature and 0.85MPa total pressure. The pH of the solution during the experimental runs decreases initially due to the formation of carboxylic acid and then increases due to the decomposition of acids. [Copyright &y& Elsevier]

Dyes are toxic and inherently resistant to microbial degradation. In this study, decolorization and degradation of textile dye reactive yellow 145 (RY145) were evaluated using pure bacterial strains Pseudomonas aeruginosa (RS1) and Thiosphaera pantotropha ATCC 35512. In nutrient broth under static condition, complete decolorization of 50 mg L−1 RY145 could be achieved within 96 h and 72 h, for Pseudomonas aeruginosa (RS1) and Thiosphaera pantotropha , respectively. In contrast, under shaking condition both the cultures could achieve only 50% decolorization in 96 h. Treatment under sequential static and shaking condition resulted in complete decolorization and 65% mineralization after 96 h. Higher dye concentration in excess of 100 mg L−1 and 50 mg L−1 decreased the extent of dye mineralization in Pseudomonas aeruginosa and Thiosphaera pantotropha, respectively. Even with the repetitive addition of the dye, both the strains were capable of decolorizing the dye. Acclimatized cultures showed 54% decolorization of RY145 in mineral media (MM) even in the absence of a readily degradable external carbon source. Amongst various individual carbon and nitrogen sources, maximum decolorization was observed in MM supplemented with peptone as carbon and nitrogen source at pH 7 under static condition. • Complete decolorization could be achieved in nutrient broth under static condition. • Lower decolorization of dye was observed under shaking condition in nutrient broth. • Static followed by shaking condition resulted in greater mineralization of the dye. • Acclimatized cultures showed dye decolorization in mineral media (MM). • Maximum decolorization was observed in MM supplemented with peptone at pH 7. [ABSTRACT FROM AUTHOR]

Catalytic advanced oxidation processes (AOPs) utilising UV irradiation have been reported to be highly efficient for the degradation of recalcitrant compounds. The focus of present study was to evaluate the potential of steel industry waste as an alternative to homogenous iron salts often used in AOPs. Iron rich sludge from effluent treatment plant (ETP) of a steel industry was subjected to acid washing and acid washing followed by calcination before using as catalyst for the oxidative removal of chlorinated organics present in synthetic and simulated bleaching effluents. The maximum total organic carbon removals of 64% and 25% from 4-chlorophenol solution and simulated pulp bleaching effluent, respectively were observed during photo-catalytic oxidation with acid washed steel sludge at stoichiometric H 2 O 2 dose after 2 h reaction (catalyst dose = 1 g/L, and pH = 4.4). Low iron leaching (<2%) was observed from the catalyst even in acidic conditions and it could be reused twice without significant loss of catalytic activity. Image 1 • Potential of steel industry waste as heterogeneous Fenton-type catalysts. • Evaluation of catalysts for advanced oxidation of chlorinated organics. • Catalyst displayed 64% mineralisation during 4-CP photo-Fenton oxidation. • Catalyst contained 40–50% but showed less than 3% iron leaching during treatment. [ABSTRACT FROM AUTHOR]

Imaging is essential for managing COVID-19 pneumonia. In resource-limited settings, chest radiography is the only practicable imaging modality. The Brixia radiographic scoring system, an objective method of assessing pulmonary involvement, is yet to be studied in India. (a) To study the association between the clinical severity of COVID-19 patients with their Brixia scores and, (b) to evaluate the utility of the score as a predictor for invasive ventilation. Peripheral rural hospital by Indian Armed Forces; Cross-sectional study. A thousand patients diagnosed with COVID-19 and hospitalized were classified as having a mild, moderate, and severe disease based on their least oxygen saturation (SpO2 >94: mild, between 90-94: moderate, and <90: severe) recorded. The highest Brixia score was calculated for each patient. The mean Brixia scores of the three groups were compared. The Brixia score of each intubated patient was calculated as was the mean score of all intubated patients. Statistical analysis was performed on SPSS software. Seven hundred fifty-six (756) patients were classified as mild, 104 as moderate, and 140 as severe with a mean Brixia score of 0.12, 2.35, and 10.9, with a standard deviation of 0.66, 2.98, and 2.66, respectively. The difference in means between these groups was statistically significant (p < 0.0001). The median Brixia score of 13 for the intubated patients was significantly higher than for the non-intubated. The clinical severity of the patients and their requirement for invasive ventilation correlated well with their Brixia scores. The Brixia system may be usefully incorporated into our Medicare systems. [ABSTRACT FROM AUTHOR]

In the present study, sewage sludge (SS) was used to synthesize activated carbon (AC) which was further utilized as adsorbent for the removal of ciprofloxacin (CPX) from synthetic wastewater. The adsorbent was prepared by chemical activation method using ZnCl2 as activating agent. Design of experiments (DOE) approach was explored to determine the optimum operating conditions for the synthesis of AC and CPX removal from the wastewater. The optimum conditions for AC synthesis (i.e., carbonization temperature = ~500°C, activation time = 30 min, and impregnation ratio = 2.26) were decided based on results for three response parameters, that is, adsorbent yield, methylene blue removal, and iodine number. The synthesized adsorbent showed ~93% CPX removal (initial CPX concentration = 100 mg/L) at the following optimum conditions: adsorbent dose = 1.31 g/L, pH = 7 and reaction time = 12 h. Langmuir isotherm model was best fit to the equilibrium adsorption data (maximum adsorption capacity of SS derived AC = 102 mg/g) whereas pseudo‐second order model showed the best fit to adsorption kinetic data (adsorption capacity = 77.5 mg/g). An effort was also made to reduce fresh water requirement for adsorbent synthesis by recycling the wastewater produced during chemical activation of SS. Practitioner points: Experiment design approach was used for optimization of adsorbent preparation conditions and CPX removal conditions by waste derived adsorbent.Sewage sludge derived adsorbent had BET surface area of 564 m2/g which is comparable to commercial activated carbon.93% CPX adsorption with the sewage sludge derived adsorbent at optimum conditions.Langmuir model better suited the CPX adsorption data.Wastewater recycling and ZnO recovery from wastewater produced during adsorbent synthesis were performed. [ABSTRACT FROM AUTHOR]

In this study, the performance of activated sludge derived granular activated carbon (SGAC) was investigated for ciprofloxacin (CPX) removal from synthetic and simulated wastewaters in a fixed-bed adsorption column operated in continuous mode. The adsorbent was synthesized using chemical activation using ZnCl 2 as activating agent. Its surface area and pore volume were found comparable to that of the commercial granular activated carbon (CGAC). The maximum saturation adsorption capacities for CPX were ~16 mg/g and ~14 mg/g, respectively, with SGAC column under identical operating conditions (CPX concentration = 50 mg/L, bed height = 4 cm and wastewater flow rate = 1.5 mL/min) for synthetic and simulated wastewaters. The presence of other organics reduced CPX adsorption capacity of SGAC. The breakthrough curve data for both wastewaters could be adequately fit in Thomas and Yoon-Nelson kinetic models. The addition of H 2 O 2 in wastewater showed no considerable improvement in CPX removal. However, H 2 O 2 oxidation of spent adsorbent exhibited better results compared to thermal treatment for adsorbent regeneration. The results showed that sewage sludge can be recycled as an efficient adsorbent for the removal of recalcitrant organic pollutants from wastewater. Image 1 • CPX removal by activated sludge derived AC was studied in a fixed bed column. • The effect of particle size and matrix components on CPX removal was investigated. • In comparison to adsorption, Fenton-like oxidation slightly improved CPX removal. • The breakthrough curve data could be adequately fit in Thomas and Yoon-Nelson models. • Peroxide oxidation of waste derived AC was better than thermal regeneration process. [ABSTRACT FROM AUTHOR]

Cerebral palsy, a disorder presenting with various neurological and muscular manifestations depending on severity of cerebral involvement causes variable functional limitation. This presents as a challenge when major surgeries are planned. Thoracic surgeries need detailed evaluation and optimization due to functional limitations to attain optimal outcome. We report a case of cerebral palsy who underwent thoracic surgery for posttubercular hydropneumothorax. [ABSTRACT FROM AUTHOR]

Background: Bioprosthesis has been increasingly implanted for the treatment of transvalvular disease across the world. A new Dafodil™ pericardial bioprosthesis (Meril Life Sciences Pvt. Ltd., India) recently approved by Conformité Européenne (CE) is a tri-leaflet, stented, bovine valve. The purpose of Dafodil-1 first-in-human trial was to evaluate clinical safety and performance (including hemodynamic parameters) of the Dafodil pericardial bioprosthesis in patients who underwent aortic or mitral valve replacement.Methods: This prospective, multicenter clinical trial enrolled 60 patients (Aortic: 30 patients; Mitral: 30 patients) from seven sites across India. Safety endpoints were early (≤30 days) and late (> 30 days) mortality and valve-related morbidity. The performance endpoints were hemodynamic performance, improvement in NYHA functional class, and change in the quality of life using SF-12v1 health survey.Results: From July 2017 to July 2018, 60 patients underwent implantation of the Dafodil pericardial bioprosthesis. Post-operatively, NYHA functional class significantly improved in all the patients (Aortic: 90% NYHA class-I and 10% NYHA class-II; Mitral: 96.55% NYHA class-I and 3.45% NYHA class-II; P < 0.001). There was no death in aortic valve replacement patients till 12-month. In mitral valve replacement patients, early mortalities occurred in three patients, and late mortality occurred in one patient; none of these were valve-related. Freedom from all-cause mortality reported was 93.33% at 12-month. Mean aortic pressure gradient decreased from 52.71 ± 24.47 mmHg [with 0.89 ± 0.70 cm2 effective orifice area (EOA)] pre-operatively to 14.49 ± 6.58 mmHg (EOA: 1.85 ± 0.27 cm2) at 12-month. Overall, the mitral mean pressure gradient and EOA were 4.41 ± 1.69 mmHg and 2.67 ± 0.48 cm2, respectively, at 12-month. Significant improvement (P < 0.05) in the patients' quality of life was reported at all follow-ups.Conclusions: The clinical safety and performance of the Dafodil pericardial bioprosthesis were favourable at 12-month. Moreover, a study with a larger patient population and longer follow-up is warranted to further assess the device.Trial Registration: Dafodil-1 trial has been prospectively registered on 10/07/2017 under Clinical Trial Registry-India (http://www.ctri.nic.in). (Registration number: CTRI/2017/07/009008). [ABSTRACT FROM AUTHOR]

Household wet biodegradable waste (HWBW) forms a major portion of municipal solid waste (MSW) in developing nations. Its recycling at the source of generation can not only reduce waste transportation costs but also prevent harmful air emissions. Therefore, the present study was planned to investigate the performance of a decentralized household composting system for onsite recycling of source-segregated HWBW. The study was carried out in the recycled plastic drums (capacity = 100 L). The effect of waste turning and addition of microbial inoculum and bulking agent (garden waste) on the composting process was examined. The results showed that proper provisions for aeration and periodic waste turning are necessary to produce good quality compost. The addition of a suitable microbial inoculum can reduce duration of waste stabilization. During composting, the peak temperature was found greater than 55 °C for 3–6 days and the compost yield (<4 mm fraction) was 18%–20%. The phytotoxicity tests results showed that the growth of cress plants is not affected in the presence of 20% of compost mixed in soil. One-time addition of inoculum at the start of composting process was found sufficient for completion of the active decomposition period within 30 days. Based on the above results, two-drum systems can be suggested as feasible option to produce compost from HWBW. • A low cost composting system for household wet biodegradable waste was developed • Waste turning and passive aeration are necessary to produce good compost • Only one-time addition of inoculum reduced the composting period significantly • Up to 20% of compost mixed in soil showed no phytotoxicity for cress seeds • Two-drum composting system can be used to treat ∼2.5 kg/d of wet waste [ABSTRACT FROM AUTHOR]

Severe hypertriglyceridemia (HTG) is associated with an increased risk of cardiovascular disease and acute pancreatitis. We report the case of a 34-year-old female admitted with complaints of recurrent pancreatitis and triglyceride (TG) levels above 995 mg/dl. The patient was started on therapeutic plasma exchange (TPE) to achieve a rapid fall (78%) in serum TG levels. We conclude that TPE is a safe and quick therapeutic treatment modality for patients with HTG-induced recurrent acute pancreatitis who fail to respond to conventional therapy. [ABSTRACT FROM AUTHOR]

The bleaching effluent discharged from a pulp and paper mill contains chlorinated organic compounds which are toxic to living matter. Physicochemical treatments such as coagulation and different advanced oxidation processes (AOPs) were employed for combined bleaching effluent generated from the first two stages (i.e. chlorination and alkali extraction) (pH = 3.5, chemical oxygen demand (COD) = 1,920 mg/L, and total organic carbon (TOC) = 663 mg/L). At optimum conditions (pH = 7.5, polyaluminium chloride (PAC) dose= 3.84 g/L and slow mixing time= 25 min), ~68% removal in UV254 and ~23% TOC removal was obtained during coagulation. Among various AOPs, UV/Fe2+/TiO2/H2O2 system showed the highest TOC and COD removals (~78%) after 2 h duration (Fe2+:H2O2 molar ratio= 1:100). After the AOP process, chloride ion concentration and biodegradability of the treated wastewater was increased to 2,762 mg/L and 0.46 from an initial value of 2,131 mg/L and 0.29, respectively. The wastewater and sludge analysis showed oxidation and adsorption as the major mechanisms for organics removal. Upon reuse of the regenerated catalysts, TOC removal was reduced significantly. It was found that three times more sludge per unit TOC removal was generated after coagulation in comparison to that produced after UV/Fe2+/TiO2/H2O2 treatment. [ABSTRACT FROM AUTHOR]

Wet waste recycling at generation point will alleviate burden on the overflowing waste dumpsites in developing nations. Drum composting is a potential treatment option for such waste at individual or community level. The present study was aimed to produce compost from wet waste (primarily comprising food waste) in composting drums modified for improved natural air circulation. Effect of microbial inoculum and waste turning on composting process was also studied. The final results showed the production of matured and stable compost in the modified drums. Addition of the microbial inoculum resulted in thermophilic phase within a week time. The self-heating test and germination index (>80%) showed the production of non-phytotoxic and mature compost in the modified drums after 60 days. The change in microbial population, humic substances and biological parameters (lignin, cellulose and hemicellulose) during the study is discussed. Moreover, the reduction in waste mass and volume is also reported. [ABSTRACT FROM AUTHOR]

Construction and demolition waste disposal is a major challenge in developing nations due to its ever increasing quantities. In this study, the recycling potential of waste concrete as aggregates in construction activities was studied. The metal leaching from the recycled concrete aggregates (RCA) collected from the demolition site of a 50 year old building, was evaluated by performing three different leaching tests (compliance, availability and Toxic Characteristic Leaching Procedure). The metal leaching was found mostly within the permissible limit except for Hg. Several tests were performed to determine the physical and mechanical properties of the fine and coarse aggregates produced from recycled concrete. The properties of recycled aggregates were found to be satisfactory for their utilization in road construction activities. The suitability of using recycled fine and coarse aggregates with Portland pozzolanic cement to make a sustainable and environmental friendly concrete mix design was also analyzed. No significant difference was observed in the compressive strength of various concrete mixes prepared by natural and recycled aggregates. However, only the tensile strength of the mix prepared with 25% recycled fine aggregates was comparable to that of the control concrete. For other mixes, the tensile strength of the concrete was found to drop significantly. In summary, RCA should be considered seriously as a building material for road construction, mass concrete works, lightly reinforced sections, etc. The present work will be useful for the waste managers and policy makers particularly in developing nations where proper guidelines are still lacking. [ABSTRACT FROM AUTHOR]

Cosmetic alteration of iris colour with implants, along with its secondary complications, is already well described in the literature. However the use of cosmetic iris laser is relatively novel. We report on a rare case of bilateral secondary pigmentary glaucoma, in a young patient who underwent such a treatment to cause a change in iris pigmentation. Data on the safety of such procedures are lacking. Ophthalmic healthcare professionals should be aware of the potentially devastating consequences and encourage caution in patients seeking this novel treatment. [ABSTRACT FROM AUTHOR]

This paper reports on the extraction of residual stress in surface-micromachined nickel thin films of electrostatically actuated fixed-fixed beams using a wafer-scale technique. The distribution of residual stress for 87 beams on a 4-in quarter wafer piece is presented. The residual stress ( \sigma 0 ) is determined from the best fit of the displacement-voltage curves predicted by a computationally efficient model to the experimental data. The nondestructive and automated measurements are taken at room temperature and directly at the beam itself without any additional test structures. The model employed incorporates the nonideal effects of inclined supports, nonflat initial beam profiles, and fringing fields. The extracted residual stress values vary between −12.8 and 13.6 MPa (negative values are for compressive stresses and positive ones for tensile stresses). The residual stresses for these 87 beams follow a nearly normal distribution with a mean value of −1.7 MPa and a standard deviation of 5.9 MPa, which represents the variability of the residual stresses across the wafer. Detailed uncertainty analysis has been conducted, and it reveals that inaccurate modeling of the nonideal effects will result in significant errors in the extracted residual stress. Although demonstrated on nickel thin films, this technique can be applied to other metallic thin films. [2014-0344] [ABSTRACT FROM AUTHOR]

The treatment of simulated textilewastewater [chemical oxygendemand (COD) = 3360 mg/L] was performed using three chemical/physicochemicalprocesses, viz., coagulation, Fenton oxidation, and adsorption. Coagulationof the wastewater was performed in a jar test apparatus using inorganicand organic coagulants. The best color removal (∼96%) was obtainedwith FeSO4while FeCl3and MgCl2caused∼75% and ∼53% color removal, respectively. The optimumdose for iron-based coagulants was 3 g/L, whereas it was 6 g/L forMgCl2. FeSO4-treated wastewater showed the bestresults with regard to the settling of flocs. Chitosan was effectivefor the decolorization of wastewater at low dose (=10 mg/L) and acidicpH (∼3.0) showing ∼20% and 30% COD and color reductions,respectively. For coagulation with FeSO4followed by adsorption,overall COD and color removal of 85% and 99%, respectively, couldbe achieved. The raw wastewater treated by Fenton’s process(H2O2dose = 10.5 g/L and H2O2/Fe2+molar ratio = 20) exhibited COD and colorremoval of ∼80% and 99%, respectively. Using Fenton oxidationas a post-treatment step after coagulation with FeSO4,the COD removal was enhanced to ∼83%, although the color removalremained unaffected. The sequential treatment also increased the BOD5(biochemical oxygen demand) to COD ratio of the treated wastewaterto 0.51. [ABSTRACT FROM AUTHOR]

[Display omitted] • After HTC, carbon and energy densification were 1.36 and 1.5 times, respectively. • Longer reaction resulted in increase in aromaticity and formation of secondary HC. • Abundance of oxygen containing acidic functional groups were detected on HC surface. • Around 370 mL methane per g COD added could be recovered from PW. • Kinetic modelling of HTC process was performed to determine rate constants. In the present study, household wet waste (HWW) pretreatment was explored using hydrothermal carbonization (HTC) to enhance resource recovery opportunities. The pretreatment was performed at 200 °C for 1–8 h duration in a 2 L high pressure reactor. After HTC, the recovered solid hydrochar (HC) showed high calorific value of ∼ 27 MJ/kg compared to 18 MJ/kg of HWW. Moreover, it contained significant amount of oxygen containing acidic functional groups, hence the waste derived HC may also be utilized as adsorbent in wastewater treatment and soil conditioner. The process wastewater (PW) contained several value-added organics including proteins and furfurals. The HTC reaction kinetics showed the conversion of HWW to primary HC as the fastest step (rate constant = 0.0126 min−1). Moreover, the biochemical methane potential test on PW revealed generation of significant amounts of biogas with 55–75% methane. The total energy production from HC and PW was estimated as ∼ 3.3 MJ/kg of HWW. [ABSTRACT FROM AUTHOR]

In this paper, the performance of hydrothermal carbonization (HTC) was investigated on real food waste (FW) to improve resource recovery opportunities. The HTC was performed in a high pressure batch reactor (without addition of water) at desired temperatures for different durations to study the properties of solid hydrochar (HC) and process water (PW) produced during the process. The reaction temperature and run time of 200 °C and 1 h, respectively were found suitable to produce the HC (high heating value = ~30 MJ/kg) having properties similar to that of the peat/lignite coal. Moreover, durable pellets could also be prepared from HC without addition of binder. The kinetic constants for HC combustion were also predicted using non-isothermal model-free approach for the data obtained from thermo-gravimetric analysis. In the PW samples recovered after HTC, several value-added compounds like 2,5-hydroxymethyl furfural, humic-like substances (HLS), proteins, carbohydrates and volatile fatty acids could be detected in appreciable quantities. However, longer reaction resulted in further degradation of above macromolecules into VFAs. Based on the observations, a pathway for FW degradation during HTC process is proposed. Moreover, the HLS and proteins mixture recovered from the PW sample exhibited no adverse impact on seed growth. The present study demonstrates that the HTC can be a potential treatment method for FW to recover a variety of useful materials. Further studies should focus on developing cost-effective methods for the recovery of various macromolecules from PW. Unlabelled Image • HTC of food waste may enable recovery of hydrochar and beneficial macromolecules. • Strong hydrochar pellets (HHV ~30 MJ/kg) could be formed without any additives. • High proteins and humic-like compounds recovery is possible from process water. • Reaction pathway for HTC of FW is proposed based on the identified by-products. • Energy and economic analyses showed favourable results for HTC of FW. [ABSTRACT FROM AUTHOR]

Aim: To devise a simple, cheap and effective improvised method of treating deep sternal wound infections (DSWI) by negative pressure obviating high cost of patented systems. Method: Records of ten post CABG patients operated via median sternotomy approach over a two and half year period and treated for DSWI were analysed. Sterile foam with drain was placed in the wound, which was covered with Ioban (Steridrape), the drain being connected to a suction unit maintaining 100mmHg pressure (<$12 cost). Results: Ten (10) patients of DSWI were managed with this therapy. Mean age was 60.4 years. Pseudomonas found in 1 (10%), Acinetobacter and Pseudomonas in 1 (10%) with Escherichia coli in 1 (10%). Five (50%) patients had diabetes mellitus. Mean hospitalisation period was 43 days. Seven (70%) patients underwent secondary suturing. Two (22%) patients had relapse, which was managed with dressings and secondary intention suturing. One patient who underwent a muscle flap cover had major recurrence with multiple sinuses. Excellent wound healing in 9 (90%) patients with no (0%) 90-day mortality. Improvised components can be safely employed to provide effective negative pressure therapy for DSWI with excellent results. [Copyright &y& Elsevier]

To compare visual field outcomes of ocular hypertensive and glaucoma patients treated first with medical therapy with those treated first with selective laser trabeculoplasty (SLT). Secondary analysis of patients from the Laser in Glaucoma and Ocular Hypertension study, a multicenter randomized controlled trial. Three hundred forty-four patients (588 eyes) treated first with medical therapy and 344 patients (590 eyes) treated first with SLT. Visual fields (VFs) were measured using standard automated perimetry and arranged in series (median length and duration, 9 VFs over 48 months). Hierarchical linear models were used to estimate pointwise VF progression rates, which were then averaged to produce a global progression estimate for each eye. Proportions of points and patients in each treatment group with fast (<–1 dB/year) or moderate (<–0.5 dB/year) progression were compared using log-binomial regression. Pointwise and global progression rates of total deviation (TD) and pattern deviation (PD). A greater proportion of eyes underwent moderate or fast TD progression in the medical therapy group compared with the SLT group (26.2% vs. 16.9%; risk ratio [RR], 1.55; 95% confidence interval [CI], 1.23–1.93; P < 0.001). A similar pattern was observed for pointwise rates (medical therapy, 26.1% vs. SLT, 19.0%; RR, 1.37; 95% CI, 1.33–1.42; P < 0.001). A greater proportion of pointwise PD rates were categorized as moderate or fast in the medical therapy group (medical therapy, 11.5% vs. SLT, 8.3%; RR, 1.39; 95% CI, 1.32–1.46; P < 0.001). No statistical difference was found in the proportion of eyes that underwent moderate or fast PD progression (medical therapy, 9.9% vs. SLT, 7.1%; RR, 1.39; 95% CI, 0.95, 2.03; P = 0.0928). A slightly larger proportion of ocular hypertensive and glaucoma patients treated first with medical therapy underwent rapid VF progression compared with those treated first with SLT. [ABSTRACT FROM AUTHOR]

• HTC was performed for paper and food waste (FW) at moderate conditions. • FW was found to be the most suitable feedstock with maximum HHV (29.6 MJ/kg). • Carbon densification in hydrochar formed from HTC of FW was 141%. • Paper wastes require additional water for HTC unlike FW. • HTC of FW showed highest energy recovery potential with lower CO 2 emissions. In this study, food waste (FW) and paper wastes were subjected to hydrothermal carbonization (HTC) with a purpose to improve energy recovery potential. FW is suggested as the suitable feedstock for production of hydrochar (HC) having highest calorific value (29.6 MJ/kg). Carbon content in FW derived HC was increased from 50% to ∼72% whereas energy retention efficiency was found to be 5.74 times of that in FW. Wastewater recovered after HTC of FW was rich in carbohydrates with chemical oxygen demand of ∼56,000 mg/L which may further be subjected to anaerobic treatment for biogas generation. Energy balance calculations showed that the solid and liquid fractions recovered after HTC of FW yielded highest energy output (2950 kJ/kg FW) compared to incineration (2217 kJ/kg FW), anaerobic digestion (2605 kJ/kg) and in-vessel composting. HTC process can be adopted as decentralized facility by institutions where highly moisturized wastes are generated. [ABSTRACT FROM AUTHOR]