Hydrogen peroxide bleaching of cellulose pulps obtained from brewer’s spent grain

Brewer’s spent grain (BSG) was evaluated for bleached pulp production. Two cellulose pulps with different chemical compositionswere produced by soda pulping: one from the original raw material and the other from material pretreated by dilute acid. Both of them were bleached by a totally chlorine-free sequence performed in three stages, using 5% hydrogen peroxide in the two initial, and a 0.25 NNaOHsolution in the last one. Chemical composition, kappa number, viscosity, brightness and yield of bleached and unbleached pulps were evaluated. The high hemicellulose (28.4% w/w) and extractives (5.8% w/w) contents in original BSG affected the pulping and bleaching processes.However, soda pulping of acid pretreated BSG gave a celluloserich pulp (90.4% w/w) with low hemicellulose and extractives contents (7.9% w/w and <3.4% w/w, respectively), which was easily bleached achieving a kappa number of 11.21, viscosity of 3.12 cp, brightness of 71.3%, cellulose content of 95.7% w/w, and residual lignin of 3.4% w/w. Alkaline and oxidative delignification of acid pretreated BSG was found as an attractive approach for producing high-purity, chlorine-free cellulose pulp.FAPESP (Fundação de Amparo à Pesquisa do Estado de São Paulo), Brazil.CNPq (Conselho Nacional de Desenvolvimento Científico e Tecnológico).Capes (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior)

Splenectomy and/or cyclophosphamide as salvage therapies in thrombotic thrombocytopenic purpura: the French TMA Reference Center experience: SALVAGE THERAPIES IN SEVERE TTP

BACKGROUND: The objective was to assess the efficacy and safety of splenectomy and cyclophosphamide as salvage therapies in severe thrombotic thrombocytopenic purpura (TTP).STUDY DESIGN AND METHODS: During a 10-year period, patients who did not improve with plasma exchanges, steroids, vincristine, and/or rituximab were considered for splenectomy or cyclophosphamide. Patients with a documented severe (&lt;10% of normal value) acquired ADAMTS13 deficiency are reported here. RESULTS: Eighteen patients with a severe acquired ADAMTS13 deficiency required a salvage therapy. Thirteen patients had a splenectomy 19 (interquartile range [IQR], 10-51) days after TTP diagnosis. One patient died the day after splenectomy. The remaining patients improved platelets (PLTs) until Day 6, along with a rapid and major lactate dehydrogenase improvement. Six patients, however, subsequently experienced a transient worsening. Durable PLT count recovery in survivors was observed within 13 (IQR, 11.5-25.5) days. Postoperative complications included thromboembolic events (two cases) and infections (five cases). Five patients received pulses of cyclophosphamide 12 (IQR, 12-15) days after TTP diagnosis. All patients recovered PLTs 10 (IQR, 9-24) days after the first pulse and two experienced a transient worsening. Three patients experienced infections. Three relapses occurred 5 months, 2.5 years, and 4.5 years after splenectomy and one relapse occurred 3.5 years after cyclophosphamide. After a 2.5 (IQR, 0.75-6.2)-year follow-up, the overall survival was 94%. CONCLUSION: Cyclophosphamide and splenectomy provide comparable high remission rates in severe TTP with acceptable side effects and should be considered in the more severe patients who do not improve with other therapies

Amélioration de l'échelle d'intensité des incendies de forêt mise en oeuvre en région méditerranéenne française

[Departement_IRSTEA]Territoires [TR1_IRSTEA]SEDYVINIn the Mediterranean region of southern France, many large fires are linked to the land use changes that have taken place in recent decades. The area under flammable vegetation is increasing due to abandonment of agricultural land and subsequent colonisation by vegetation, existing forests and woodlands are not sufficiently used, both of which result in increased accumulation of fuels. In addition, urbanization combined with forest extension results in new spatial configurations called wildland-urban interfaces (WUI). Significant wildfires, that have major ecological, social and economic consequences, are observed in those interfaces. Our objective is to better understand the impacts on dwellings and their surrounding environment during a fire. Currently, data about damages due to fire on dwellings and their surrounding vegetation are not collected. Our project consists in: (1) firstly elaborating a protocol so as to organize data gathering, after a fire, and allow to assess the fire intensity by estimating physical impacts on the field; (2) secondly, developing a spatially explicit database of the damages due to fire. Here, we take both physical impacts and social response to fire into account. With those tools we aim to improve knowledge about fire prone dwelling environment and their damages, so as to improve feedbacks and the intensity scale for wildfire.En région méditerranéenne, la plupart des incendies sont liés aux changements d'occupation du sol, entrepris ces dernières années. Le déclin des activités agricoles et pastorales a favorisé l'extension des friches, et l'arrêt des activités telles que le prélèvement du bois et l'entretien de la forêt, a conduit à l'accumulation de biomasse combustible. De plus, l'urbanisation croissante couplée à l'extension de la forêt génère de nouvelles configurations spatiales appelées interfaces Habitat-Forêt (IHF). De violents incendies de forêts, qui ont des conséquences dramatiques d'un point de vue écologique et socio-économique sont observés dans ces interfaces. Ce projet a pour objectif de mieux connaître l'importance des dommages causés sur les bâtis et leur environnement proche lors d'un incendie. En effet, actuellement, il n'existe aucune structure en charge de recueillir ces données relatives à l'endommagement des bâtis et de leur végétation environnante, après incendie. L'étude a donc consisté : (1) dans un premier temps, à élaborer un protocole, qui organise le recueil de données sur le terrain dont l'analyse servira à mesurer l'intensité d'un feu à travers l'évaluation des dommages ; (2) dans un second temps, à concevoir une base de données géoréférencée des dommages mesurés après incendie s'intéressant à la fois aux impacts physiques et à la réponse sociale face au risque. Ces outils contribueront à une meilleure connaissance des environnements de bâtis propices à l'incendie et leur endommagement, à améliorer les retours d'expérience en les systématisant à partir de données exhaustives et à terme à améliorer l'échelle d'intensité pour les incendies de forêt

Am J Hematol

To the Editor: Thrombotic thrombocytopenic purpura (TTP) is a specific form of thrombotic microangiopathy (TMA) characterized by thrombocytopenia, erythrocyte fragmentation, and widespread microvascular thrombi responsible for multi-organ failure of variable severity [1]. Surprisingly, while a profound thrombocytopenia is a typical feature of the disease, severe hemorrhage is a rare cause of mortality. Nevertheless, in case of severe bleeding or when an invasive procedure is needed (i.e., catheter insertion, spinal puncture), platelets transfusion may be required, although sudden clinical deteriorations and fatalities suggestive of a worsening of TTP within few hours after a platelet transfusion were reported [2,3]. To date, controversies remain on the effect of platelet transfusions during TTP [4–6]. In light of the uncertain risk of platelet transfusions in TTP and the lack of recently published data, we retrospectively reviewed admission data of all TTP patients with a severe acquired ADAMTS13 deficiency (\textless10% of activity in normal plasma) enrolled in the French TMA Reference Centre registry, in order to better assess the risk of platelet transfusions at the acute phase of TTP. ..

Relationship between ventilator-associated pneumonia and mortality in COVID-19 patients: a planned ancillary analysis of the coVAPid cohort

BACKGROUND: Patients with SARS-CoV-2 infection are at higher risk for ventilator-associated pneumonia (VAP). No study has evaluated the relationship between VAP and mortality in this population, or compared this relationship between SARS-CoV-2 patients and other populations. The main objective of our study was to determine the relationship between VAP and mortality in SARS-CoV-2 patients. METHODS: Planned ancillary analysis of a multicenter retrospective European cohort. VAP was diagnosed using clinical, radiological and quantitative microbiological criteria. Univariable and multivariable marginal Cox&apos;s regression models, with cause-specific hazard for duration of mechanical ventilation and ICU stay, were used to compare outcomes between study groups. Extubation, and ICU discharge alive were considered as events of interest, and mortality as competing event. FINDINGS: Of 1576 included patients, 568 were SARS-CoV-2 pneumonia, 482 influenza pneumonia, and 526 no evidence of viral infection at ICU admission. VAP was associated with significantly higher risk for 28-day mortality in SARS-CoV-2 (adjusted HR 1.70 (95% CI 1.16-2.47), p = 0.006), and influenza groups (1.75 (1.03-3.02), p = 0.045), but not in the no viral infection group (1.07 (0.64-1.78), p = 0.79). VAP was associated with significantly longer duration of mechanical ventilation in the SARS-CoV-2 group, but not in the influenza or no viral infection groups. VAP was associated with significantly longer duration of ICU stay in the 3 study groups. No significant difference was found in heterogeneity of outcomes related to VAP between the 3 groups, suggesting that the impact of VAP on mortality was not different between study groups. INTERPRETATION: VAP was associated with significantly increased 28-day mortality rate in SARS-CoV-2 patients. However, SARS-CoV-2 pneumonia, as compared to influenza pneumonia or no viral infection, did not significantly modify the relationship between VAP and 28-day mortality. CLINICAL TRIAL REGISTRATION: The study was registered at ClinicalTrials.gov, number NCT04359693

Selection-Based Mid-Air Text Entry on Large Displays

Abstract. Most text entry methods require users to have physical devices within reach. In many contexts of use, such as around large displays where users need to move freely, device-dependent methods are ill suited. We explore how selection-based text entry methods may be adapted for use in mid-air. Initially, we analyze the design space for text entry in mid-air, focusing on singlecharacter input with one hand. We propose three text entry methods: H4 Mid-Air (an adaptation of a game controller-based method by MacKenzie et al. [21]), MultiTap (a mid-air variant of a mobile phone text entry method), and Projected QWERTY (a mid-air variant of the QWERTY keyboard). After six sessions, participants reached an average of 13.2 words per minute (WPM) with the most successful method, Projected QWERTY. Users rated this method highest on satisfaction and it resulted in the least physical movement

Early bacterial identification among intubated patients with COVID-19 or influenza pneumonia: A european multicenter comparative clinical trial

Rationale: Early empirical antimicrobial treatment is frequently prescribed to critically ill patients with coronavirus disease (COVID-19) based on Surviving Sepsis Campaign guidelines. Objectives: We aimed to determine the prevalence of early bacterial identification in intubated patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia, as compared with influenza pneumonia, and to characterize its microbiology and impact on outcomes. Methods: A multicenter retrospective European cohort was performed in 36 ICUs. All adult patients receiving invasive mechanical ventilation > 48 hours were eligible if they had SARS-CoV-2 or influenza pneumonia at ICU admission. Bacterial identification was defined by a positive bacterial culture within 48 hours after intubation in endotracheal aspirates, BAL, blood cultures, or a positive pneumococcal or legionella urinary antigen test. Measurements and Main Results: A total of 1,050 patients were included (568 in SARS-CoV-2 and 482 in influenza groups). The prevalence of bacterial identification was significantly lower in patients with SARS-CoV-2 pneumonia compared with patients with influenza pneumonia (9.7 vs. 33.6%; unadjusted odds ratio, 0.21; 95% confidence interval [CI], 0.15-0.30; adjusted odds ratio, 0.23; 95% CI, 0.16-0.33; P,0.0001). Gram-positive cocci were responsible for 58% and 72% of coinfection in patients with SARS-CoV-2 and influenza pneumonia, respectively. Bacterial identification was associated with increased adjusted hazard ratio for 28-day mortality in patients with SARS-CoV-2 pneumonia (1.57; 95% CI, 1.01-2.44; P =0.043). However, no significant difference was found in the heterogeneity of outcomes related to bacterial identification between the two study groups, suggesting that the impact of coinfection on mortality was not different between patients with SARS-CoV-2 and influenza. Conclusions: Bacterial identification within 48 hours after intubation is significantly less frequent in patients with SARSCoV-2 pneumonia than patients with influenza pneumonia. Copyright © 2021 by the American Thoracic Societ