Biomass Processing Research in Enea CR Trisaia (Italy) and in the Gas Institute of NAS of Ukraine

The main results of R&D activities on biofuel research area of Biomass laboratory at ENEA CR Trisaia and Combustion Processes Department of the Gas Institute of NAS of Ukraine such as synthesis gas, ethanol and produced gas production for natural gas substitution in industrial steam boilers are represented.Представлены основные результаты технологических исследований по биотопливной тематике лаборатории биомассы исследовательского центра ENEA CR Trisaia (Италия) и отдела процессов горения Института газа НАН Украины в области производства синтез-газа, этанола и генераторного газа как заменителя природного газа в промышленных паровых котлах.Представлено основні результати технологічних досліджень з біопаливної тематики лабораторії біомаси дослідного центру ENEA CR Trisaia (Італія) та відділу процесів горіння Інституту газу НАН України, а саме з виробництва синтез-газу, етанолу та генераторного газу як замінювача природного газу у промислових парових котлах

Safety of meningococcal group B vaccination in hospitalised premature infants.

OBJECTIVES: To assess the risk of significant adverse events in premature infants receiving the novel 4-component group B meningococcal vaccine (4CMenB) with their routine immunisations at 2 months of age. PARTICIPANTS, DESIGN AND SETTING: In December 2015, Public Health England requested neonatal units across England to voluntarily participate in a national audit; 19 units agreed to participate. Anonymised questionnaires were completed for infants receiving 4CMenB alongside their routine immunisations. For comparison, a historical cohort of premature infants receiving their primary immunisations without 4CMenB or paracetamol prophylaxis was used. MAIN OUTCOME MEASURES: Paracetamol use; temperature, cardiovascular, respiratory and neurological status before and after vaccination; and management and investigations postvaccination, including serum C reactive protein levels, infection screens and antibiotic use. RESULTS: Complete questionnaires were returned for 133 premature infants (38°C) after vaccination compared with 20% (5/25) of those receiving 4CMenB without paracetamol (P=0.06) and none of those in the historical cohort. There were no significant differences between cohorts in the proportion of infants with apnoea, bradycardia, desaturation and receiving respiratory support after vaccination. CONCLUSIONS: 4CMenB does not increase the risk of serious adverse events in hospitalised premature infants. This audit supports the current national recommendations to offer 4CMenB with other routine vaccinations and prophylactic paracetamol to premature infants at their chronological age

(E)-3-[(Dimethylamino)methylidene]-4-phenyl-1-(prop-2-ynyl)-1H-1,5-benzodiazepin-2(3H)-one

A new metal-organic framework compound, poly[[mu(7)-dihydrogen (4,5-dicyano1,2-phenylene) diphosphonato](oxonium) caesium], [Cs(C8H4N2O6P2)(H3O)](n) (I), based on Cs+ and the organic linker 4,5-dicyano-1,2-phenylene) bis(phosphonic acid, (H(4)cpp), containing two distinct coordinating functional groups, has been prepared by a simple diffusion method and its crystal structure is reported. The coordination polymeric structure is based on a CsO8N2 complex unit comprising a monodentate hydronium cation, seven O-atom donors from two phosphonium groups of the (H(2)cpp)(2-) ligand, and two N-atom donors from bridging cyano groups. The high level of connectivity from both the metal cation and the organic linker allow the formation of a compact and dense three-dimensional network without any crystallization solvent. Topologically (I) is a seven-connected uninodal network with an overall Schafli symbol of {4(17).6(4)}. Metal cations form an undulating inorganic layer, which is linked by strong and highly directional O-H center dot center dot center dot O hydrogen-bonding interactions. These metallic layers are, in turn, connected by the organic ligands along the [010] direction to form the overall three-dimensional framework structure

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Intraperitoneal drain placement and outcomes after elective colorectal surgery: international matched, prospective, cohort study

Despite current guidelines, intraperitoneal drain placement after elective colorectal surgery remains widespread. Drains were not associated with earlier detection of intraperitoneal collections, but were associated with prolonged hospital stay and increased risk of surgical-site infections.Background Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice. Methods COMPASS (COMPlicAted intra-abdominal collectionS after colorectal Surgery) was a prospective, international, cohort study which enrolled consecutive adults undergoing elective colorectal surgery (February to March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included: rate and time to diagnosis of postoperative intraperitoneal collections; rate of surgical site infections (SSIs); time to discharge; and 30-day major postoperative complications (Clavien-Dindo grade at least III). After propensity score matching, multivariable logistic regression and Cox proportional hazards regression were used to estimate the independent association of the secondary outcomes with drain placement. Results Overall, 1805 patients from 22 countries were included (798 women, 44.2 per cent; median age 67.0 years). The drain insertion rate was 51.9 per cent (937 patients). After matching, drains were not associated with reduced rates (odds ratio (OR) 1.33, 95 per cent c.i. 0.79 to 2.23; P = 0.287) or earlier detection (hazard ratio (HR) 0.87, 0.33 to 2.31; P = 0.780) of collections. Although not associated with worse major postoperative complications (OR 1.09, 0.68 to 1.75; P = 0.709), drains were associated with delayed hospital discharge (HR 0.58, 0.52 to 0.66; P < 0.001) and an increased risk of SSIs (OR 2.47, 1.50 to 4.05; P < 0.001). Conclusion Intraperitoneal drain placement after elective colorectal surgery is not associated with earlier detection of postoperative collections, but prolongs hospital stay and increases SSI risk

Prevention and treatment of mother-to-child transmission of syphilis.

PURPOSE OF REVIEW: Athough more than 90% of syphilis cases are diagnosed in developing countries, syphilis rates in industrialized countries have been increasing since the 1980s. Untreated syphilis in pregnancy is associated with high rates of adverse pregnancy outcomes, including fetal loss, premature birth, congenital syphilis, and neonatal death. We reviewed the recent literature on adverse pregnancy outcomes associated with untreated syphilis and the benefits of early and effective treatment. RECENT FINDINGS: Up to two-thirds of pregnant women with untreated syphilis may develop unwanted complications compared with a background rate of 14% in pregnant women without syphilis. A review of interventions to screen and manage infections during pregnancy found that those focusing on syphilis demonstrated an 80% reduction in stillbirths as compared with strategies to treat, detect, or prevent other infections in pregnancy, such as malaria (22% reduction), HIV (7% reduction) or bacterial vaginosis (12% reduction). Detection and treatment of syphilis before the third trimester (28 weeks) can revert the risk of adverse outcomes to background rates. SUMMARY: Transplacental transmission of syphilis, especially in the third trimester, is associated with high rates of adverse outcomes, but the risk can be significantly reduced with early detection and treatment in the first and second trimesters, along with careful management of the infant after birth

Lo sviluppo delle aree rurali remote. Petrolio, uranio e governance locale in Niger

Chi ha visitato un'area remota di un paese povero si sarà forse chiesto come sia possibile sviluppare l'economia locale. Investire in queste zone può in effetti sembrare un azzardo, specie se è già difficile far crescere le aree più accessibili. Ciononostante, in molti casi si è visto che la rottura dell'isolamento ha ridotto la povertà. Ed è proprio ciò di cui il Nigrer ha bisogno. Le sue aree remote accolgono il 40% della popolazione. Da esse proviene la maggior parte dei prodotti d'esportazione. Ma un'economia così povera dove può trovare le risorse per spezzare l'isolamento? Negli ultimi anni la scoperta di petrolio e di nuovi giacimenti d'uranio apre una prospettiva. Tuttavia, nelle zone d'estrazione gli abitanti temono il degrado delle risorse naturali e non credono a ricadute positive sull'economia locale. Nelle altre zone remote, come il dipartimento di Keita, la governance locale non riesce a innescare lo sviluppo da sola, e non è chiaro quali benefici potrà trarre dalla rendita petrolifera e mineraria. Il libro propone un'analisi regionale condotta con un apposito indice di accessibilità della popolazione dipartimentale e diversi indicatori. L'andamento delle risorse naturali, della produzione, della popolazione e dell'accesso alle attrezzature è confrontato con le strategie di sviluppo nazionali e locali e con i programmi d'aiuto. Ciò consente di smontare alcuni cliché sulla relazione popolamento-intensificazione agricola, sulla rigenerazione della vegetazione, sugli strumenti di governance locale e di formulare suggerimenti per l'azione