Myringotomy and ventilation tube insertion with endoscopic or microscopic technique in adults: a pilot study

The purpose of this study is to assess the feasibility of endoscopic-assisted myringotomy and ventilation tube insertion in adults affected by chronic otitis media with effusion, comparing the outcomes of this approach with those obtained with the traditional microscopic technique. Twenty-four patients were enrolled in this trial and alternately assigned to 2 groups of 12 subjects each. In group A, patients underwent myringotomy and ventilation tube insertion under endoscopic view, whereas in group B, the same procedure was performed traditionally using a microscope. All cases were evaluated 1 week after surgery and then monthly until tube extrusion. Type A tympanogram was achieved in 10 of 13 ears in both groups (76.92%). No significant difference in operative times or complication rates was observed (P > .05). Endoscopic technique could be a viable alternative to the microscopic approach for myringotomy and ventilation tube positioning in adults affected by chronic otitis media with effusion

Thermally enhanced solid–liquid separation process in food waste biorefinery: modelling the anaerobic digestion of solid residues

The biochemical valorization potential of food waste (FW) could be exploited by extracting decreasing added-value bio-based products and converting the final residues into energy. In this context, multi-purpose and versatile schemes integrating thermal and biochemical conversion processes will play a key role. An upstream thermal pretreatment + solid-liquid separation unit was here proposed to optimize the conversion of the liquid fraction of FW into valuable chemicals through semi-continuous fermentation process, and the conversion of the residual solid fraction into biomethane through anaerobic digestion. The solid residues obtained after thermal pretreatment presented a higher soluble COD fraction, which resulted in higher methane production with respect to the raw residues (0.33 vs. 0.29 Nm3CH4 kg-1VSfed) and higher risk of acidification and failure of methanogenesis when operating at lower HRT (20d). On the contrary, at HRT = 40 d, the pretreatment did not affect the methane conversion rates and both tests evidenced similar methane productions of 0.33 Nm3CH4 kg-1VSfed. In the reactor fed with pretreated residue, the association of hydrogenotrophic methanogens with syntrophic bacteria prevented the acidification of the system. Modelling proved the eligibility of the FW solid residues as substrates for anaerobic digestion, given their small inert fractions that ranged between 0% and 30% of the total COD content

Posttraumatic parotid fistula treated with transdermal scopolamine: a case report.

A parotid fistula is a rare and extremely unpleasant condition. In this paper, we present the case of a 53-year-old woman with a diagnosis of posttraumatic fistula of the parotid gland. After exclusion of other therapeutic alternatives, it was decided to use transdermal scopolamine patches at sustained release (Scopoderm TTS). This technique consists in the application every three days of a patch with 1.5 mg of scopolamine in the area of the mastoid apophysis; the patch releases a dose of 0.5 mg of the active substance over each 24-hour period. The patient underwent periodic clinical followup over a period of three years, achieving satisfactory results with no significant adverse effects

Land Application of Biosolids in Europe: Possibilities, Con-Straints and Future Perspectives

The agricultural use of good quality sludge represents a value-added route to ensure growth sustainability in Europe, where raw material availability, for example, for phosphorus, is insufficient to meet demand. However, the possible presence of pathogens, pharmaceuticals and heavy metals requires specific regulations to minimize sludge-related health issues and environmental risks. The current regulation on sludge agricultural use applied by many EU countries is here presented and compared, highlighting scarce harmonization of the legislative framework among Member States. Actual issues, such as the fate of emerging micropollutants and microplastics in sludge-amended soils, and public health concerns regarding sludge spreading during the COVID-19 epidemic, are considered, too

Insights into the Anaerobic Hydrolysis Process for Extracting Embedded EPS and Metals from Activated Sludge

The amount of sewage sludge generated from wastewater treatment plants globally is unavoidably increasing. In recent years, significant attention has been paid to the biorefinery concept based on the conversion of waste streams to high-value products, material, and energy by microorganisms. However, one of the most significant challenges in the field is the possibility of controlling the microorganisms’ pathways in the anaerobic environment. This study investigated two different anaerobic fermentation tests carried out with real waste activated sludge at high organic loading rate (10 g COD L−1d−1) and short hydraulic retention time (HRT) to comprehensively understand whether this configuration enhances extracellular polymeric substance (EPS) and metal solubilisation. The quantity of EPS recovered increased over time, while the chemical oxygen demand to EPS ratio remained in the range 1.31–1.45. Slightly acidic conditions and sludge floc disintegration promoted EPS matrix disruption and release, combined with the solubilisation of organically bound toxic metals, such as As, Be, Cu, Ni, V, and Zn, thereby increasing the overall metal removal efficiency due to the action of hydrolytic microorganisms. Bacteroidetes, Firmicutes, and Chloroflexi were the most abundant phyla observed, indicating that the short HRT imposed on the systems favoured the hydrolytic and acidogenic activity of these taxa

Direct Conversion of Food Waste Extract into Caproate: Metagenomics Assessment of Chain Elongation Process

In a circular economy strategy, waste resources can be used for the biological production of high added-value substances, such as medium chain fatty acids (MCFAs), thus minimising waste and favouring a sustainable process. This study investigates single-stage fermentation processes for the production of MCFAs in a semi-continuous reactor treating the extract of real food waste (FW), without the addition of external electron donors. Two sequential acidogenic fermentation tests were carried out at an organic loading rate (OLR) of 5 and 15 gCOD L−1d−1 with a hydraulic retention time of 4 days and pH controlled at 6 ± 0.2. The highest level of caproate (4.8 g L−1) was observed at OLR of 15 gCOD L−1d−1 with a microbiome mainly composed by lactate-producing Actinomyces, Atopobium, and Olsenella species and caproate-producing Pseudoramibacter. Metagenomic analysis revealed the presence of key enzymes for the production of lactate, such as lactate dehydrogenase and pyruvate ferredoxin oxidoreductase, as well as several enzymes involved in the reverse β-oxidation pathway, thus suggesting the occurrence of a lactate-based chain elongation process

Syntrophic acetate oxidation during the two-phase anaerobic digestion of waste activated sludge: Microbial population, Gibbs free energy and kinetic modelling

A system using a two-phase anaerobic configuration (mesophilic/thermophilic) was tested by feeding waste activated sludge (WAS). The first acidogenic stage presented a hydraulic retention time (HRT) of 3 days, while the second methanogenic stage had an HRT of 10 days. Both raw and ultrasonically pretreated WAS samples were utilized for the experiment. Previous Fluorescence in Situ Hybridization (FISH) observations, revealed that in the thermophilic phase, the acetoclastic methanogenesis was likely replaced by a nonacetoclastic pathway, namely, syntrophic acetate oxidation (SAO). A modified version of Anaerobic Digestion Model n°1 (ADM1), accounting for the SAO pathway, was implemented and calibrated. The proposed model addressed the relationship between the hydrogen concentration and Gibbs free energy and showed the thermodynamic feasibility of the SAO pathway, while simultaneously highlighting the role played by hydrogenotrophic methanogens in maintaining a sufficiently low hydrogen partial pressure so that the SAO was energetically feasible. The estimated energy loss was estimated to be approximately 20% due to the switch of the microbial pathway from acetoclastic methanogenesis to SAO