Salinity Reduction of Real Produced Waters via Assisted Reverse Electrodialysis

Produced waters (PWs) are waste streams generated during the crude oil extraction processes. The management of these wastewaters is complicated by the large volumes extracted during the oil recovery operations: these depends on the life of the oil-well: typically, 3 barrels of PWs on average are produced for each barrel of oil extracted. After oil separation, PWs are usually re-injected into the well, but this approach is not always possible without a preliminary and suitable treatment. Bioremediation techniques might be a good option, but they fail due to the PWs high salinity, which inhibit bacteria growth and metabolism. Thus, reducing their salinity upstream a bioremediation unit is a matter of crucial importance. To this aim, Assisted Reverse electrodialysis (ARED) along with the use of a dilute stream typically available on site is here proposed as a novel solution. In ARED an additional voltage is applied in the same direction of the salinity gradient through the membranes in order to enhance the passage of ions from the PW to the diluted solution, thus significantly reducing the required membrane area. An experimental campaign was carried out in order to assess the process feasibility. A fixed volume of real PWs was fed to a laboratory scale ARED unit. Each experimental test lasted for three days to reduce the salinity down to about 20 g l-1, a value compatible with the biomass metabolism for a downstream bioremediation step. Two different types of commercial membranes were tested and relevant energy consumptions were calculated. The long-runs performed did not show a significant loss of efficiency due to fouling, thus suggesting that ARED might a suitable technology for a pre-dilution of produced water

Economic Analysis of an Innovative Scheme for the Treatment of Produced Waters

During the crude oil extraction processes, for each barrel of oil turns out an equivalent of 3 barrels of wastewaters on average. These wastes are known as Produced Waters (PWs) and their dramatic impact on the environment has attracted the attention of researchers in order to find an economic and efficient method for their treatment. Dealing with PWs is not easy: the long exposure with oil increases their hydrocarbon fraction, while the contact with the underground wells increases their concentration in salts and minerals. The direct discharge of PWs into the sea is obviously not allowed by law and PWs are usually re-injected into the well. The present work deals with a novel and innovative treatment chain (including assisted reverse electrodialysis (ARED) as dilution step) able to reduce both the salinity and organic content of PWs. The innovative scheme includes an ultrafiltration unit as pre-treatment, upstream an ARED unit for the PW dilution. Once the salinity level has been reduced down to a value affordable for a bioremediation step, PWs are sent to a bio-reactor, where the organic compounds are digested. Finally, a reverse osmosis unit is used to recover water from the treated PWs and to recycle it as diluted stream in the ARED unit. A techno-economic model was purposely developed in the present work to assess the economic feasibility of the proposed scheme. Preliminary results suggest that the treatment costs are lower than 5 € m-3 PW and fully competitive with current PWs treatment technologies

Rectus Femoris Characteristics in Post Stroke Spasticity: Clinical Implications from Ultrasonographic Evaluation

In stroke survivors, rectus femoris (RF) spasticity is often implicated in gait pattern alterations such as stiff knee gait (SKG). Botulinum toxin type A (BoNT-A) is considered the gold standard for focal spasticity treatment. However—even if the accuracy of injection is crucial for BoNT-A efficacy—instrumented guidance for BoNT-A injection is not routinely applied in clinical settings. In order to investigate the possible implications of an inadequate BoNT-A injection on patients' clinical outcome, we evaluated the ultrasound-derived RF characteristics (muscle depth, muscle thickness, cross-sectional area and mean echo intensity) in 47 stroke survivors. In our sample, we observed wide variability of RF depth in both hemiparetic and unaffected side of included patients (0.44 and 3.54 cm and between 0.25 and 3.16 cm, respectively). Moreover, our analysis did not show significant differences between treated and non-treated RF in stroke survivors. These results suggest that considering the inter-individual variability in RF muscle depth and thickness, injection guidance should be considered for BoNT-A treatment in order to optimize the clinical outcome of treated patients. In particular, ultrasound guidance may help the clinicians in the long-term follow-up of muscle quality

Economic Analysis of an Innovative Scheme for the Treatment of Produced Waters

During the crude oil extraction processes, for each barrel of oil turns out an equivalent of 3 barrels of wastewaters on average. These wastes are known as Produced Waters (PWs) and their dramatic impact on the environment has attracted the attention of researchers in order to find an economic and efficient method for their treatment. Dealing with PWs is not easy: the long exposure with oil increases their hydrocarbon fraction, while the contact with the underground wells increases their concentration in salts and minerals. The direct discharge of PWs into the sea is obviously not allowed by law and PWs are usually re-injected into the well. The present work deals with a novel and innovative treatment chain (including assisted reverse electrodialysis (ARED) as dilution step) able to reduce both the salinity and organic content of PWs. The innovative scheme includes an ultrafiltration unit as pre-treatment, upstream an ARED unit for the PW dilution. Once the salinity level has been reduced down to a value affordable for a bioremediation step, PWs are sent to a bio-reactor, where the organic compounds are digested. Finally, a reverse osmosis unit is used to recover water from the treated PWs and to recycle it as diluted stream in the ARED unit. A techno-economic model was purposely developed in the present work to assess the economic feasibility of the proposed scheme. Preliminary results suggest that the treatment costs are lower than 5 € m-3PW and fully competitive with current PWs treatment technologies

Salinity Reduction of Real Produced Waters via Assisted Reverse Electrodialysis

Produced waters (PWs) are waste streams generated during the crude oil extraction processes. The management of these wastewaters is complicated by the large volumes extracted during the oil recovery operations: these depends on the life of the oil-well: typically, 3 barrels of PWs on average are produced for each barrel of oil extracted. After oil separation, PWs are usually re-injected into the well, but this approach is not always possible without a preliminary and suitable treatment. Bioremediation techniques might be a good option, but they fail due to the PWs high salinity, which inhibit bacteria growth and metabolism. Thus, reducing their salinity upstream a bioremediation unit is a matter of crucial importance. To this aim, Assisted Reverse electrodialysis (ARED) along with the use of a dilute stream typically available on site is here proposed as a novel solution. In ARED an additional voltage is applied in the same direction of the salinity gradient through the membranes in order to enhance the passage of ions from the PW to the diluted solution, thus significantly reducing the required membrane area. An experimental campaign was carried out in order to assess the process feasibility. A fixed volume of real PWs was fed to a laboratory scale ARED unit. Each experimental test lasted for three days to reduce the salinity down to about 20 g l-1, a value compatible with the biomass metabolism for a downstream bioremediation step. Two different types of commercial membranes were tested and relevant energy consumptions were calculated. The long-runs performed did not show a significant loss of efficiency due to fouling, thus suggesting that ARED might a suitable technology for a pre-dilution of produced waters

The Lack of Systemic and Subclinical Side Effects of Botulinum Neurotoxin Type-A in Patients Affected by Post-Stroke Spasticity: A Longitudinal Cohort Study

Botulinum Neurotoxin type-A (BoNT-A) is the treatment of choice for focal post-stroke spasticity (PSS). Due to its mechanism of action and the administration method, some authors raised concern about its possible systemic diffusion leading to contralateral muscle weakness and autonomic nervous system (ANS) alterations. Stroke itself is a cause of motor disability and ANS impairment; therefore, it is mandatory to prevent any source of additional loss of strength and adjunctive ANS disturbance. We enrolled 15 hemiparetic stroke survivors affected by PSS already addressed to BoNT-A treatment. Contralateral handgrip strength and ANS parameters, such as heart rate variability, impedance cardiography values, and respiratory sinus arrythmia, were measured 24 h before (T0) and 10 days after (T1) the ultrasound (US)-guided BoNT-A injection. At T1, neither strength loss nor modification of the basal ANS patterns were found. These findings support recent literature about the safety profile of BoNT-A, endorsing the importance of the US guide for a precise targeting and the sparing of "critical" structures as vessels and nerves

Vaccination coverage in healthcare workers: a multicenter cross-sectional study in Italy

IntroductionIn recent years, a phenomenon known as "vaccine hesitancy" has spread throughout the world, even among health workers, determining a reduction in vaccination coverage (VC). A study aimed at evaluating VC among healthcare workers (HCWs) in 10 Italian cities (L'Aquila, Genoa, Milan, Palermo, Sassari, Catanzaro, Ferrara, Catania, Naples, Messina) was performed.Materials and methodsAnnex 3 of the Presidential Decree n. 445 of 28 December 2000 was used to collect information on the vaccination status of HCWs. The mean and standard deviation (SD) were calculated with regard to the quantitative variable (age), while absolute and relative frequencies were obtained for categorical data (sex, professional profile, working sector, vaccination status). The connection between VC and the categorical variables was evaluated by chi-square method (statistical significance at p<0.05). The statistical analyses were performed by SPSS and Stata software.ResultsA total of 3,454 HCWs participated in the project: 1,236 males and 2,218 females. The sample comprised: physicians (26.9%), trainee physicians (16.1%), nurses (17.2%) and other professional categories (9.8%). Low VC was generally recorded. Higher VC was found with regard to polio, hepatitis B, tetanus and diphtheria, while coverage was very low for measles, mumps, rubella, pertussis, chickenpox and influenza (20-30%). ConclusionsThis study revealed low VC rates among HCWs for all the vaccinations. Measures to increase VC are therefore necessary in order to prevent HCWs from becoming a source of transmission of infections with high morbidity and/or mortality both within hospitals and outside

Clinical efficacy of botulinum toxin type A in patients with traumatic brain injury, spinal cord injury, or multiple sclerosis: An observational longitudinal study

Botulinum toxin type A (BoNT-A) is the treatment of choice for focal spasticity, with a concomitant effect on pain reduction and improvement of quality of life (QoL). Current evidence of its efficacy is based mainly on post stroke spasticity. This study aims to clarify the role of BoNT-A in the context of non-stroke spasticity (NSS). We enrolled 86 patients affected by multiple sclerosis, spinal cord injury, and traumatic brain injury with clinical indication to perform BoNT-A treatment. Subjects were evaluated before injection and after 1, 3, and 6 months. At every visit, spasticity severity using the modified Ashworth scale, pain using the numeric rating scale, QoL using the Euro Qol Group EQ-5D-5L, and the perceived treatment effect using the Global Assessment of Efficacy scale were recorded. In our population BoNT-A demonstrated to have a significant effect in improving all the outcome variables, with different effect persistence over time in relation to the diagnosis and the number of treated sites. Our results support BoNT-A as a modifier of the disability condition and suggest its implementation in the treatment of NSS, delivering a possible starting point to generate diagnosis-specific follow-up programs.Clinical trial identifierNCT04673240

Hippocampal neuroinflammation, functional connectivity, and depressive symptoms in multiple sclerosis

Depression, a condition commonly comorbid with multiple sclerosis (MS), is associated more generally with elevated inflammatory markers and hippocampal pathology. We hypothesized that neuroinflammation in the hippocampus is responsible for depression associated with MS. We characterized the relationship between depressive symptoms and hippocampal microglial activation in patients with MS using the 18-kDa translocator protein radioligand [18F]PBR111. To evaluate pathophysiologic mechanisms, we explored the relationships between hippocampal neuroinflammation, depressive symptoms, and hippocampal functional connectivities defined by resting-state functional magnetic resonance imaging. Methods The Beck Depression Inventory (BDI) was administered to 11 patients with MS and 22 healthy control subjects before scanning with positron emission tomography and functional magnetic resonance imaging. We tested for higher [18F]PBR111 uptake in the hippocampus of patients with MS relative to healthy control subjects and examined the correlations between [18F]PBR111 uptake, BDI scores, and hippocampal functional connectivities in the patients with MS. Results Patients with MS had an increased hippocampal [18F]PBR111 distribution volume ratio relative to healthy control subjects (p = .024), and the hippocampal distribution volume ratio was strongly correlated with the BDI score in patients with MS (r = .86, p = .006). Hippocampal functional connectivities to the subgenual cingulate and prefrontal and parietal regions correlated with BDI scores and [18F]PBR111 distribution volume ratio. Conclusions Our results provide evidence that hippocampal microglial activation in MS impairs the brain functional connectivities in regions contributing to maintenance of a normal affective state. Our results suggest a rationale for the responsiveness of depression in some patients with MS to effective control of brain neuroinflammation. Our findings also lend support to further investigation of the role of inflammatory processes in the pathogenesis of depression more generally