The Diagnosis and Management of Toxic Alcohol Poisoning in the Emergency Department: A Review Article

Context: This review discusses the range of clinical presentations seen with poisonings by the major toxic alcohols--methanol, ethylene glycol, and isopropyl alcohol. It outlines a straightforward diagnostic strategy and discusses in detail the current treatment recommendations. Evidence acquisition: The authors conducted a literature search of primary and secondary sources related to the topic. For treatment recommendations, search restrictions included articles published between 2008 and 2019. For background information, search restrictions included articles written from 1990 – present. Results: This review discusses in detail how the diagnosis can be made via clinical signs, symptoms, and laboratory values as well as the most recent treatment recommendations. This paper will also discuss the limitations of the emergency department workup and how the absence of particular laboratory findings does not necessarily rule out the diagnosis. Conclusion: Poisoning with methanol, ethylene glycol, and isopropanol present diagnostic and therapeutic challenges to emergency physicians. Toxic alcohol poisonings lead to an elevated osmolar gap and, with the exception of Isopropanol, a metabolic acidosis. In order for the timely initiation of life-saving treatment, emergency physicians need a solid understanding of the pathophysiology, clinical presentation, laboratory workup, and treatment. Laboratory assays for these compounds are send-out tests in most hospitals and are therefore of no value in the acute clinical setting

Novel waste printed circuit board recycling process with molten salt

The objective of the method was to prove the concept of a novel waste PCBs recycling process which uses inert, stable molten salts as the direct heat transfer fluid and, simultaneously, uses this molten salt to separate the metal products in either liquid (solder, zinc, tin, lead, etc.) or solid (copper, gold, steel, palladium, etc.) form at the operating temperatures of 450–470 °C. The PCB recovery reactor is essentially a U-shaped reactor with the molten salt providing a continuous fluid, allowing molten salt access from different depths for metal recovery. A laboratory scale batch reactor was constructed using 316L as suitable construction material. For safety reasons, the inert, stable LiCl–KCl molten salts were used as direct heat transfer fluid. Recovered materials were washed with hot water to remove residual salt before metal recovery assessment. The impact of this work was to show metal separation using molten salts in one single unit, by using this novel reactor methodology. The reactor is a U-shaped reactor filled with a continuous liquid with a sloped bottom representing a novel reactor concept. This method uses large PCB pieces instead of shredded PCBs as the reactor volume is 2.2 L. The treated PCBs can be removed via leg B while the process is on-going

Tyre recycling utilising molten metal – risk assessment of a laboratory scale investigation

This paper describes the process undertaken prior to the commencement of a proposed tyre laboratory scale experiment carried out in University College Cork, Ireland to identify the hazards, assess the risks, change the design and implement control measures to manage the hazards of the experiment

Scrap tyre recycling process with molten zinc as direct heat transfer and solids separation fluid: A new reactor concept

Every year about 1.5 billion tyres are discarded worldwide representing a large amount of solid waste, but also a largely untapped source of raw materials. The objective of the method was to prove the concept of a novel scrap tyre recycling process which uses molten zinc as the direct heat transfer fluid and, simultaneously, uses this media to separate the solids products (i.e. steel and rCB) in a sink-float separation at an operating temperature of 450–470 °C. This methodology involved: construction of the laboratory scale batch reactor, separation of floating rCB from the zinc, recovery of the steel from the bottom of the reactor following pyrolysis

How to return to subjectivity? Natorp, Husserl, and Lacan on the limits of reflection

This article discusses the recent call within contemporary phenomenology to return to subjectivity in response to certain limitations of naturalistic explanations of the mind. The meaning and feasibility of this call is elaborated by connecting it to a classical issue within the phenomenological tradition concerning the possibility of investigating the first-person perspective through reflection. We will discuss how this methodological question is respectively treated and reconfigured in the works of Natorp, Husserl, and Lacan. Finally, we will lay out some possible consequences of such a cross-reading for the conception of subjectivity and the concomitant effort to account for this dimension of first-person experience in response and in addition to its omission within the standard third-person perspective of psychological research

Millimeter-Wave Line Ratios and Sub-beam Volume Density Distributions

We explore the use of mm-wave emission line ratios to trace molecular gas density when observations integrate over a wide range of volume densities within a single telescope beam. For observations targeting external galaxies, this case is unavoidable. Using a framework similar to that of Krumholz and Thompson (2007), we model emission for a set of common extragalactic lines from lognormal and power law density distributions. We consider the median density of gas producing emission and the ability to predict density variations from observed line ratios. We emphasize line ratio variations, because these do not require knowing the absolute abundance of our tracers. Patterns of line ratio variations have the prospect to illuminate the high-end shape of the density distribution, and to capture changes in the dense gas fraction and median volume density. Our results with and without a high density power law tail differ appreciably; we highlight better knowledge of the PDF shape as an important area. We also show the implications of sub-beam density distributions for isotopologue studies targeting dense gas tracers. Differential excitation often implies a significant correction to the naive case. We provide tabulated versions of many of our results, which can be used to interpret changes in mm-wave line ratios in terms of changes in the underlying density distributions.Comment: 24 pages, 16 figure, Accepted for publication in the Astrophysical Journal, two online tables temporarily available at http://www.astronomy.ohio-state.edu/~leroy.42/densegas_table2.txt and http://www.astronomy.ohio-state.edu/~leroy.42/densegas_table3.tx

Trade in the balance: reconciling trade and climate policy: report of the Working Group on Trade, Investment, and Climate Policy

This repository item contains a report published by the Working Group on Trade, Investment, and Climate Policy at The Frederick S. Pardee Center for the Study of the Longer-Range Future at Boston University, and the Global Economic Governance Initiative at Boston University.This report outlines the general tensions between the trade and investment regime and climate policy, and outlines a framework toward making trade and investment rules more climate friendly. Members of the working group have contributed short pieces addressing a range of issues related to the intersection of trade and climate policy. The first two are by natural scientists. Anthony Janetos discusses the need to address the effects of international trade on efforts to limit the increase in global annual temperature to no more than 2oC over preindustrial levels. James J. Corbett examines the failure of the Trans Pacific Partnership (TPP) and the Transatlantic Trade and Investment Partnership (TTIP) to adequately address the environmental implications of shipping and maritime transport. The next two pieces are by economists who examine economic aspects of the trade-climate linkage. Irene Monasterolo and Marco Raberto discuss the potential impacts of including fossil fuel subsidies reduction under the TTIP. Frank Ackerman explores the economic costs of efforts to promote convergence of regulatory standards between the United States and the European Union under the TTIP. The following two contributions are by legal scholars. Brooke Güven and Lise Johnson explore the potential for international investment treaties to redirect investment flows to support climate change mitigation and adaptation, particularly with regard to China and India. Matt Porterfield provides an overview of the ways in which both existing and proposed trade and investment agreements could have either “climate positive” or “climate negative” effects on mitigation policies. The final article is by Tao Hu, a former WTO trade and environment expert advisor for China and currently at the World Wildlife Fund, arguing that the definition of environmental goods and services’ under the WTO negotiations needs to be expanded to better incorporate climate change

Dense Molecular Gas in the Nearby Low Metallicity Dwarf Starburst Galaxy IC 10

Dense molecular gas and star formation are correlated in galaxies. The effect of low metallicity on this relationship is crucial for interpreting observations of high redshift galaxies, which have lower metallicities than galaxies today. However, it remains relatively unexplored because dense molecular gas tracers like HCN and HCO+ are faint in low metallicity systems. We present Green Bank Telescope observations of HCN(1-0) and HCO+(1-0) on giant molecular cloud (34pc) scales in the nearby low metallicity ($12+\log({\rm O/H})=8.2$) starburst IC 10 and compare them to those in other galaxies. We detect HCN and HCO+ in one and three of five pointings, respectively. The $I_{\rm HCN}/I_{\rm HCO+}$ values are within the range seen in other galaxies, but are most similar to those seen in other low metallicity sources and in starbursts. The detections follow the fiducial $L_{\rm IR}$-$L_{\rm HCN}$ and $L_{\rm IR}$-$L_{\rm HCO+}$ relationships. These trends suggest that HCN and HCO+ can be used to trace dense molecular gas at metallicities of 1/4 $Z_\odot$, to first order. The dense gas fraction is similar to that in spiral galaxies, but lower than that in U/LIRGs. The dense molecular gas star formation efficiency, however, is on the upper end of those in normal galaxies and consistent with those in U/LIRGs. These results suggest that the CO and HCN/HCO+ emission occupy the same relative volumes as at higher metallicity, but that the entire emitting structure is reduced in size. Dense gas mass estimates for high redshift galaxies may need to be corrected for this effect.Comment: Accepted to Ap

A Population of X-ray Weak Quasars: PHL 1811 Analogs at High Redshift

We report the results from Chandra and XMM-Newton observations of a sample of 10 type 1 quasars selected to have unusual UV emission-line properties (weak and blueshifted high-ionization lines; strong UV Fe emission) similar to those of PHL 1811, a confirmed intrinsically X-ray weak quasar. These quasars were identified by the Sloan Digital Sky Survey at high redshift (z~2.2); eight are radio quiet while two are radio intermediate. All of the radio-quiet PHL 1811 analogs are notably X-ray weak by a mean factor of ~13. These sources lack broad absorption lines and have blue UV/optical continua, suggesting they are intrinsically X-ray weak. However, their average X-ray spectrum appears to be harder than those of typical quasars, which may indicate the presence of heavy intrinsic X-ray absorption. Our radio-quiet PHL 1811 analogs support a connection between an X-ray weak spectral energy distribution and PHL 1811-like UV emission lines; this connection provides an economical way to identify X-ray weak type 1 quasars. The fraction of radio-quiet PHL 1811 analogs in the radio-quiet quasar population is estimated to be < 1.2%. We have investigated correlations between relative X-ray brightness and UV emission-line properties for a sample combining radio-quiet PHL 1811 analogs, PHL 1811, and typical type 1 quasars. These correlation analyses suggest that PHL 1811 analogs may have extreme wind-dominated broad emission-line regions. Observationally, radio-quiet PHL 1811 analogs appear to be a subset (~30%) of radio-quiet weak-line quasars. The existence of a subset of quasars in which high-ionization "shielding gas" covers most of the BELR, but little more than the BELR, could potentially unify the PHL 1811 analogs and WLQs. The two radio-intermediate PHL 1811 analogs are X-ray bright. One of them appears to have jet-dominated X-ray emission, while the nature of the other remains unclear.Comment: ApJ accepted; 25 pages, 11 figures and 8 table