Structural characterization of humic acids, extracted from sewage sludge during composting, by thermochemolysis–gas chromatography–mass spectrometry

Thermochemolysis coupled with gas chromatography and mass spectrometry were applied to determine the structure of humic acids (HA) extracted from a sewage sludge and straw mixture at different steps of composting. The HA extracted from sludge mixture released various compounds, such as mono-, di-, tri-methoxy (alkyl) benzene and (alkyl) benzoic acids, which originated from lignin like derivatives of phydroxyphenyl, guiaicyl and syringyl units. In addition, other aromatic non-lignin derived structures were found along with series of branched C15, linear C16, C18 fatty acid methyl esters. The follow-up of various lignin-derived units during composting shows a decrease in phydroxyphenyl type-compounds (C) after the stabilisation phase. In parallel the more oxidized units, derived from guaiacyl (G) and syringyl (S) units, corresponding mainly to methylated derivatives of cafeic acids, protocatechuic acids, gallic acids and aldehydes, significantly increased in comparison with the other aromatic structures. Various ratios commonly used as parameters to determine the degree of lignin decomposition during humification were followed to monitor the chemical structure changes of the HA extracted from sludge mixture during composting. In the present case, the S/G ratio did not present significant changes during composting. The acid/aldehyde ratio was supervised using the ratio of gallic acids to gallic aldehyde methylated derivatives and showed an increase from 0.73 to 2.13 after the stabilisation phase but a decrease to 0.93 at the end of composting. This evolution may be explained by the increase of acid-containing derivatives following the intense oxidation of lignin side-chains during the stabilisation phase. But, the decrease of the acid/aldehyde ratio during the maturation phase could be attributed to a decrease in acid units by polymerisation of benzoic acid type-compounds through ester/ether linkages. The follow up of six families of compounds of similar chemical structures during composting showed a decrease of lignin-type compounds C6–C3 and that C6–C1 units predominated in the humic acid isolated from end compost sludge. The fatty acid methyl esters showed an increase in the intermediate phase of composting probably originating from the activities and tissues of microorganisms, which are numerous during the process. The final decrease in the amount of fatty acids may be explained by the death of most of the microbial population at the end of composting typified by a low respiratory rate. The index of Shannon-Weaver (Ish) remained constant at about 3 in course of composting indicating the neoformation of HA from subunits of similar chemical nature. A similitude index (Sij, S0 i j) showed a split between 30 and 90 days of composting indicating a change in the rate of neoformation of HA after a stabilisation phase. Afterwards, the rate of HA neoformation varied linearly with the duration of composting

Structural characterization of fulvic acids, extracted from sewage sludge during composting, by thermochemolysis–gas chromatography–mass spectrometry

Thermochemolysis coupled with gas chromatography and mass spectrometry were applied to determine the chemical structure of fulvic acids (FA) extracted from a sewage sludge and straw mixture at different steps of composting. The FA starting structures were composed mainly of mono-, di- and tri-methoxy (alkyl) benzoic acids representing lignin derivatives in an advanced stage of oxidation, as well as of methylated polyphenols and a series of fatty acids saturated C15, C16, C18, unsaturated and branched C18:1. Besides, there are many unidentified structures suspected to be N-containing compounds. During the composting process, the fate of the three structural typical monomer units of lignin was followed. The p-hydroxyphenyl units showed a strong relative decrease especially at the beginning of composting. The guiaicyl units showed a steady increase in course of composting. A relative decrease of syringyl units was noted at the beginning of composting, but they then relatively increased towards the end of composting. These changes support the formation during composting of more oxidized units. All subunits composing the fulvic acid structures have been subdivided into main five groups of similar chemical structure. The lignin-like C6–C3 subunits showed a relative decrease during composting attributed to microbial oxidation, but there was a relative increase during the intermediate step of composting related probably of an enhancing of lignin solubility. The C6–C1 subunits were reduced at the beginning of composting, which mainly attributed to the oxidation of 4-methoxybenzaldehyde to hydroquinones derivatives under the composting conditions. Although, the relative increase of these subunits (C6–C1) at the end of composting originates from oxidation of C6–C3 lignin side-chains or could be partly attributed to microbial neosynthesis. The unidentified N-containing compounds increased strongly during course of composting. The rise in the level of fatty acids at the beginning of composting is attributed to an increase of branched-chain fatty acids such as C18:1 commonly used as bacterial biomarkers. Their amounts were greatly reduced at the end of composting. Both the Shannon–Weaver and similitude indices show a relative increase in structural diversity at the start of composting conditions following the appearance of hydroquinone derivatives and unidentified nitrogen compounds in the FA network. But, the produced FA structure reaches a certain level of homogeneity at the end of composting through self-polycondensation or recombination of C6–C1 subunits and hydroquinones derivatives with N-containing compounds

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Lipid signature of the microbial community structure during composting of date palm waste alone or mixed with couch grass clippings

International audienceThe content of total lipids and fatty-acid methyl esters (FAMEs) identified by GC MS analysis was followed during composting of date palm waste (DPW) alone or mixed with couch-grass clippings (DPGC). The DPGC compost contained more fats and FAMEs (FAs) than did the DPW compost. Total lipid content decreased during both composting processes with an increase towards the end of DPW composting. The initial fatty acid composition in both composts showed that the DPGC mixture was richer in microbial biomass than the DPW compost. The lignocellulose nature of the date palm substrate probably obstructed the proliferation and development of a broad category of microbial biomass. The appearance of a series of odd-numbered carbon and branched FAMEs was recorded only toward the end of DPW composting. This confirms the low level of biodegradation of date palm substrate rich in substrates that presented difficult access to micro-organisms, as confirmed by a slower degradation. DPW compost required longer to reach similar maturity to DPGC that of the mixture. Calculating the relationship between the various bacterial groups showed that bacteria strongly prevailed over fungi during both DPW and DPGC composting. The follow-up of these ratios in both composts showed that the stabilization phase was not complete in DPGC compost, but that it reached a very advanced stage during DPGC composting after the 8-month trial. An increase in G(+)/G(-) and G(+)/fungus ratios toward the end of DPW composting indicated that composting had just started in the DPW. The variations in the levels of the different steroid compounds identified in the two composts showed that dehydration was stronger in the DPGC mixture than in DPW. An increase of the level of stigmastanol acetate (24-ethylcholestanol), methyl cholestadiene (campestadienes), and cholestanol acetate (cholestanol) in DPGC compost suggests the stimulation of microbial organisms and/or micro-fauna capable of performing the hydrogenation of the corresponding sterols. This microbial activity fluctuated during DPW composting following the bioavailability of substrate that was steadily degraded. The appearance of stigmastadienone toward the end of DPW composting confirmed that composting had just started after the full 8 months

Persistent headaches one year after bacterial meningitis: prevalence, determinants and impact on quality of life

International audienceBackground: Little is known on headaches long-term persistence after bacterial meningitis and on their impact on patients' quality of life.Methods: In an ancillary study of the French national prospective cohort of community-acquired bacterial meningitis in adults (COMBAT) conducted between February 2013 and July 2015, we collected self-reported headaches before, at onset, and 12 months (M12) after meningitis. Determinants of persistent headache (PH) at M12, their association with M12 quality of life (SF 12), depression (Center for Epidemiologic Studies Depression Scale) and neuro-functional disability were analysed.Results: Among the 277 alive patients at M12 87/274 (31.8%), 213/271 (78.6%) and 86/277 (31.0%) reported headaches before, at the onset, and at M12, respectively. In multivariate analysis, female sex (OR: 2.75 [1.54-4.90]; p < 0.001), pre-existing headaches before meningitis (OR: 2.38 [1.32-4.30]; p < 0.01), higher neutrophilic polynuclei percentage in the CSF of the initial lumbar puncture (OR: 1.02 [1.00-1.04]; p < 0.05), and brain abscess during the initial hospitalisation (OR: 8.32 [1.97-35.16]; p < 0.01) were associated with M12 persistent headaches. Neither the responsible microorganism, nor the corticoids use were associated with M12 persistent headaches. M12 neuro-functional disability (altered Glasgow Outcome Scale; p < 0.01), M12 physical handicap (altered modified Rankin score; p < 0.001), M12 depressive symptoms (p < 0.0001), and M12 altered physical (p < 0.05) and mental (p < 0.0001) qualities of life were associated with M12 headaches.Conclusion: Persistent headaches are frequent one year after meningitis and are associated with quality of life alteration

One-Year Sequelae and Quality of Life in Adults with Meningococcal Meningitis: Lessons from the COMBAT Multicentre Prospective Study

Trial registration: ClinicalTrial.Gov identification number NCT01730690.International audienceIntroduction: COMBAT is a prospective, multicentre cohort study that enrolled consecutive adults with community-acquired bacterial meningitis (CABM) in 69 participating centres in France between February 2013 and July 2015 and followed them for 1 year.Methods: Patients aged at least 18 years old, hospitalised with CABM were followed during their hospitalisation and then contacted by phone 12 months after enrolment. Here we present the prevalence of sequelae at 12 months in a subgroup of patients with meningococcal meningitis.Results: Five of the 111 patients with meningococcal meningitis died during initial hospitalisation and two died between discharge and 12 months, leaving 104 patients alive 1 year after enrolment, 71 of whom provided 12-month follow-up data. The median age was 30.0 years and 54.1% of the patients had no identified risk factor for meningitis. More than 30% reported persistent headache, more than 40% were not satisfied with their sleep and 10% had concentration difficulties. Hearing loss was present in about 15% of the patients and more than 30% had depressive symptoms. About 13% of the patients with a previous professional activity had not resumed work. On the SF-12 Health Survey, almost 50% and 30% had physical component or mental component scores lower than the 25th percentile of the score distribution in the French general population. There was a non-significant improvement in the patients' disability scores from hospital discharge to 12 months (p = 0.16), but about 10% of the patients had residual disability.Conclusions: Although most patients in our cohort survive meningococcal meningitis, the long-term burden is substantial and therefore it is important to ensure a prolonged follow-up of survivors and to promote preventive strategies, including vaccination

Relationship between serotypes, disease characteristics and 30-day mortality in adults with invasive pneumococcal disease

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Impact on disease mortality of clinical, biological, and virological characteristics at hospital admission and overtime in COVID‐19 patients

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