Evaluation of the potential of different high calorific waste fractions for the preparation of solid recovered fuels

Solid recovered fuels constitute a valuable alternative for the management of those non-hazardous waste fractions that cannot be recycled. The main purpose of this research is to assess the suitability of three different wastes from the landfill of the local waste management company (COGERSA), to be used as solid recovered fuels in a cement kiln near their facilities. The wastes analyzed were: End of life vehicles waste, packaging and bulky wastes. The study was carried out in two different periods of the year: November 2013 and April 2014. In order to characterize and classify these wastes as solid recovered fuels, they were separated into homogeneous fractions in order to determine different element components, such as plastics, cellulosic materials, packagings or textile compounds, and the elemental analysis (including chlorine content), heavy metal content and the heating value of each fraction were determined. The lower heating value of the waste fractions on wet basis varies between 10 MJ kg−1 and 42 MJ kg−1. One of the packaging wastes presents a very high chlorine content (6.3 wt.%) due to the presence of polyvinylchloride from pipe fragments, being the other wastes below the established limits. Most of the wastes analyzed meet the heavy metals restrictions, except the fine fraction of the end of life vehicles waste. In addition, none of the wastes exceed the mercury limit content, which is one of the parameters considered for the solid recovered fuels classification. A comparison among the experimental higher heating values and empirical models that predict the heating value from the elemental analysis data was carried out. Finally, from the three wastes measured, the fine fraction of the end of life vehicles waste was discarded for its use as solid recovered fuels due to the lower heating value and its high heavy metals content. From the point of view of the heating value, the end of life vehicles waste was the most suitable residue with a lower heating value of 35.89 MJ kg−1, followed by the packaging waste and the bulky waste, respectively. When mixing the wastes studied a global waste was obtained, whose classification as solid recovered fuels was NCV 1 Cl 3 Hg 3. From the empirical models used for calculating higher heating value from elemental content, Scheurer–Kestner was the model that best fit the experimental data corresponding to the wastes collected in November 2013, whereas Chang equation was the most approximate to the experimental heating values for April 2014 fractions. This difference is due to higher chlorine content of the second batch of wastes, since Chang equation is the only one that incorporates the chlorine content

Hydrothermal Carbonization of Biomass Wastes: Sustainability and Geochemistry

Introduction. To reduce the stream of solid waste going to landfills, innovative means for beneficial use are essential. The diversity and volume of organic wastes pose singular problems and opportunities for recovery and circularity. Common processes for organics include conversion to biofuels and carbonization to biochar, typically done by torrefaction (dry pyrolysis). Research on biochar explores its potential as pollutant adsorbent, agricultural or polluted soil amendment, biofuel (directly or as feedstock), and for carbon sequestration (Ighalo et al., 2022; Cavali et al., 2023). Recently, other processes at lower temperatures such as hydrothermal carbonization (HTC) offer new possibilities (Seshadri et al., 2016; Madsen et al., 2017). The properties of both biochar and hydrochar are strongly dependent on the biomass feedstock type (e.g., wood vs. algae) and on the carbonization process employed. In a real world pilot study, the public company for solid waste management in Asturias, Spain (COGERSA SAU) experimented with HTC of organic waste streams, including treated wood waste (mainly bulky waste, furniture, etc.), winery bagasse, and the organic fraction from separate collection of municipal solid waste (OFMSW). An advantage of HTC is that the feedstock can be processed wet, as received. Water was added to achieve a uniform 1:4 solid to water mass ratio and the mixtures were processed in a 2 m3 reactor vessel (195 °C, 1.3 MPa, 3 h) fed by the superheated steam available at the COGERSA plant (waste-to-energy of clinical waste by rotary kiln). Then, excess water was expelled mechanically (30 MPa) and the solids were dried in air at 100 °C. The resulting hydrochars were characterized by methods organic geochemists traditionally use in fossil fuel studies: proximate and ultimate analyses, porosimetry, thermogravimetric analysis, thermodesorption-gas chromatography-mass spectrometry (TD-GC-MS, heating in He at 350 °C for 20 s), and pyrolysis of the thermodesorption residue (Py-GC-MS, 610 °C, 20 s). For comparison, a commercial torrefied biochar (Vermichar S.L.) produced from Quercus ilex wood was also analyzed by the above methods. Results. Yields of hydrochar varied from 65% (OFMSW) to 83% (wood) of the initial feedstock mass (dry, ash-free). Molar H/C and O/C ratios decreased by mean values of 10 and 24%, respectively, relative to the raw feedstocks. HTC increased the high heating values slightly, to a mean of 21 MJ kg-1, in the range of sub-bituminous coal. Thermogravimetry overall shows a slight shift towards decomposition at higher temperatures, as well as peak narrowing after HTC. OFMSW TD-GC-MS yielded predominantly C16 and C18 saturated and unsaturated fatty acids and their methyl and ethyl esters (Fig. 1A). Subsequent Py-GC-MS results were similar, but with greatly reduced yield. In contrast, the Py-GC-MS yield for the wood was greater than that of the preceding thermodesorption, with abundant lignin (methoxyphenol) and polysaccharide markers, and minor, but notable, monoaromatic tricyclic terpenoids and methoxyphenol dimers (Fig. 1B). The TD-GC-MS of the biochar yielded little, while subsequent Py-GC-MS presented a predominance of simple monoaromatic hydrocarbons and phenols, along with phenanthrenes, retene in particular (Fig. 1C). Minor naphthalenes and monoaromatic tricyclic terpenoids are also noted. Conclusions. Analytical techniques usually applied in advanced characterization of fossil fuels, such as Py-GC-MS, were shown to be useful in unraveling molecular hydrochar and biochar composition. This opens new possibilities for the study of these products in detail, including diverse applications such as tracking of the evolution of different feedstock materials after carbonization, the possible uses as biofuels (specially for the liquid fraction obtained in the HTC process), or even the identification of potential pollutants. In this preliminary study of several hydrochars and a commercial biochar, interesting general and specific features were revealed: the molecular composition of hydrochar was strongly influenced by feedstock type, the OFMSW hydrochar revealed potential for biodiesel production, and biochar presented marked differences from “woody” biomass hydrochars

Critical update, systematic review, and meta-analysis of oral erythroplakia as an oral potentially malignant disorder

Background: Oral erythroplakia has been classically considered as the potentially malignant disorder with the highest rate of malignant development into squamous cell carcinoma. This critical systematic review and meta-analysis aim to estimate the malignant development rate of oral erythroplakia and identify the associated risk factors. Methods: We performed a bibliographic search in PubMed, Scopus, Web of Science, Embase, and LILACS, with keywords “erythroplakia,” “erythroplasia,” “malignant transformation,” “malignant development,” “malignization,” “carcinogenesis,” “oral cancer,” “oral squamous cell carcinoma,” “mouth neoplasm,” and “prognosis.” Meta-analysis was conducted using a random-effects model. Results: Ten observational studies with 441 patients met the inclusion criteria, whose mean malignant development rate was 12.7% and with a mean follow-up period of patients of 6.66 years. In the initial biopsy, 42.8% of oral erythroplakia were already squamous cell carcinoma. The buccal mucosa was the most frequent location of oral erythroplakia, but the floor of the mouth was the most common site of malignant development. All patients who underwent malignant development showed epithelial dysplasia on the initial diagnostic biopsy. Conclusion: Overall malignant development rate of OE in the meta-analysis was 19.9%. We could not associate any specific clinicopathological feature with the malignant development. The presence of epithelial dysplasia in the initial biopsy remains the worst prognostic factor. Further observational studies on OE are needed, with well-established diagnostic criteria and good clinical follow-up, in order to identify the true risk of malignant development of oral erythroplakia and the related risk factorsS

La didàctica en un entorn virtual interuniversitari : experimentació d'ECTS basada en TIC

En el context actual de desenvolupament tecnològic i de construcció de l'espai europeu d'educació superior emergeixen les necessitats d'adaptació a les noves exigències de treball didàctic d'estratègies propiciades pel mateix sistema de crèdits (ECTS). És a dir, es fa present l'exigència d'experimentar metodologies relacionades amb la implementació imminent dels crèdits europeus. En l'estudi, fet sobre la virtualització de determinades assignatures del Pla d'estudis de Pedagogia, es presenten diversos projectes individuals que conjuntament aposten per la incorporació de les tecnologies de la informació i la comunicació (TIC) a la docència com un dels elements clau per millorar el procés d'ensenyament-aprenentatge, com també l'experimentació dels crèdits europeus. En aquest article es presenten els resultats més rellevants de l'experimentació duta a terme el curs acadèmic 2005-2006, des de la valoració dels actors (professorat i alumnat).En el contexto actual de desarrollo tecnológico y de construcción del Espacio Europeo de Educación Superior emergen las necesidades de adaptación a las nuevas exigencias de trabajo didáctico de estrategias propiciadas por el propio sistema de créditos (ECTS). Es decir, se hace presente la exigencia de experimentar metodologías relacionadas con la implementación inminente de los créditos europeos. En el estudio, realizado sobre la virtualización de determinadas asignaturas del plan de estudios de pedagogía, se presentan varios proyectos individuales que conjuntamente apuestan por la incorporación de las tecnologías de la información y la comunicación (TIC) a la docencia como uno de los elementos clave para mejorar el proceso de enseñanza-aprendizaje, así como la experimentación de los créditos europeos. En este artículo se presentan los resultados más relevantes de la experimentación realizada en el curso académico 2005-2006, desde la valoración de los actores (profesores y alumnos).In today's environment of technological development and the construction of the European Higher Education Area, new needs are emerging to adapt to the new demands of teaching using strategies being promoted by the credit system (ECTS). That is, there is an imperative to experiment with methodologies related to the imminent implementation of the European credit system. In this study, which was conducted on the virtualisation of certain courses in within the curriculum of the Pedagogy degree programme, several individual projects are presented that together aim to incorporate information and communication technologies (ITCs) into teaching as one of the key elements to improving the teachinglearning process, as well as experimenting with the new European credits. This article presents the most noteworthy results of the experiment carried out in academic year 2005-06 based on the assessments of the main stakeholders (professors and students)

Major Adverse Cardiovascular Events in Coronary Type 2 Diabetic Patients: Identification of Associated Factors Using Electronic Health Records and Natural Language Processing

Patients with Type 2 diabetes mellitus (T2DM) and coronary artery disease (CAD) are at high risk of developing major adverse cardiovascular events (MACE). This is a multicenter, retrospective, and observational study performed in Spain aimed to characterize these patients in a real-world setting. Unstructured data from the Electronic Health Records were extracted by EHRead (R), a technology based on Natural Language Processing and machine learning. The association between new MACE and the variables of interest were investigated by univariable and multivariable analyses. From a source population of 2,184,662 patients, we identified 4072 adults diagnosed with T2DM and CAD (62.2% male, mean age 70 +/- 11). The main comorbidities observed included arterial hypertension, hyperlipidemia, and obesity, with metformin and statins being the treatments most frequently prescribed. MACE development was associated with multivessel (Hazard Ratio (HR) = 2.49) and single coronary vessel disease (HR = 1.71), transient ischemic attack (HR = 2.01), heart failure (HR = 1.32), insulin treatment (HR = 1.40), and percutaneous coronary intervention (PCI) (HR = 2.27), whilst statins (HR = 0.73) were associated with a lower risk of MACE occurrence. In conclusion, we found six risk factors associated with the development of MACE which were related with cardiovascular diseases and T2DM severity, and treatment with statins was identified as a protective factor for new MACE in this study

Impact of Advanced Age on the Incidence of Major Adverse Cardiovascular Events in Patients with Type 2 Diabetes Mellitus and Stable Coronary Artery Disease in a Real-World Setting in Spain

Patients with type 2 diabetes mellitus (T2DM) and coronary artery disease (CAD) without myocardial infarction (MI) or stroke are at high risk for major cardiovascular events (MACEs). We aimed to provide real-world data on age-related clinical characteristics, treatment management, and incidence of major cardiovascular outcomes in T2DM-CAD patients in Spain from 2014 to 2018. We used EHRead (R) technology, which is based on natural language processing and machine learning, to extract unstructured clinical information from electronic health records (EHRs) from 12 hospitals. Of the 4072 included patients, 30.9% were younger than 65 years (66.3% male), 34.2% were aged 65-75 years (66.4% male), and 34.8% were older than 75 years (54.3% male). These older patients were more likely to have hypertension (OR 2.85), angina (OR 1.64), heart valve disease (OR 2.13), or peripheral vascular disease (OR 2.38) than those aged <65 years (p < 0.001 for all comparisons). In general, they were also more likely to receive pharmacological and interventional treatments. Moreover, these patients had a significantly higher risk of MACEs (HR 1.29; p = 0.003) and ischemic stroke (HR 2.39; p < 0.001). In summary, patients with T2DM-CAD in routine clinical practice tend to be older, have more comorbidities, are more heavily treated, and have a higher risk of developing MACE than is commonly assumed from clinical trial data

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

ATP5H/KCTD2 locus is associated with Alzheimer's disease risk

To identify loci associated with Alzheimer disease, we conducted a three-stage analysis using existing genome-wide association studies (GWAS) and genotyping in a new sample. In Stage I, all suggestive single-nucleotide polymorphisms (at P <0.001) in a previously reported GWAS of seven independent studies (8082 Alzheimer's disease (AD) cases; 12 040 controls) were selected, and in Stage II these were examined in an in silico analysis within the Cohorts for Heart and Aging Research in Genomic Epidemiology consortium GWAS (1367 cases and 12904 controls). Six novel signals reaching P <5 × 10 −6 were genotyped in an independent Stage III sample (the Fundació ACE data set) of 2200 sporadic AD patients and 2301 controls. We identified a novel association with AD in the adenosine triphosphate (ATP) synthase, H+ transporting, mitochondrial F0 (ATP5H)/Potassium channel tetramerization domain-containing protein 2 (KCTD2) locus, which reached genome-wide significance in the combined discovery and genotyping sample (rs11870474, odds ratio (OR)=1.58, P =2.6 × 10 −7 in discovery and OR=1.43, P =0.004 in Fundació ACE data set; combined OR=1.53, P =4.7 × 10 −9). This ATP5H / KCT D2 locus has an important function in mitochondrial energy production and neuronal hyperpolarization during cellular stress conditions, such as hypoxia or glucose deprivation