A fast and simple method to monitor carbonation of MSWI bottom ash under static and dynamic conditions

Accelerated carbonation may be employed to improve the leaching behaviour and the geotechnical properties of MSWI bottom ash (BA). Here we report on a novel method to monitor and evaluate the progress of carbonation in both static and dynamic reactor systems. The method is based on following the pressure drop in the gas phase induced by the CO2-uptake of BA and was benchmarked against carbonate contents as measured by thermogravimetry. Laboratory results demonstrated the serviceability and reproducibility of the method. Complementary logging of relative humidity and temperature showed constant moisture conditions and self -heating induced by the exothermal carbonation reaction, respectively. Under dynamic conditions BA carbonation was higher than in the static reactor. Consistently, the self-heating was more pronounced. After a reaction time of 120 min the pressure records indicated a CO2-uptake of 1.5 g CO2/100 g BA (static tests) and of 2.6 g CO2/100 g BA (dynamic tests). The proposed method is suited to study carbonation processes at minimum analytical expense and integrates over the small-scale heterogeneity of BA. (C) 2018 Elsevier Ltd. All rights reserved

Neutrophil-to-lymphocyte ratio and its association with critical limb ischemia in PAOD patients.

BACKGROUND: The Neutrophil-to-Lymphocyte ratio (NLR) is an easy to perform test from the white blood cell count. An increase in NLR has been associated with vascular endpoints reflecting inflammation in atherosclerotic lesions. Atherosclerosis is a global threat and vascular endpoints, like myocardial infarction or critical limb ischemia (CLI), are a leading cause of death in industrialized countries. We therefore investigated NLR and its association with CLI and other vascular endpoints in peripheral arterial occlusive disease (PAOD) patients. METHODS AND FINDINGS: We evaluated 2121 PAOD patients treated at our institution from 2005 to 2010. NLR was calculated and the cohort was divided into tertiles according to the NLR. An optimal cut-off value for the continuous NLR was calculated by applying a receiver operating curve analysis to discriminate between CLI and non-CLI. In our cohort occurrence of CLI significantly increased with an increase in NLR. As an optimal cut-off a NLR of 3.95 was identified. Two groups were categorized, one containing 1441 patients (NLR≤3.95) and a second group with 680 patients (NLR>3.95). CLI was more frequent in NLR>3.95 patients (330(48.5%)) compared to NLR≤3.95 patients (350(24.3%)) (p3.95 was associated with an OR of 2.5 (95%CI 2.3-2.7) for CLI even after adjustment for other vascular risk factors. CONCLUSIONS: An increased NLR is significantly associated with patients at high risk for CLI and other vascular endpoints. The NLR is an easy to perform test, which could be used to highlight patients at high risk for vascular endpoints

Endothelial dysfunction and brachial intima-media thickness: long term cardiovascular risk with claudication related to peripheral arterial disease: a prospective analysis.

OBJECTIVE: Endothelial dysfunction plays a key role in the development, progression, and clinical manifestation of atherosclerosis, and in symptomatic peripheral arterial disease, endothelial dysfunction and enlarged intima-media thickness might be associated with increased cardiovascular risk. Flow-mediated dilatation and serologic parameters are used to evaluate individual endothelial function. Brachial intima-media thickness, a less recognized parameter of cardiovascular risk, is independently associated with coronary artery disease. The aim of this study was to evaluate the prognostic value of ultrasound and serologic parameters of endothelial function in relation to cardiovascular mortality in peripheral arterial disease. DESIGN: monocentric, prospective cohort study. METHODS: Flow mediated dilatation and brachial intima-media thickness were assessed in 184 (124 male) patients with peripheral arterial disease (Rutherford stages 2-3). Serologic parameters of endothelial function included asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), and L-homoarginine. Cardiovascular events were recorded during a follow-up of 99.1±11.1 months. Subjects who died of noncardiovascular causes were excluded from further analysis. RESULTS: Eighty-two patients (44.6%) died during follow-up after a mean duration of 49.7±28.3 months. There were 49 cardiovascular deaths (59.8%) and 33 other deaths (40.2%). Flow mediated dilatation was associated with cardiovascular death [1.17% (0.0, 4.3) vs. 4.1% (1.2, 6.4), p<0.001]. Intima-media thickness was greater in patients who succumbed to cardiovascular disease [0.37 mm (0.30, 0.41)] than in survivors [0.21 mm (0.15, 0.38), p<0.001]. Brachial intima-media thickness above 0.345 mm was most predictive of cardiovascular death, with sensitivity and specificity values of 0.714 and 0.657, respectively (p<0.001). Furthermore, ADMA levels above 0.745 µmol/l and SDMA levels above 0.825 µmol/l were significantly associated with cardiovascular death (p<0.001 and 0.030). CONCLUSION: In symptomatic peripheral arterial disease, decreased flow mediated dilatation, enlarged intima-media thickness, and elevated levels of ADMA and SDMA were associated with increased cardiovascular risk

Platelet-to-lymphocyte ratio: a novel marker for critical limb ischemia in peripheral arterial occlusive disease patients.

BACKGROUND: Platelet-to-Lymphocyte Ratio (PLR) is an easily applicable blood test. An elevated PLR has been associated with poor prognosis in patients with different oncologic disorder. As platelets play a key role in atherosclerosis and atherothrombosis, we investigated PLR and its association with critical limb ischemia (CLI) and other vascular endpoints in peripheral arterial occlusive disease (PAOD) patients. METHODS AND FINDINGS: We evaluated 2121 PAOD patients treated at our institution from 2005 to 2010. PLR was calculated and the cohort was categorized into tertiles according to the PLR. An optimal cut-off value for the continuous PLR was calculated by applying a receiver operating curve analysis to discriminate between CLI and non-CLI. In our cohort occurrence of CLI significantly increased with an increase in PLR. As an optimal cut-off value, a PLR of 150 was identified. Two groups were categorized, one containing 1228 patients (PLR≤150) and a second group with 893 patients (PLR>150). CLI was more frequent in PLR>150 patients (410(45.9%)) compared to PLR≤150 patients (270(22.0%)) (p150 was associated with an OR of 1.9 (95%CI 1.7-2.1) for CLI even after adjustment for other well-established vascular risk factors. CONCLUSIONS: An increased PLR is significantly associated with patients at high risk for CLI and other cardiovascular endpoints. The PLR is a broadly available and cheap marker, which could be used to highlight patients at high risk for vascular endpoints

Percentage of patients with CLI stratified by tertile of NLR.

<p>Numbers below the figure are median NLR and the 25^th and 75^th percentile.</p

Clinical and hematological characteristics of population with NLR≤3.95 and NLR>3.95.

<p>Clinical and hematological characteristics of population with NLR≤3.95 and NLR>3.95.</p

Patients' characteristics of all PAOD patients included in the study.

<p>Patients' characteristics of all PAOD patients included in the study.</p

Cox regression survival analysis for cut-off values of flow-mediated dilatation (FMD), brachial intima-media thickness (B-IMT), ADMA and SDMA, all parameters adjusted for age, gender, arterial hypertension, eGFR, and smoking behavior.

<p>Cox regression survival analysis for cut-off values of flow-mediated dilatation (FMD), brachial intima-media thickness (B-IMT), ADMA and SDMA, all parameters adjusted for age, gender, arterial hypertension, eGFR, and smoking behavior.</p

Cox regression survival plots showing cardiovascular mortality as a function of FMD, B-IMT, ADMA and SDMA with adjustment for age, gender, arterial hypertension, smoking behavior, and creatinine clearance.

<p>Cox regression survival plots showing cardiovascular mortality as a function of FMD, B-IMT, ADMA and SDMA with adjustment for age, gender, arterial hypertension, smoking behavior, and creatinine clearance.</p