Congenital Diaphragmatic Hernia: Review of Current Concept in Surgical Management

Congenital diaphragmatic hernias (CDHs) occur mainly in two locations: the foramen of Morgagni and the more common type involving the foramen of Bochdalek. Hiatal hernia and paraesophageal hernia have also been described as other forms of CDH. Pulmonary hypertension and pulmonary hypoplasia have been recognized as the two most important factors in the pathophysiology of congenital diaphragmatic hernia. Advances in surgical management include delayed surgical approach that enables preoperative stabilization, introduction of fetal intervention due to improved prenatal diagnosis, the introduction of minimal invasive surgery, in addition to the standard open repair, and the use of improved prosthetic devices for closure

Biofuel as an alternative shipping fuel : technological, environmental and economic assessment

© Royal Society of Chemistry 2019Fossil derived fuels available for application within the maritime sector have been dominated by heavy fuel oil (HFO), which is conventionally used in low speed (main) engines, and more refined fuels such as marine diesel oil (MDO), which is consumed in fast or medium speed engines. However, increasing fuel costs and regulatory pressure such as the restrictions placed on sulphur content have increased interest in the use of alternative fuels. A number of alternative fuels have been identified and may be viable for use within the maritime sector including straight vegetable oil (SVO) as an alternative to HFO in low speed engines, biodiesel to replace MDO/MGO in low to medium speed engines and bio-liquefied natural gas (bio-LNG) in gas engines using LNG. The potential sources of biomass feedstocks, conversion pathways and technologies are identified. The key parameters limiting their potential application are examined, in particular, availability, technological development, technical integration, and operational consequences. A proposed solution to overcome these limitations is recommended. The effective implementation of these strategies will enable the more widespread use of biofuels in marine applications, significantly reducing emissions from ships and improving global air quality and also protecting the ecological environment.Peer reviewe

The optimal use of tris-2-ethylhexylamine to recover hydrochloric acid and metals from leach solutions and comparison with other extractants

This document is the Accepted Manuscript version of the following article: Uchenna Kesieme, Andreas Chrysanthou, Maurizio Catulli, and Chu Yong Cheng, ‘The optimal use of tris-2-ethylhexylamine to recover hydrochloric acid and metals from leach solutions and comparison with other extractants’, Journal of Environmental Chemical Engineering, Vol. 6 (2): 3177-3184, April 2018. Under embargo until 1 May 2019. The final, definitive version is available online via: https://doi.org/10.1016/j.jece.2018.05.001This paper describes the use of TEHA for HCl recovery from a leach solution generated by a hydrometallurgical plant. Four organic extractants were tested including TEHA, Alamine 336, Cyanex 923 and TBP. TEHA organic system performed best in terms of acid extraction, stripping and scrubbing efficiency. The successive extraction shows that more than 99% HCl was extracted after three stages of extraction. Scrubbing tests with different A/O ratios at different temperatures were conducted to identify the optimal conditions to separate HCl, Mn and Fe. After scrubbing the loaded organic solution at an A/O ratio of 1:4 and 22 °C, 94–100% of entrained metals were removed in a single contact with only 5.2% acid lost in the loaded scrub liquor. It was found that the phase disengagement time was in the range of 2– 4 min for both extraction and stripping, indicating reasonable fast phase separation. Based on these results from batch tests, it can be expected that after optimisation in a counter current circuit consisting of extraction, scrubbing, selective and bulk stripping, nearly all metals and HCl would be recovered and recycled.Peer reviewe

A review of acid recovery from acidic mining waste solutions using solvent extraction

This is the peer reviewed version of the following article: Uchenna Kesieme, Andreas Chrysanthou, Maurizio Catulli, and Chu Yong Cheng, ‘A review of acid recovery from acidic mining waste solutions using solvent extraction’, Journal of Chemical Technology and Biotechnology, (2018), which has been published in final form at https://doi.org/10.1002/jctb.5728. Under embargo until 1 July 2019. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.The minerals industry is increasingly being forced by regulatory and cost pressures to reduce the amount of liquid acidic waste they produce. This requires a strong focus on waste reduction by recycling, regeneration and reuse. Four mineral acids were examined for recovery from waste acidic solutions including H 2SO 4, HNO 3, HCl, and H 3PO 4. The selection of the optimal extractant for acid recovery was based on extraction, stripping and scrubbing efficiencies. The extractants suitable for the recovery of H 2SO 4 and HCl are in the order of TEHA > Cyanex 923 > TBP > Alamine 336. TEHA has the highest degree of acid extraction and stripping compared with Cyanex 923 and almost 99% of the acid can be stripped. Alamine 336 can extract higher acid (for H 2SO 4 and HCl systems) than Cyanex 923 and TBP. However loaded acid for Alamine 336 system cannot be stripped using water at 60°C. For the recovery of nitric and phosphoric acids from acidic waste effluents, TBP was the best option. This work clearly demonstrates that extractant suitable for acid extraction may not be suitable for its recovery. However such extractant may be applied for the removal of acid from any waste acidic solution sacrificing the back extraction of the loaded acid. The effective implementation of options for acid recovery was examined to improve sustainability in the mineral industry.Peer reviewe

Tube Thoracostomy: Complications and Its Management

Background. Tube thoracostomy is widely used throughout the medical, surgical, and critical care specialities. It is generally used to drain pleural collections either as elective or emergency. Complications resulting from tube thoracostomy can occasionally be life threatening. Aim. To present an update on the complications and management of complications of tube thoracostomy. Methods. A review of the publications obtained from Medline search, medical libraries, and Google on tube thoracostomy and its complications was done. Results. Tube thoracostomy is a common surgical procedure which can be performed by either the blunt dissection technique or the trocar technique. Complication rates are increased by the trocar technique. These complications have been broadly classified as either technical or infective. Technical causes include tube malposition, blocked drain, chest drain dislodgement, reexpansion pulmonary edema, subcutaneous emphysema, nerve injuries, cardiac and vascular injuries, oesophageal injuries, residual/postextubation pneumothorax, fistulae, tumor recurrence at insertion site, herniation through the site of thoracostomy, chylothorax, and cardiac dysrhythmias. Infective complications include empyema and surgical site infection. Conclusion. Tube thoracostomy, though commonly performed is not without risk. Blunt dissection technique has lower risk of complications and is hence recommended

Attributional life cycle assessment of biofuels for shipping: addressing alternative geographical locations and cultivation Systems

Crown Copyright © 2019 Published by Elsevier Ltd. All rights reserved.The purpose of this study is to evaluate a life cycle assessment of straight vegetable oil (SVO) and biodiesel addressing alternative upstream pathways. The pathways are SVO and biodiesel produced in the United Kingdom (UK) using European rapeseed and also, SVO and biodiesel produced in the UK using soybean grain and soybean oil imported from Argentina. Four environmental impact categories have been assessed using the SimaPro (ReCiPe life cycle impact assessment) method: this includes global warming potential (GWP); acidification; eutrophication and particulate matter. Rapeseed based biofuel had the lowest emission impact in terms of GHG emissions. Significant greenhouse gas (GHG) emissions can result from land use change due to the expansion and cultivation of soybean in Argentina. When land use change is not considered, the soy based biofuel system has the lowest GHG impact with more than 70% GHG emission reduction. The GHG emission at cultivation stage far outweighs the impacts of the other life-cycle stages irrespective of the feedstock used for the biofuel production systems. The use of fertilizers and associated soil emissions are the main contributors. The environmental impacts of biofuel can be reduced by avoiding land use change, improving soil management practices and yield, and also optimizing transportation routes. Effective implementation of options for biofuels production were explored to improve sustainability in shipping.Peer reviewe

Pattern of pericardial diseases in HIV positive patients at University College Hospital, Ibadan, Nigeria

Rationale. Pericarditis has been reported as the most common cardiac complication of HIV disease, followed by pericardial effusion. Methods. A retrospective review was conducted of all 68 patients treated for pericardial diseases between August 2003 and July 2008 at University College Hospital, Ibadan, Nigeria. HIV-positive patients (N=42) were compared with those who were HIV negative (N=26). Results. More male than female patients presented with pericardial disease, and the HIV-positive patients were younger than those who were HIV negative. Pericardial effusion was the commonest mode of presentation, accounting for 20 HIV-positive patients (47.7%) and 13 HIV-negative patients (50%). Pericardiostomy was the commonest surgical intervention performed in HIV-positive patients (N=15), while the majority of HIV-negative patients had pericardiocentesis. Conclusion. Pericardial effusion was the commonest cardiac presentation in HIV-positive patients in our setting. We recommend that patients with pericardial effusion be investigated for HIV infection

Exploring the sectoral level impacts and absolute emission changes of using alternative fuels in international shipping

The shipping sector is required to reduce fuel sulphur content to 0.1% in Emission Control Areas by 2015 and to 0.5% globally by 2020. At the same time there is regulation and a need to address NOx and PM emissions at a localised level and increasing pressure to address the sector’s rising CO2 emissions, which is a major contributor to global climate change. A measure to address these challenges is to switch from the use of heavy fuel oil to alternative fuels that are able to address local pollutants and carbon emissions in parallel. This paper aims to explore the wider impacts of decisions on the choice of fuel undertaken at ship level. This is achieved by incorporating into shipping tool deployed in this study (GloTraM) the upstream and operational emissions for a range of alternative fuels, and test running them with a series of future scenarios. Key research questions include: (1) what are the total CO2 emissions when GloTraM is run with upstream emission factors added?; (2) what impact do these emissions have on the amount/type of fuels used in the sector?; (3) What are the nonGHG emissions and how significant are they compared to CO2 emissions? A life cycle approach is used to generate the upstream, i.e. well-to-tank emissions, accounting for the emissions associated with the processes used to grow and/or manufacture, distribute and dispose of an alternative fuel. The functional unit is tonne of CO2 per tonne of fuel delivered (to the vessel). These emissions are then incorporated alongside the operational emissions, which have been taken from the IMO’s 3rd GHG study. The results of the study provide a better understanding of the magnitude of total emissions from international shipping and the wider system level implications of fuel switching decisions