Modéliser pour prévoir les flux de polluants émis par un dispositif contenant des déchets

Une méthodologie d'étude du comportement en scénario de valorisation de déchets minéraux solidifiés/stabilisés est présentée. La méthodologie est basée sur des outils expérimentaux (des tests paramétriques et des essais de simulation du scénario) et des modèles de comportement. Le cas d'un bassin de stockage d'eau construit avec un matériau contenant des résidus d'épuration des fumées d'incinération d'ordures ménagères est présenté. L'influence de la carbonatation du lixiviat par le CO2 atmosphérique sur le relargage des éléments de constitution du matériau est étudiée. Un modèle de comportement est mis en place pour le cas étudié; il comporte trois niveaux : 1) le matériau (chimie et diffusion), 2) le lixiviat (chimie et convection), 3) l'absorption du CO2 dans le lixiviat. Plusieurs échelles d'expérimentation (tests de laboratoire, pilote de laboratoire, pilote de terrain) ont été mises en place pour l'étude du scénario et pour la validation du modèle de comportement. Le rôle de la modélisation est mis en avant par les résultats prévisionnels des simulations. Ainsi, pour le cas étudié, la carbonatation du système diminue la concentration du plomb dans l'eau du bassin par rapport à un scénario "bassin couvert". La carbonatation ne modifie pas le relargage des éléments solubles (Na, K, Cl) et détermine la spéciation du Ca dans le bassin et à la surface du matériau.The reuse of wastes and industrial residues should only be considered if we can assure that the environmental risks related to the planned use remain acceptable. The assessment and development of methodologies and tools used in evaluating the long-term release of pollutants from materials containing wastes is an area of research that is expanding. These methods depend on not only the characteristics of the materials (especially physical structure and composition) but also contact with both water and the reactive atmosphere.The methodological standard ENV 12 920 is fundamental in the definition of the European approach, which involves the intrinsic and dynamic characterisation of the material/scenario couple in order to model the time-dependent source term. The main steps of the methodology are: 1) definition of the problem and the solution sought; 2) description of the scenario; 3) description of the waste; 4) determination of the influence of parameters on leaching behaviour; 5) modelling of leaching behaviour and 6) behavioural model validation.The reuse scenario considered in the paper was a storage tank open to the atmosphere including material leaching, carbonation and contact with air. The reservoir content was composed of a mixture of hydraulic binders and air pollution control residues from a Municipal Solid Waste Incinerator. Modelling of the source term (the reservoir material) was performed in several steps ranging from the physico-chemical characterisation of the material to the validation of the proposed model by field simulation devices.An experimental "toolbox" consisting of equilibrium dissolution tests and a dynamic leaching test was used. The experimental data supplied by the tests are the necessary input parameters for the behavioural model and give information about the release mechanisms. Identification of the main transfer mechanisms indicates that the release of soluble pollutants is the combined result of diffusional transfer of pollutants in the solution and the physico-chemical specificity of the species.A physico-chemical and transport model has been developed for the long-term prediction of environmental leaching behaviour of porous materials containing inorganic waste solidified with hydraulic binders and placed in a reuse scenario. The model includes the source term, the leachate and the gas/liquid interface. The source term considers the main chemical equilibria (a simplified system) occurring in the interstitial water of the porous material. The consideration of the base content of the material, and the experimental determination of the solubility of heavy metals in the pore water, ensure a good representation of the metal release. The source term also includes diffusion in the porous system, which is considered the main transport phenomenon.The leachate component considers chemical reactions that occur in the leachate. Many competitive dynamic processes (fluxes of mobile species coming from or penetrating into the material, gas absorption) take place in the leachate. Mass transport by convection of the leachate is also considered. Finally, the gas/liquid interface includes absorption with chemical reactions of carbon dioxide.The physico-chemical parameters (initial element content, lead solubility and diffusion coefficient) of the model with respect to the source term were estimated using laboratory leaching tests. The gas/liquid mass transfer coefficient was estimated for each pilot. The simulation results agree with the two scales of experimental data: laboratory scale (volume of reservoir 80 L) and field tests (20 m3). No scale effect was observed as the intensity of the absorption phenomenon was virtually the same.Experimental data and simulations show the main trends for the release of elements contained in the material: 1) The results obtained show that air carbonation of the leachate does not fundamentally change mass transfer mechanisms of easily soluble species (especially for alkaline metals). For these species, the use of the apparent diffusional model is a satisfactory solution for the prediction of long-term leaching behaviour. 2) The release of Ca and Pb was governed by chemical equilibria in pore water and diffusion whereas their speciation in the leachate was determined by pH and the presence of carbonate ions. 3) A carbonation front appears at the leachate/material interface and progresses into the material. 4) The target metal (lead) has a weak release (non-detectable by the analytical method used) for the study period. 5) Simulations of similar scenarios but without carbonation (a closed reservoir) predicts a higher concentration of lead than in the studied scenario.Model estimations may be enhanced by a better knowledge of the source term (particularly the mineralogy and chemistry) and by an exhaustive listing of external factors acting in each scenario. In this study, factors such as the biological activity or temperature fluctuations were not taken into account. The general methodology used is based on several indispensable steps that lead to an environmental assessment of materials containing wastes destined for reuse scenarios. The necessary tools (experimental tests and mathematical models) are however specific for categories of materials (wastes) and types of scenarios.A new generation of decision-making tools, based on modelling and simulation results, can complete, or even replace, the normalised procedures that mainly focus on laboratory experimental data

Mortality and pulmonary complications in patients undergoing surgery with perioperative sars-cov-2 infection: An international cohort study

Background The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (740%) had emergency surgery and 280 (248%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (261%) patients. 30-day mortality was 238% (268 of 1128). Pulmonary complications occurred in 577 (512%) of 1128 patients; 30-day mortality in these patients was 380% (219 of 577), accounting for 817% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 175 [95% CI 128-240], p<00001), age 70 years or older versus younger than 70 years (230 [165-322], p<00001), American Society of Anesthesiologists grades 3-5 versus grades 1-2 (235 [157-353], p<00001), malignant versus benign or obstetric diagnosis (155 [101-239], p=0046), emergency versus elective surgery (167 [106-263], p=0026), and major versus minor surgery (152 [101-231], p=0047). Interpretation Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Elective surgery cancellations due to the COVID-19 pandemic: global predictive modelling to inform surgical recovery plans.

BACKGROUND: The COVID-19 pandemic has disrupted routine hospital services globally. This study estimated the total number of adult elective operations that would be cancelled worldwide during the 12 weeks of peak disruption due to COVID-19. METHODS: A global expert response study was conducted to elicit projections for the proportion of elective surgery that would be cancelled or postponed during the 12 weeks of peak disruption. A Bayesian β-regression model was used to estimate 12-week cancellation rates for 190 countries. Elective surgical case-mix data, stratified by specialty and indication (surgery for cancer versus benign disease), were determined. This case mix was applied to country-level surgical volumes. The 12-week cancellation rates were then applied to these figures to calculate the total number of cancelled operations. RESULTS: The best estimate was that 28 404 603 operations would be cancelled or postponed during the peak 12 weeks of disruption due to COVID-19 (2 367 050 operations per week). Most would be operations for benign disease (90·2 per cent, 25 638 922 of 28 404 603). The overall 12-week cancellation rate would be 72·3 per cent. Globally, 81·7 per cent of operations for benign conditions (25 638 922 of 31 378 062), 37·7 per cent of cancer operations (2 324 070 of 6 162 311) and 25·4 per cent of elective caesarean sections (441 611 of 1 735 483) would be cancelled or postponed. If countries increased their normal surgical volume by 20 per cent after the pandemic, it would take a median of 45 weeks to clear the backlog of operations resulting from COVID-19 disruption. CONCLUSION: A very large number of operations will be cancelled or postponed owing to disruption caused by COVID-19. Governments should mitigate against this major burden on patients by developing recovery plans and implementing strategies to restore surgical activity safely

Global wealth disparities drive adherence to COVID-safe pathways in head and neck cancer surgery

Peer reviewe

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Functional outcomes in symptomatic versus asymptomatic patients undergoing incisional hernia repair: Replacing one problem with another? A prospective cohort study in 1312 patients

Background: Incisional hernias can be associated with pain or discomfort. Surgical repair especially mesh reinforcement, may likewise induce pain. The primary objective was to assess the incidence of pain after hernia repair in patients with and without pre-operative pain or discomfort. The secondary objectives were to determine the preferred mesh type, mesh location and surgical technique in minimizing postoperative pain or discomfort. Materials and methods: A registry-based prospective cohort study was performed, including patients undergoing incisional hernia repair between September 2011 and May 2019. Patients with a minimum follow-up of 3–6 months were included. The incidence of hernia related pain and discomfort was recorded perioperatively. Results: A total of 1312 patients were included. Pre-operatively, 1091 (83%) patients reported pain or discomfort. After hernia repair, 961 (73%) patients did not report pain or discomfort (mean follow-up = 11.1 months). Of the pre-operative asymptomatic patients (n = 221), 44 (20%, moderate or severe pain: n = 14, 32%) reported pain or discomfort after mean follow-up of 10.5 months. Of those patients initially reporting pain or discomfort (n = 1091), 307 (28%, moderate or severe pain: n = 80, 26%) still reported pain or discomfort after a mean follow-up of 11.3 months postoperatively. Conclusion: In symptomatic incisional hernia patients, hernia related complaints may be resolved in the majority of cases undergoing surgical repair. In asymptomatic incisional hernia patients, pain or discomfort may be induced in a considerable number of patients due to surgical repair and one should be aware if this postoperative complication

Measurement of vector boson production cross sections and their ratios using pp collisions at √s = 13.6 TeV with the ATLAS detector

Abstract available from publisher's website

Distribution of vascular plant species in woodland patches of Ojcow National Park (southern Poland) in relation to seed dispersal

Plant diaspore dispersal is a fundamental process affecting the development of forest vegetation and its natural regeneration, especially with regard to typical woodland species, which spread slowly and form short-term soil seed banks. Most of these species have poor seed dispersal mechanisms, which is the major cause of their very slow expansion. The following questions were asked: (i) is there a relationship between the age of a woodland and the presence of forest vascular plant species representing different seed dispersal types; (ii) how do the proportions change between species representing different seed dispersal types in relation to the age of woodland; (iii) what factors determine the presence of species representing a given seed dispersal type; (iv) which factors affect the presence and which ones influence the abundance of selected woodland species? A multiple regression models were developed based on data obtained from 144 woodland patches designated for the study. A probit regression analysis was performed for selected species exhibiting various seed dispersal models. Woodland plants of all seed dispersal types show a significant relationship with the age of woodland, starting from the strongest linkage: anemochores, myrmecochores, endozoochores, epizoochores, barochores, autochores. As the woodland ages, the proportion of forest myrmecochores and anemochores grows, whilst the proportion of autochores, epizoochores and endozoochores shrinks. Results obtained indicate that the direct proximity of ancient woodland has a major effect on the occurrence of more poorly dispersing plants in recent woodlands, such as myrmecochores and heavy anemochores