LEÓN, JOSÉ CLAUDIO DE Y SRA. [Material gráfico]

Copia digital. Madrid : Ministerio de Educación, Cultura y Deporte, 201

Sludge

International audienceWater treatment residuals, sewage sludge and dredged sediments, hereinafter referred to as sludge, share common features, like inherent high moisture content, high organic and mineral pollutant load and above all a pasty consistency. Several recovery opportunities exist. However, sludge composition is closely correlated with human activity and the design of the recovery processes requires knowledge of physical, thermal or biological characteristics of the sludge that will be processed, often even before the specific sludge exists. Therefore, sludge characterization is a key challenge for the process design, control and optimization and further valorization. The present chapter is divided into four parts dedicated to the composition, the material properties, the dynamic processing properties and the environmental assessments, respectively. Standard tests methods for the characterization of solids and water distribution in sludge are introduced first. Then, the fate of organic constituents, inorganic nonmetallic and metallic constituents as well as pathogenic organism. In the second part, standard and state-of-the-art methods for the characterization of chemical, physical and thermal properties of sludge are described. Dynamic tests, required for the selection and design of conventional processes for sludge concentration and conveying, are detailed in the third part. Finally, methods for assessing the environment impacts of sludge and secondary raw materials derived from sludge are addressed

Heart failure in Europe: Guideline-directed medical therapy use and decision making in chronic and acute, pre-existing and de novo, heart failure with reduced, mildly reduced, and preserved ejection fraction – the ESC EORP Heart Failure III Registry

Aims We analysed baseline characteristics and guideline-directed medical therapy (GDMT) use and decisions in theEuropean Society of Cardiology (ESC) Heart Failure (HF) III Registry. Methods and results Between1November 2018and31December 2020,10162 patients with acute HF (AHF, 39%, age 70 [62-79],36% women) or outpatient visit for HF (61%, age 66 [58-75], 33% women), with HF with reduced (HFrEF, 57%),mildly reduced (HFmrEF,17%) or preserved (HFpEF, 26%) ejection fraction were enrolled from 220 centres in 41European or ESC-affiliated countries. With AHF, 97% were hospitalized, 2.2% received intravenous treatment in theemergency department, and 0.9% received intravenous treatment in an outpatient clinic. AHF was seen by most bya general cardiologist (51%) and outpatient HF most by a HF specialist (48%). A majority had been hospitalized forHF before, but 26% of AHF and 6.1% of outpatient HF had de novo HF. Baseline use, initiation and discontinuation ofGDMT varied according to AHF versus outpatient HF, de novo versus pre-existing HF, and by ejection fraction. Afterthe AHF event or outpatient HF visit, use of any renin-angiotensin system inhibitor, angiotensin receptor-neprilysininhibitor, beta-blocker, mineralocorticoid receptor antagonist and loop diuretics was 89%, 29%, 92%, 78%, and 85%in HFrEF; 89%, 9.7%, 90%, 64%, and 81% in HFmrEF; and 77%, 3.1%, 80%, 48%, and 80% in HFpEF. ConclusionUse and initiation of GDMT was high in cardiology centres in Europe, compared to previous reports from cohortsand registries including more primary care and general medicine and regions more local or outside of Europe andESC-affiliated countries....................................