Ulnar-sided wrist pain. II. Clinical imaging and treatment

Pain at the ulnar aspect of the wrist is a diagnostic challenge for hand surgeons and radiologists due to the small and complex anatomical structures involved. In this article, imaging modalities including radiography, arthrography, ultrasound (US), computed tomography (CT), CT arthrography, magnetic resonance (MR) imaging, and MR arthrography are compared with regard to differential diagnosis. Clinical imaging findings are reviewed for a more comprehensive understanding of this disorder. Treatments for the common diseases that cause the ulnar-sided wrist pain including extensor carpi ulnaris (ECU) tendonitis, flexor carpi ulnaris (FCU) tendonitis, pisotriquetral arthritis, triangular fibrocartilage complex (TFCC) lesions, ulnar impaction, lunotriquetral (LT) instability, and distal radioulnar joint (DRUJ) instability are reviewed

TRY plant trait database – enhanced coverage and open access

Plant traits - the morphological, anatomical, physiological, biochemical and phenological characteristics of plants - determine how plants respond to environmental factors, affect other trophic levels, and influence ecosystem properties and their benefits and detriments to people. Plant trait data thus represent the basis for a vast area of research spanning from evolutionary biology, community and functional ecology, to biodiversity conservation, ecosystem and landscape management, restoration, biogeography and earth system modelling. Since its foundation in 2007, the TRY database of plant traits has grown continuously. It now provides unprecedented data coverage under an open access data policy and is the main plant trait database used by the research community worldwide. Increasingly, the TRY database also supports new frontiers of trait‐based plant research, including the identification of data gaps and the subsequent mobilization or measurement of new data. To support this development, in this article we evaluate the extent of the trait data compiled in TRY and analyse emerging patterns of data coverage and representativeness. Best species coverage is achieved for categorical traits - almost complete coverage for ‘plant growth form’. However, most traits relevant for ecology and vegetation modelling are characterized by continuous intraspecific variation and trait–environmental relationships. These traits have to be measured on individual plants in their respective environment. Despite unprecedented data coverage, we observe a humbling lack of completeness and representativeness of these continuous traits in many aspects. We, therefore, conclude that reducing data gaps and biases in the TRY database remains a key challenge and requires a coordinated approach to data mobilization and trait measurements. This can only be achieved in collaboration with other initiatives

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication

Devolatilization characteristics of Oedogonium sp., Loy Yang coal and their blends using thermogravimetric analysis

In order to assess the potential of gasification for the utilisation of algal biomass, the devolatilisation characteristics of a fresh water macroalgae (Oedogonium sp.), a Victoria brown coal (Loy Yang) and their blends were investigated. The study indicated that Oedogonium sp. and Loy Yang coal exhibit quite different pyrolysis characteristics under the same pyrolysis conditions, the devolatization of Oedogonium sp. occurs mainly between 180-410 °C, while for Loy Yang coal pyrolysis occurs over a wider temperature zone. The effect of heating rate on the devolatilization characteristics of these two fuels was also studied; for heating rates of 10-40 °C /min it was found that pyrolysis shifts to higher temperatures as the heating rate increases for both fuels. There is no significant change in the residual mass for Loy Yang coal, however, the residual mass of Oedogonium sp. decreases slightly as the heating rate increases. The pyrolysis characteristics of blends of these two fuels were also investigated for different blending ratios. No interaction effects were observed to exist for the experimental conditions investigated. Based on this work, successful co-gasification of macroalgae and coal is not expected to be impeded by limitations occurring during the pyrolysis stage

Polycyclic aromatic hydrocarbons on particulate matter emitted during the co-generation of bioenergy and biochar from rice husk

The aim of this study was to evaluate the emissions of polycyclic aromatic hydrocarbons (PAHs) bound to the particulate matter (PM) during the combustion of raw pyrolysis volatiles (bio-oil and pyrogas mixture) generated from the pyrolysis of rice husk. Five different raw pyrolysis volatiles were produced at varying pyrolysis temperatures (400-800 degrees C) and subsequently combusted in a laboratory-scale, continuous pyrolysis-combustion facility at 850 degrees C. 15 priority pollutant PAH levels in the resulting biochar, bio-oil, and PM were evaluated. Results showed that combustion of the raw pyrolysis volatiles produced at elevated pyrolysis temperatures resulted in greater concentrations of PM-bound PAHs (119% increase between 400 and 800 degrees C) due to the increased PAH and oxy-aromatic content of the bio-oil fraction. Significantly increased benzo(a) pyrene (BaP) equivalent toxicity of the biochar and PM was observed at elevated pyrolysis temperatures.</p

Pyrolysis characteristics and char reactivity of Oedogonium sp. and Loy Yang coal

The proposition of combining the application of algae in wastewater treatment, CO2 fixation, and energy production maximizes the opportunity of algal bioremediation. In this paper, the freshwater macroalga Oedogonium, a key target species for the bioremediation of waste waters, was investigated for its utilization in energy production via gasification or co-gasification with coal. The pyrolysis characteristics of Oedogonium and the effects of pyrolysis conditions on char reactivity were investigated in this paper, and an Australian lignite was also studied for comparison purposes. The pyrolysis process of Oedogonium and coal can be divided into three stages: moisture evaporation, volatile release, and decomposition of the remaining carbonaceous compounds. However, the devolatilization of Loy Yang coal was slower and occurred over a wider temperature range compared to Oedogonium. As the heating rate increased, the pyrolysis curves for both Oedogonium and Loy Yang coal shifted to higher temperatures. To investigate the effects of pyrolysis conditions on char reactivity, a tube reactor was employed to generate char samples under a range of pyrolysis conditions. The produced char samples were characterized using a CHN analyzer and scanning electron microscopy technique. It was found that char samples almost maintain their original shape following pyrolysis at a low heating rate. However, evidence of char swelling was observed in the structure of chars prepared at a high heating rate. Pyrolysis conditions also had a significant influence on the reactivity of the derived chars. Char reactivity for both fuels was enhanced at a higher heating rate and lower pyrolysis temperature. Oedogonium char reactivity was around 2–5 times that of Loy Yang char prepared under the same pyrolysis conditions. However, the differences in reactivity became less significant as the pyrolysis temperature increased. Oedogonium has a higher devolatilization rate and higher char reactivity than Loy Yang lignite. It implies that it is easier to be gasified, and the co-gasification with lignite is advantageous

Mobilisation of trace elements during thermal conversion of algae cultivated in ash dam water

The work presented here assesses the potential for the mobilisation of 11 trace elements (As, Be, Co, Cu, Mn, Ni, Pb, Sb, Se, V, Zn) during the thermal conversion of micro-and macroalgae that were cultivated in ash dam water. The volatility of the trace elements was quantified by mass balances based on elemental analyses of char and ash residues. The residues were prepared in a laboratory-scale fixed-bed reactor at a range of different temperatures (500-1100 degrees C) and gas atmospheres (N-2, 2% O-2 and CO2) to simulate pyrolysis, combustion and gasification processes. The results showed high volatilities for Se (similar to 79-97%) and As (similar to 51-79%) below 500 degrees C. Zn, Pb and Sb were mainly volatilised above 700 degrees C. The different gas atmospheres had little influence on the volatility of these elements, which increased sharply to more than 90% with increasing temperature from 700 to 1100 degrees C. Volatilities for V, Mn, Cu, Co, Ni and Be were relatively minor over the full range of investigated operating conditions. Samples of each alga and their thermal conversion residues were subject to batch leaching in water. All of the tested trace elements, except for Pb and Be, were partially leached from the algae. Vanadium was up to 4-5 times more leachable in the combustion residues than in the algae. The other trace elements were generally less leachable following thermal conversion. The trace elements were more stable in residues prepared under pyrolysis and gasification conditions than in residues prepared under combustion conditions at the same temperature

Algal biomass: occurrence of the main inorganic elements and simulation of ash interactions with bed material

The work presented here provides greater insight into the occurrence of the main inorganic elements in algae and how this varies for different species of algae and production methods. It also provides valuable insights into the behavior of algal ashes during combustion, particularly in regard to their interaction with quartz bed material, which is of direct relevance to agglomeration in fluidized bed reactors. A diverse range of algal species was selected for this work using a species of marine microalgae (Tetraselmis sp.) and marine macroalgae (Derbesia tenuissima) and a species of freshwater macroalgae (Oedogonium sp.). Two samples of Oedogonium were tested. One sample was cultivated using a standard nutrient addition regime, and the other was starved of essential nutrients at the completion of the culture cycle. Samples of algae were subject to chemical fractionation and the mode of occurrence of the main inorganic elements was inferred from their leaching behavior. Both the relative proportions of the main inorganic elements in the algae and their mode of occurrence are largely dependent on the culturing environment and harvesting history. The leaching behavior of the inorganic elements indicates a high level of inorganic, water-soluble, alkali salts in all of the tested algae. In order to simulate ash interactions with bed particles during fluidized bed combustion, pellets consisting of algal ashes mixed with quartz particles were heated in a muffle furnace at 850 °C in air. Scanning electron microscopy and energy dispersive spectroscopy analyses were performed on cross sections of the resultant samples. Melted ash coatings had formed on the surfaces of the quartz particles. In all cases there was no evidence of chemical reactions between the ashes and quartz particles. Melt-induced agglomeration appeared to be the principal agglomeration mechanism. The ashes from the two marine algae both formed salt-type melts. The ashes from the Oedogonium sample, which had been starved of essential nutrients during cultivation, formed a silicate-type melt. The resultant ash coating consisted of melted, Ca-rich, K−silicate. The Oedogonium sample grown under a standard nutrient addition regime had higher levels of P in its inorganic matter. The increased P content appeared to have a significant influence on the composition and adhesive behavior of the formed melt. The melt formed from the ashes of the P-rich Oedogonium sample had the greatest affinity for the quartz particles and the strongest tendency to form bridges. The resultant ash coating consisted of melted alkali silicate with discrete dispersions of alkali phosphate rich in Ca and Mg

The ash-quartz sand interaction behaviours during steam gasification or combustion of a freshwater and a marine species of macroalgae

The interactions between ash and quartz sand as the bed material were studied for two species of macroalgae, Oedogonium intermedium (a freshwater species) and Derbesia tenuissima (a marine species). The interaction tests were performed in a lab-scale, fixed-bed reactor under a steam gasification (50% v/v steam) or a combustion (5% v/v O-2) atmosphere at 900 degrees C for different reaction times (10 min to 6 h). For both macroalgae, some of the Na and K are found to interact with other elements, such as Mg, Si, P, Ca and Fe to form ash particles. For ODN, these low melting-point phosphorus-rich ash particles are present in sufficient quantities to adhere to the quartz sand and form agglomerates via a melting-induced mechanism. In addition, some of the Na and K react with Si from the quartz sand to form a coating layer, which promotes a coating-induced mechanism. Both mechanisms contribute to a similar extent for ODN; while the coating-induced mechanism dominates for Deb, which includes the diffusion of some Ca into the coating layer. For Deb, the steam gasification atmosphere significantly affects the size of the agglomerates, the mass fractions of K and Na retained in the agglomerates and the formation of various types of silicates in the agglomerates, when compared with those under the combustion atmosphere. However, the influence of the steam gasification atmosphere on both the morphology and the elemental composition of the ODN agglomerates is less obvious. For Deb, a high content of S is detected for the individual separate ash particles within the agglomerates during combustion, whereas negligible S is found during steam gasification