Characteristics of effluents from healthcare waste treatment with alkaline hydrolysis

Although alkaline hydrolysis emerges as an alternative process to treat healthcare waste (HCW), information about its emissions is scarce, namely as regards effluents production. This work aims to characterize the effluents from alkaline hydrolysis tests with samples of components usually present in HCW, under a temperature of 110 degrees C and with 1 M NaOH aqueous solutions. Some of the regulatory parameters for discharging effluents were determined; also, tests for assessing aerobic and anaerobic biodegradation of those effluents were carried out. The effluents showed values lower than threshold values for almost all the parameters except pH, total nitrogen, TOC, COD and BOD5. Although with high organic load, the effluents from discarded medical components (DMC) and animal tissues (AT) showed a percentage of aerobic biodegradation of 50.5 and 52.9%, respectively. The anaerobic biodegradability obtained for the effluents from DMC were 22.3 and 42.2% for those with AT

Inactivation of Geobacillus stearothermophilus spores by alkaline hydrolysis applied to medical waste treatment

Although alkaline hydrolysis treatment emerges as an alternative disinfection/sterilization method for medical waste, information on its effects on the inactivation of biological indicators is scarce. The effects of alkaline treatment on the resistance of Geobacillus stearothermophilus spores were investigated and the influence of temperature (80 degrees C, 100 degrees C and 110 degrees C) and NaOH concentration was evaluated. In addition, spore inactivation in the presence of animal tissues and discarded medical components, used as surrogate of medical waste, was also assessed. The effectiveness of the alkaline treatment was carried out by determination of survival curves and D-values. No significant differences were seen in D-values obtained at 80 degrees C and 100 degrees C for NaOH concentrations of 0.5 M and 0.75 M. The D-values obtained at 110 degrees C (2.3-0.5 min) were approximately 3 times lower than those at 100 degrees C (8.8-1.6 min). Independent of the presence of animal tissues and discarded medical components, 6 log10 reduction times varied between 66 and 5 min at 100 degrees C-0.1 M NaOH and 110 degrees C-1 M NaOH, respectively. The alkaline treatment may be used in future as a disinfection or sterilization alternative method for contaminated waste

Validating a measure for eco-anxiety in Portuguese young adults and exploring its associations with environmental action

Background: Worsening environmental conditions may amplify people’s emotional responses to an environmental crisis (eco-anxiety). In Portugal, young people seem to be especially concerned about climate change. However, this phenomenon needs to be interpreted using accurate instruments. Thus, this study aimed to validate the Portuguese version of the Hogg Eco-Anxiety Scale (HEAS) in young adults and examine the associations among eco-anxiety, sociodemographic characteristics, and pro-environmental behaviours. Methods: A survey was administered to 623 Portuguese university students aged between 18 and 25 years. The survey included our Portuguese translation of the HEAS (obtained through a back-translation and pretesting process), a sociodemographic assessment, and questions related to pro-environmental behaviours. Confirmatory factor analysis was conducted to assess the construct validity of the Portuguese version of the HEAS, and global fit indices were used to assess whether the original four-dimensional structure of the scale was reproduced. The reliability of the Portuguese version of the HEAS was evaluated by Cronbach’s alpha and the intraclass correlation coefficient. Measurement invariance examined sex differences in scale interpretation. Linear regressions were used to detect whether sociodemographic variables predict eco-anxiety and whether eco-anxiety predicts pro-environmental behaviours. Results: The factorial structure of the original scale was replicated in the Portuguese version of the HEAS, showing good internal consistency, reliability over time and strict invariance between men and women. A higher paternal education level predicted greater eco-anxiety in children. Two dimensions of eco-anxiety—namely, rumination and anxiety about personal impacts on the environment—predicted higher engagement in pro-environmental behaviours. Conclusions: The translated scale is an appropriate tool to measure eco-anxiety in the Portuguese context and should be used to collect evidence to drive environmental and health policies. An individual’s education level should be considered a determinant of their emotional response to environmental conditions. Importantly, eco-anxiety can act as a protective emotional response to preserving the planet

Determinants of health and food choice among free-living Portuguese seniors

Chanaud Robert. Le Roy Ladurie (Emmanuel). — Le Carnaval de Romans. De la Chandeleur an mercredi des Cendres 1579-1580. 1979. Collection Bibliothèque des Histoires. In: Le Monde alpin et rhodanien. Revue régionale d'ethnologie, n°3-4/1978. pp. 260-262

Peri-operative red blood cell transfusion in neonates and infants: NEonate and Children audiT of Anaesthesia pRactice IN Europe: A prospective European multicentre observational study

BACKGROUND: Little is known about current clinical practice concerning peri-operative red blood cell transfusion in neonates and small infants. Guidelines suggest transfusions based on haemoglobin thresholds ranging from 8.5 to 12 g dl-1, distinguishing between children from birth to day 7 (week 1), from day 8 to day 14 (week 2) or from day 15 (≥week 3) onwards. OBJECTIVE: To observe peri-operative red blood cell transfusion practice according to guidelines in relation to patient outcome. DESIGN: A multicentre observational study. SETTING: The NEonate-Children sTudy of Anaesthesia pRactice IN Europe (NECTARINE) trial recruited patients up to 60 weeks' postmenstrual age undergoing anaesthesia for surgical or diagnostic procedures from 165 centres in 31 European countries between March 2016 and January 2017. PATIENTS: The data included 5609 patients undergoing 6542 procedures. Inclusion criteria was a peri-operative red blood cell transfusion. MAIN OUTCOME MEASURES: The primary endpoint was the haemoglobin level triggering a transfusion for neonates in week 1, week 2 and week 3. Secondary endpoints were transfusion volumes, 'delta haemoglobin' (preprocedure - transfusion-triggering) and 30-day and 90-day morbidity and mortality. RESULTS: Peri-operative red blood cell transfusions were recorded during 447 procedures (6.9%). The median haemoglobin levels triggering a transfusion were 9.6 [IQR 8.7 to 10.9] g dl-1 for neonates in week 1, 9.6 [7.7 to 10.4] g dl-1 in week 2 and 8.0 [7.3 to 9.0] g dl-1 in week 3. The median transfusion volume was 17.1 [11.1 to 26.4] ml kg-1 with a median delta haemoglobin of 1.8 [0.0 to 3.6] g dl-1. Thirty-day morbidity was 47.8% with an overall mortality of 11.3%. CONCLUSIONS: Results indicate lower transfusion-triggering haemoglobin thresholds in clinical practice than suggested by current guidelines. The high morbidity and mortality of this NECTARINE sub-cohort calls for investigative action and evidence-based guidelines addressing peri-operative red blood cell transfusions strategies. TRIAL REGISTRATION: ClinicalTrials.gov, identifier: NCT02350348

Protective intraoperative ventilation with higher versus lower levels of positive end-expiratory pressure in obese patients (PROBESE): study protocol for a randomized controlled trial

Background: Postoperative pulmonary complications (PPCs) increase the morbidity and mortality of surgery in obese patients. High levels of positive end-expiratory pressure (PEEP) with lung recruitment maneuvers may improve intraoperative respiratory function, but they can also compromise hemodynamics, and the effects on PPCs are uncertain. We hypothesized that intraoperative mechanical ventilation using high PEEP with periodic recruitment maneuvers, as compared with low PEEP without recruitment maneuvers, prevents PPCs in obese patients. Methods/design The PRotective Ventilation with Higher versus Lower PEEP during General Anesthesia for Surgery in OBESE Patients (PROBESE) study is a multicenter, two-arm, international randomized controlled trial. In total, 2013 obese patients with body mass index ≥35 kg/m2 scheduled for at least 2 h of surgery under general anesthesia and at intermediate to high risk for PPCs will be included. Patients are ventilated intraoperatively with a low tidal volume of 7 ml/kg (predicted body weight) and randomly assigned to PEEP of 12 cmH2O with lung recruitment maneuvers (high PEEP) or PEEP of 4 cmH2O without recruitment maneuvers (low PEEP). The occurrence of PPCs will be recorded as collapsed composite of single adverse pulmonary events and represents the primary endpoint. Discussion To our knowledge, the PROBESE trial is the first multicenter, international randomized controlled trial to compare the effects of two different levels of intraoperative PEEP during protective low tidal volume ventilation on PPCs in obese patients. The results of the PROBESE trial will support anesthesiologists in their decision to choose a certain PEEP level during general anesthesia for surgery in obese patients in an attempt to prevent PPCs. Trial registration ClinicalTrials.gov identifier: NCT02148692. Registered on 23 May 2014; last updated 7 June 2016. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-1929-0) contains supplementary material, which is available to authorized users

Alkaline hydrolysis applied to animal tissues treatment

In this study, the minimum temperature and NaOH concentration for the total destruction of animal tissues were determined using either pork or beef as surrogates. The alkaline hydrolysis trials were performed with 1 M and 2 M NaOH solutions at different temperatures and different hydrolysis times. The pork and beef showed a similar behavior when subjected to alkaline hydrolysis. The destruction of meat was faster than the bone. The meat was totally hydrolyzed above 90C in less than 60 minutes. The effluents obtained after alkaline treatment are hazardous due to their very high pH. Although with very high organic load, the effluents produced in alkaline hydrolysis were biodegradable after neutralization. Therefore, it may be acceptable to discharge the neutralized effluents in a domestic wastewater treatment plant. © 2015 Taylor & Francis Group, London

Enzymatic esterification of acid oil from soapstocks obtained in vegetable oil refining: Effect of enzyme concentration

The enzymatic esterification of an acid waste oil was investigated using a commercial lipase (Thermo-myces lanuginosus) in batch reactors, under the following reaction conditions: temperature of 35 degrees C, molar ratio of acid:alcohol of 1:1.5, vigorous magnetic stirring and enzyme concentration from 2 to 5 wt.%. The reaction progressed during 24 h. The acid oil obtained from soapstock of vegetable oil refining had an acidity of 65.5 wt.% and a very high sulphur content of 10 400 mg/kg. Thus, a pretreatment to reduce the mineral acidity before enzymatic esterification was necessary. The selected pretreatment consisted of one wash with 1:1 V/V oil:NaOH solution followed by two washings with 1:1 V/V oil: distilled water. The results from the esterification of the pretreated oil showed a clear influence of enzyme concentration in the reduction of the acidity, most of which was achieved in the first 7 h. The amount and type of alcohol had minor influence in the reaction conversion and the fractionated addition of methanol had only expressive effect for lower catalyst concentrations, with final conversions being still unsatisfactory. The best conditions found were 4 wt.% of enzyme, 35 degrees C, 24 h, and 1:1.5 molar ratio of acid:alcohol, which afforded an 80% reduction of acidity