Altered chemical evolution in landfill leachate post implementation of biodegradable waste diversion

Within the UK implementation of the European Union Landfill Directive (1999) has led to the diversion of biodegradable waste (BW) from municipal solid wastes away from landfills. It has been widely anticipated, but thus far not verified, that the diversion of BW and consequent reduction in BW reaching landfill would lead to a change in the degradation processes occurring within landfills and that this would be reflected in an altered evolution in leachate chemistry compared to pre-Directive landfills. This paper provides evidence based on leachate chemistry from two operational landfills together with calculations of the reduced BW content, that demonstrate the acetogenic phase that characterised pre-Directive landfill leachates is missing and is now more typical of methanogenic phase leachate. The paper demonstrates how data from national datasets and detailed landfill records can be used to constrain likely and upper estimates of the amount of BW going into post-Directive landfills, and the observed change in the evolution of leachate chemistry which has resulted from a decrease in BW content from typical values of BW (pre-Landfill Directive) of 22% to an inferred 12% in the case-study landfills. Data provided here add to the growing literature that estimates the amount of BW in recent post-Directive landfills which importantly allow the quantitative linkage between a decrease in landfilled BW and observed changes in leachate chemistry to be established such that future landfill operators can increase confidence in the effect of Directive implementation on landfill operational parameters

Omicron variant infection in inflammatory rheumatological conditions – outcomes from a COVID-19 naive population in Aotearoa New Zealand

Background: Due to geographic isolation and border controls Aotearoa New Zealand (AoNZ) attained high levels of population coronavirus disease-19 (COVID-19) vaccination before widespread transmission of COVID-19. We describe outcomes of SARS-CoV-2 infection (Omicron variant) in people with inflammatory rheumatic diseases in this unique setting. Methods: This observational study included people with inflammatory rheumatic disease and SARS-CoV-2 infection in AoNZ between 1 February and 30 April 2022. Data were collected via the Global Rheumatology Alliance Registry including demographic and rheumatic disease characteristics, and COVID-19 vaccination status and outcomes. Multivariable logistic regression was used to explore associations of demographic and clinical factors with COVID-19 hospitalisation and death. Findings: Of the 1599 cases included, 96% were from three hospitals that systematically identified people with inflammatory rheumatic disease and COVID-19. At time of COVID-19, 1513 cases (94.6%) had received at least two COVID-19 vaccinations. Hospitalisation occurred for 104 (6.5%) cases and 10 (0.6%) patients died. Lower frequency of hospitalisation was seen in cases who had received at least two vaccinations (5.9%), compared to the unvaccinated (20.6%) or those with a single vaccine dose (10.7%). In multivariable adjusted models, people with gout or connective tissue diseases (CTD) had increased risk of the combined outcome of hospitalisation/death, compared to people with inflammatory arthritis. Glucocorticoid and rituximab use were associated with increased rates of hospitalisation/death. All patients who died had three or more co-morbidities or were over 60 years old. Interpretation: In this cohort with inflammatory rheumatic diseases and high vaccination rates, severe outcomes from SARS-CoV-2 Omicron variant were relatively infrequent. The outcome of Omicron variant infection among vaccinated but SARS-CoV-2 infection-naive people with inflammatory rheumatic disease without other known risk factors were favourable. Funding: Financial support from the American College of Rheumatology (ACR) and European Alliance of Associations for Rheumatology (EULAR) included management of COVID-19 Global Rheumatology Alliance funds

International trials of vertical flow reactors for coal mine water treatment

Vertical flow reactors (VFRs) were tested at coal mine sites in New Zealand, South Korea, and the USA. The objective was to evaluate the iron removal efficiency and iron removal mechanisms during field trials at low pH and circumneutral pH, and to evaluate the potential use of VFRs as stand-alone systems or in combination with other passive treatment technologies. Total iron and manganese removal efficiencies at circumneutral pH (6–8) often exceeded 90%, with effluent concentrations less than 1 mg/L. This is attributed to both homogeneous and heterogenous Fe(II) oxidation and filtration of the precipitated ferrihydrite. Iron removal efficiencies at moderately acidic conditions (pH 3–4.5) averaged close to 40%, with an average 71.0% removal in one of the trials after iron removal capacity was stabilized. Microbial Fe(II) oxidation and precipitation as schwertmannite together with aggregation of colloidal and nano-particulate Fe(III) are suspected to be the main removal mechanisms. Iron solubility limited removal under very acidic conditions (pH < 3). The reproducibility of the results with respect to previous research confirmed that VFRs can be used as stand-alone passive treatment systems for iron removal from mine waters with a footprint less than half of the area required by a conventional aerobic wetland. A VFR can also provide useful iron pretreatment for other passive treatment systems under circumneutral conditions, but would have to be combined with alkaline generating systems to achieve full iron removal from acidic mine waters

Male Imprisoned Firesetters Have Different Characteristics than Other Imprisoned Offenders and Require Specialist Treatment

Objective: This study investigated whether a group of firesetters (n = 68) could be distinguished, psychologically, from a matched group of non-firesetting offenders (n = 68). Method: Participants completed measures examining psychological variables relating to fire, emotional/ self-regulation, social competency, self-concept, boredom proneness, and impression management. Official prison records were also examined to record offending history and other offense-related variables. A series of MANOVAs were conducted with conceptually related measures identified as the dependent variables. Follow up discriminant function and clinical cut-off score analyses were also conducted to examine the best discriminating variables for firesetters. Results: Firesetters were clearly distinguishable, statistically, from non-firesetters on three groups of conceptually related measures relating to: fire, emotional/self-regulation, and self-concept. The most successful variables for the discrimination of firesetters determined via statistical and clinical significance testing were higher levels of anger-related cognition, interest in serious fires, and identification with fire and lower levels of perceived fire safety awareness, general self-esteem, and external locus of control. Conclusions: Firesetters appear to be a specialist group of offenders who hold unique psychological characteristics. Firesetters are likely to require specialist treatment to target these psychological needs as opposed to generic offending behavior programs

Microparticles in acute coronary syndrome

BACKGROUND: Emerging evidence supports the role of cell-derived microparticles (MPs) in the pathophysiology of acute coronary syndrome (ACS). OBJECTIVES: To explore the relationship between coronary and systemic MP levels, investigate the correlation between MPs, inflammatory markers and Troponin T in patients with ACS. METHODS: Thirty seven patients with ACS scheduled for percutaneous coronary interventions (PCI) were studied. Eleven patients with stable angina (SA) were included as a control group. AnnexinV+MPs (AnV+MPs) and activated platelet-monocyte aggregates (PMA) from right atrium (RA) and culprit coronary artery (CO) distal to culprit lesion were measured using flow cytometry. High sensitivity C-reactive protein (CRP), Interleukin - 6 (IL-6), tumour necrosis factor - α (TNF-α), serum amyloid A (SAA) and Troponin T were assayed. RESULTS: Total and cell specific AnV+MP expression were higher in the ACS group in both the CO and RA, with greater levels detected in the CO. Platelet activation showed positive correlation with Troponin-T and platelet MP in both CO and RA of the ACS group (r=0.4 for both; p=0.04 & p=0.03 respectively). Inflammatory markers levels did not differ between the ACS and SA patients. CONCLUSIONS: Elevated coronary and systemic MP levels and positive correlation of platelet activation with Troponin-T and platelet MPs suggest a pathogenic role for MPs in ACS

Challenges and opportunities in the care of chronic subdural haematoma: perspectives from a multi-disciplinary working group on the need for change.

INTRODUCTION: A chronic subdural haematoma (cSDH) is a collection of altered blood products between the dura and brain resulting in a slowly evolving neurological deficit. It is increasingly common and, in high income countries, affects an older, multimorbid population. With changing demographics improving the care of this cohort is of increasing importance. METHODS: We convened a cross-disciplinary working group (the 'Improving Care in Elderly Neurosurgery Initiative') in October 2020. This comprised experts in neurosurgical care and a range of perioperative stakeholders. An Implementation Science framework was used to structure discussions around the challenges of cSDH care within the United Kingdom. The outcomes of these discussions were recorded and summarised, before being circulated to all attendees for comment and refinement. RESULTS: The working group identified four key requirements for improving cSDH care: (1) data, audit, and natural history; (2) evidence-based guidelines and pathways; (3) shared decision-making; and (4) an overarching quality improvement strategy. Frequent transfers between care providers were identified as impacting on both perioperative care and presenting a barrier to effective data collection and teamworking. Improvement initiatives must be cognizant of the complex, system-wide nature of the problem, and may require a combination of targeted trials at points of clinical equipoise (such as anesthetic technique or anticoagulant management), evidence-based guideline development, and a cycle of knowledge acquisition and implementation. CONCLUSION: The care of cSDH is a growing clinical problem. Lessons may be learned from the standardised pathways of care such as those as used in hip fracture and stroke. A defined care pathway for cSDH, encompassing perioperative care and rehabilitation, could plausibly improve patient outcomes but work remains to tailor such a pathway to cSDH care. The development of such a pathway at a national level should be a priority, and the focus of future work

Development of FRET Assay into Quantitative and High-throughput Screening Technology Platforms for Protein–Protein Interactions

Förster resonance energy transfer (FRET) technology has been widely used in biological and biomedical research and is a very powerful tool in elucidating protein interactions in many cellular processes. Ubiquitination and SUMOylation are multi-step cascade reactions, involving multiple enzymes and protein–protein interactions. Here we report the development of dissociation constant (Kd) determination for protein–protein interaction and cell-based high-throughput screening (HTS) assay in SUMOylation cascade using FRET technology. These developments are based on steady state and high efficiency of fluorescent energy transfer between CyPet and YPet fused with SUMO1 and Ubc9, respectively. The developments in theoretical and experimental procedures for protein interaction Kd determination and cell-based HTS provide novel tools in affinity measurement and protein interaction inhibitor screening. The Kd determined by FRET between SUMO1 and Ubc9 is compatible with those determined with other traditional approaches, such as isothermal titration calorimetry (ITC) and surface plasmon resonance (SPR). The FRET-based HTS is pioneer in cell-based HTS. Both Kd determination and cell-based HTS, carried out in 384-well plate format, provide powerful tools for large-scale and high-throughput applications