Removal of ammonium from wastewater with geopolymer sorbents fabricated via additive manufacturing

Geopolymers have been recently explored as sorbents for wastewater treatment, thanks to their mechanical and chemical stability and to their low-energy manufacturing process. One specific application could be the removal of ammonium (NH4+) through exchange with Na+ ions. Additive manufacturing (AM) represents an especially interesting option for fabrication, as it allows to tailor the size, distribution, shape, and interconnectivity of pores, and therefore the access to charge-bearing sites. The present study provides a proof of concept for NH4+ removal from wastewater using porous geopolymer components fabricated via direct ink writing (DIW) AM approach. A metakaolin-based ink was employed for the fabrication of a log-pile structure with 45\ub0 rotation between layers, producing continuous yet tortuous macropores which are responsible for the high permeability of the sorbents. The ink consolidates in an amorphous, mesoporous network, with the mesopores acting as preferential sites for ion exchange. The printed sorbents were characterized for their physicochemical and mechanical properties and the NH4+ removal capacity in continuous-flow column experiments by using a model effluent. The lattices present high permeability and high cation exchange capacity and maintained a high amount of active ions after four cycles, allowing to reuse them multiple times

Are Vascularized Fibula Autografts a Long-lasting Reconstruction After Intercalary Resection of the Humerus for Primary Bone Tumors?

BackgroundA vascularized fibula graft (VFG) is the vascular autograft most frequently used to restore large segmental long bone defects, particularly in the upper limb. Because the use of a vascularized fibula involves an operation in an uninvolved extremity with potential morbidity, it is important to document that this type of reconstruction is successful in restoring function to the humerus. However, the long-term results of VFG after intercalary resection of the humeral diaphysis for bone tumors are still unknown.Questions/purposes(1) What was the complication rate of reconstruction? (2) What was the functional result after surgical treatment, as assessed by the Musculoskeletal Tumor Society (MSTS) score, the American Shoulder and Elbow Society (ASES) score, and Constant score? (3) What was the survivorship of these grafts free from revision and graft removal at 5, 10, and 15 years?MethodsBetween 1987 and 2021, 127 patients were treated at our institution with en bloc resection for a primary malignant or an aggressive benign bone tumor of the humerus; we excluded patients treated with extra-articular resection or amputation. Of those, 14% (18 of 127) were treated with intercalary resection of the humeral diaphysis for primary bone tumors and reconstruction with VFG, with or without a bulk allograft, and were analyzed in this retrospective study. Generally, our indications for reconstruction with VFG are intercalary resection of the humerus for primary malignant or aggressive benign bone tumors in patients with long life expectancy and high functional demands, in whom adequate bone stock of the proximal and distal epiphysis can be preserved. In 13 patients, VFG was used alone, whereas in five patients, a massive allograft was used. Our policy was to use VFG combined with a massive allograft in patients undergoing juxta-articular joint-sparing resections in which proximal osteotomy was performed close to the anatomic neck of the humerus to obtain more stable fixation and better tendinous reattachment of the rotator cuff and deltoid. All 18 patients who were treated with a VFG were available for follow-up at a minimum of 2 years (median follow-up 176 months, range 26 to 275 months), and although three have not been seen in the past 5 years and are not known to have died, they had 172, 163, and 236 months of follow-up, and were included. The median age at surgery was 25 years (range 2 to 63 years), the median humeral resection length was 15 cm (range 8 to 21 cm), and the median fibular length was 16 cm (range 12 to 23 cm). Complications and functional scores were ascertained by chart review that was performed by an individual not involved in patient care. Functional results were assessed with the MSTS score (range 0 to 30), the ASES score (range 0 to 100), and the Constant score (range 0% to 100%). Survivorship was estimated using a Kaplan-Meier survivorship estimator, which was suitable because there were few deaths in this series.ResultsSeven patients underwent a revision procedure (one radial nerve transient palsy because of screw impingement, four nonunions in three patients with one humeral head avascular necrosis, treatment for screw-related pain in one patient, and two VFG fractures), and one patient underwent VFG removal. Donor site complications were observed in four patients (one ankle valgus deformity and three claw toes - the first toe in two patients and the other toes in the third). At the final clinical control, at a median follow-up of 176 months (range 26 to 275 months), the median MSTS score was 30 of 30 (range 28 to 30), the median ASES score was 98.3 (range 93 to 100), and the median Constant score was 93.5% (range 79% to 100%). Revision-free survival was 71% (95% CI 53% to 96%) at 5 years and 57% (95% CI 37% to 88%) at 10 and 15 years; VFG removal-free survival was 94% (95% CI 83% to 100%) at 5, 10, and 15 years.ConclusionVFG appears to be an effective reconstructive option after humeral intercalary resection for primary bone tumors. These are complex procedures and should be performed by an experienced team of surgeons who recognize that complications may occur frequently in the first years after the procedure. The frequency of mechanical complications observed in the first 5 years postoperatively may be lessened by using long spanning-plate fixation, and if successful, this reconstruction provides a long-term, durable reconstruction with excellent functional results.Level of EvidenceLevel IV, therapeutic study

Implant supported cantilevered fixed dental rehabilitations in partially edentulous patients : systematic review of the literature. Part I

Objectives: To investigate in which clinical situations a cantilever fixed implant supported restorations can be a treatment alternative and which complications are reported. Materials and Methods: Two operators screened the literature (MEDLINE, EMBASE) and performed a hand search on the main journals dealing with implantology and prosthetics until 31 December 2017. Only articles that considered cantilever implant fixed restorations with at least 10 patients and with a mean follow-up of at least 5\ua0year were selected. The outcome variables were survival of implants and prosthesis, mechanical, technical and biological complications, marginal bone loss. The review was performed according to the PRISMA statements. Risk of bias assessment was evaluated. Failure and complication rates were analysed using random effect Poisson regression models to obtain summary estimate of 5- and 10-year survival and complication rates. Results: A total of nine papers were selected for partially edentulous patients and reported high survival rate of the prosthesis. The estimated survival rate for 5\u201310\ua0years was calculated to be 98.4% for the implants and 99.2% for the rehabilitations. Mechanical, technical and biological complications were reported with a cumulative 5\u201310\ua0years complication rate of 28.66% and 26.57% for the patients and for the prosthesis, respectively. Two papers for single implant supporting 2-unit cantilever were not sufficient to draw conclusions. Conclusions: There is evidence that cantilever can be successful treatment in partially edentulous patients. In two adjacent edentulous sites, data are not yet sufficient

Identification of most relevant variables and processes to assess the environmental impacts of remediation technologies along their life cycles: Focus on the waste management scenarios

The application of Life Cycle Assessment (LCA) to remediation technologies is still not a consolidated practice and it is especially lacking in the assessment of the environmental impacts associated to the management of the waste produced during remediation. This study aims at addressing these methodological gaps by identifying the typologies of waste typically generated during the remediation of a contaminated site and classifying them according to the European Waste Catalogue (EWC) codes. Thereafter, the following steps are: (i) the identification of the waste management scenarios (WMSs) applicable to the identified waste typologies, (ii) the selection of Life Cycle Assessment processes that can be used to assess the impacts of the different WMSs and (iii) the quantification and comparison of the environmental impacts caused by the different WMSs applied considering hazardousness levels to which the same waste may belong in relation to its contamination levels and characteristics: inert, non-hazardous and hazardous waste (Waste Framework Directive 2008/98/EC). As results, a matrix reporting the classes and typologies of waste, their EWC codes, their different WMSs and the suitable LCA processes from the Ecoinvent database that can be applied to each EWC within a specific WMS, has been developed. Additionally, the comparative assessment of the impacts caused by the Ecoinvent processes applicable to the same waste typology within the same WMS has been performed to support the selection of the most appropriate WMS case by case

Six-mm versus 10-mm long implants in the rehabilitation of posterior edentulous jaws : a 5-year follow-up of a randomised controlled trial

To compare the clinical outcome of 6-mm and 10-mm long implants in partially edentulous posterior areas. MATERIALS AND METHODS: Twenty-four patients, with a partially edentulous area in the jaws with a height and width allowing the positioning of 2 to 3 adjacent 10 7 4.1 mm implants without any augmentation procedure, were randomly allocated according to a parallel group design to receive 6-mm long or 10-mm long implants. A total of 54 implants were placed (26 7 6 mm and 28 7 10 mm implants). Patients were restored 8 weeks after surgery and were followed for 5 years. Outcome measures were prosthesis and implant survival, as well as marginal bone level changes and complications. RESULTS: After 5 years, 18 patients were available. One 6 mm implant failed during the healing period and its related prosthesis could not be placed. No implants were lost after loading. The 6 mm group registered 5 complications (1 mucositis, 3 prosthesis decementations and 1 chipping), while only 3 were registered in the 10 mm group (2 decementations and 1 chipping). The difference in complications between the two groups was not statistically significant (P = 0.39). Marginal bone loss at 5 years was 0.43 and 0.24 mm with the 6 mm and 10 mm groups, respectively (not statistically significant; difference between the two groups 0.19 mm; SD 0.23 mm; 95% CI -0.34;0.73; t test P = 0.42) CONCLUSIONS: Implant and prosthetic survival and success rates were similar between prostheses supported by 6-mm or 10-mm long implants. Conflict-of-interests statement: The present study was supported by grant 369_2004 from ITI, Basel, Switzerland used to provide free implants and prosthetic components to the patient. Authors declare no conflict of interest