From waste cooking oil to oxygen-rich onion-like nanocarbons for the removal of hexavalent chromium from aqueous solutions

Vegetable cooking oil is used in domestic and commercial kitchens owing to its ability to modify and enhance the taste of the food through the frying process. However, as the oil is used through several frying cycles, it changes colour to dark brown and acquires an unpleasant smell. At this point, the waste oil is usually discarded, thereby finding its way into freshwater streams due to poor disposal and thus becoming an environmental pollutant. To provide an alternative, ‘green’ route to waste oil disposal, herein we report on the metal-free synthesis of onion-like nanocarbons (OLNCs) made from waste cooking oil via flame pyrolysis. The OLNCs were then applied in the removal of hexavalent chromium ions from aqueous solutions. The as-synthesised OLNCs were found to have similar properties (size, quasi-spherical shape etc.) to those synthesised from pure cooking oils. The Fourier-transform infrared spectroscopy data showed that the OLNCs contained C-O-type moieties which were attributed to the oxygenation process that took place during the cooking process. The OLNCs from waste oil were applied as an adsorbent for Cr(VI) and showed optimal removal conditions at pH = 2, t = 360 min, Co = 10 mg/L and Q0max = 47.62 mg/g, superior to data obtained from OLNCs prepared from pristine cooking oil. The results showed that the OLNCs derived from the waste cooking oil were effective in the removal of hexavalent chromium. Overall, this study shows how to repurpose an environmental pollutant (waste cooking oil) as an effective adsorbent for pollutant (Cr(VI)) removal. Significance: • Waste cooking oil outperformed olive oil as a starting material for the production of OLNCs for the removal of toxic Cr(VI) from water. • The superior performance of the OLNCs from waste cooking oil was attributed to the higher oxygen content found on their surface and acquired through the cooking process. • Not only are the OLNCs produced from waste cooking oil effective in the removal of Cr(VI), but they can be used multiple times before replacement, which makes them sustainable

The ASOS Surgical Risk Calculator: development and validation of a tool for identifying African surgical patients at risk of severe postoperative complications

Background: The African Surgical Outcomes Study (ASOS) showed that surgical patients in Africa have a mortality twice the global average. Existing risk assessment tools are not valid for use in this population because the pattern of risk for poor outcomes differs from high-income countries. The objective of this study was to derive and validate a simple, preoperative risk stratification tool to identify African surgical patients at risk for in-hospital postoperative mortality and severe complications. Methods: ASOS was a 7-day prospective cohort study of adult patients undergoing surgery in Africa. The ASOS Surgical Risk Calculator was constructed with a multivariable logistic regression model for the outcome of in-hospital mortality and severe postoperative complications. The following preoperative risk factors were entered into the model; age, sex, smoking status, ASA physical status, preoperative chronic comorbid conditions, indication for surgery, urgency, severity, and type of surgery. Results: The model was derived from 8799 patients from 168 African hospitals. The composite outcome of severe postoperative complications and death occurred in 423/8799 (4.8%) patients. The ASOS Surgical Risk Calculator includes the following risk factors: age, ASA physical status, indication for surgery, urgency, severity, and type of surgery. The model showed good discrimination with an area under the receiver operating characteristic curve of 0.805 and good calibration with c-statistic corrected for optimism of 0.784. Conclusions: This simple preoperative risk calculator could be used to identify high-risk surgical patients in African hospitals and facilitate increased postoperative surveillance. © 2018 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.Medical Research Council of South Africa gran

Maternal and neonatal outcomes after caesarean delivery in the African Surgical Outcomes Study: a 7-day prospective observational cohort study.

BACKGROUND: Maternal and neonatal mortality is high in Africa, but few large, prospective studies have been done to investigate the risk factors associated with these poor maternal and neonatal outcomes. METHODS: A 7-day, international, prospective, observational cohort study was done in patients having caesarean delivery in 183 hospitals across 22 countries in Africa. The inclusion criteria were all consecutive patients (aged ≥18 years) admitted to participating centres having elective and non-elective caesarean delivery during the 7-day study cohort period. To ensure a representative sample, each hospital had to provide data for 90% of the eligible patients during the recruitment week. The primary outcome was in-hospital maternal mortality and complications, which were assessed by local investigators. The study was registered on the South African National Health Research Database, number KZ_2015RP7_22, and on ClinicalTrials.gov, number NCT03044899. FINDINGS: Between February, 2016, and May, 2016, 3792 patients were recruited from hospitals across Africa. 3685 were included in the postoperative complications analysis (107 missing data) and 3684 were included in the maternal mortality analysis (108 missing data). These hospitals had a combined number of specialist surgeons, obstetricians, and anaesthetists totalling 0·7 per 100 000 population (IQR 0·2-2·0). Maternal mortality was 20 (0·5%) of 3684 patients (95% CI 0·3-0·8). Complications occurred in 633 (17·4%) of 3636 mothers (16·2-18·6), which were predominantly severe intraoperative and postoperative bleeding (136 [3·8%] of 3612 mothers). Maternal mortality was independently associated with a preoperative presentation of placenta praevia, placental abruption, ruptured uterus, antepartum haemorrhage (odds ratio 4·47 [95% CI 1·46-13·65]), and perioperative severe obstetric haemorrhage (5·87 [1·99-17·34]) or anaesthesia complications (11·47 (1·20-109·20]). Neonatal mortality was 153 (4·4%) of 3506 infants (95% CI 3·7-5·0). INTERPRETATION: Maternal mortality after caesarean delivery in Africa is 50 times higher than that of high-income countries and is driven by peripartum haemorrhage and anaesthesia complications. Neonatal mortality is double the global average. Early identification and appropriate management of mothers at risk of peripartum haemorrhage might improve maternal and neonatal outcomes in Africa. FUNDING: Medical Research Council of South Africa.Medical Research Council of South Africa