Hydrochars as Emerging Biofuels: Recent Advances and Application of Artificial Neural Networks for the Prediction of Heating Values

In this study, the growing scientific field of alternative biofuels was examined, with respect to hydrochars produced from renewable biomasses. Hydrochars are the solid products of hydrothermal carbonization (HTC) and their properties depend on the initial biomass and the temperature and duration of treatment. The basic (Scopus) and advanced (Citespace) analysis of literature showed that this is a dynamic research area, with several sub-fields of intense activity. The focus of researchers on sewage sludge and food waste as hydrochar precursors was highlighted and reviewed. It was established that hydrochars have improved behavior as fuels compared to these feedstocks. Food waste can be particularly useful in co-hydrothermal carbonization with ash-rich materials. In the case of sewage sludge, simultaneous P recovery from the HTC wastewater may add more value to the process. For both feedstocks, results from large-scale HTC are practically non-existent. Following the review, related data from the years 2014–2020 were retrieved and fitted into four different artificial neural networks (ANNs). Based on the elemental content, HTC temperature and time (as inputs), the higher heating values (HHVs) and yields (as outputs) could be successfully predicted, regardless of original biomass used for hydrochar production. ANN3 (based on C, O, H content, and HTC temperature) showed the optimum HHV predicting performance (R2 0.917, root mean square error 1.124), however, hydrochars’ HHVs could also be satisfactorily predicted by the C content alone (ANN1, R2 0.897, root mean square error 1.289)

When Intervention Becomes Imperative: A Case Report of Spontaneous Vulvar Edema During Pregnancy

Spontaneous idiopathic vulvar edema during the second trimester is a rare condition. The approach to managing this condition involves relieving symptoms, identifying underlying causes, and implementing appropriate treatment. Managing such cases during pregnancy is challenging because of concerns for potential adverse fetal outcomes. Conservative management expects the condition to be relieved spontaneously postpartum, whereas invasive treatment offers a more rapid resolution. Treatment choices are controversial because each method has its pros and cons and influences the delivery process to a certain extent. Surgical drainage becomes a viable option when patients are not responsive to medications. We report a case of spontaneous massive vulvar edema in a 22-year-old primigravida in her 23rd week of pregnancy. After ruling out other notable causes of vulvar edema, we decided to intervene using an invasive procedure because she complained of progressive symptoms and discomfort. Subsequently, the edema subsided postprocedure, and the patient experienced successful labor with no complications. This report aims to alert clinicians that drainage attempts should be considered in pregnant patients with worsening symptoms

Safety and efficacy of fluoxetine on functional outcome after acute stroke (AFFINITY): a randomised, double-blind, placebo-controlled trial

Background Trials of fluoxetine for recovery after stroke report conflicting results. The Assessment oF FluoxetINe In sTroke recoverY (AFFINITY) trial aimed to show if daily oral fluoxetine for 6 months after stroke improves functional outcome in an ethnically diverse population. Methods AFFINITY was a randomised, parallel-group, double-blind, placebo-controlled trial done in 43 hospital stroke units in Australia (n=29), New Zealand (four), and Vietnam (ten). Eligible patients were adults (aged ≥18 years) with a clinical diagnosis of acute stroke in the previous 2–15 days, brain imaging consistent with ischaemic or haemorrhagic stroke, and a persisting neurological deficit that produced a modified Rankin Scale (mRS) score of 1 or more. Patients were randomly assigned 1:1 via a web-based system using a minimisation algorithm to once daily, oral fluoxetine 20 mg capsules or matching placebo for 6 months. Patients, carers, investigators, and outcome assessors were masked to the treatment allocation. The primary outcome was functional status, measured by the mRS, at 6 months. The primary analysis was an ordinal logistic regression of the mRS at 6 months, adjusted for minimisation variables. Primary and safety analyses were done according to the patient's treatment allocation. The trial is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12611000774921. Findings Between Jan 11, 2013, and June 30, 2019, 1280 patients were recruited in Australia (n=532), New Zealand (n=42), and Vietnam (n=706), of whom 642 were randomly assigned to fluoxetine and 638 were randomly assigned to placebo. Mean duration of trial treatment was 167 days (SD 48·1). At 6 months, mRS data were available in 624 (97%) patients in the fluoxetine group and 632 (99%) in the placebo group. The distribution of mRS categories was similar in the fluoxetine and placebo groups (adjusted common odds ratio 0·94, 95% CI 0·76–1·15; p=0·53). Compared with patients in the placebo group, patients in the fluoxetine group had more falls (20 [3%] vs seven [1%]; p=0·018), bone fractures (19 [3%] vs six [1%]; p=0·014), and epileptic seizures (ten [2%] vs two [<1%]; p=0·038) at 6 months. Interpretation Oral fluoxetine 20 mg daily for 6 months after acute stroke did not improve functional outcome and increased the risk of falls, bone fractures, and epileptic seizures. These results do not support the use of fluoxetine to improve functional outcome after stroke

Hydrochars as Emerging Biofuels: Recent Advances and Application of Artificial Neural Networks for the Prediction of Heating Values

In this study, the growing scientific field of alternative biofuels was examined, with respect to hydrochars produced from renewable biomasses. Hydrochars are the solid products of hydrothermal carbonization (HTC) and their properties depend on the initial biomass and the temperature and duration of treatment. The basic (Scopus) and advanced (Citespace) analysis of literature showed that this is a dynamic research area, with several sub-fields of intense activity. The focus of researchers on sewage sludge and food waste as hydrochar precursors was highlighted and reviewed. It was established that hydrochars have improved behavior as fuels compared to these feedstocks. Food waste can be particularly useful in co-hydrothermal carbonization with ash-rich materials. In the case of sewage sludge, simultaneous P recovery from the HTC wastewater may add more value to the process. For both feedstocks, results from large-scale HTC are practically non-existent. Following the review, related data from the years 2014&ndash;2020 were retrieved and fitted into four different artificial neural networks (ANNs). Based on the elemental content, HTC temperature and time (as inputs), the higher heating values (HHVs) and yields (as outputs) could be successfully predicted, regardless of original biomass used for hydrochar production. ANN3 (based on C, O, H content, and HTC temperature) showed the optimum HHV predicting performance (R2 0.917, root mean square error 1.124), however, hydrochars&rsquo; HHVs could also be satisfactorily predicted by the C content alone (ANN1, R2 0.897, root mean square error 1.289)

Towards Engineered Hydrochars: Application of Artificial Neural Networks in the Hydrothermal Carbonization of Sewage Sludge

Sewage sludge hydrochars (SSHs), which are produced by hydrothermal carbonization (HTC), offer a high calorific value to be applied as a biofuel. However, HTC is a complex processand the properties of the resulting product depend heavily on the process conditions and feedstock composition. In this work, we have applied artificial neural networks (ANNs) to contribute to the production of tailored SSHs for a specific application and with optimum properties. We collected data from the published literature covering the years 2014–2021, which was then fed into different ANN models where the input data (HTC temperature, process time, and the elemental content of hydrochars) were used to predict output parameters (higher heating value, (HHV) and solid yield (%)). The proposed ANN models were successful in accurately predicting both HHV and contents of C and H. While the model NN1 (based on C, H, O content) exhibited HHV predicting performance with R2 = 0.974, another model, NN2, was also able to predict HHV with R2 = 0.936 using only C and H as input. Moreover, the inverse model of NN3 (based on H, O content, and HHV) could predict C content with an R2 of 0.939

Feasibility, acceptability, and bacterial recovery for community-based sample collection to estimate antibiotic resistance in commensal gut and upper respiratory tract bacteria

Abstract Vietnam has high rates of antibiotic use and resistance. Measuring resistance in commensal bacteria could provide an objective indicator for evaluating the impact of interventions to reduce antibiotic use and resistance. This study aimed to evaluate the feasibility, acceptability, and bacterial recovery for different sampling strategies. We conducted a cross-sectional mixed methods study in a rural community in Ha Nam Province, northern Vietnam, and collected structured interviews, samples, and in-depth interviews from households. Out of 389 households invited, 324 participated (83%), representing 1502 individuals. Samples were collected from these individuals (1498 stool, 1002 self-administered nasal swabs, and 496 HW-administered nasopharyngeal swabs). Pneumococci were recovered from 11.1% (128/1149) of the total population and 26.2% (48/183) of those under 5-years. Recovery was higher for health-worker (HW)-administered swabs (13.7%, 48/350) than self-administered swabs (10.0%, 80/799) (OR 2.06, 95% CI 1.07–3.96). Cost per swab was cheaper for self-administered ($7.26) than HW-administered ($8.63) swabs, but the overall cost for 100 positive samples was higher ($7260 and$6300 respectively). Qualitative interviews revealed that HW-administered nasopharyngeal swabs took longer to collect, caused more discomfort, and were more difficult to take from children. Factors affecting participation included sense of contribution, perceived trade-offs between benefits and effort, and peer influence. Reluctance was related to stool sampling and negative perceptions of research. This study provides important evidence for planning community-based carriage studies, including cost, logistics, and acceptability. Self-administered swabs had lower recovery, and though cheaper and quicker, this would translate to higher costs for large population-based studies. Recovery might be improved by swab-type, transport medium, and better cold-chain to lab

Twelve-Month Outcomes of the AFFINITY Trial of Fluoxetine for Functional Recovery After Acute Stroke: AFFINITY Trial Steering Committee on Behalf of the AFFINITY Trial Collaboration

Background and Purpose: The AFFINITY trial (Assessment of Fluoxetine in Stroke Recovery) reported that oral fluoxetine 20 mg daily for 6 months after acute stroke did not improve functional outcome and increased the risk of falls, bone fractures, and seizures. After trial medication was ceased at 6 months, survivors were followed to 12 months post-randomization. This preplanned secondary analysis aimed to determine any sustained or delayed effects of fluoxetine at 12 months post-randomization. Methods: AFFINITY was a randomized, parallel-group, double-blind, placebo-controlled trial in adults (n=1280) with a clinical diagnosis of stroke in the previous 2 to 15 days and persisting neurological deficit who were recruited at 43 hospital stroke units in Australia (n=29), New Zealand (4), and Vietnam (10) between 2013 and 2019. Participants were randomized to oral fluoxetine 20 mg once daily (n=642) or matching placebo (n=638) for 6 months and followed until 12 months after randomization. The primary outcome was function, measured by the modified Rankin Scale, at 6 months. Secondary outcomes for these analyses included measures of the modified Rankin Scale, mood, cognition, overall health status, fatigue, health-related quality of life, and safety at 12 months. Results: Adherence to trial medication was for a mean 167 (SD 48) days and similar between randomized groups. At 12 months, the distribution of modified Rankin Scale categories was similar in the fluoxetine and placebo groups (adjusted common odds ratio, 0.93 [95% CI, 0.76–1.14]; P =0.46). Compared with placebo, patients allocated fluoxetine had fewer recurrent ischemic strokes (14 [2.18%] versus 29 [4.55%]; P =0.02), and no longer had significantly more falls (27 [4.21%] versus 15 [2.35%]; P =0.08), bone fractures (23 [3.58%] versus 11 [1.72%]; P =0.05), or seizures (11 [1.71%] versus 8 [1.25%]; P =0.64) at 12 months. Conclusions: Fluoxetine 20 mg daily for 6 months after acute stroke had no delayed or sustained effect on functional outcome, falls, bone fractures, or seizures at 12 months poststroke. The lower rate of recurrent ischemic stroke in the fluoxetine group is most likely a chance finding. REGISTRATION: URL: http://www.anzctr.org.au/ ; Unique identifier: ACTRN12611000774921