From Pollution to Resource: Advancing Swine Waste Treatment in the USA

Concentrated animal feeding operations (CAFOs) have led to environmental challenges, specifically waste management. Swine CAFOs generate large amounts of waste, requiring proper treatment to avoid air and water pollution. Conventional waste management technologies, such as lagoon and spray field systems, do not prevent air and water pollution impacts. Research for the past few decades led to recommendations for waste treatment technologies superior to lagoons and spray fields. Private environmental sustainability initiatives focused on reducing greenhouse gas emissions in the food supply chain have implemented biogas digester projects for capturing methane in covered swine lagoons to reduce greenhouse gas emissions. However, research indicates that methane capture alone does not solve the broader pollution issues associated with lagoon and spray field systems still in use at these CAFOs to dispose of digested effluents. The Environmentally Superior Technologies (EST) initiative in North Carolina set public standards to eliminate waste discharge, reduce atmospheric emissions, and control odors and pathogens. Research has confirmed that technologies coupling solids separation with water treatments to remove volatile organic carbon, pathogens, and reactive forms of nitrogen can meet EST standards. A designated EST—the Super Soil System—substantially reduced odor by 99.9%; pathogens by 99.99%, nutrients (phosphorus and nitrogen) by \u3e90%, and heavy metals (cooper and zinc) by 99%. The ammonia emissions were reduced by 94.4% for the warm and 99.0% for the cool season with respect to a conventional lagoon system. Corresponding greenhouse gas emission reductions were 96.7%. Components of designated EST can be applied to retrofit covered lagoons and anaerobic digestion systems with significant environmental benefits. Recommendations are proposed, based on the collective experience with EST and current trends in animal production concentration, for environmentally safe technologies to handle excess manure produced in the USA

Disease-specific versus standard nutritional support for the treatment of pressure ulcers in institutionalised elderly : a randomized-controlled trial

OBJECTIVES: To investigate whether a disease-specific nutritional approach is more beneficial than a standard dietary approach to the healing of pressure ulcers (PUs) in institutionalized elderly patients. DESIGN: Twelve-week follow-up randomized controlled trial (RCT). SETTING: Four long-term care facilities in the province of Como, Italy. PARTICIPANTS: Twenty-eight elderly subjects with Stage II, III, and IV PUs of recent onset (<1-month history). INTERVENTION: All 28 patients received 30 kcal/kg per day nutritional support; of these, 15 received standard nutrition (hospital diet or standard enteral formula; 16% calories from protein), whereas 13 were administered a disease-specific nutrition treatment consisting of the standard diet plus a 400-mL oral supplement or specific enteral formula enriched with protein (20% of the total calories), arginine, zinc, and vitamin C (P<.001 for all nutrients vs control). MEASUREMENTS: Ulcer healing was evaluated using the Pressure Ulcer Scale for Healing (PUSH; 0=complete healing, 17=greatest severity) tool and area measurement (mm2 and %). RESULTS: The sampled groups were well matched for age, sex, nutritional status, oral intake, type of feeding, and ulcer severity. After 12 weeks, both groups showed significant improvement (P<.001). The treatment produced a higher rate of healing, the PUSH score revealing a significant difference at Week 12 (-6.1\ub12.7 vs -3.3\ub12.4; P<.05) and the reduction in ulcer surface area significantly higher in the treated patients already by Week 8 (-1,140.9\ub1669.2 mm 2 vs -571.7\ub1391.3 mm2; P<.05 and 3c57% vs 3c33%; P<.02). CONCLUSION: The rate of PU healing appears to accelerate when a nutrition formula enriched with protein, arginine, zinc, and vitamin C is administered, making such a formula preferable to a standardized one, but the present data require further confirmation by high-quality RCTs conducted on a larger scale

The ability of the Geriatric Nutritional Risk Index to assess the nutritional status and predict the outcome of home-care resident elderly : a comparison with Mini Nutritional Assessment

The Mini Nutritional Assessment (MNA) is recommended for grading nutritional status in the elderly. A new index for predicting the risk of nutrition-related complications, the Geriatric Nutritional Risk Index (GNRI), was recently proposed but little is known about its possible use in the assessment of nutritional status. Thus, we aimed to investigate its ability to assess the nutritional status and predict the outcome when compared with the MNA. Anthropometry and biochemical parameters were determined in 241 institutionalised elderly (ninety-four males and 147 females; aged 801 (sd 83) years). Nutritional risk and nutritional state were graded by the GNRI and MNA, respectively. At 6 months outcomes were: death; infections; bedsores. According to the GNRI and MNA, the prevalence of high risk (GNRI 98)/good status (MNA > 24) were 20.7/12.8%, 36.1/39% and 432/482%, respectively, with poor agreement in scoring the patient (Cohen's kappa test:\u3ba =0.29; 95% CI 0.19, 0.39). GNRI categories showed a stronger association (OR) with overall outcomes than MNA classes, although no difference (P>0.05) was found between malnutrition (v. good status, OR 6.4; 95% CI 2.1, 71.9) and high nutritional risk (v. no risk, OR 9.7; 95% CI 3.0, 130). Multivariate logistic regression revealed the GNRI as an independent predictor of complications. In overall-outcome prediction, a good sensitivity was found only for GNRI 98 with an MNA > 24 seemed to exclude adverse outcomes. The GNRI showed poor agreement with the MNA in nutritional assessment, but appeared to better predict outcome. In home-care resident elderly, outcome prediction should be performed by combining the suggestions from both these tools

Nitrogen removal from swine wastewater by combining treated effluent with raw manure

Effluents from swine raising can be harmful to the environment if not correctly managed. Nitrogen (N) is usually the main element present at high concentrations in the effluent. Since the use as biofertilizer is not always a feasible alternative, the treatment of swine wastewater is necessary. Variations in N species and water solubility make the treatment difficult and expensive. Additional N removal at low cost via denitrification may be possible by recirculating nitrified effluent in the barns. In this study, raw manure (RM) was homogenized with treated effluent (TE) at RM/(RM + TE) ratios of 1.0, 0.9, 0.8, 0.7, 0.6, 0.5 and 0 in order to simulate the effect of reused water on swine wastewater nitrogen removal. Samples were collected daily during four days and analyzed for pH, oxidation-reduction potential, NH4-N, NO2-N, NO3-N and chemical oxidation demand. The oxidized nitrogen (NOx-N) half-life degradation was estimated using linear regression. NOx-N species half-life less than one day was obtained when treated effluent was combined and thoroughly homogenized with raw manure. It is suggested that combining raw manure with treated effluent (e.g. water reuse) can be a simple and cost-effective strategy to remove nitrogen from swine wastewaters

Validation of the Finnish version of the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) and evaluation of the applicability of the Multiple Sclerosis Neuropsychological Questionnaire (MSNQ) and the Fatigue Scale for Motor and Cognitive Functions (FSMC)

Objectives Cognitive impairment is frequent in multiple sclerosis (MS) as approximately half of the patients manifest some degree of cognitive impairment. The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) has been designed for brief cognitive evaluation. The purpose of the study was to validate the BICAMS along with the Finnish versions of one self-rating questionnaire each for cognition and fatigue. Methods A total of 65 MS patients and 45 healthy controls (HC) were assessed with the BICAMS, the Multiple Sclerosis Neuropsychological Questionnaire (MSNQ), and the Fatigue Scale for Motor and Cognitive Functions (FSMC) twice, approximately within nine days. Results MS patients scored markedly lower than the HCs on each of the three tests of the BICAMS. Of the patients, 60% scored at least 1.5 SD below the mean of the HCs on at least one test; 49% on the SDMT, 26% on the CVLT-II, and 28% on the BVMT-R. Correlation coefficients for the repeated measurement were between 0.75 and 0.89 for the three tests in the whole study sample. MS patients reported more cognitive symptoms and more fatigue than the HCs. Cronbach's alpha was 0.94 for the MSNQ and 0.98 for the FSMC. Correlation coefficient for the repeated measurement was 0.91 for the MSNQ and between 0.92 and 0.94 for the FSMC scores for the whole study sample. Conclusions The present study supports the validity of the Finnish version of the BICAMS. The SDMT was the most sensitive of the three BICAMS tests and showed cognitive impairment in half of the patients. The Finnish versions of the MSNQ and the FSMC proved useful tools in approaching concerns related to cognition and fatigue.Peer reviewe

Influence of nationality on the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS)

OBJECTIVE: In answer to the call for improved accessibility of neuropsychological services to the international community, the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS; MS) was validated in multiple, non-English-speaking countries. It was created to monitor processing speed and learning in MS patients, including abbreviated versions of the Symbol Digit Modalities Test, California Verbal Learning Test, 2nd Edition, and the Brief Visuospatial Memory Test, Revised. The objective of the present study was to examine whether participant nationality impacts performance above and beyond common demographic correlates. METHOD: We combined published data-sets from Argentina, Brazil, Czech Republic, Iran, and the U.S.A. resulting in a database of 1,097 healthy adults, before examining the data via multiple regression. RESULTS: Nationality significantly predicted performance on all three BICAMS tests after controlling for age and years of education. Interactions among the core predictor variables were non-significant. CONCLUSION: We demonstrated that nationality significantly influences BICAMS performance and established the importance of the inclusion of a nationality variable when international norms for the BICAMS are constructed