Proposta d'automatització d'un digestor anaerobi experimental

Due to the digital moment in which we find ourselves, it is increasingly common to implement technology in the monitoring and control of biological processes for different reasons, such as optimization, creating production records or releasing the workload operator. Anaerobic digestion stands out as a bioprocess for obtaining an energy resource, biogas, from the use of almost any type of organic waste. The automation of industrial anaerobic bioreactors is becoming more frequent, but the automation of experimental bioreactors has also evolved. At the laboratory level, more varied and affordable automation systems can often be used, as they do not normally require sophisticated technological solutions. It is for this reason that in this final project a thorough study is carried out of the different experimental bioreactors and the components that make up a system of supervision and/or control. Ultimately, an example of flexible design is presented in order to group suitable current market solutions to automate an experimental batch-type bioreactor that is currently located in the facilities of the Institute of Agri-Food Research and Technology.Debido al momento digital en el que nos encontramos, cada vez es más habitual implementar tecnología en la supervisión y el control de procesos biológicos por diferentes motivos, como por ejemplo: optimización, crear históricos de producción o liberar al operario de carga de trabajo. La digestión anaerobia destaca como bioproceso para la obtención de un recurso energético, el biogás, a partir del aprovechamiento de casi cualquier tipo de residuo orgánico. La automatización de biorreactores anaerobios industriales es cada vez más frecuente, pero también ha ido evolucionando la automatización de biorreactores experimentales. A nivel de laboratorio a menudo se pueden emplear sistemas de automatización más variados y asequibles, ya que normalmente no requieren de soluciones tecnológicas sofisticadas. Es por este motivo que en este trabajo de fin de grado se realiza un estudio exhaustivo de los diferentes biorreactores experimentales y los componentes que integran un sistema de supervisión y/o control. En última instancia se presenta un ejemplo de diseño flexible con el fin de agrupar soluciones adecuadas de mercado actual para automatizar un biorreactor experimental tipo batch que actualmente se encuentra en las instalaciones del Instituto de Investigación y Tecnología Agroalimentaria.Degut al moment digital en el que ens trobem, cada vegada és més habitual implementar tecnologia en la supervisió i el control de processos biològics per diferents motius, com per exemple: optimització, crear històrics de producció o alliberar l'operari de càrrega de feina. La digestió anaeròbia destaca com a bioprocés per l'obtenció d'un recurs energètic, el biogàs, a partir de l'aprofitament de gairebé qualsevol tipus de residu orgànic. L'automatització de bioreactors anaerobis industrials és cada vegada més freqüent, però també ha anat evolucionant l'automatització de bioreactors experimentals. A nivell de laboratori sovint es poden emprar sistemes d'automatització més variats i assequibles, ja que normalment no requereixen de solucions tecnològiques sofisticades. És per aquest motiu que en aquest treball de fi de grau es realitza un estudi exhaustiu dels diferents bioreactors experimentals i dels components que integren un sistema de supervisió i/o control. En última instància es presenta un exemple de disseny flexible amb la finalitat d'agrupar solucions adients de mercat actual per automatitzar un bioreactor experimental tipus batch que actualment es troba a les instal·lacions de l'Institut de Recerca i Tecnologia Agroalimentària

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

The association between SARS-CoV-2 infection and preterm delivery: a prospective study with a multivariable analysis.

To determine whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, the cause of COVID-19 disease) exposure in pregnancy, compared to non-exposure, is associated with infection-related obstetric morbidity. We conducted a multicentre prospective study in pregnancy based on a universal antenatal screening program for SARS-CoV-2 infection. Throughout Spain 45 hospitals tested all women at admission on delivery ward using polymerase-chain-reaction (PCR) for COVID-19 since late March 2020. The cohort of positive mothers and the concurrent sample of negative mothers was followed up until 6-weeks post-partum. Multivariable logistic regression analysis, adjusting for known confounding variables, determined the adjusted odds ratio (aOR) with 95% confidence intervals (95% CI) of the association of SARS-CoV-2 infection and obstetric outcomes. Preterm delivery (primary), premature rupture of membranes and neonatal intensive care unit admissions. Among 1009 screened pregnancies, 246 were SARS-CoV-2 positive. Compared to negative mothers (763 cases), SARS-CoV-2 infection increased the odds of preterm birth (34 vs 51, 13.8% vs 6.7%, aOR 2.12, 95% CI 1.32-3.36, p = 0.002); iatrogenic preterm delivery was more frequent in infected women (4.9% vs 1.3%, p = 0.001), while the occurrence of spontaneous preterm deliveries was statistically similar (6.1% vs 4.7%). An increased risk of premature rupture of membranes at term (39 vs 75, 15.8% vs 9.8%, aOR 1.70, 95% CI 1.11-2.57, p = 0.013) and neonatal intensive care unit admissions (23 vs 18, 9.3% vs 2.4%, aOR 4.62, 95% CI 2.43-8.94, p  This prospective multicentre study demonstrated that pregnant women infected with SARS-CoV-2 have more infection-related obstetric morbidity. This hypothesis merits evaluation of a causal association in further research

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)