Influence of temperature and high acetate concentrations on methanogenensis in lake sediment slurries

Methanogenesis from main methane precursors H2/CO2 and acetate was investigated in a temperature range of 2-70 °C using sediments from Lake Baldegg, Switzerland. Psychrophilic, psychrotrophic, mesophilic, and thermophilic methanogenic microbial communities were enriched by incubations for 1-3 months of nonamended sediment slurries at 5, 15, 30, and 50 °C. Isotope experiments with slurries amended with 14C-labeled bicarbonate and 14C-2-acetate showed that in the psychrophilic community (enriched at 5 °C), about 95% of methane originated from acetate, in contrast to the thermophilic community (50 °C) where up to 98% of methane was formed from bicarbonate. In the mesophilic community (30 °C), acetate was the precursor of about 80% of the methane produced. When the hydrogen-carbon dioxide mixture (H2/CO2) was used as a substrate, it was directly converted to methane under thermophilic conditions (70 and 50 °C). Under mesophilic conditions (30 °C), both pathways, hydrogenotrophic and acetoclastic, were observed. At low temperatures (5 and 15 °C), H2/CO2 was converted into methane by a two-step process; first acetate was formed, followed by methane production from acetate. When slurries were incubated at high partial pressures of H2/CO2, the high concentrations of acetate produced of more than 20 mM inhibited acetoclastic methanogenesis at a temperature below 15 °C. However, slow adaptation of the psychrophilic microbial community to high acetate concentrations was observe

Cosmesis and body image after single-port laparoscopic or conventional laparoscopic cholecystectomy: a multicenter double blinded randomised controlled trial (SPOCC-trial)

BACKGROUND: Emerging attempts have been made to reduce operative trauma and improve cosmetic results of laparoscopic cholecystectomy. There is a trend towards minimizing the number of incisions such as natural transluminal endoscopic surgery (NOTES) and single-port laparoscopic cholecystectomy (SPLC). Many retrospective case series propose excellent cosmesis and reduced pain in SPLC. As the latter has been confirmed in a randomized controlled trial, patient's satisfaction on cosmesis is still controversially debated. METHODS/DESIGN: The SPOCC trial is a prospective, multi-center, double blinded, randomized controlled study comparing SPLC with 4-port conventional laparoscopic cholecystectomy (4PLC) in elective surgery. The hypothesis and primary objective is that patients undergoing SPLC will have a better outcome in cosmesis and body image 12 weeks after surgery. This primary endpoint is assessed using a validated 8-item multiple choice type questionnaire on cosmesis and body image. The secondary endpoint has three entities: the quality of life 12 weeks after surgery assessed by the validated Short-Form-36 Health Survey questionnaire, postoperative pain assessed by a visual analogue scale and the use of analgesics. Operative time, surgeon's experience with SPLC and 4PLC, use of additional ports, conversion to 4PLC or open cholecystectomy, length of stay, costs, time of work as well as intra- and postoperative complications are further aspects of the secondary endpoint. Patients are randomly assigned either to SPLC or to 4PLC. Patients as well as treating physicians, nurses and assessors are blinded until the 7th postoperative day. Sample size calculation performed by estimating a difference of cosmesis of 20% (alpha = 0.05 and beta = 0.90, drop out rate of 10%) resulted in a number of 55 randomized patients per arm. DISCUSSION: The SPOCC-trial is a prospective, multi-center, double-blind, randomized controlled study to assess cosmesis and body image after SPLC

Influence of temperature and high acetate concentrations on methanogenensis in lake sediment slurries

Methanogenesis from main methane precursors H2/CO2 and acetate was investigated in a temperature range of 2–70 °C using sediments from Lake Baldegg, Switzerland. Psychrophilic, psychrotrophic, mesophilic, and thermophilic methanogenic microbial communities were enriched by incubations for 1–3 months of nonamended sediment slurries at 5, 15, 30, and 50 °C. Isotope experiments with slurries amended with 14C-labeled bicarbonate and 14C-2-acetate showed that in the psychrophilic community (enriched at 5 °C), about 95% of methane originated from acetate, in contrast to the thermophilic community (50 °C) where up to 98% of methane was formed from bicarbonate. In the mesophilic community (30 °C), acetate was the precursor of about 80% of the methane produced. When the hydrogen–carbon dioxide mixture (H2/CO2) was used as a substrate, it was directly converted to methane under thermophilic conditions (70 and 50 °C). Under mesophilic conditions (30 °C), both pathways, hydrogenotrophic and acetoclastic, were observed. At low temperatures (5 and 15 °C), H2/CO2 was converted into methane by a two-step process; first acetate was formed, followed by methane production from acetate. When slurries were incubated at high partial pressures of H2/CO2, the high concentrations of acetate produced of more than 20 mM inhibited acetoclastic methanogenesis at a temperature below 15 °C. However, slow adaptation of the psychrophilic microbial community to high acetate concentrations was observed

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

Completely Thoracoscopic Diaphragmatic Plication.

BACKGROUND Thoracoscopic diaphragmatic plication for diaphragmatic paralysis with consecutive eventration and respiratory compromise is a desirable alternative to standard thoracotomy. Since minimally invasive techniques usually involve suturing of the diaphragm, most surgeons use a video-assisted approach with a minithoracotomy. Herein we describe our completely thoracoscopic technique for diaphragmatic plication including outcome. METHODS We present our technique and experience for completely thoracoscopic diaphragmatic plication for the treatment of symptomatic diaphragmatic paralysis in six consecutive patients. The surgical technique basically consisted of stapling of the abundant diaphragm and reinforcement of the staple line using a self-locking thread. Primary outcome measure was the postoperative result (flattened diaphragm) and resolution of symptoms. Secondary outcome was improvement of lung function values 3 months after surgery. RESULTS Between June 2015 and March 2016, six patients have been operated for symptomatic diaphragmatic paralysis, with one of them suffering from additional transdiaphragmatic hernia. Flattening of the diaphragm was achieved in all 6 patients with resolution of their pre-existing symptoms within days after surgery and without any surgical complications. Lung function volumes measured 3 months postoperative improved markedly with an increase in FEV1 as well as FVC of 540 ml (SD ± 193 ml) and 776 ml (SD ± 121 ml), respectively. CONCLUSIONS In our experience, the presented technique is a safe and simple minimally invasive way to perform a completely thoracoscopic diaphragmatic plication with excellent results so far

Offerten-Check für Solaranlagen

«Kassensturz» macht die Stichprobe und bittet versteckt neun Anbieter um eine Offerte für ein Photovoltaik-System. Kassensturz»-Musterkunde Ernst Messerli bestellt mehrere Offerten für eine Solaranlage auf sein Hausdach. Für ihn ist klar: «Es ist auch eine Investition für kommende Generationen. Wenn man bedenkt, dass die Photovoltaikanlage eine Lebensdauer von bis zu 30 Jahren hat. Ernst Messerli kontaktiert unter anderem spezialisierte Solarunternehmen, Energieversorger und Vermittlungsplattformen für lokale Installateure. Alle Firmen erhalten die gleichen Angaben und Fotos zu Haus und Dach. Nebst Architekturplänen sind das auch Informationen zum jährlichen Stromverbrauch und zur Art der Heizung. Obwohl das Chaletdach von Ernst Messerli für die Offertenersteller keine komplizierte Aufgabe ist, erhält er bloss vier Offerten zurück. Die Solarbranche kämpft aktuell mit einem grossen Fachkräftemangel. Matthias Burri vom Labor für Photovoltaiksysteme an der Berner Fachhochschule sagt dazu: «Momentan herrscht in der Solarbranche ein unheimlicher Boom. Das Thema wird immer wichtiger und die Anbieter werden überrannt mit Anfragen.» Wenig überraschend folgt Absage auf Absage. Zum Beispiel die Online-Plattform «Hausheld», welche lokale Installateure vermittelt, bedauert: «Es ist uns aktuell leider nicht immer möglich, passende Photovoltaikfirmen zu vermitteln, welche noch Kapazitäten für neue Aufträge haben.

Effects of endodontic irrigants on blood and blood-stained dentin

Objectives: This study aimed to investigate bleaching effects of common endodontic irrigants on human whole blood and blood-stained dentin. Specifically, it was assessed whether sodium hypochlorite at a clinically recommended concentration (2.5% NaOCl) would bleach with similar efficacy as a peroxide-based irrigant at higher molarity (5% H2O2). Furthermore, the effects of a NaOCl-compatible chelator with a high affinity to iron (Dual Rinse HEDP) were investigated. Methods: Human whole blood was mixed at a 1:20 ratio with either phosphate-buffered saline, 9% HEDP, 2.5% NaOCl, 2.5% NaOCl containing 9% HEDP, or 5% H2O2. Effects were assessed spectrometrically and photographically. Human dentin specimens were prepared with a methacrylate reservoir for liquids and a polished assessment side over 1 mm dentin thickness. Dentin was stained using human whole blood for 3 weeks and subsequently exposed to the irrigants for 60 min. Measurements were performed in the CIELAB color space. Results were compared using parametric tests with the alpha-type error set to 5%. Results: When directly exposed, the solutions containing NaOCl completely discolored the blood, while the 5% H2O2 exerted a bleaching effect without complete dissolution of dissolved matter, and the pure 9% HEDP had no effect at all. The NaOCl solutions bleached blood-stained dentin more efficiently than H2O2 (p < 0.05). Conclusions: Under the current conditions, the 2.5% NaOCl solution had a stronger bleaching effect on blood and blood-stained dentin than 5% H2O2. HEDP did not have any direct impact on blood color or NaOCl-derived bleaching

Das Thoracic-Outlet-Syndrom: selten, vielmals verpasst oder zu häufig diagnostiziert?

Thoracic Outlet Syndrome: Rare, Often Missed or Over-Diagnosed? Abstract. The thoracic outlet syndrome (TOS) presents with various symptoms caused by compression of the neurovascular bundle in the region of the upper thoracic aperture. Since the pathogenesis also determines the therapy of TOS, the classification according to the affected structure into neurogenic, venous and arterial TOS (nTOS, vTOS and aTOS) is useful. However, mixed forms are often to be assumed, which are then usually also classified under the term 'non-specific or disputed TOS' in the group of nTOS. In the absence of a gold standard diagnostic test, accurate history taking and clinical examination continue to be of great importance. Diagnostic experience and therapeutic advances have led to hopeful possibilities in the challenging management of this condition

Effects of endodontic irrigants on blood and blood-stained dentin

Objectives This study aimed to investigate bleaching effects of common endodontic irrigants on human whole blood and blood-stained dentin. Specifically, it was assessed whether sodium hypochlorite at a clinically recommended concentration (2.5% NaOCl) would bleach with similar efficacy as a peroxide-based irrigant at higher molarity (5% H2O2). Furthermore, the effects of a NaOCl-compatible chelator with a high affinity to iron (Dual Rinse HEDP) were investigated. Methods Human whole blood was mixed at a 1:20 ratio with either phosphate-buffered saline, 9% HEDP, 2.5% NaOCl, 2.5% NaOCl containing 9% HEDP, or 5% H2O2. Effects were assessed spectrometrically and photographically. Human dentin specimens were prepared with a methacrylate reservoir for liquids and a polished assessment side over 1 mm dentin thickness. Dentin was stained using human whole blood for 3 weeks and subsequently exposed to the irrigants for 60 min. Measurements were performed in the CIELAB color space. Results were compared using parametric tests with the alpha-type error set to 5%. Results When directly exposed, the solutions containing NaOCl completely discolored the blood, while the 5% H2O2 exerted a bleaching effect without complete dissolution of dissolved matter, and the pure 9% HEDP had no effect at all. The NaOCl solutions bleached blood-stained dentin more efficiently than H2O2 (p < 0.05). Conclusions Under the current conditions, the 2.5% NaOCl solution had a stronger bleaching effect on blood and blood-stained dentin than 5% H2O2. HEDP did not have any direct impact on blood color or NaOCl-derived bleaching

IgG4-related disease of the lung: a rare differential diagnosis to lung cancer after positive positron emission tomography and biopsy.

Immunoglobulin G4-related disease is a rare immune-mediated condition that often causes serious diagnostic problems. Symptoms are unspecific, and several organs can be involved. To date, IgG4-related lung disease has seldom been reported in literature. Nevertheless, a variety of pulmonary involvement has been described, which can mimic malignancy. The gold standard for the diagnosis is the identification of typical histopathological features, even if diagnostic biomarker such as serum IgG4 concentration can be an indicator for a more aggressive course of the disease