Physico-chemical monitoring of biodegradation of furfural from oil industry effluents from the Arzew refinery (Oran) Algeria

Furfural is one of the petroleum products posing a potential danger to the environment and human health. However, the decontamination of these pollutants released into the environment is primarily governed by biodegra-dation processes. This study is based on biodegradation kinetics at increasing concentrations of furfural by natural mixed culture in order to assess the potential of this process in the elimination of furfural from petrochemical effluents from the ARZEW refinery. This biodegradation was measured through physicochemical parameters such as pH, electrical conductivity, con-centration of hydrocarbons, the chemical oxygen demand (COD), biochemi-cal oxygen demand (BOD5) and the concentration of furfural. The results obtained show at a concentration of 250ppm of injected furfural: a decrease in pH 4.9 and an increase in other parameters (conductivity 3450 μS.cm-1, HC 102 mg / l; furfural 210 ppm, COD 327mg / l, BOD5 98mgO2 / l. The study findings indicated that the injection of these effluents with concentrations greater than 180 ppm leads to values of pH, EC, HC, Furfural, COD, BOD5 which do not comply with direct discharge standards and disrupt biological treatment. The high levels of furfural not only cause a pollution problem but can also disrupt the functioning of bacteria at the biological treatment level. Therefore, dilution with the filtration wash water before switching to biologi-cal treatment is recommended in order to reduce the concentrations below 180 ppm.

Dynamics of macro- and micro-bubbles induced by nanosecond discharge in liquid water

Gaseous micro-bubbles dispersed in liquid water represent perturbations of the homogeneity of the liquid and influence the onset of electrical discharge in the bulk liquid. In this study, we systematically examined shadowgraph images to analyse the gaseous structures occurring in response to nanosecond micro-discharges produced in deionised water. The images revealed the dynamics of resolved bubbles and unresolved sub-micrometric structures starting from nanoseconds after the onset of discharge. We provide absolute counts and the radii distributions of micro-bubbles that occur near the anode needle and show how this depends on the amplitude and repetition frequency of the applied high-voltage pulses, when the latter varies between 0.1 and 100 Hz. A systematic statistical analysis showed that the probability of producing bubble-assisted nanosecond discharge in the liquid phase rapidly increases with the discharge repetition rate (>0.5 Hz). Although the cavitation bubble formed around the anode disintegrates and disappears from the anode region within the first millisecond, the sub-micrometric structures remain for tens of milliseconds, and fragmented micro-bubbles survive even for hundreds of milliseconds. Our findings impose strict limitations on the experimental setups used to investigate the mechanisms of direct discharge in liquid water.

Cost-effectiveness of direct discharge from the emergency department of patients with simple stable injuries in the Netherlands

BackgroundApproximately one-third of musculoskeletal injuries are simple stable injuries (SSIs). Direct discharge (DD) from the emergency department (ED) of patients with SSIs reduces healthcare utilization, without compromising patient outcome and experience, when compared with “traditional” care with routine follow-up. This study aimed to determine the cost-effectiveness of DD compared with traditional care from a societal perspective.MethodsSocietal costs, including healthcare, work absenteeism, and travel costs, were calculated for patients with an SSI, 6 months before (pre-DD cohort) and after implementation of DD (DD cohort). The pre-DD cohort was treated according to local protocols. The DD cohort was treated using orthoses, discharge leaflet, smartphone application, and telephone helpline, without scheduling routine follow-up. Effect measures included generic health-related quality of life (HR-QoL; EuroQol Five-Dimensional Questionnaire); disease-specific HR-QoL (functional outcome, different validated questionnaires, converted to 0–100 scale); treatment satisfaction (Visual Analog Scale (VAS), 1–10); and pain (VAS, 1–10). All data were assessed using a 3-month postinjury survey and electronic patient records. Incremental cost-effectiveness ratios were calculated and uncertainty was assessed using bootstrapping techniques.ResultsBefore DD, 144 of 348 participants completed the survey versus 153 of 371 patients thereafter. There were no statistically significant differences between the pre-DD cohort and the DD cohort for generic HR-QoL (0.03; 95% CI −0.01 to 0.08), disease-specific HR-QoL (4.4; 95% CI −1.1 to 9.9), pain (0.08; 95% CI −0.37 to 0.52) and treatment satisfaction (−0.16; 95% CI −0.53 to 0.21). Total societal costs were lowest in the DD cohort (−€822; 95% CI −€1719 to −€67), including healthcare costs (−€168; 95% CI −€205 to −€131) and absenteeism costs (−€645; 95% CI −€1535 to €100). The probability of DD being cost-effective was 0.98 at a willingness-to-pay of €0 for all effect measures, remaining high with increasing willingness-to-pay for generic HR-QoL, disease-specific HR-QoL, and pain, and decreasing with increasing willingness-to-pay for treatment satisfaction.DiscussionDD from the ED of patients with SSI seems cost-effective from a societal perspective. Future studies should test generalizability in other healthcare systems and strengthen findings in larger injury-specific cohorts.Level of evidenceII.

Direct discharge of patients with simple stable musculoskeletal injuries as an alternative to routine follow-up: a systematic review of the current literature

Purpose There is growing evidence that patients with certain simple stable musculoskeletal injuries can be discharged directly from the Emergency Department (ED), without compromising patient outcome and experience. This study aims to review the literature on the effects of direct discharge (DD) of simple stable musculoskeletal injuries, regarding healthcare utilization, costs, patient outcome and experience. Methods A systematic review was performed in Medline, Embase, CINAHL, Cochrane Library and Web of Science using PRISMA guidelines. Comparative and non-comparative studies on DD of simple stable musculoskeletal injuries from the ED in an adult/paediatric/mixed population were included if reporting ≥ 1 of: (1) logistic outcomes: DD rate (proportion of patients discharged directly); number of follow-up appointments; DD return rate; (2) costs; (3) patient outcomes/experiences: functional outcome; treatment satisfaction; adverse outcomes; other. Results Twenty-six studies were included (92% conducted in the UK). Seven studies (27%) assessed functional outcome, nine (35%) treatment satisfaction, and ten (38%) adverse outcomes. A large proportion of studies defined DD eligibility criteria as injuries being minor/simple/stable, without further detail. ED DD rate was 26.7–59.5%. Mean number of follow-up appointments was 1.00–2.08 pre-DD, vs. 0.00–0.33 post-DD. Return rate was 0.0–19.4%. Costs per patient were reduced by €69–€210 (ranging from − 38.0 to − 96.6%) post-DD. Functional outcome and treatment satisfaction levels were ‘equal’ or ‘better’ (comparative studies), and ‘high’ (non-comparative studies), post-DD. Adverse outcomes were low and comparable. Conclusions This systematic review supports the idea that DD of simple stable musculoskeletal injuries from the ED provides an opportunity to reduce healthcare utilization and costs without compromising patient outcomes/experiences. To improve comparability and facilitate implementation/external validation of DD, future studies should provide detailed DD eligibility criteria, and use a standard set of outcomes. Systematic review registration number: 120779, date of first registration: 12/02/2019.

Insight Into Impacts of Sewage Discharge and River Self-Purification on Microbial Dynamics and Pathogenicity in River Ecosystem

Sewage directly discharge causes serious environmental problems. Here, the effects of treated and untreated sewage on the river ecosystem were investigated. The variations of microbial community structure, including infectious pathogenic bacteria and functional bacteria related to nitrogen, phosphorus, and COD metabolism were studied in detail. Bacterial diversity and richness were significantly decreased, while, Proteobacteria containing various infectious pathogens, such as Vibrio and Helicobacter, significantly increased after the discharge of raw sewage. Although the microbial structure was slightly restored and the abundance of most pathogenic bacteria was also slightly reduced through river self-purification, direct discharge of raw sewage caused severe and short-term irreversible damage to the river environment. Direct discharge also introduced various pollutants such as nitrogen, phosphorus, and COD, increasing the corresponding functional bacteria and their related genes. Furthermore, the high abundance of pathogenic bacteria of the drain outlet was mainly from raw sewage rather than bacteria reproduction caused by water deterioration according to the RDA analysis. With these results, direct discharge disturbed the ecological balance of the river. Therefore, more attention is needed to provide a hygienic situation for people and all sewage should be treated properly. In conclusion, all sewage should be treated properly before discharge into ecosystems to mitigate its negative impacts on receiving water bodies.

Diabetes Mellitus Is Associated With Poor In‐Hospital and Long‐Term Outcomes in Young and Midlife Stroke Survivors

Background The incidence of ischemic stroke has increased among adults aged 18 to 64 years, yet little is known about relationships between specific risk factors and outcomes. This study investigates in‐hospital and long‐term outcomes in patients with stroke aged <65 years with preexisting diabetes mellitus. Methods and Results Consecutive patients aged <65 years admitted to comprehensive stroke centers for acute ischemic stroke between 2003 and 2013 were identified from the Ontario Stroke Registry. Multinomial logistic regression was used to estimate adjusted odds ratio (OR [95% CI]) of in‐hospital mortality or direct discharge to long‐term or continuing care. Cox proportional hazards regression was used to estimate the adjusted hazards ratio (aHR [95% CI]) of long‐term mortality, readmission for stroke/transient ischemic attack, admission to long‐term care, and incident dementia. Predefined sensitivity analyses examined stroke outcomes among young (aged 18–49 years) and midlife (aged 50–65 years) subgroups. Among 8293 stroke survivors (mean age, 53.6±8.9 years), preexisting diabetes mellitus was associated with a higher likelihood of in‐hospital death (adjusted OR, 1.46 [95% CI, 1.14–1.87]) or direct discharge to long‐term care (adjusted OR, 1.65 [95% CI, 1.07–2.54]). Among stroke survivors discharged (N=7847) and followed up over a median of 6.3 years, preexisting diabetes mellitus was associated with increased hazards of death (aHR, 1.68 [95% CI, 1.50–1.88]), admission to long‐term care (aHR, 1.57 [95% CI, 1.35–1.82]), readmission for stroke/transient ischemic attack (aHR, 1.37 [95% CI, 0.21–1.54]), and incident dementia (aHR, 1.44 [95% CI, 1.17–1.77]). Only incident dementia was not increased for young stroke survivors. Conclusions Focused secondary prevention and risk factor management may be needed to address poor long‐term outcomes for patients with stroke aged <65 years with preexisting diabetes mellitus.

Assessment of Industrial Symbiosis Implementation Opportunities: A Study in a Selected Industrial Zone, Sri Lanka

Most Sri Lankan Industries discharge or dispose of many waste materials in large quantities in solid, liquid, and gaseous forms. Due to the high cost of treatment, many industries dispose of wastes either to dumpsites or lowlands through third-party contractors. The haphazard disposal of untreated waste is growing into a significant problem in the country. As a result, this study was conducted to identify the application options to treat or reuse the valuable waste generated by some selected industries by implementing the industrial symbiosis process in an industrial zone. Personal interviews and questionnaires were used as the methodological tools of the study to collect firm-related waste. Material properties and feasibility facts were mainly considered concerning industrial symbiosis application potential with respect to the waste receivers' and doners' perspectives. Through the study, potential secondary usage of waste was identified, avoiding direct discharge into the environment. The result from the evaluation indicates some support to the theories that industrial symbiosis can have benefits both from an economic and environmental point of view.