Electric recycling of Portland cement at scale.

Cement production causes 7.5% of global anthropogenic CO2 emissions, arising from limestone decarbonation and fossil-fuel combustion1-3. Current decarbonation strategies include substituting Portland clinker with supplementary materials, but these mainly arise in emitting processes, developing alternative binders but none yet promises scale, or adopting carbon capture and storage that still releases some emissions4-8. However, used cement is potentially an abundant, decarbonated feedstock. Here we show that recovered cement paste can be reclinkered if used as a partial substitute for the lime-dolomite flux used in steel recycling nowadays. The resulting slag can meet existing specifications for Portland clinker and can be blended effectively with calcined clay and limestone. The process is sensitive to the silica content of the recovered cement paste, and silica and alumina that may come from the scrap, but this can be adjusted easily. We show that the proposed process may be economically competitive, and if powered by emissions-free electricity, can lead to zero emissions cement while also reducing the emissions of steel recycling by reducing lime flux requirements. The global supply of scrap steel for recycling may treble by 2050, and it is likely that more slag can be made per unit of steel recycled. With material efficiency in construction9,10, future global cement requirements could be met by this route.

Framework and Overview of a State-Wide College Mental Health Program in Kerala, India.

Background: Mental health issues are common among college students, and structured services have been proven to enhance outcomes. Despite increased enrolment for higher education in India, college mental health services remain sparse. JEEVANI is the first structured state-wide college mental health service in India. This paper describes its framework and provides an overview of its functioning during the initial five months. Methods: In 2019-2020, the Directorate of Collegiate Education, Government of Kerala, implemented the program in 66 colleges catering to approximately 60,000 students. Qualified counsellors were trained to identify issues and provide interventions and early referrals, using a stepped-care approach. They conducted awareness programs to promote mental health and reduce stigma. Results: The services were accessed by 2,315 students during the assessment period (October 2019 to February 2020). The beneficiaries were predominantly females (54.1%). Over a third (38.8%) belonged to the lower socio-economic strata, and 2.5% had significant vulnerabilities. Although no syndromal diagnoses were made, anxiety and depression were the most common presentations. The counsellors provided 3,758 individual sessions and facilitated support for students who reported academic difficulties or interpersonal issues. Severe mental illness was detected in 54 students, and referrals for specialist mental health input were initiated in 68. Conclusion: Describing the framework, sharing the technical material, and providing an overview of its functioning from a resource-constrained setting in India may encourage higher education institutions in low- and middle-income countries to consider similar projects.

Hydration of Hybrid Cements at Low Temperatures: A Study on Portland Cement-Blast Furnace Slag-Na2SO4.

Replacement of Portland cement with high volumes of blast furnace slag is known to negatively affect the early-age properties of concrete, particularly at low temperatures. In this study, the effectiveness of Na2SO4 on the mechanical properties, hydration kinetics and microstructure development of a commercial CEM III/B (~69% slag) is investigated at 10 and 20 °C. Na2SO4 enhances compressive strength at both 10 and 20 °C, and at both early (1 and 7 days) and later ages (28 and 90 days). QXRD shows an increase in the degree of alite hydration at 1 day with Na2SO4 addition, while the degree of clinker and slag hydration is similar for all the systems from 7 to 90 days. An increase in ettringite content is observed at all ages in the systems with Na2SO4. Microstructure and pore structure shows densification of hydrates and reduction in porosity on addition of Na2SO4.

Effect of Water-Solid Mixing Sequence and Crystallization Water of Calcium Sulphate on the Hydration of C3A.

Tricalcium aluminate (Ca3Al2O6: C3A) is the most reactive clinker phase in Portland cement. In this study, the effect of the sequence of mixing of C3A with gypsum and water on the hydration kinetics and phase assemblage is investigated. Three mixing sequences were employed: (i) Turbula mixing of C3A first with gypsum and then with water (T-mix); (ii) Hand mixing of C3A with gypsum before mixing with water (H-mix); (iii) Pre-mixing gypsum with water and then with C3A (P-mix). The results suggest that there is a considerable difference in the hydration kinetics and hydrate phase assemblage, particularly during the initial stages of hydration. P-mix promotes a higher degree of hydration in the initial minutes and considerably influences the main peak in the calorimetry curve of C3A hydration. Effects of calcium sulphate with different amounts of crystallisation water (anhydrite, hemihydrate and gypsum) on C3A hydration are also investigated, and it is found that the water of crystallisation does not have a significant impact on the kinetics of reaction or the formed hydrate phase assemblage.

Pharmacokinetics and Safety of a Novel Oral Liquid Formulation of 13-cis Retinoic Acid in Children with Neuroblastoma: A Randomized Crossover Clinical Trial.

(1) Background: 13-cis-retinoic acid (13-CRA) is a key component of neuroblastoma treatment protocols. This randomized crossover study compares the pharmacokinetics (PK), safety and palatability of a novel oral liquid formulation to the current method of extracting 13-CRA from capsules. (2) Methods: Pharmacokinetics was evaluated in two consecutive treatment cycles. Patients were randomized to receive either liquid or capsule formulation on cycle 1 and then crossed over to the alternative formulation on cycle 2. The daily dose was 200 mg/m2, reduced to 160 mg/m2 in patients with weight ≤ 12 kg. (3) Results: A total of 20 children, median (range) age 4.3 (1-11.6) y were recruited. Pharmacokinetic data were pooled and a population model describing the disposition of 13-CRA and 4-oxo-13-CRA was developed. Bioavailability of the liquid formulation was estimated to be 65% higher (95% CI; 51-79%) than the extracted capsule. CmaxSS and AUC(0-12)SS estimates were also significantly higher; mean (95% CI) differences were 489 (144-835) ng/mL and 3933 (2020-5846) ng/mL·h, respectively (p < 0.01). There were no significant differences in reported adverse effects. Parents found dosing considerably easier with liquid formulation. (4) Conclusions: The pharmacokinetics, safety and palatability of a new liquid formulation of 13-CRA compares favorably to 13-CRA extracted from capsules. Clinical Trial Registration: clinicaltrial.gov NCT03291080.

Spontaneous Coronary Artery Dissection: Pathophysiological Insights From Optical Coherence Tomography.

OBJECTIVES: This study used optical coherence tomography to investigate the mechanism of false lumen (FL) formation in spontaneous coronary artery dissection (SCAD) by studying: 1) differences between fenestrated and nonfenestrated SCAD; 2) vasa vasorum density; and 3) light attenuation characteristics of the FL. BACKGROUND: SCAD is an increasingly recognized cause of acute coronary syndromes, characterized by FL formation and compression of the true lumen (TL). The mechanisms underlying FL formation remain poorly understood. METHODS: A total of 65 SCAD patients (68 vessels) who underwent acute OCT imaging as part of routine clinical care were included. Images were classified by the absence or presence of a connection (fenestration) between the TL and FL. Indexed measurements of TL stenosis, external elastic lamina (EEL) area, FL area, and light attenuation of the FL were assessed. Vasa vasorum densities of SCAD cases were compared with those in control non-SCAD myocardial infarction cases. RESULTS: In nonfenestrated cases, there was significantly larger expansion of the EEL area (9.1% vs. -1.9%; p <0.05) and a larger FL area (73.6% vs. 53.2%, respectively; p <0.05) in dissected segments. No significant differences were found between vasa vasorum density in SCAD and those in control subjects. The FL contents were heterogeneous but attenuated less light than whole blood or thrombus (4.28 ± 0.55 mm-1 vs. 5.08 ± 0.56 mm-1; p < 0.05; vs. 4.96 ± 0.56 mm-1; p < 0.05). CONCLUSIONS: These observational data suggest that the absence of a fenestration leads to increased FL pressure and compression of the TL. Although vasa vasorum may still be implicated in pathogenesis, increased vasa vasorum density could be an epiphenomenon of vascular healing.

Post-mortem imaging of the infant and perinatal dura mater and superior sagittal sinus using optical coherence tomography.

Infants and young children are likely to present with subdural haemorrhage (SDH) if they are the victims of abusive head trauma. In these cases, the most accepted theory for the source of bleeding is the bridging veins traversing from the surface of the brain to the dura mater. However, some have suggested that SDH may result from leakage of blood from a dural vascular plexus. As post-mortem examination of the bridging veins and dura is challenging, and imaging modalities such as magnetic resonance and computed tomography do not have the resolution capabilities to image small blood vessels, we have trialled the use of intravascular and benchtop optical coherence tomography (OCT) systems for imaging from within the superior sagittal sinus (SSS) and through the dura during five infant/perinatal autopsies. Numerous vessel-like structures were identified using both OCT systems. Measurements taken with the intravascular rotational system indicate that the approximate median diameters of blood vessels entering anterior and posterior segments of the SSS were 110 µm (range 70 to 670 µm, n = 21) and 125 µm (range 70 to 740 µm, n = 23), respectively. For blood vessels close to the wall of the SSS, the median diameters for anterior and posterior segments of the SSS were 80 µm (range 40 to 170 µm, n = 25) and 90 µm (range 30 to 150 µm), respectively. Detailed characterisation of the dural vasculature is important to aid understanding of the source of SDH. High resolution 3-dimensional reconstructions of the infant dural vasculature may be possible with further development of OCT systems.

Automatic segmentation of coronary morphology using transmittance-based lumen intensity-enhanced intravascular optical coherence tomography images and applying a localized level-set-based active contour method.

Lumen segmentation from clinical intravascular optical coherence tomography (IV-OCT) images has clinical relevance as it provides a full three-dimensional perspective of diseased coronary artery sections. Inaccurate segmentation may occur when there are artifacts in the image, resulting from issues such as inadequate blood clearance. This study proposes a transmittance-based lumen intensity enhancement method that ensures only lumen regions are highlighted. A level-set-based active contour method that utilizes the local speckle distribution properties of the image is then employed to drive an image-specific active contour toward the true lumen boundaries. By utilizing local speckle properties, the intensity variation issues within the image are resolved. This combined approach has been successfully applied to challenging clinical IV-OCT datasets that contains multiple lumens, residual blood flow, and its shadowing artifact. A method to identify the guide-wire and interpolate the lost lumen segments has been implemented. This approach is fast and can be performed even when guide-wire boundaries are not easily identified. Lumen enhancement also makes it easy to identify vessel side branches. This automated approach is not only able to extract the arterial lumen, but also the smaller microvascular lumens that are associated with the vasa vasorum and with atherosclerotic plaque.

Optical clearing of the dura mater using glycerol: a reversible process to aid the post-mortem investigation of infant head injury.

PURPOSE: In cases of suspected abusive head trauma, a thorough and systematic study of the cranium and its contents is essential, preferably using the best available methods for observing the brain and its coverings. Building upon recent developments in skull bone removal techniques in infant autopsies, we have assessed the use of two optical clearing agents (OCAs), glycerol and mannitol, on pediatric dura mater in an attempt to increase the transparency of this tissue and thereby enhance the post-mortem assessment of infant head injuries, particularly subdural hematomas. METHODS: Extracorporeal testing revealed glycerol to be the more effective OCA. Therefore, in situ investigations were commenced using glycerol during 33 pediatric post-mortem examinations. RESULTS: An increase in the transparency of the dura was observed in 32 of the 33 cases, within 1 min of application of the OCA. In a 2 year old with cerebral palsy, only partial optical clearance of the dura was seen, most likely due to a significantly atrophic brain, prominent gelatinous leptomeninges, and abnormally thickened dura. This technique allowed for detection of minimal amounts of subdural bleeding over the convexities, before dissection of the dura, avoiding post-mortem blood spillage from artifactually disrupted bridging veins. Optical clearing of the dura aided in the evaluation of patterns of subdural hemorrhage in three cases of non-accidental head injury, three cases of peri-natal head injury and one case of overlaying, apparently resulting in minor crush injury to the head. CONCLUSIONS: We have demonstrated that glycerol is an effective and easy-to-use OCA to effect the readily reversible optical clearing of human infant calvarial dura at autopsy.

Developing cross-correlation as a method for microvessel imaging using clinical intravascular optical coherence tomography systems.

Current clinical intravascular optical coherence tomography (IV-OCT) imaging systems have limited in-vivo flow imaging capability because of non-uniform catheter rotation and inadequate A-line scan density. Thus any flow-localisation method that seeks to identify sites of variation within the OCT image data-sets, whether that is in amplitude or phase, produces non-representative correlation (or variance) maps. In this study, both mean and the variation within a set of cross-correlation maps, for static OCT imaging was used to differentiate flow from nonflow regions. Variation was quantified by use of standard deviation. The advantage of this approach is its ability to image flow, even in the presence of motion artifacts. The ability of this technique to suppress noise and capture flow maps was demonstrated by imaging microflow in an ex-vivo porcine coronary artery model, by nailfold capillary imaging and in-vivo microvessel imaging from within the human coronary sinus.

Coronary optical coherence tomography: minimally invasive virtual histology as part of targeted post-mortem computed tomography angiography.

Social, cultural and practical barriers to conventional invasive autopsy have led to considerable interest in the development of minimally invasive radiological techniques as an alternative to the invasive autopsy for determining the cause of death. Critical to accurate diagnosis in this context is detailed examination of coronary anatomy and pathology. Current computed tomography and magnetic resonance imaging approaches have significantly advanced minimally invasive autopsy practice but have limited spatial resolution. This prohibits assessment at a microscopic level, meaning that histological assessment is still required for detailed analysis of, for example, coronary plaque rupture or dissection. Coronary optical coherence tomography (OCT) is used in the living during percutaneous coronary interventions to provide high-resolution coronary imaging, but this technique for obtaining virtual histology has not, to date, been translated into minimally invasive autopsy practice. We present a first description of minimally invasive post-mortem coronary OCT and discuss the potential for this technique to advance current practice.