[Symptom Control in Nephrological Palliative Care].

INTRODUCTION: Nephrology may have quite a lot in common with with palliative care. Examples of this are the conservative therapy of a terminal chronic kidney disease or dialysis termination. Nevertheless, palliative co-care of patients with chronic kidney disease still happens rather rarely. On the one hand, this might be due to lacking experience regarding the benefits and opportunities of incorporating palliative care in nephrology care, on the other hand, palliative care is often misunderstood as pure "end-of-life" care. By highlighting the whole spectrum of palliative care, we aim to promote these two disciplines in order to integrate palliative care services into the nephrological treatment concept at an early stage.

Ambient and substrate energy influence decomposer diversity differentially across trophic levels.

The species-energy hypothesis predicts increasing biodiversity with increasing energy in ecosystems. Proxies for energy availability are often grouped into ambient energy (i.e., solar radiation) and substrate energy (i.e., non-structural carbohydrates or nutritional content). The relative importance of substrate energy is thought to decrease with increasing trophic level from primary consumers to predators, with reciprocal effects of ambient energy. Yet, empirical tests are lacking. We compiled data on 332,557 deadwood-inhabiting beetles of 901 species reared from wood of 49 tree species across Europe. Using host-phylogeny-controlled models, we show that the relative importance of substrate energy versus ambient energy decreases with increasing trophic levels: the diversity of zoophagous and mycetophagous beetles was determined by ambient energy, while non-structural carbohydrate content in woody tissues determined that of xylophagous beetles. Our study thus overall supports the species-energy hypothesis and specifies that the relative importance of ambient temperature increases with increasing trophic level with opposite effects for substrate energy.

[End-of-Life Dreams and Visions]. / Traum- und Wachvisionen am Lebensende.

End-of-Life Dreams and Visions Abstract: End-of life dreams and visions (ELDVs) or so-called death bed phenomena are transcendent experiences at the end of life that can be visual, auditory and/or kinesthetic, and often include visions of (deceased) loved ones, close friends or perceptions of places, travels, bright lights, or music. ELDVs typically occur weeks to hours prior to death and may comfort the dying and prepare spiritually for the end of life. Such experiences are frequently reported by dying individuals, the prevalence varying between 30 and 80%, but in the clinical context ELDVs are usually neglected, but interpreted and treated as pathological changes in the brain that result in, and from, delirium. This article tries to enlighten the occurrence, the contents and meanings of ELDVs in dying persons as opposed to delirium and night dreams using findings from the literature and from clinical observations. Implications of these conclusions for palliative care and the therapeutic relevance of ELDVs when taking care of dying individuals and their loved ones will also be discussed.

Datasets on material properties and energy yields of lab-designed organic fraction of municipal solid waste (OFMSW) components.

The organic fraction of municipal solid waste (OFMSW) is a complex material with different ingredients characterized by varying properties depending on parameters such as season or geographical region of origin. Consequently, studies on OFMSW are hard to compare due to the changing characteristics of the samples. Therefore, this article presents data on the physico-chemical composition of standardized, recipe-based OFMSW components divided into the categories "Paper", "Green waste" and "Food waste", and further subcategories. Data presented in this article include (1) dry matter, (2) organic dry matter, (3) C, H and N concentrations, (4) gross calorific values, (5) ash melting behavior, (6) specific biogas yield and (7) methane concentration. An application example of an experiment requiring the same starting material properties is represented by storage experiments, as performed within the original scientific article [1]. Thus, this Data in Brief article also provides additional data on recipe-based storage experiments complementing the original article. The datasets cannot only be used to estimate biowaste potentials but they can also be used for the design and execution of experiments that require standardized OFMSW samples.

Improving the energetic utilization of household food waste: Impact of temperature and atmosphere during storage.

Food waste (FW) from households represents a major fraction of municipal waste and it is often collected in separate biowaste bins. Until waste collection is carried out, storage conditions in the biowaste bin influence FW properties. To draw conclusions for an optimized waste utilization in anaerobic digestion (AD), the aim of this study was to evaluate the impact of storage duration (20 to 40 days) and temperature (5 °C and 20 °C) on inherent energy potentials of household FW during aerobic and anaerobic storage. Therefore, physico-chemical parameters of recipe-based FW samples with reproducible initial compositions were monitored. After 20 days of aerobic storage, water contents (WC) were reduced from 61.9% to 39.5% (20 °C) and from 63.9% to 50.3% (5 °C) while organic dry matter (oDM) concentrations were lowered by 4.3% (20 °C) and 1.1% (5 °C). Increased pH-values of 6.6 (initially 5.5) were only measured for FW stored aerobically at 20 °C. In total, the energy potential was decreased by 31% (20 °C) and by 16% (5 °C). Thus, storage temperature and duration are crucial parameters for optimized aerobic FW storage leading to higher energy yields in AD. Instead, anaerobic storage of FW decreased pH-values to <5 while increasing WC in all samples (up to 67% at 20 °C). As oDM concentrations were preserved almost completely, the energy potential losses were only marginal proving that energy contents of FW could be preserved at household level. Consequently, energy yields in AD of FW could be increased through anaerobic storage conditions.

Dataset for a full-year time series characterization of separately collected organic fraction of municipal solid waste from rural and urban regions in Germany.

In the municipal context and depending on the collection scheme, different waste streams are of relevance. This article contains year-round data on the chemical composition of organic fractions of municipal solid waste (OFMSW) of rural and urban origins. All samples were collected in the municipality of Tübingen, which is located in southern Germany. The sampling procedure was executed in accordance with standard procedures mentioned in the German Biowaste Ordinance. The data presented in this article include (1) sampling area and process specifications (2) organoleptic examinations (3) dry matter and organic dry matter contents (4) impurity concentrations and (5) elemental compositions (major, minor and trace elements). All datasets are presented as a time series for the year 2018. Thus, this article especially presents the influence of season and settlement structure on the physico-chemical characteristics of OFMSW. Researchers, waste management companies and municipalities can compare and expand their own OFMSW data with those presented in this article. The dataset can also be used to calculate energy yields of OFMSW when utilized in anaerobic digestion. Based on the data, it is also possible to discuss and to evaluate the material utilization of OFMSW-based digestates and compost products, especially with regard to concentrations of major, minor and trace elements. For further discussion, please refer to the original scientific article Sailer et al. (2021).

Characterization of the separately collected organic fraction of municipal solid waste (OFMSW) from rural and urban districts for a one-year period in Germany.

Knowledge on material properties is beneficial to fully exploit inherent utilization potentials of the organic fraction of municipal solid waste (OFMSW). The objective of this study was to analyze and compare the physico-chemical characteristics of separately collected OFMSW (biowaste bin) originating in southwestern Germany. Therefore, 22 rural and 20 urban OFMSW samples, each from the same location were analyzed in the course of one year. Next to the basic characteristics such as the impurity, dry matter (DM) and organic dry matter (oDM) contents, this study focused on the analysis of 37 major, minor and trace elements. In addition, stoichiometric CH4 potentials for the anaerobic digestion were calculated. The fresh mass (FM) based DM contents were significantly (p = 0.001) higher in rural OFMSW (32.86 ± 2.35% vs. 30.50 ± 1.75%) while the DM based oDM content was higher (p = 0.07) in urban OFMSW (84.59 ± 3.90% vs. 82.22 ± 4.16%). The impurities in rural OFMSW were significantly lower (2.83 ± 1.67% DM vs. 5.07 ± 2.71% DM with p = 0.004) while oDM based CH4 potentials were higher for urban OFMSW (533 ± 22 L/kg vs. 519 ± 26L/kg). For both OFMSW types, contents >1000 mg/kgDM were detected for Ca, K, Si, Na, Al, Fe, Mg, P and S while Ti, Mn, Ba, Zn, Sr, Cr, Cu, V, Ni, Li, Pb and B were measured between 1 and 1000 mg/kgDM. The determined element concentrations are useful for an improved classification of OFMSW as a biorefinery resource.

Datasets on chemical composition and anaerobic digestion of organic fraction of municipal solid waste (OFMSW), digested sewage sludge (inoculum) and ashes from incineration or gasification.

This article contains data on the chemical composition and anaerobic digestion of different residue streams including OFMSW, digested sewage sludge, low-carbon (LC) ashes from incineration subdivided into LC coarse and LC fly ash as well as high-carbon (HC) ashes from gasification subdivided into HC reactor and HC fly ash. All materials were collected in accordance to standard procedures in southern Germany. The data presented in this article include (1) dry matter (2) organic dry matter (3) elemental analysis (4) trace elements and (5) cumulative biogas and CH4 yields. Researchers and waste management companies on lab-/pilot-/industrial-scale can rely on the presented data for classification and comparison of biogenic waste streams. For further discussion, please refer to the scientific article entitled "Optimizing anaerobic digestion of organic fraction of municipal solid waste (OFMSW) by using biomass ashes as additives" [ 1 ].

Optimizing anaerobic digestion of organic fraction of municipal solid waste (OFMSW) by using biomass ashes as additives.

The purpose of this study is to test alternative additives for trace element (TE) supplementation and process stabilization during anaerobic digestion (AD) of the organic fraction of municipal solid waste (OFMSW) and sewage sludge. Process instabilities due to acidification are a typical problem in waste fermentation. Provision with minerals and TE is crucial for microorganisms in AD to work effectively, allowing higher organic loading rates within the digester without risking acid accumulation. In batch-fermentation tests, different mixture configurations of OFMSW, digested sewage sludge and biomass ashes were evaluated. Based on an extensive characterization of the TE contained in wood ashes, suitable combinations of digested sewage sludge and OFMSW as a baseline substrate together with ash additives were derived. While high dosages of ash reduced biogas production, 1:1 mix of ash and OFMSW facilitated higher CH4 yields (6%). The supplementation of ashes increased the pH-value within AD and CO2 precipitation through metal oxides in situ elevated the CH4 concentration in biogas up to 98%. Therefore, ashes may increase the efficiency of AD and serve as a basis for a new gas purification method, minimizing technical effort. Additional investigations are needed to examine long-term effects as well as financial and legal aspects such as possible ways of digestate usage. As a further area of research, the transferability of batch-test results into practical applications is identified.

Reducing Willow Wood Fuel Emission by Low Temperature Microwave Assisted Hydrothermal Carbonization.

Biomass is a sustainable fuel, as its CO2 emissions are reintegrated in biomass growth. However, the inorganic precursors in the biomass cause a negative environmental impact and slag formation. The selected short rotation coppice (SRC) willow wood has a high ash content ( = 1.96%) and, therefore, a high content of emission and slag precursors. Therefore, the reduction of minerals from SRC willow wood by low temperature microwave assisted hydrothermal carbonization (MAHC) at 150 °C, 170 °C, and 185 °C is investigated. An advantage of MAHC over conventional reactors is an even temperature conductance in the reaction medium, as microwaves penetrate the whole reactor volume. This allows a better temperature control and a faster cooldown. Therefore, a succession of depolymerization, transformation and repolymerization reactions can be analyzed effectively. In this study, the analysis of the mass loss, ash content and composition, heating values and molar O/C and H/C ratios of the treated and untreated SCR willow wood showed that the mineral content of the MAHC coal was reduced and the heating value increased. The process water showed a decreasing pH and contained furfural and 5-methylfurfural. A process temperature of 170 °C showed the best combination of energy input and ash component reduction. The MAHC allows a better understanding of the hydrothermal carbonization process, while a large-scale industrial application is unlikely because of the high investment costs.

Retinal Ganglion Cell Topography in Patients With Visual Pathway Pathology.

BACKGROUND: To investigate and quantify the impact of intracranial lesions at different locations within the visual pathway on the ganglion cell layer-inner plexiform layer (GCL-IPL) complex and the retinal nerve fiber layer (RNFL). METHODS: Patients with intracranial lesions affecting the optic chiasm (Group I) or the optic tract and/or lateral geniculate nucleus (Group II) were included. All patients received kinetic visual field assessment and underwent spectral domain optical coherence tomography. Peripapillary and papillomacular bundle (PMB) RNFL and macular GCL-IPL thickness in 4 perifoveal areas were measured and compared with normal values derived from 52 age-matched healthy control subjects. Z-scores for each parameter of every patient were calculated and compared with the normative data. Z-scores less than -2.0 (e.g., -2.5) were considered as being statistically significant. RESULTS: Twenty-two patients (Group I and II: 13 and 9, respectively) were included. Ten of 13 patients in Group I showed significant binasal GCL-IPL thinning, with associated temporal sector thinning in 8 patients. In Group II, all 9 patients showed significant reduction of the GCL-IPL corresponding to the homonymous visual field defect, but only 4 demonstrated RNFL thinning. Contralateral RNFL thinning within the PMB clinically similar to bow-tie atrophy was evident in all patients in Group II. GCL-IPL and RNFL thinning varied in severity from mild (isolated PMB RNFL thickness reduction) to severe (bilateral asymmetrical reduction of PMB RNFL associated with asymmetric, predominantly nasal reduction of GCL-IPL) in Group I. CONCLUSION: Clinical abnormalities in patients with visual pathway lesions are more likely to demonstrate abnormalities of GCL-IPL than global peripapillary RNFL thickness. However, PMB thickness measurement appears to be a valuable tool to detect abnormalities of the anterior visual pathways. If peripapillary RNFL measurements are performed in such patients, PMB thickness should be considered the most useful quantitative parameter.