Synergistic improvements in energy recovery and bio-oil quality through integrated thermochemical valorization of agro-industrial waste of varying moisture content.

Two thermochemical valorization schemes were investigated for co-upgrading dry and wet agricultural wastes through integrated hydrothermal carbonization (HTC) and pyrolysis. In the first pathway, dry and wet wastes were co-carbonized. The resulting hydrochar was pyrolyzed to yield an energy dense biochar (26-32 MJ/kg) high in fixed carbon (41-86 wt%) and low in volatile matter (6-12 wt%). The resulting bio-oil was lower in carboxylic acids and higher in phenols than predicted based on an additive scheme. In pathway two, wet waste (only) underwent HTC and the resulting hydrochar was mixed with dry waste and the mixture pyrolyzed. This pathway showed a lower biochar yield (32-67 wt%) and lower HHV values (24-31 MJ/kg) but higher fixed carbon content (65-84 wt%). The bio-oil contained more carboxylic acids than pathway 1 bio-oil. Pathway 1 biochars were more thermally reactive than pathway 2 biochars, reflecting a synergistic deoxygenation that occurs when incorporating dry waste in HTC prior to pyrolysis.

Inflammatory bowel disease and cannabis: key counseling strategies.

PURPOSE OF REVIEW: Cannabis use is becoming more frequent in patients with inflammatory bowel disease (IBD). Because of the increased usage, gastroenterologists need to be cognizant of the benefits and risks associated with cannabis use in the IBD-patient population. RECENT FINDINGS: Recent studies have attempted to determine whether cannabis can improve biomarkers or endoscopic findings of inflammation in patients with IBD, but the results have been inconclusive. However, cannabis has been shown to have an impact on the symptoms and quality of life of individuals with IBD. Despite these benefits, the use of cannabis in IBD is not without risks, including the potential for systemic illness, toxin ingestion and significant drug interactions. SUMMARY: In this review article, we use a case-based approach to discuss the critical clinical data that informs us of the benefits and risks of cannabis use in IBD. The endocannabinoid system plays a crucial role in regulating various physiological functions including the gastrointestinal tract. Studies have investigated the impact of cannabis on various medical conditions, including IBD. Clinicians must be aware of the most recent data to properly educate their patients on the benefits and risks of its use.

Skin tissue dielectric constant in women with high body fat content.

BACKGROUND: Skin tissue dielectric constant (TDC) measurements at a frequency of 300 MHz are used to assess skin properties in many conditions. Impacts of patient obesity on these values are unknown, and its quantitative assessment was the goal of this research. MATERIALS AND METHODS: Women in a weight loss program (N = 32) had TDC measured on forearm, biceps, neck, jowl, and submental regions along with measurements of total body fat (TBF), water (TBW), intracellular water (ICW), and extracellular water (ECW) via multi-frequency bioimpedance. Group age (mean ± SD) was 40.0 ± 11.6 years (20-70 years) with body mass index (BMI) of 31.8 ± 6.7 Kg/m2 (23.0-49.9 Kg/m2 ). For analysis, subjects were divided into those with BMI < 30 Kg/m2 (subgroup A, n = 16) vs ≥30 Kg/m2 (subgroup B, n = 16). RESULTS: Tissue dielectric constant at forearm and biceps decreased significantly (P < .001) with increasing depth from 0.5 to 1.5 to 2.5 mm but TDC values and their inter-side ratios did not differ between subgroups A and B at any measured site. Although correlations between TBW, ECW, and ICW were significant (P < .001), there was no dependence of TDC values on any of these parameters. CONCLUSIONS: Previously unknown TDC values for obese persons are provided and based on subgroup analyses suggest that skin TDC values in overweight and obese persons are not confounded by variables such as TBW and TBF. Further, since inter-side ratios and their SD's yielded thresholds for forearm and biceps similar to those established for women with normal BMI, use of these clinical inter-arm TDC ratios now is extended to include a wider BMI range.

Applications of Out of Body Lung Perfusion.

RATIONALE AND OBJECTIVES: Out of body organ perfusion is a concept that has been around for a long time. As technology has evolved, so have the systems available for out of body perfusion making whole organ preservation for extended evaluation, resuscitation, and discovery routine. MATERIALS AND METHODS: Clinical use of ex vivo lung perfusion (EVLP) systems has continued to expand as evidence has accumulated to suggest EVLP transplants experience similar mortality, ICU length of stay, length of mechanical ventilation, hospital length of stay, and rates of primary graft dysfunction as conventional lung transplants. In 2017, more lung transplants were performed than any previous year in the US history. RESULTS: Early success of EVLP has motivated groups to evaluate additional donor types and methods for expanding the donor pool. The ability to keep a lung alive in a physiologically neutral environment opens the ability to better understand organ quality, define pathophysiology in certain disease conditions, and provides a platform for interventions to prevent or repair injury. CONCLUSION: The next several years will usher in significant changes in understanding and interventions focused on lung injury. This manuscript highlights applications of EVLP to clarify how this system can be used for basic and translational research.

Donor Lung Sequence Number and Survival after Lung Transplantation in the United States.

RATIONALE: In the United States, an algorithm known as the "match-run" creates an ordered ranking of potential recipients for available lung allografts. A potential recipient's match-run position, or "sequence number," is available to the transplant center when contacted with a lung offer. Lung offers with higher sequence numbers may be interpreted as a crowd-sourced evaluation of poor organ quality, though the association between the sequence number at which a lung is accepted and its recipient's post-transplant outcomes is unclear. OBJECTIVES: We sought to evaluate the primary reasons provided when a lung offer was refused by a transplant center, transplant center and donor/organ factors associated with a higher sequence number at acceptance, and the association of the sequence number at acceptance with post-transplant mortality and graft failure. METHODS: Match-run outcomes for lung offers that occurred in the United States from May 2007 through June 2014 were merged with recipient follow-up data through December 2017. Associations between the sequence number at the time of acceptance and selected transplant center and donor characteristics were estimated using multivariable logistic and multinomial regression models. The associations between the final sequence number and recipient survival and graft survival were estimated using multivariable time-to-event models. RESULTS: Of 10,981 lung offer acceptances, nearly 70% were accepted by one of the top 10 ranked candidates. Higher median annual center volume and potential indicators of organ quality (e.g., abnormal chest radiograph or bronchoscopy) were associated with a higher sequence number at acceptance. There was weak evidence for a small positive relationship between the sequence number at acceptance and both mortality and graft failure. For example, the unadjusted and adjusted hazard ratios for death associated with the log-sequence number at acceptance were 1.019 (95% confidence interval, 1.001-1.038) and 1.011 (95% confidence interval, 0.989-1.033), respectively. On the absolute scale, using the multivariable model, a 10-fold increase in the sequence number translated into a 0.8% absolute decline in the predicted 5-year survival. CONCLUSIONS: Acceptance of a donor lung offer at a later point in the match-run was associated with measurable indicators of organ quality, but not with clinically meaningful differences in post-transplant mortality or graft failure.