A perspective on the role of uncertainty in sustainability science and engineering.

The Trans-Atlantic Research and Development Interchange on Sustainability Workshop (TARDIS) is a meeting on scientific topics related to sustainability. The 2019 workshop theme was "On the Role of Uncertainty in Managing the Earth for Global Sustainability." This paper presents the perspectives on this topic derived from talks and discussions at the 2019 TARDIS workshop. There are four kinds of uncertainties encountered in sustainability ranging from clear enough futures to true surprises. The current state-of-the-art in assessing and mitigating these uncertainties is discussed.

Life cycle assessment of sludge management with phosphorus utilisation and improved hygienisation in Sweden.

To provide input to sewage sludge management strategies that address expected new regulations in terms of hygienisation and phosphorus recovery in Sweden, an environmental life cycle assessment (LCA) was made. The LCA identified environmental hot spots for methods that may permit sludge or phosphorus from sludge to be applied on agricultural land. In particular, thermophilic digestion, pasteurisation, thermal hydrolysis, urea treatment and mono-incineration with phosphorus recovery were compared. In addition, a sludge management system involving drying of sludge before use in forestry was investigated. The results showed that some major impacts are related to large uncertainties, such as those related to emissions from sludge storage. It also showed that large gains can be achieved when products from the systems replace other products, in particular when biogas is used to replace natural gas in vehicles, but also when sludge is used in agriculture and forestry. In general, there are small differences between the sludge management methods. Retaining the sludge matrix to allow for its utilisation in agriculture may conflict with keeping emissions to air and water from the sludge matrix low. It is recommended that any sludge management option minimises emissions from sludge to air and water and that resources are recovered and used, in line with the principles of a circular economy.

Signs of myocardial ischaemia after injection of oxytocin: a randomized double-blind comparison of oxytocin and methylergometrine during Caesarean section.

BACKGROUND: ECG changes, similar to those seen during myocardial ischaemia, together with symptoms of chest pain, are common during Caesarean section (CS). We hypothesized that oxytocin administration has cardiovascular effects leading to these symptoms and ECG changes. METHODS: Forty women undergoing elective CS under spinal anaesthesia were given an i.v. bolus of either 10 IU of oxytocin (Group OXY-CS, n=20) or 0.2 mg of methylergometrine (Group MET-CS, n=20), in a double-blind, randomized fashion after delivery. Ten healthy, non-pregnant, non-anaesthetized women were used as normal controls (Group OXY-NC, n=10) and were given 10 IU of oxytocin i.v. Twelve-lead ECG, on-line, computerized vectorcardiography (VCG), and invasive arterial pressure were recorded. RESULTS: Oxytocin produced a significant increase in heart rate, +28 (SD 4) and +52 (3) beats min(-1) [mean (SEM); P<0.001], decreases in mean arterial pressure, -33 (2) and -30 (3) mm Hg (P<0.001), and increases in the spatial ST-change vector magnitude (STC-VM), +77 (12) and +114 (8) microV (P<0.001), in CS patients and controls, respectively. Symptoms of chest pain and subjective discomfort were simultaneously present. Methylergometrine produced mild hypertension and no significant ECG changes. CONCLUSIONS: Oxytocin administered as an i.v. bolus of 10 IU induces chest pain, transient profound tachycardia, hypotension, and concomitant signs of myocardial ischaemia according to marked ECG and STC-VM changes. The effects are related to oxytocin administration and not to pregnancy, surgical procedure, delivery, or sympathetic block from spinal anaesthesia.

Direct energy recovery from primary and secondary sludges by supercritical water oxidation.

Supercritical water oxidation (SCWO) oxidizes organic and biological materials virtually completely to benign products without the need for stack gas scrubbing. Heavy metals are recovered as stabilized solid, along with the sand and clay that is present in the feed. The technology has been under development for twenty years. The major obstacle to commercialization has been developing reactors that are not clogged by inorganic solid deposits. That problem has been solved by using tubular reactors with fluid velocities that are high enough to keep solids in suspension. Recently, system designs have been created that reduce the cost of processing sewage sludges below that of incineration. At 10 wt- % dry solids, sludge can be oxidized with virtually complete recovery of the sludge heating value as hot water or high-pressure steam. Liquid carbon dioxide of high purity can be recovered from the gaseous effluent and excess oxygen can be recovered for recycle. The net effect is to reduce the stack to a harmless vent with minimal flow rate of a clean gas. Complete simulations have been developed using physical property models that accurately simulate the thermodynamic properties of sub- and supercritical water in mixtures with O2, N2, CO2, and organics. Capital and operating cost estimates are given for sewage sludge treatment, which are less costly than incineration. The scenario of direct recovery of energy from sludges has inherent benefits compared to other gasification or liquefaction options.

[2 cases of severe Streptococcus group A infection]. / Två fall av allvarlig grupp A-streptokockinfektion.

During recent years there have been several cases of death due to severe infection caused by GAS. Here we report two cases treated at our hospital, one of a patient presenting with preshock (case 1), the other of a patient with septic shock (case 2), in both of whom the concentrations of various coagulation factors and platelet counts were low. Other clinical findings common to both cases were scarlet coloured maculopapular exanthema, relative bradycardia, excessive tendency to develop oedema, and impaired function both in the lungs, kidneys and brain; and both patients were devoid of antibodies against the most predominant toxins (B and C) of the GAS strains isolated. Initial treatment comprised extensive administration of fluids, antibiotics, antithrombin, and low dose hydrocortisone. Plasma exchange by continuous centrifugation (CS 3000 Travenol Baxter) was given twice in case 1 and five times in case 2. In case 2, besides human immunoglobulin with a high anti-GAS (toxins A, B and C) antibody content given at admission, the patient received respiratory support, infusion of inotropic drugs and CAVH. Both patients recovered. The risk of death is high in cases of progressive multiple organ failure during the course of septic shock; and where conventional treatment combinations fail to remedy the condition, adjuvant treatment components may prove successful.