Terminal Complement Pathway Deficiency in an Adult Patient with Meningococcal Sepsis.

The complement system is an essential part of our innate immune system. Three enzymatic activation pathways are described, all converging into a common terminal pathway which causes lysis of the target cell. Late complement deficiencies (LCDs) are typically diagnosed in children or adolescents with invasive meningococcal disease (IMD). However, IMD can also be a first manifestation in adulthood and should prompt for the evaluation of the LCD. We report the case of a young adult with IMD who was found to have a LCD, caused by a compound heterozygous mutation in C6. His vaccination status was optimized and prophylactic antibiotic treatment was initiated. By means of this case, we would like to raise awareness of underlying LCD in (young) adults presenting with IMD by N. meningitidis. Screening for complement deficiencies after IMD, followed by genetic testing, can be lifesaving and allows for genetic counselling. In addition, we discuss the diagnosis and treatment of LCD.

Combined OCT distance and FBG force sensing cannulation needle for retinal vein cannulation: in vivo animal validation.

PURPOSE: Retinal vein cannulation is an experimental procedure during which a clot-dissolving drug is injected into an obstructed retinal vein. However, due to the fragility and minute size of retinal veins, such procedure is considered too risky to perform manually. With the aid of surgical robots, key limiting factors such as: unwanted eye rotations, hand tremor and instrument immobilization can be tackled. However, local instrument anatomy distance and force estimation remain unresolved issues. A reliable, real-time local interaction estimation between instrument tip and the retina could be a solution. This paper reports on the development of a combined force and distance sensing cannulation needle, and its experimental validation during in vivo animal trials. METHODS: Two prototypes are reported, relying on force and distance measurements based on FBG and OCT A-scan fibres, respectively. Both instruments provide an 80 [Formula: see text] needle tip and have outer shaft diameters of 0.6 and 2.3 mm, respectively. RESULTS: Both prototypes were characterized and experimentally validated ex vivo. Then, paired with a previously developed surgical robot, in vivo experimental validation was performed. The first prototype successfully demonstrated the feasibility of using a combined force and distance sensing instrument in an in vivo setting. CONCLUSION: The results demonstrate the feasibility of deploying a combined sensing instrument in an in vivo setting. The performed study provides a foundation for further work on real-time local modelling of the surgical scene. This paper provides initial insights; however, additional processing remains necessary.

Potential of chopped heath biomass and spent growth media to replace wood chips as bulking agent for composting high N-containing residues.

We investigated the potential of C-rich byproducts to replace wood chips as bulking agent (BA) during composting. The impact of these alternatives on the composting process and on compost stability and characteristics was assessed. Three BA (chopped heath biomass and spent growth media used in strawberry and tomato cultivation) were used for processing leek residues in windrow composting. All BA resulted in stable composts with an organic matter (OM) content suitable for use as soil amendment. Using chopped heath biomass led to high pile temperatures and OM degradation and a nutrient-poor compost with high C/P ratio appropriate for increasing soil organic carbon content in P-rich soils. Spent substrates can replace wood chips, however, due to their dense structure and lower biodegradation potential, adding a more coarse BA is required. Generally, the nutrient content of the composts with growth media was higher than the composts with wood chips and chopped heath biomass.

Opportunities and barriers to on-farm composting and compost application: A case study from northwestern Europe.

Maintaining and increasing soil quality and fertility in a sustainable way is an important challenge for modern agriculture. The burgeoning bioeconomy is likely to put further pressure on soil resources unless they are managed carefully. Compost has the potential to be an effective soil improver because of its multiple beneficial effects on soil quality. Additionally, it fits within the bioeconomy vision because it can valorize biomass from prior biomass processing or valorize biomass unsuitable for other processes. However, compost is rarely used in intensive agriculture, especially in regions with high manure surpluses. The aim of this research is to identify the barriers to on-farm composting and the application of compost in agriculture, using a mixed method approach for the case of Flanders. The significance of the 28 identified barriers is analyzed and they are categorized as market and financial, policy and institutional, scientific and technological and informational and behavioral barriers. More specifically, the shortage of woody biomass, strict regulation, considerable financial and time investment, and lack of experience and knowledge are hindering on-farm composting. The complex regulation, manure surplus, variable availability and transport of compost, and variable compost quality and composition are barriers to apply compost. In conclusion, five recommendations are suggested that could alleviate certain hindering factors and thus increase attractiveness of compost use in agriculture.

Effect of composting on the Cd, Zn and Mn content and fractionation in feedstock mixtures with wood chips from a short-rotation coppice and bark.

Micronutrient content and availability in composts may be affected by the addition of wood chips or tree bark as a bulking agent in the compost feedstock. In the first part of this study, micronutrient levels were assessed in bark and wood of poplar and willow clones in a short-rotation coppice. Large differences between species were observed in bark concentrations for Cd, Zn and Mn. In the second part of the study, we aimed to determine the effect of feedstock composition and composting on Cd, Zn and Mn concentrations and availability. By means of three composting experiments we examined the effect of (a) bark of different tree species, (b) the amount of bark, and (c) the use of bark versus wood chips. In general, compost characteristics such as pH, organic matter and nutrient content varied due to differences in feedstock mixture and composting process. During the composting process, the availability of Cd, Zn and Mn decreased, although the use of willow and poplar bark or wood chips resulted in elevated total Cd, Zn or Mn concentrations in the compost. Cd concentrations in some composts even exceeded legal criteria. Cd and Zn were mainly bound in the reducible fraction extracted with 0.5M NH2OH⋅HCl. A higher acid-extractable fraction for Mn than for Cd and Zn was found. Higher Cd concentrations in the compost due to the use of bark or wood chips did not result in higher risk of Cd leaching. The results of the pH-stat experiment with gradual acidification of composts illustrated that only a strong pH decline in the compost results in higher availability of Cd, Zn and Mn.