Hydrothermal liquefaction aqueous phase mycoremediation to increase inorganic nitrogen availability.

Hydrothermal liquefaction aqueous phase (HTL-AP) is a waste product from a thermochemical process where wet biomass is converted into biocrude oil. This nutrient-rich wastewater may be repurposed to benefit society by assisting crop growth after adequate treatment to increase inorganic nitrogen, especially NO3 -. This study aims to increase HTL-AP inorganic nitrogen, specifically NH3/NH4 + and NO3 -, through fungal remediation for further use in hydroponic systems. Trametes versicolor, a white-rot fungus known for degrading a range of organic pollutants, was used to treat a diluted (5 %) HTL-AP for 9 days. No fungal growth was observed, but T. versicolor activity was suspected by laccase activity throughout cultivation time. NO3 --N and NH3/NH4 +-N increased by 17 and 8 times after three days of fungal treatment, which was chosen as the appropriate time for HTL-AP fungal treatment as it resulted in the highest concentration of NO3 --N. The addition of nitrifying bacteria to the fungal treatment resulted in a twofold increase in NO3 --N concentration compared to the fungal treatment alone, indicating an enhancement in treatment efficacy. COD decreased by 51.33 % after 24 h, which may be related to the fungus' capacity to reduce the concentration of organics in the wastewater; nonetheless, COD increased in the following days, which may be related to the release of fungal byproducts. T. versicolor shows promise as a potential candidate for increasing inorganic nitrogen in HTL-AP. However, future studies should primarily address HTL-AP toxicity, reducing NH3/NH4 +-N while increasing NO3 --N, and hydroponics crop production after fungal treatment.

Saturated buffer design flow and performance in Illinois.

There are few peer-reviewed studies documenting saturated buffer annual nitrate (NO3 ) removal or that have assessed the federal practice standard design criteria. Drainage flow, NO3 , and dissolved reactive phosphorus (DRP) were monitored at three saturated buffers in Illinois, USA, for a combined 10 site-years. Nitrate loss reduction averaged 48 ± 19% with removals of 3.5-25.2 kg NO3 -N ha-1 annually. Median DRP concentrations at all sampling locations were at the analytical detection limit of 0.01 mg L-1 . The current design paradigm (i.e., USDA practice standard) prescribes there should be no flow bypassing the saturated buffer at flow rates that are ≤5% of the peak drainage system flow rate. The drainage coefficient-based and Manning's equation-based peak flow estimates were higher and lower, respectively, than the observed annual peaks in all years. This illustrated inherent uncertainty introduced early in the design process, which can be further compounded by dynamic in-buffer hydrology. The percentage of the observed peak flow rate at which bypass initiated ranged across an order of magnitude between sites (4.4-8.1% of peak flow rate at one site and 42-49% of peak at another) despite the buffers providing relatively similar NO3 removal. Bypass at one site (SB2) was related to the concept of "antecedent buffer capacity filled," which was defined as the 5-d average water depth in the middle control structure chamber expressed as a relative percentage of the bypass stop log height. This design flow analysis serves as a call to further evaluate predictive relationships and design models for edge-of-field practices.

Core Ideas Three saturated buffers in Illinois provided an ≈50% annual reduction in NO3 load. Observed peak flow rates differed from estimation methods used for design purposes. Two sites had relatively similar nitrate removals but different bypass trends. "Antecedent buffer capacity filled" was the water depth in the middle chamber as a percent of stop log height.

A quantitative understanding of the role of co-composted biochar in plant growth using meta-analysis.

The combined use of biochar and compost as a soil amendment presents benefits to crops and nutrient cycling. Although there are literature reviews regarding biochar and biochar-compost mixtures, a quantitative literature review on the role of co-composted biochar (hereby called COMBI) in plant productivity is currently missing. The goal of this review paper is to find evidence-based measures of the effects of application rates, soil pH, plant types, biochar feedstock, and compost materials, on plant productivity. Plant productivity covers a variety of measurements but mostly refers to grain yield and above-ground biomass. Response ratio was selected as the effect size. Funnel plot showed that the studies were reasonably symmetrically distributed around the mean effect size. Results showed that application rates of <20 t/ha and >30 t/ha significantly increased plant productivity by 48.3 and 15.7%, respectively, while no significant yield increases were found for the application rates between 20 and 30 t/ha. When data was grouped based on the soil pH, the greatest increase in plant productivity was found to be at acidic soil pH values (pH 4-5), which was expected because the liming effect of biochar is often reported as one of the main mechanisms behind the increased crop yields. When different plant species were compared, cereal grasses grown with COMBI yielded significantly higher grain yields (39.7%). Rice husk biochar yielded the highest increase in productivity but this result was based on only one study. The second highest increase was obtained with wood-based biochars (29.4%) based on ten studies. The effect sizes found with our meta-analyses are based on 14 research works worldwide and represent the most updated information regarding the effects of COMBI on plant production. As more data on COMBI become available, data analyses can be updated to make more robust comparisons.

There's a frog in my salad! A review of online media coverage for wild vertebrates found in prepackaged produce in the United States.

Prepackaged leafy green vegetables represent one of the fastest growing segments of the fresh-produce industry in the United States. Several steps in the production process have been mechanized to meet the downstream demand for prebagged lettuces. The growth in this market, however, has come with drawbacks, and chief among them are consumers finding wild animals in prepackaged crops. These incidents may signal an overburdened produce supply chain, but we currently lack the information needed to determine if this is a food-safety problem or food-quality concern. Here, we address this gap by reviewing online media coverage of wild vertebrates found in prepackaged produce items by customers in the United States. We discovered 40 independent incidents since 2003 with 95% having occurred during 2008-2018, suggesting that the frequency of incidents may have increased during the last decade. The minority of incidents included wild animals found in organic produce (27.5%), whereas the majority involved conventionally grown crops (72.5%). Most incidents involved amphibians (52.5%) and reptiles (22.5%), while fewer contained mammals (17.5%) and birds (7.5%). Frogs and toads made up all of the amphibian-related incidents, with more than 60% comprising small-bodied treefrogs found in various types of fresh leafy greens. At least seven incidents involved Pacific Treefrogs (Hyliola regilla) and three comprised Green Anoles (Anolis carolinensis). One lizard and nine frogs were found alive, and at least two frogs were released into non-native areas. This is the first review quantifying incidents of vertebrates found by customers in prepackaged produce, yet it remains unclear whether these occurrences indicate a food-safety crisis or a complaint against food quality. Nevertheless, wild animals can spread diseases to humans via contaminated produce, therefore we contend that industry professionals can reduce the potential health risk to their consumers and negative economic consequences to themselves through increased attention to this matter.

Modeling effect of cover condition and soil type on rotavirus transport in surface flow.

Runoff from animal production facilities contains various microbial pathogens which pose a health hazard to both humans and animals. Rotavirus is a frequently detected pathogen in agricultural runoff and the leading cause of death among children around the world. Diarrheal infection caused by rotavirus causes more than two million hospitalizations and death of more than 500,000 children every year. Very little information is available on the environmental factors governing rotavirus transport in surface runoff. The objective of this study is to model rotavirus transport in overland flow and to compare the model results with experimental observations. A physically based model, which incorporates the transport of infective rotavirus particles in both liquid (suspension or free-floating) and solid phase (adsorbed to soil particles), has been used in this study. Comparison of the model results with experimental results showed that the model could reproduce the recovery kinetics satisfactorily but under-predicted the virus recovery in a few cases when multiple peaks were observed during experiments. Similarly, the calibrated model had a good agreement between observed and modeled total virus recovery. The model may prove to be a promising tool for developing effective management practices for controlling microbial pathogens in surface runoff.

Effects of formulation on transport of pyrethroids in residential settings.

Washoff of 17 pyrethroid products resulting from a 1-h, 25.4-mm rainfall occurring 24 h after application was measured in indoor studies with concrete slabs. These products included different pyrethroid active ingredients and a range of formulation types. Based on this replicated study, 5 product pairs with contrasting washoff behaviors were chosen for an outdoor study using 6 full-scale house fronts in central California. Products in 4 of these pairs were applied once to different rectangular areas on the driveway (1 product in each pair to 3 house lots and the other to the remaining 3 house lots). The products in the fifth pair were applied 3 times at 2-mo intervals to vertical stucco walls above the driveway. All house lots received natural and simulated rainfall over 7 mo. Indoor studies showed differences up to 170-fold between paired products, whereas the maximum difference between paired products in the field was only 5-fold. In the pair applied to the wall, 1 product had 91 times the washoff of the other in the indoor study, whereas in the field the same product had 15% lower washoff. These results show that, although the formulation may influence washoff under actual use conditions, its influence is complex and not always as predicted by indoor experiments. Because the formulation also affects insect control, washoff research needs to be conducted together with efficacy testing.

Major transport mechanisms of pyrethroids in residential settings and effects of mitigation measures.

The major pathways for transport of pyrethroids were determined in runoff studies conducted at a full-scale test facility in central California, USA. The 6 replicate house lots were typical of front lawns and house fronts of California residential developments and consisted of stucco walls, garage doors, driveways, and residential lawn irrigation sprinkler systems. Each of the 6 lots also included a rainfall simulator to generate artificial rainfall events. Different pyrethroids were applied to 5 surfaces­driveway, garage door and adjacent walls, lawn, lawn perimeter (grass near the house walls), and house walls above grass. The volume of runoff water from each house lot was measured, sampled, and analyzed to determine the amount of pyrethroid mass lost from each surface. Applications to 3 of the house lots were made using the application practices typically used prior to recent label changes, and applications were made to the other 3 house lots according to the revised application procedures. Results from the house lots using the historic application procedures showed that losses of the compounds applied to the driveway and garage door (including the adjacent walls) were 99.75% of total measured runoff losses. The greatest losses were associated with significant rainfall events rather than lawn irrigation events. However, runoff losses were 40 times less using the revised application procedures recently specified on pyrethroid labels.

A comparison study of continuous insulin infusion protocols in the medical intensive care unit: computer-guided vs. standard column-based algorithms.

PURPOSE: To compare the safety and efficacy of continuous insulin infusion (CII) via a computer-guided and a standard paper form protocol in a medical intensive care unit (ICU). METHODS: Multicenter randomized trial of 153 ICU patients randomized to CII using the Glucommander (n = 77) or a standard paper protocol (n = 76). Both protocols used glulisine insulin and targeted blood glucose (BG) between 80 mg/dL and 120 mg/dL. RESULTS: The Glucommander resulted in a lower mean BG value (103 ± 8.8 mg/dL vs. 117 ± 16.5 mg/dL, P < 0.001) and in a shorter time to reach BG target (4.8 ± 2.8 vs.7.8 hours ± 9.1 hours, P < 0.01), and once at target resulted in a higher percentage of BG readings within target (71.0 ± 17.0% vs. 51.3 ± 19.7%, P < 0.001) than the standard protocol. Mean insulin infusion rate in the Glucommander was similar to the standard protocol (P = 0.12). The percentages of patients with ≥1 episode of BG <40 mg/dL and <60 mg/dL were 3.9% and 42.9% in the Glucommander and 5.6% and 31.9% in the standard, respectively [P = not significant (NS)]. Repeated measures analyses show that the probabilities of BG reading <40 mg/dL or <60 mg/dL were not significantly different between groups (P = 0.969, P = 0.084) after accounting for within-patient correlations with or without adjusting for time effect. There were no differences between groups in the length of hospital stay (P = 0.704), ICU stay (P = 0.145), or inhospital mortality (P = 0.561). CONCLUSION: Both treatment algorithms resulted in significant improvement in glycemic control in critically ill patients in the medical ICU. The computer-based algorithm resulted in tighter glycemic control without an increased risk of hypoglycemic events compared to the standard paper protocol.

Analysis of guidelines for basal-bolus insulin dosing: basal insulin, correction factor, and carbohydrate-to-insulin ratio.

OBJECTIVE: To analyze and compare the underlying mathematical models for basal-bolus insulin-dosing guidelines in patients with type 1 diabetes in a retrospective controlled study. METHODS: Algebraic model-development yielded several systems of models with unknown constants, including 3 systems currently in use. These systems were compared for logic and consistency. One of these systems was the accurate insulin management (AIM) system, which we developed in the setting of our large endocrine practice. Our database consisted of retrospective clinical records for a 7-month period. During this time, correction factor (CF), carbohydrate-to-insulin ratio (CIR), and basal insulin were being adjusted incrementally by titration. The variables studied were height, body weight in pounds (BWlb), CF, CIR, hemoglobin A1c (A1C), basal insulin, and 6-day mean total daily dose of insulin (TDD). The values of the variables used in the study were those determined on arrival of the patients at the office. The last 6 TDDs were entered into the database, and the mean was calculated by formulas within the database. We sorted our database into 2 groups, a well-controlled test group (n = 167; A1C 180 days, no severe hypoglycemic events since the last office visit, and C-peptide level 7% or time on pump <180 days). We obtained one office visit per patient, as follows: from the test group, we chose the visit with the lowest A1C value; from the control group, we chose one visit by use of a computer's random number generator. A significant difference was demonstrated between the correlation constants of the test group versus the control group by performing T tests between the means and F tests between the standard deviations. The least squares estimates of the correlation constants from the test group were recommended in the guidelines, in place of the means, to gain accuracy. By these methods, the guidelines used by the patients with good glycemic control are made available for all patients. RESULTS: With use of the AIM system, the TDD for continuous subcutaneous insulin infusion = 0.24 * BWlb; basal insulin = 0.47 * TDD; CF = 1,700/TDD; and CIR = 2.8 * BWlb/TDD. CONCLUSION: Three mathematical models for CIR are presented, with a rationale for supporting one of them (the AIM model). This model, together with 3 related AIM models, when provided with statistically correlated constants, constitutes the AIM system of guidelines, a consistent and convenient means of estimating insulin-dosing variables for patients with type 1 diabetes.

Use of a computerized intravenous insulin algorithm within a nurse-directed protocol for patients undergoing cardiovascular surgery.

BACKGROUND: Several studies have shown the benefits of tight glycemic control in the intensive care unit. A large hospital became concerned about certain deficiencies in the management of glucose control in conjunction with cardiovascular surgery. A multidisciplinary steering committee was formed, which implemented a glycemic protocol, the subject of this study. METHODS: The glycemic protocol is a perioperative, nurse-directed program that incorporates the computerized intravenous (IV) insulin algorithm, Glucommander. Upon admission, hemoglobin A1c and blood glucose (BG) were tested, and patients were screened for previously diagnosed diabetes. This information was used to determine if preoperative insulin will be used, if the patient will be transitioned post-IV to subcutaneous (SC) basal-bolus insulin, and if insulin will be prescribed on discharge. IV insulin was initiated perioperatively in known diabetes cases or if one BG value >140 mg/dl or two BG values >110 mg/dl within 24 hours before or during surgery. The target range was 90 to 120 mg/dl. RESULTS: In the 9 months after protocol implementation, 93% of the patients had no BG value >200 mg/dl during the first 48 hours postoperatively. In the 6 months of study data, there were 457 patients. The mean time to target range was 3.0 hours. The mean IV insulin run time was 37 hours. The mean BG value was 107 mg/dl. Only 2% of patients had transient BG <50 mg/dl, and no BG values were <40 mg/dl. Of the patients, 52% were transitioned to SC basal-bolus, and 26% were discharged on insulin. CONCLUSIONS: The Glucommander earned high respect from the nurses for the way it scheduled BG tests and eliminated the calculation time and calculation errors associated with manual methods. The protocol was highly effective in normalizing glucose without hypoglycemia. The multidisciplinary steering committee proved to be a good approach to implementing a glycemic protocol.

Working to improve care of hospital hyperglycemia through statewide collaboration: the Georgia Hospital Association Diabetes Special Interest Group.

OBJECTIVE: To review the efforts of the Georgia Hospital Association Diabetes Special Interest Group (DSIG) to develop and disseminate sample clinical guidelines on management of inpatient hyperglycemia. METHODS: Beginning in February 2003, a consortium of physicians and allied health professionals from throughout the state of Georgia began meeting on a frequent basis to formulate a plan to enhance the care of hospitalized patients with hyperglycemia. The immediate goals of the DSIG were the identification and organization of interested stakeholders, the development of consensus sample clinical guidelines, and the dissemination of information. RESULTS: Since its inception, the DSIG has accomplished the following: development of 7 consensus sample clinical guidelines, construction of a Web site that posts these clinical guidelines and other useful related information and educational materials, and sponsorship of workshops throughout the state of Georgia. CONCLUSION: As the importance of glucose control in the hospital setting has become increasingly recognized, institutions must find ways of applying results of clinical trials to "real-world" hospital environments. The DSIG is an example of a successful collaboration that could serve as a model for other state hospital organizations that wish to develop programs to enhance the care of inpatients with hyperglycemia.

A cause-and-effect-based mathematical curvilinear model that predicts the effects of self-monitoring of blood glucose frequency on hemoglobin A1c and is suitable for statistical correlations.

BACKGROUND: Previous studies have shown an association between the frequency of self-monitored blood glucose (SMBG) and hemoglobin A1c. Randomized controlled trials (RCTs) have shown this to be a causal correlation for insulin-using patients. Several studies have used linear regression, but a straight line will descend into negative hemoglobin A1c values (an impossibility). This study developed a cause-and-effect-based nonlinear model to predict the outcome of RCTs on this subject, tested this model with clinical data, and offered this model in place of linear regression, especially for the still-debated case of noninsulin-using patients. METHODS: The model was developed from cause-and-effect principles. The clinical study utilized retrospective data from patient histories of a large endocrine practice. Data sets were obtained for five treatment regimens: continuous subcutaneous insulin infusion (CSII), subcutaneous insulin (SC), no insulin (NI), oral medication (OM), and no medication (NM). OM and NM are subgroups of NI. The model was fitted to each group using nonlinear leastsquares methods. Each group was ordered by SMBG tests per day (BGpd) and was divided in half; t tests were run between the A1C's of the two halves. RESULTS: Self-monitored blood glucose readings from 1255 subjects were analyzed (CSII, N = 417; SC, N = 286; NI, N = 552; OM, N = 505; NM, N = 47). The CSII, SC, NI, and OM groups showed the expected declining statistically fitted curve and a significant association of BGpd with hemoglobin A1c (P < 0.004). The NM group showed insignificant results. CONCLUSIONS: The nonlinear model is based on cause-and-effect principles and mathematics. It yields a prediction that RCTs will be able to reveal that higher SMBG frequency causes lower hemoglobin A1c.

Improving hyperglycemia management in the intensive care unit: preliminary report of a nurse-driven quality improvement project using a redesigned insulin infusion algorithm.

PURPOSE: The purpose of this study was to assess the feasibility of a nurse-driven effort to improve hyperglycemia management in the intensive care unit (ICU) setting. METHODS: The setting was the ICU of a large urban hospital. The program was composed of 3 components: nurses as leaders, a clinical pathway to identify patients in need of hyperglycemia therapy, and implementation of a redesigned insulin infusion algorithm (the Columnar Insulin Dosing Chart). Time to reach a target glucose range of 80 to 110 mg/dL (4.4-6.1 mmol/L) was evaluated. RESULTS: One hundred sixteen ICU nurses were trained in the project. The Columnar Insulin Dosing Chart was applied to 20 patients. The average time required to reach the target blood glucose range was 12.8 hours. Below-target blood glucose levels were 6.9% of all blood glucose levels recorded, but only 0.9% were below 60 mg/dL (3.3 mmol/L). There was no sustained hypoglycemia, and no persistent clinical findings attributable to hypoglycemia were noted. Barriers to implementing the project included an increased nursing workload, the need for more finger-stick blood glucose monitors, and the need to acquire new finger-lancing devices that allowed for shallower skin puncture and increased patient comfort. CONCLUSIONS: Tighter glycemic control goals can be attained in a busy ICU by a nurse-led team using a pathway for identifying and treating hyperglycemia, clear decision support tools, and adequate nurse education. The novel chart-based insulin infusion algorithm chosen as the standard for this pilot was an effective tool for reducing the blood glucose to target range with no clinically significant hypoglycemia.

Glucommander: a computer-directed intravenous insulin system shown to be safe, simple, and effective in 120,618 h of operation.

OBJECTIVE: Intravenous insulin is now the recommended method of diabetes management in critically ill persons in the hospital. The published methods for administering the insulin are complex and are usually limited to intensive care units with a low patient-to-nurse ratio. RESEARCH DESIGN AND METHODS: A computer-directed algorithm for advice on the delivery of intravenous insulin that is flexible in blood glucose timing and advises insulin dosing in a graduated manner has been developed. This software program, known as the Glucommander, has been used extensively by our group. The data were analyzed for this study. RESULTS: The data from 5,080 intravenous insulin runs over 120,683 h show that blood glucose levels can be safely stabilized in a target range without significant hypoglycemia by nonspecialized nurses working on any unit of a general hospital. The mean glucose level reached <150 mg/dl in 3 h. Only 0.6% of all glucose values were <50 mg/dl. The prevalence of hypoglycemia <40 mg/dl was 2.6% of all runs. No hypoglycemia was severe. CONCLUSIONS: This computer-directed algorithm is a simple, safe, effective, and robust method for maintaining glycemic control. It has been extensively studied and is applicable in a wide variety of conditions. In contrast to other published intravenous insulin protocols, which have been limited to intensive care units, Glucommander can be used in all units of any hospital.

Intravenous insulin infusion therapy: indications, methods, and transition to subcutaneous insulin therapy.

OBJECTIVE: To describe indications for intravenous (IV) insulin infusion therapy and glycemic thresholds, discuss methods and protocols, and promote use of and access to IV insulin infusion therapy for all appropriate patients in the hospital setting. RESULTS: Randomized, prospectively designed trials support the use of IV insulin infusion therapy for patients in the surgical intensive-care unit, including postoperative cardiac patients and patients having myocardial infarction. Among patients in the surgical intensive-care unit, reanalysis of the data suggested no threshold at which benefit occurred above the blood glucose level of 110 mg/dL. In another study, retrospective analysis of data among critically ill medical and surgical patients suggested a target blood glucose level of 145 mg/dL or less. In other populations, the threshold or ideal target blood glucose range has not been determined. Three protocols for IV insulin infusion are described that maintain blood glucose levels safely below the upper limit of their respective target ranges without substantial risk of hypoglycemia. CONCLUSION: The threshold for initiation of IV insulin infusion is 110 mg/dL for critically ill surgical patients, 140 mg/dL for other medical or surgical patients, 180 mg/dL for patients in whom subcutaneous insulin regimens fail, and 100 mg/dL for pregnant women. The blood glucose target range is 80 to 110 mg/dL for selected critically ill surgical patients, 70 to 100 mg/dL for pregnant women, and 90 to 140 mg/dL for all other patients. Hospitals should develop procedures to make IV insulin infusion therapy available to all appropriate patients.

Insulin pump therapy in the 21st century. Strategies for successful use in adults, adolescents, and children with diabetes.

Intensive diabetes management can be achieved in adults, adolescents, and children with use of CSII. Compared with MDI, CSII has better insulin pharmacokinetics, less variability in insulin absorption, and decreased risk of hypoglycemia; it also offers patients greater flexibility in lifestyle. Careful adjustment of basal and bolus doses and close follow-up, including patient education, are vital to the success of CSII.

Diabetes management in the new millennium using insulin pump therapy.

Current goals of therapy of type 1 and 2 diabetes are to achieve near normal glycemia, minimize the risk of severe hypoglycemia, limit excessive weight gain, improve quality of life and delay or prevent late vascular complications. As discussed in this review, insulin pump or continuous subcutaneous insulin infusion (CSII) therapy provides a treatment option that can dramatically aid in achieving all of these goals. In comparison to multiple daily injections (MDI), CSII uses only rapid-acting insulin, provides greater flexibility in timing of meals and snacks, has programmable basal rates to optimize overnight glycemic control, can reduce the risk of exercise-induced hypoglycemia, and enhances patients' ability to control their own diabetes. Most important, in adults and adolescents with type 1 diabetes, CSII has been shown to lower HbA(1c) levels, reduce the frequency of severe hypoglycemia and limit excessive weight gain versus MDI without increasing the risk of diabetic ketoacidosis. Similarly positive results are being seen with CSII in adults with type 2 diabetes. The effectiveness of CSII and improvements in pump technology have fueled a dramatic increase in the use of this therapy. Practical guidelines are presented for selection of patients, initiation of treatment, patient education, follow-up assessments and troubleshooting. The recent introduction of methods for continuous glucose monitoring provides a new means to optimize the basal and bolus capabilities of CSII and offers the hope of the development of a feedback-controlled artificial pancreas.

Advantages of a Simple Treadmill Exercise Program.

Every physician knows the frustration of trying to get patients into a running program for exercise; the treadmill can be an effective alternative program.