Measuring Biomethane Potential of Food Scrap Waste Anaerobically Co-Digested with Waste-Activated Sludge Using Respirometry.

The use of respirometry to study the biokinetics of microbiota treating wastewater or digesting wastewater sludges has become more prevalent over the last few decades. The use of respirometry to examine the biokinetics of anaerobic microbiota co-digesting organic waste streams such as wastewater sludge and food scrap is an area of active research. To date, no visualized protocol has been published on the topic. Accordingly, in this protocol, we configured a respirometer to measure methane production and flow rate over time using three different food-to-microorganism (F:M) ratios and food scrap waste and waste-activated sludge as substrates. The resulting data, coupled with substrate utilization measurements, provides the basis for understanding how different substrate concentrations influence the rate at which anaerobic microbiota produce methane. Additionally, this protocol presents a method to develop biokinetic parameters (e.g., methane production rate constant and yield). Others can use this respirometry protocol to examine organic degradation under anaerobic conditions and develop microbial parameters.

Hospital resource use and costs among abdominal aortic aneurysm repair patients admitted to the intensive care unit.

BACKGROUND: Abdominal aortic aneurysm (AAA) repair is associated with significant morbidity and mortality. As a result, many of these patients are monitored postoperatively in the intensive care unit (ICU). However, little is known about resource utilization and costs associated with ICU admission in this population. We sought to evaluate predictors of total costs among patients admitted to the ICU after repair of nonruptured or ruptured AAA. METHODS: We retrospectively analyzed prospectively collected data (2011-2016) of ICU patients admitted after AAA repair. The primary outcome was total hospital costs. We used elastic net regression to identify pre-ICU admission predictors of hospitalization costs separately for nonruptured and ruptured AAA patients. RESULTS: We included 552 patients in the analysis. Of these, 440 (79.7%) were admitted after repair of nonruptured AAA, and 112 (20.3%) were admitted after repair of ruptured AAA. The mean age of patients with nonruptured AAA was 74 (standard deviation, 9) years, and the mean age of patients with ruptured AAA was 70 (standard deviation, 8) years. Median total hospital cost (in Canadian dollars) was $21,555 (interquartile range, $17,798-$27,294) for patients with nonruptured AAA and $33,709 (interquartile range, $23,173-$53,913) for patients with ruptured AAA. Among both nonruptured and ruptured AAA patients, increasing age, illness severity, use of endovascular repair, history of chronic obstructive pulmonary disease, and excessive blood loss (≥4000 mL) were associated with increased costs, whereas having an anesthesiologist with vascular subspecialty training was associated with lower costs. CONCLUSIONS: Patient-, procedure-, and clinician-specific variables are associated with costs in patients admitted to the ICU after repair of AAA. These factors may be considered future targets in initiatives to improve cost-effectiveness in this population.

Medical emergency teams at The Ottawa Hospital: the first two years.

PURPOSE: Medical emergency teams (MET) merge earlier-than-conventional treatment of worrisome vital signs with a skilled resuscitation response team, and may possibly reduce cardiac arrests, postoperative complications, and hospital mortality. METHODS: At the two sites of The Ottawa Hospital, MET was introduced in January 2005. We reviewed call diagnoses, interventions, and outcomes from MET activity, and examined outcomes [cardiac arrests, intensive care unit (ICU) admissions, and readmissions] from Health Records and the ICU database. We compared the first fully operational year, 2006, with pre-MET years, 2003-4. RESULTS: In 5,741 patient encounters, the teams (nurse, respiratory therapist, and intensivist) responded to 1,931 calls over two years, predominantly for high-risk in-patients. As well, there were 3,810 follow-up visits to these patients and to recently discharged ICU patients. In 2006, there were 40.3 calls/team/1,000 hospital admissions, with 71.2% of in-patient ICU admissions preceded by MET calls. Patient illness severity scores decreased from 4.9 +/- 2.6 (mean +/- SD) before implementing MET to 2.9 +/- 2.3 (P < 0.0001) after MET interventions. Intervention on the respiratory system was performed on 72% of patients. Admission to the ICU occurred in 27% of MET patients. Compared with the pre-MET period, we observed decreases in: cardiac arrests (from 2.53 +/- 0.8 to 1.3 +/- 0.4/1,000 admissions, P < 0.001); ICU admissions from in-patient nursing units/month (42.3 +/- 7.3 to 37.6 +/- 5.1, P = 0.05); readmissions after ICU discharge/month (13.5 +/- 5.1 to 8.8 +/- 4.5, P = 0.01); and readmissions within 48 hr of ICU discharge/month (4.4 +/- 2.4 to 2.8 +/- 1.0 ICU readmissions/month, P = 0.01). CONCLUSIONS: Successful implementation of MET reduces patient morbidity and ICU resource utilization.

The influence of training with heavy rugby balls on selected spin pass variables in youth rugby union players.

The purpose of this study was to investigate the influence of training with heavy rugby balls on selected spin pass variables in youth rugby union players. Pre-training, 14 participants performed rapid spin passes (using right and left hands) at a wall-mounted target, from 7-m and 10-m distances. Horizontal (linear) and spin (longitudinal angular) velocities of the passes were recorded using a 25Hz video camera. Participants also performed right- and left-handed spin passes for maximal distance. The participants were then randomly divided into two equal groups, to train twice weekly for eight weeks, using either normal or heavy rugby balls. Each individual performed 50-90 rapid spin passes ranging from 5m to 12m with each hand per session. Following training, participants were reassessed using the same pre-training protocols. Significant changes were found pre-to-post training for both the normal ball, and heavy ball groups, for 7-m right-handed horizontal (linear) velocities (9.80+/-0.45 to 10.27+/-0.82ms(-1), and 9.42+/-1.04 to 10.19+/-1.03ms(-1), respectively; p=0.029), 10-m left-handed spin (longitudinal angular) velocities (5.13+/-1.60 to 6.08+/-1.30revss(-1), and 4.39+/-1.62 to 5.81+/-0.65revss(-1), respectively; p=0.014), right-handed maximal distance passes (19.0+/-3.6 to 20.6+/-4.0m, and 18.6+/-3.4 to 20.7+/-4.3m, respectively; p=0.001) and left-handed maximal distance passes (15.3+/-3.2 to 18.1+/-2.5m, and 15.0+/-3.0 to 17.6+/-3.7m, respectively; p<0.000). No significant changes could be attributed to training exclusively with the heavy rugby balls. The results of this investigation suggest that intense repetitive passing practice increases a small number of selected spin passing variables in youth rugby union players.

In-use efficacy of a chlorhexidine in alcohol surgical rub: a comparative study.

BACKGROUND: Although full surgical scrubs are performed prior to each case on an operating list, optimum regimens for hand cleaning have yet to be determined, and in-use efficacy evaluations are very limited. METHODS: A crossover study was undertaken comparing a chlorhexidine in detergent/alcohol regimen with povidine-iodine detergent scrub, within an orthopaedic operating environment. Depending on the skin asepsis regimen used, five surgical team members scrubbed or rubbed prior to each case for a complete operating list. Bactericidal efficacy was measured using the 'glove-juice' technique before and after hand asepsis, and at the completion of each case. RESULTS: The chlorhexidine regimen caused substantial and sustained reductions in hand bacterial counts (>50-fold prior to case 1) during surgical cases. Application of alcoholic chlorhexidine prior to each subsequent case reduced bacterial counts to the same level as the original scrub. In contrast, the povidine-iodine scrub reduced counts <3-fold prior to the first case and <2-fold in subsequent cases. The chlorhexidine regimen also resulted in persistent bactericidal effects between cases, as counts prior to application of cases 2 and higher were significantly lower than prior to case 1 (>7-fold for case 2 vs case 1). CONCLUSIONS: The chlorhexidine regimen demonstrated excellent bactericidal efficacy throughout an operating list, and was superior to povidine-iodine scrubbing in all aspects. The alcoholic chlorhexidine regimen is simpler and should have wide surgical application.

Current attitudes to total hip replacement in younger patients: a comparison of two nations.

INTRODUCTION: Orthopaedic surgeons performing total hip replacements (THR) today are faced with a vast array of options. Inspired by a recent UK study, we wanted to determine the current trend in prosthesis choice, fixation and bearing surfaces used in 'young' Australian patients, and to compare this trend to the UK. METHODS: A questionnaire identical to that used in the UK study was posted to all current members of the Australian Orthopaedic Association and returned questionnaires were directly compared to the UK results on a percentage-of-responses basis. RESULTS: Two hundred and forty-six valid responses were received. The number of THR reported to be performed by these respondents (15 789) was equivalent to the estimated number of prostheses sold here during the same period (15 624). The UK results showed a predominant use of Charnley and Exeter femoral prostheses, an all-polyethylene acetabular component, and cement fixation of both the acetabular and femoral components for both their older and younger patients. In younger patients, Australian surgeons favoured uncemented fixation techniques for the femur (57%vs 23%), and especially the acetabulum (85%vs 32%). There was a higher percentage use of modular design (95%vs 67%) and a very high use of ceramic as a bearing surface, 49% (vs 25%) using it for the femoral head, and 21% (vs 2%) employing a ceramic-on-ceramic bearing combination. DISCUSSION: Despite being privy to the same published papers, the THR prosthesis and fixation preferences of UK and Australian orthopaedic surgeons are markedly different. This may be because of interpretation of papers, peers, personal experience, patient assessment, budgets, institutions, theories, fashions, differences in autonomy and advertising.