Survival following acute type A aortic dissection: a multicenter study.

Background: While surgery is almost always indicated for acute type A aortic dissections (ATAADs), the extent of surgery is often debated, with some surgeons preferring a conservative option and others preferring a more radical option This study aims to assess the outcome after surgery for ATAAD and the prognostic impact of surgical strategy (with vs. without aortic arch replacement). Methods: Data was gathered between 1 January 2005 and 31 December 2021 and retrospectively analyzed with multivariable logistic and Cox regression to ascertain risk factors and survival respectively. Results: A total of 601 patients underwent type A aortic dissection repair across the recruiting centers with an operative mortality of 24.3% (146 patients) which was considerably linked with the clinical condition at presentation. In-hospital mortality was 23.1% for ascending and root replacement alone vs. 28.7% for arch involvement. Overall survival was 73.3% after the first year, 68.2% at 5 years, and 53.5% at 10 years. The median follow-up period was 2.5 years [interquartile range (IQR), 6.6 years]. Aortic arch replacements were more often carried out in younger patients and those without adverse clinical conditions, although outcomes for patients who underwent either surgical option were comparable throughout apart from a higher rate of cerebrovascular complications in the arch group (7.6% vs. 21.9%) (P=0.01). Conclusions: Surgery for ATAAD still confers a relatively high mortality. In our study, there was a higher stroke rate associated with patients who underwent arch replacements at the time of dissection despite them being younger. The choice of repair with or without arch replacement should be individualized to the patient and the severity of clinical status presentation.

New trends on green energy and environmental technologies, with special focus on biomass valorization, water and waste recycling: editorial of the special issue.

In this editorial piece, the Editors of the Virtual Special Issue (VSI) "New Trends on Green Energy and Environmental Technologies, with Special Focus on Biomass Valorization, Water and Waste Recycling", present summarized data corresponding to the accepted submissions, as well as additional comments regarding the thematic of the VSI. Overall, 83 manuscripts were received, with final publication of those having the highest quality, accepted after peer-reviewing. The Editors think that the result is a set of very interesting papers that increase the knowledge on the matter, and which would be useful for researchers and the whole society.

Synthesis and characterisation of acid/basic modified adsorbents. Application for chlorophenols removal.

A commercial activated carbon was modified with acid and basic reagents -an acidic one via treatment with sulphuric acid and a basic via treatment with pentaethylenehexamine- to yield adsorbents with different surface acid/base character. These modified adsorbents were characterised by elemental and immediate analysis, N2 adsorption, XPS and point zero charge measurements. The new adsorbents were tested for chlorophenols removal in water (4-chlorophenol, 3,5-dichlorophenol, 2,4,6-trichlorophenol, 2,3,4,6-tetrachlorophenol and pentachlorophenol) at different temperatures. Although the calculated process enthalpy was positive for all cases, indicating an endothermic process, the entropy was positive, resulting in a negative Gibbs free energy and spontaneous process. The adsorption capacity increases with temperature and decreases when the phenols' number of substituents increases. The modified acid-activated carbon demonstrated an exciting higher adsorbing capacity from 426.9 to 742.3 mg g-1 for 2,4,6-trichlorophenol, whereas the adsorption capacity for the basic ranged between 142.9 and 238.0 mg g-1. The Langmuir model satisfactorily fitted the adsorption equilibrium data for all chlorophenol contaminants.

BDD electrochemical oxidation of neonicotinoid pesticides in natural surface waters. Operational, kinetic and energetic aspects.

Neonicotinoids pesticides were introduced to the market in the 1990s to control various pests. Its accumulation in the environment supposes a severe problem that can affect human health. This study investigates the electrochemical degradation of four common neonicotinoid pesticides; thiamethoxam (TMX), imidacloprid (ICP), acetamiprid (ACP) and thiacloprid (TCP), in different natural surface waters by a boron-doped diamond anode (BDD). The most influencing variable was the current density (j), and to a lesser extent, the supporting electrolyte concentration (Ce). In optimal conditions (j = 34.14 mA cm-2 and Ce = 10.00 mM, using Na2SO4 as electrolyte) pesticide removals for TMX, ICP, ACP and TCP were 97.2, 96.9, 87.8 and 98.2 %, respectively. The obtained results with different support electrolytes (Na2SO4, NaCl, NaNO3 and HK2PO4) suggest that sulphate electrolyte was the optimum for TMX, ICP and ACP. However, for TCP, a total removal was achieved in less than 10 min using NaCl. It was also verified that the initial pH of the solution did not significantly influence the process in the range 3-9. All these results were rationalized in this paper. Finally, to evaluate the matrix influence, some experiments were carried out in different natural surface water matrices (river, reservoir and two different WWTP effluents). The factors influencing the process were the conductivity of the solution and the organic matter content. It was noticeable that the specific energy consumption (SEC) reduced by approximately 15 % for river water and WWTP effluent. High mineralization rates were obtained for all water matrices, with TOC removals ranging between 60 and 80 %.

Electrochemical and sonochemical advanced oxidation processes applied to tartrazine removal. Influence of operational conditions and aqueous matrix.

Tartrazine degradation was investigated by electrochemical and sonochemical oxidation processes. Anodic oxidation was carried out using boron-doped diamond (BDD) electrodes. The influence of current density and dye initial concentration on the removal of tartrazine from water was analyzed. The experimental results indicate that total removal of tartrazine was obtained, and Chemical Oxygen Demand (COD) and Total Organic Carbon (TOC) removals of up to 94.4% and 72.8% were achieved, respectively. To optimize the process, the pollutant removal percentage, the kinetic rate constant, and the TOC removal efficiency were chosen as target variables. Moreover, sonochemical oxidation experiments at a high-frequency range of cavitation (up to 1 MHz) were performed to establish the influence of three different operating variables, namely ultrasound frequency (0.5-1.1 MHz), ultrasound power (2.0-26.6 W ⋅L-1), and pulse-stop ratio (5:1-1:1). The process was also analyzed in terms of kinetics and energy costs. The kinetics resulted to be three times faster for the electrochemical process. However, the calculated energy costs were very similar, at least at long treatment times. Finally, the influence of three aqueous matrices was investigated. According to the experimental results, the natural occurrence of chloride and/or nitrate ions in water strongly conditions the rate of the process, although at least 90% of tartrazine removal was achieved within the first 50 min of treatment.

New research on reduction and/or elimination of hazardous substances in the design, manufacture and application of chemical products.

The Virtual Special Issue (VSI) "New research on reduction and/or elimination of hazardous substances in the design, manufacture and application of chemical products" was initially associated to the "International Conference on Green Chemistry and Sustainable Engineering, GreenChem-20" that was postponed due to the COVID-19 pandemic. Anyway, the international conference will take place in the near future. However, the VSI was maintained in this journal, received a high number of submissions, and selected manuscripts have been accepted after peer-reviewing. The published papers constitute a set of high-quality contributions, which, in the future, could be complemented with others related to additional conferences about similar topics. In this editorial piece, the Editors include brief comments on papers accepted for publication in the Special Issue, as well as additional aspects of interest related to the subject.

New research on water, waste and energy management, with special focus on antibiotics and priority pollutants.

The Editors of the Virtual Special Issue (VSI) "New Research on Water, Waste and Energy Management, with Special Focus on Antibiotics and Priority Pollutants" (VSI WWEM-20) here present details corresponding to papers that have been accepted, as well as further comments on the matter. It should be noted that the VSI should be associated to a Conference that had been initially programmed to be held in Rome during the summer of 2020, Unfortunately, it was postponed due to the COVID-19 pandemic. That conference was one of those within the series called "International Congress on Water, Waste and Energy Management". Although the Conference was postponed, the Call for Papers for the VSI was maintained by this journal. As a result, a set of very interesting papers were accepted after a careful peer-review process. We hope that it will be complemented with additional VSIs associated to future conferences corresponding to the series, increasing the knowledge on the topic.

Sonochemical degradation of neonicotinoid pesticides in natural surface waters. Influence of operational and environmental conditions.

Neonicotinoids sonochemical oxidation at high-frequency ultrasound (MHz range) has been carried out in ultrapure and natural surface-water matrices (river, reservoir and wastewater treatment plant effluent). To evaluate the influence of the operating variables, that is initial pollutant concentration, ultrasound frequency, ultrasound power, and pulse-stop time a Box-Behnken experimental design was planned. Optimal results were obtained using a frequency of 578 kHz, a power of 40 W L-1, with a pollutant concentration of 1 µM (for each pesticide), and using a pulse-stop time of 100 ms. The experimental data adjustment using the Langmuir-Hinshelwood heterogeneous kinetic model showed that neonicotinoids oxidation was carried out in the bubble-liquid interface by the attack of hydroxyl radicals. Experiments performed in the presence of radical scavengers, that is, methanol, ethanol and tert-butyl alcohol corroborated this reaction mechanism. The influence of some environmental conditions such as pH, presence of soluble inorganic species (Cl-, SO42-, NO3-, HPO42-, HCO3-) and soluble organic species (humic acids content) were established. Finally, the aqueous matrix's influence was investigated for three natural surface water cases, and the results were rationalized according to the main water physicochemical characteristics.

SARS-CoV-2 pandemic on the activity and professionals of a General Surgery and Digestive Surgery Service in a tertiary hospital. / Impacto de la pandemia por SARS-CoV-2 sobre la actividad y profesionales de un Servicio de Cirugía General y del Aparato Digestivo en un hospital terciario.

INTRODUCTION: The rapid spread of SARS-CoV-2 infection has led to a radical reorganization of healthcare resources. Surgical Departments need to adapt to this change. METHODS: We performed a prospective descriptive observational study of the incidence of COVID-19 in patients and surgeons of a General Surgical Department in a high prevalence area, between the 1st and 31st of March 2020. RESULTS: Patients: The incidence of SARS-CoV-2 infection in elective surgery patients was 7% (mean age 59.5 years). All survived. Of 36 patients who underwent emergency surgery, two of them were SARS-CoV-2 positive and one was clinically highly suspicious of COVID-19 (11.1%). All three patients died of respiratory failure (mean age 81 years). Surgeons: There were a total of 12 confirmed SARS-CoV-2+ cases among the surgical department staff (24.4%) (8 out of 34 consultants and 4 out of 15 residents). Healthcare activity: The average number of daily emergency surgical interventions declined from 3.6 in February to 1.16 in March. 42% of the patients who underwent emergency surgery had peritonitis upon presentation. CONCLUSIONS: The fast pace of COVID-19 pandemia should alert surgical departments of the need of adopting early measures to ensure the safety of patients and staff.

Neonicotinoids removal by associated binary, tertiary and quaternary advanced oxidation processes: Synergistic effects, kinetics and mineralization.

The degradation of four representative neonicotinoids, namely Thiamethoxam, Imidacloprid, Acetamiprid and Thiacloprid, was carried out by the sequential association of different advanced oxidation processes, including Ozonation, Electro-chemical Oxidation, Ultrasound, Ultraviolet radiation, and their different possible associations. There are no published papers in the literature on the removal of this type of insecticides through these associated oxidation processes. Single oxidation processes did not achieve total pollutants removal in less than 3 h (only UV radiation treatment obtain a total removal of Thiamethoxan in 150 min, but with mineralization below 15% TOC). For double sequential processes, Electro-oxidation-Ozone treatment obtains a total removal of Imidacloprid in 120 min and an increase of mineralization to 50% TOC. Three or four sequential processes are recommended to improve degradation and mineralization rates in a significant way, Electro-oxidation-Ozone-UV treatment obtains a total removal of Thiamethoxan in 80 min with mineralization over 75% TOC. These results confirm important synergistic effects which were quantified. The global trend indicates that Thiamethoxam is the most oxidizable neonicotinoid, whereas Acetamiprid is the most recalcitrant compound. The degradation rate of each neonicotinoid followed pseudo-first-order kinetics and the different oxidation pathways were also quantified from a kinetic point of view.

Parabens abatement from surface waters by electrochemical advanced oxidation with boron doped diamond anodes.

The removal efficiency of four commonly-used parabens by electrochemical advanced oxidation with boron-doped diamond anodes in two different aqueous matrices, namely ultrapure water and surface water from the Guadiana River, has been analyzed. Response surface methodology and a factorial, composite, central, orthogonal, and rotatable (FCCOR) statistical design of experiments have been used to optimize the process. The experimental results clearly show that the initial concentration of pollutants is the factor that influences the removal efficiency in a more remarkable manner in both aqueous matrices. As a rule, as the initial concentration of parabens increases, the removal efficiency decreases. The current density also affects the removal efficiency in a statistically significant manner in both aqueous matrices. In the water river aqueous matrix, a noticeable synergistic effect on the removal efficiency has been observed, probably due to the presence of chloride ions that increase the conductivity of the solution and contribute to the generation of strong secondary oxidant species such as chlorine or HClO/ClO -. The use of a statistical design of experiments made it possible to determine the optimal conditions necessary to achieve total removal of the four parabens in ultrapure and river water aqueous matrices.

Negative-Pressure Therapy to Reduce the Risk of Wound Infection Following Diverting Loop Ileostomy Reversal: An Initial Study.

OBJECTIVE: To evaluate if the application of a negative-pressure therapy system (Prevena Incision Management System, Kinetics Concepts Inc, [KCI] an Acelity Company, San Antonio, Texas) on ileostomy-closure surgical wounds would reduce surgical site infections (SSIs) in comparison with conventional closure and dressing. DESIGN: Prospective interventional pilot study. SETTING: La Paz University Hospital, tertiary care academic hospital in Madrid, Spain. PATIENTS: The Prevena device was applied on the wounds of 17 consecutive patients undergoing ileostomy reversal. Control subjects were 43 patients undergoing the same procedure, in which conventional dressings were used for the wound. INTERVENTION: The device was applied on the wound immediately after surgery (under sterile conditions) and maintained for 5 to 7 days. Patients were evaluated daily, and on the seventh postoperative day, the device was removed and wounds carefully inspected. Another evaluation was performed a month after the surgical intervention in the outpatient clinic. MAIN OUTCOME MEASURE: The primary end point of the study was the detection of SSI (defined according to the Centers for Disease Control and Prevention definitions). Other intervention-related complications were also registered. MAIN RESULTS: There were no significant differences in demographic variables between groups. In the control group, 9 patients (21%) presented SSI, with statistical significance (P < .038) when compared with the intervention group (0%). There were no complications associated with the application of the Prevena device. Other complications (for example, ileus or obstruction) occurred in 30% of patients. CONCLUSIONS: The negative-pressure Prevena System was safe and easy to use and may prevent SSIs in dirty wounds, such as those from ileostomy closure.

Radiological Evaluation and Endovascular Treatment of Hemoptysis.

Hemoptysis can be a life-threatening condition that warrants urgent investigation and intervention. Common causes include bronchiectasis, chronic obstructive pulmonary disease, tuberculosis, and malignancy. Computed tomography angiography is an accurate imaging modality for assessment of hemoptysis. The bronchial arteries are the source of bleeding in most cases of hemoptysis, and bronchial artery embolization is the treatment of choice. The aim of this article is to summarize the pathophysiology, causes, initial management, and diagnostic approach of hemoptysis. Endovascular treatment of hemoptysis, technique, embolic materials, outcomes, complications, and follow-up of patients are discussed.

Combined treatment of olive mill wastewater by Fenton's reagent and anaerobic biological process.

This work presents the application of Fenton's reagent process combined with anaerobic digestion to treat an olive mill wastewater (OMW). Firstly, OMW was pre-treated by chemical oxidation in a batch reactor with Fenton's reagent, using a fixed H2O2/COD ratio of 0.20, pH = 3.5 and a H2O2/Fe(2+) molar ratio of 15:1. This advanced oxidation treatment allowed reaching reductions of 17.6 and 82.5% of chemical oxygen demand (COD) and total polyphenols (TP), respectively. Secondly, OMW treatment by anaerobic digestion was performed using previously adapted microorganisms immobilized in Sepiolite. These biological tests were carried out varying the substrate concentration supplied to the reactor and COD conversions from 52 to 74% were obtained. Afterwards, Fenton's reagent followed by anaerobic digestion was applied to OMW treatment. This combined process presented a significant improvement on organic load removal, reaching COD degradations from 64 to 88%. Beyond the pollutant load removal, it was also monitored the yield of methane generated throughout anaerobic experiments. The methane produced ranged from 281 cm(3) to 322 cm(3) of CH4/g COD removed. Additionally, a methane generation kinetic study was performed using the Monod Model. The application of this model allowed observing a kinetic constant increase of the combined process (kFN = 0.036 h(-1)) when compared to the single anaerobic process (kF = 0.017 h(-1)).

Increased postoperative complications after protective ileostomy closure delay: An institutional study.

AIM: To study the morbidity and complications associated to ileostomy reversal in colorectal surgery patients, and if these are related to the time of closure. METHODS: A retrospective analysis of 93 patients, who had undergone elective ileostomy closure between 2009 and 2013 was performed. Demographic, clinical and surgical variables were reviewed for analysis. All complications were recorded, and classified according to the Clavien-Dindo Classification. Statistical univariate and multivariate analysis was performed, setting a P value of 0.05 for significance. RESULTS: The patients had a mean age of 60.3 years, 58% male. The main procedure for ileostomy creation was rectal cancer (56%), and 37% had received preoperative chemo-radiotherapy. The average delay from creation to closure of the ileostomy was 10.3 mo. Postoperative complications occurred in 40% of the patients, with 1% mortality. The most frequent were ileus (13%) and wound infection (13%). Pseudomembranous colitis appeared in 4%. Increased postoperative complications were associated with delay in ileostomy closure (P = 0.041). Male patients had more complications (P = 0.042), mainly wound infections (P = 0.007). Pseudomembranous colitis was also associated with the delay in ileostomy closure (P = 0.003). End-to-end intestinal anastomosis without resection was significantly associated with postoperative ileus (P = 0.037). CONCLUSION: Although closure of a protective ileostomy is a fairly common surgical procedure, it has a high rate of complications, and this must be taken into account when the indication is made. The delay in stoma closure can increase the rate of complications in general, and specifically wound infections and colitis.

Advanced photochemical oxidation of emergent micropollutants: carbamazepine.

The combination of UV radiation with hydrogen peroxide has been widely used for the photodegradation of pollutants in aqueous solutions. Statistical design of experiments is a powerful tool to optimize this kind of process. Initial hydrogen peroxide concentration, pH and temperature were considered as the variables for the process optimization. The interactions existing between these three variables were analyzed. Initial concentration of hydrogen peroxide proved to be the most important variable conditioning the removal efficiency, followed by temperature, and pH shows a non-significant positive influence along the whole operation interval. The ANOVA test reported significance for five of the nine involved variables. The Response Surface Methodology technique was used to optimize carbamazepine degradation. Under optimal conditions (hydrogen peroxide concentration = 0.38·10(-3) mol L(-1), pH = 1 and temperature = 35.6°C) total carbamazepine degradation was achieved.