Designing a circular carbon and plastics economy for a sustainable future.

The linear production and consumption of plastics today is unsustainable. It creates large amounts of unnecessary and mismanaged waste, pollution and carbon dioxide emissions, undermining global climate targets and the Sustainable Development Goals. This Perspective provides an integrated technological, economic and legal view on how to deliver a circular carbon and plastics economy that minimizes carbon dioxide emissions. Different pathways that maximize recirculation of carbon (dioxide) between plastics waste and feedstocks are outlined, including mechanical, chemical and biological recycling, and those involving the use of biomass and carbon dioxide. Four future scenarios are described, only one of which achieves sufficient greenhouse gas savings in line with global climate targets. Such a bold system change requires 50% reduction in future plastic demand, complete phase-out of fossil-derived plastics, 95% recycling rates of retrievable plastics and use of renewable energy. It is hard to overstate the challenge of achieving this goal. We therefore present a roadmap outlining the scale and timing of the economic and legal interventions that could possibly support this. Assessing the service lifespan and recoverability of plastic products, along with considerations of sufficiency and smart design, can moreover provide design principles to guide future manufacturing, use and disposal of plastics.

Research and economic perspectives on an integrated biorefinery approach for the simultaneous production of polyhydroxyalkanoates and biohydrogen.

Alarming environmental impacts have been resulted across the globe due to the recovery and consumption of fossil fuels. The elevated global carbon footprint has paved the way to an alternative to combat the prevalent pollution. On the other hand, the fossil-based plastics produced from the byproducts of petroleum remain intact in the environment leading to pollution. Fossil abated bioproducts are in high demand due to the increase in pollution. This call to utilize feedstock for simultaneous production of biologically useful products through carbon capture utilisation where the leftover carbon-rich substrate is converted into usable chemicals like bioplastics, methanol, urea and various other industrially essential components. The present review extensively focuses on the research and economic perspectives of an integrated biorefinery and addresses technical breaches, bottlenecks, and efficient strategies for the simultaneous production of biohydrogen and polyhydroxyalkanoates.

Partial-film mulch returns the same gains in yield and water use efficiency as full-film mulch with reduced cost and lower pollution: a meta-analysis.

BACKGROUND: Plastic film mulch is widely used to improve crop yield and water use efficiency (WUE, yield per unit evapotranspiration) in semi-arid regions. It is commonly applied as partial-film mulch (PM: at least 50% soil cover) or full-film mulch (FM: complete soil cover). The PM has lower economic and environmental cost; hence it would be a superior technology provided it delivers similar gains in yield and WUE in relation to FM. RESULTS: To solve contradictory results from individual studies, we compared FM and PM in a meta-analysis of 100 studies with 1881 comparisons (685 for wheat; 1196 for maize). Compared with bare ground, FM and PM both increased yield of wheat (20-26%) and maize (37-52%), and WUE of wheat (16-20%) and maize (38-48%), with statistically undistinguishable differences between PM and FM. The increases in crop yield and WUE were stronger at elevation > 1000 m, with annual precipitation<400 mm, and on loess soil, especially for maize. CONCLUSIONS: We concluded that partial-film mulch could replace full-film mulch to return similar yield and WUE improvement, with reduced cost and environmental pollution. © 2021 Society of Chemical Industry.

Investigation and Feasibility of Combined 3D Printed Thermoplastic Filament and Polymeric Foam to Simulate the Cortiocancellous Interface of Human Vertebrae.

Disorders of the spine are among the most common indications for neurosurgical and orthopedic surgical interventions. Spinal fixation in the form of pedicle screw placement is a common form of instrumentation method in the lower cervical, thoracic, and lumbar spine. A vital principle to understand for the safe and accurate placement of pedicle screws is the palpable difference between the cortical and cancellous bone, both of which have different material properties and compositions. Probing and palpation of the hard cortical bone, also known as the "ventral lamina", covering the neural elements of the spinal canal during screw placement provides manual feedback to the surgeon, indicating an impending breach if continued directional force is applied. Generally, this practice is learned at the expense of patients in live operating room scenarios. Currently, there is a paucity of human vertebra simulation designs that have been validated based on the in vivo ultrastructure and physical properties of human cortical and cancellous bone. In this study, we examined the feasibility of combining three-dimensionally printed thermoplastic polymers with polymeric foam to replicate both the vertebral corticocancellous interface and surface anatomy for procedural education.

Is this your glitter? An overlooked but potentially environmentally-valuable microplastic.

As microplastic pollution evolved to a well-established research field, microplastic scientists started to explore new avenues in the field. Yet, while a multitude of different types of microplastics (microbeads, fibres, fragments) have been well-documented in microplastic literature, our analysis of this literature shows that glitter particles have been overlooked by the field. However, due to the presence of glitter-based research in forensic science, we explore the idea that glitter may have the potential to act as "flag items" - or markers - of a likely source, due to the often complex and individual composition of glitter particles compared to traditional microplastics, such as microbeads. As such, this article demonstrates glitter has insofar been overlooked as a microplastic particle, and demonstrates that glitter may have an important role in explaining microplastic pollution dynamics from source to sink.

New antireflux plastic stent for patients with distal malignant biliary obstruction.

BACKGROUND: Endoscopic biliary stenting is a well-established palliative treatment for patients with unresectable distal malignant biliary obstruction (MBO). However, the main problem with stent placement is the relatively short duration of stent patency. Although self-expanding metal stents (SEMSs) have a longer patency period than plastic stents (PSs), the higher costs limit the wide use of SEMSs. A PS with an antireflux valve is an attractive idea to prolong stent patency, but no ideal design for an antireflux PS (ARPS) has been proposed. We developed a new ARPS with a "duckbilled" valve attached to the duodenal end of the stent. AIM: To compare the patency of ARPSs with that of traditional PSs (TPSs) in patients with unresectable distal MBO. METHODS: We conducted a single-center, prospective, randomized, controlled, double-blind study. This study was conducted at the West China Hospital of Sichuan University. Consecutive patients with extrahepatic MBO were enrolled prospectively. Eligible patients were randomly assigned to receive either an ARPS or a TPS. Patients were followed by clinic visits or telephone interviews every 1-2 mo until stent exchange, death, or the final study follow-up in October 2018. The primary outcome was the duration of stent patency. Secondary outcomes included the rate of technical success, the rate of clinical success, adverse events, and patient survival. RESULTS: Between February 2016 and December 2017, 38 patients were randomly assigned to two groups, with 19 patients in each group, to receive ARPSs or TPSs. Stent insertion was technically successful in all patients. There were no significant differences between the two groups in the rates of clinical success or the rates of early or late adverse events (P = 0.660, 1.000, and 1.000, respectively). The median duration of stent patency in the ARPS group was 285 d [interquartile range (IQR), 170], which was significantly longer than that in the TPS group (median, 130 d; IQR, 90, P = 0.005). No significant difference in patient survival was noted between the two groups (P = 0.900). CONCLUSION: The new ARPS is safe and effective for the palliation of unresectable distal MBO, and has a significantly longer stent patency than a TPS.

Understanding plastics pollution: The role of economic development and technological research.

Our world is awash with plastic. The massive increase in plastics production, combined with a shift to single-use, disposable plastics and widespread mismanagement of plastic waste, has created a huge "tragedy of the commons" (Hardin, 1968) in our oceans, seas and waterways. Plastics pollution is now a global externality that damages ecosystems, curtails biodiversity and ultimately has the potential to affect everyone on the planet. Although waste output is often modelled separately from environmental pollution in research, in the case of plastics, the waste problem has become one of global pollution. In this paper, we model the relationship between mismanaged plastic waste1 and income per capita for 151 countries, and for the first time find empirical support for the environmental Kuznets curve using plastics pollution data. Further, we find support for the hypothesis that a key instrument for reducing plastics pollution is investment in scientific and technological research. The paper concludes with a discussion of the results, limitations, and implications for future research and practice.

Phthalate pollution driven by the industrial plastics market: a case study of the plastic market in Yuyao City, China.

In attempts to evaluate the environmental risk produced by plastic markets, the levels and congener profiles of phthalate esters (PAEs) in soil, vegetable, and sediment samples collected from the plastic market in China, where numerous plastic products are exchanged every year, were investigated. The concentrations of ∑22PAEs ranged from 2131 to 27,805 ng g-1 in agricultural soils, from 8023 to 37,556 ng g-1 in vegetables and from 9031 to 87,329 ng g-1 in sediments. The predominant PAE pollutants were di-(2-ethylhexyl) phthalate (DEHP), di-n-butyl phthalate (DnBP), di-isobutyl phthalate (DiBP), and dibenzyl phthalate (DBzP). The mean percentages of the predominant PAEs in the soil, vegetable, and sediment samples accounted for 98.4%, 97.3%, and 99.5% of the total PAEs, respectively. The concentrations of PAEs at the sites around the plastic market were significantly higher than those at other pollution sites, such as sites contaminated by agricultural plastic film, electronic waste (e-waste) recycling sites, and industrial parks, indicating that the plastic market was an important pollution source. The DEHP concentrations in the soils, vegetables, and sediments and the DnBP concentrations in the vegetables all exceeded the environmental risk levels (ERL) or the environmental allowable levels (EAL), indicating that the plastic market posed potential environmental risks.

Bioplastics.

The number of newly developed bioplastics has increased sharply in recent years and innovative polymer materials are increasingly present on the plastics market. Bioplastics are not, however, a completely new kind of material, but rather a rediscovered class of materials within the familiar group of materials known as plastics. Therefore, existing knowledge from the plastics sector can and should be transferred to bioplastics in order to further increase their performance, material diversity and market penetration.

Randomized pilot study to compare metal needles versus plastic cannulae in the development of complications in hemodialysis access.

BACKGROUND: Hemodialysis requires needle insertions every treatment. Needle injury (mechanical or hemodynamic) may cause complications (aneurysms/stenosis) that compromise dialysis delivery requiring interventions. Metal needles have a sharp slanted "V"-shaped cutting tip; plastic cannulae have a dull round tip and four side holes. Preliminary observations demonstrated a difference in intradialytic blood flow images and mean Doppler velocities at cannulation sites between the two devices. Complications from mechanical and hemodynamic trauma requiring interventions were compared in each group. MATERIALS AND METHODS: In all, 33 patients (13 females and 17 new accesses) were randomized to metal group (n = 17) and plastic group (n = 16). Mechanical trauma was minimized by having five nurses performing ultrasound-guided cannulations. Complications were identified by the clinician and addressed by the interventionalists, both blinded to study participation. Patients were followed for up to 12 months. RESULTS: Baseline characteristics were not significant. Procedures to treat complications along cannulation segments increased from 0.41 to 1.29 per patient (metal group) and decreased from 1.25 to 0.69 per patient (plastic group; p = 0.004). The relative risks of having an intervention (relative risk = 1.5, 95% confidence interval = 0.88-2.67) and having an infiltration during hemodialysis (relative risk = 2.26, 95% confidence interval = 1.03-4.97) were higher for metal needles. Time to first intervention trended in favor of plastic cannula (p = 0.069). Cost of supplies for these interventions was approximately CAD$20,000 lower for the plastic group. CONCLUSION: Decreased burden of illness related to cannulation (less infiltrations during hemodialysis) and Qb were associated with plastic cannulae. Decreased procedure costs were suggested during the study period in the plastic group.

Black plastics: Linear and circular economies, hazardous additives and marine pollution.

Black products constitute about 15% of the domestic plastic waste stream, of which the majority is single-use packaging and trays for food. This material is not, however, readily recycled owing to the low sensitivity of black pigments to near infrared radiation used in conventional plastic sorting facilities. Accordingly, there is mounting evidence that the demand for black plastics in consumer products is partly met by sourcing material from the plastic housings of end-of-life waste electronic and electrical equipment (WEEE). Inefficiently sorted WEEE plastic has the potential to introduce restricted and hazardous substances into the recyclate, including brominated flame retardants (BFRs), Sb, a flame retardant synergist, and the heavy metals, Cd, Cr, Hg and Pb. The current paper examines the life cycles of single-use black food packaging and black plastic WEEE in the context of current international regulations and directives and best practices for sorting, disposal and recycling. The discussion is supported by published and unpublished measurements of restricted substances (including Br as a proxy for BFRs) in food packaging, EEE plastic goods and non-EEE plastic products. Specifically, measurements confirm the linear economy of plastic food packaging and demonstrate a complex quasi-circular economy for WEEE plastic that results in significant and widespread contamination of black consumer goods ranging from thermos cups and cutlery to tool handles and grips, and from toys and games to spectacle frames and jewellery. The environmental impacts and human exposure routes arising from WEEE plastic recycling and contamination of consumer goods are described, including those associated with marine pollution. Regarding the latter, a compilation of elemental data on black plastic litter collected from beaches of southwest England reveals a similar chemical signature to that of contaminated consumer goods and blended plastic WEEE recyclate, exemplifying the pervasiveness of the problem.

Plantics-GX: a biodegradable and cost-effective thermoset plastic that is 100% plant-based.

We recount here the story of the discovery and invention of a family of thermoset resins that are fully biodegradable and plant-based. The resin is prepared by polymerising glycerol, the simplest trialcohol, with citric acid, the simplest abundantly available triacid. Mixing these two chemicals at moderate temperatures begins a multi-step esterification that results in a network-like resin foam. The hardness, brittleness, and toughness of this resin can be controlled by changing the alcohol : acid ratio, the temperature, and the presence of additives. Remarkably, this resin is fully biodegradable, breaking down to its molecular components in water. The degradation period can be varied from a few days to a few months, depending on the degree of polymerisation. We have prepared over 800 different formulations of this new material, which is now being produced on the ton scale by Plantics BV in The Netherlands under the trade names Glycix and Plantics-GX. This resin is made from inexpensive and widely available starting materials. It is 100% biobased, non-toxic and biodegradable. Thus, it has the potential to replace petro-based thermoset polymers and foams in a variety of real-life applications.

Comparison of Metal and Plastic Disposable Laryngoscope Blade with Reusable Macintosh Blade in Difficult and Inhalation Injury Airway Scenario: A Manikin Study.

BACKGROUND: Single-use plastic blades (SUPB) and single-use metal blades (SUMB) for direct laryngoscopy and tracheal intubation have not yet been compared with reusable metal blades (RUMB) in difficult airway scenarios. OBJECTIVE: The purpose of our manikin study was to compare the effectiveness of these different laryngoscope blades in a difficult airway scenario, as well as in a difficult airway scenario with simulated severe inhalation injury. METHODS: Thirty anesthetists performed tracheal intubation (TI) with each of the three laryngoscope blades in the two scenario manikins. RESULTS: In the inhalation injury scenario, SUPB were associated with prolonged intubation times when compared with the metal blades. In the inhalation injury scenario, both metal laryngoscope blades provided a quicker, easier, and safer TI. In the difficult airway scenario, intubation times were significantly prolonged in the SUPB group in comparison to the RUMB group, but there were no significant differences between the SUPB and the SUMB. In this scenario, the RUMB demonstrated the shortest intubation times and seems to be the most effective device. CONCLUSIONS: Generally, results are in line with previous studies showing significant disadvantages of SUPB in both manikin scenarios. Therefore, metal blades might be beneficial, especially in the airway management of patients with inhalation injury.

Bio-plastic (poly-hydroxy-alkanoate) production from municipal sewage sludge in the Netherlands: a technology push or a demand driven process?

Valorisation of components from municipal 'waste' water and sewage sludge gets more and more attention in order to come to a circular economy by developing an efficient 'waste' to value concept. On behalf of the transition team 'Grondstoffenfabriek' ('Resource factory') a preliminary research was performed for all the Dutch water boards to assess the technical and economical feasibility of poly-hydroxy-alkanoate (PHA)-production from sewage sludge, a valuable product to produce bio-plastics. This study reveals that the production of bio-plastics from sewage sludge is feasible based on technical aspects, but not yet economically interesting, even though the selling price is relatively close to the actual PHA market price. (Selling price is in this particular case the indicative cost effective selling price. The cost effective selling price covers only the total production costs of the product.) Future process optimization (maximizing the volatile fatty acids production, PHA storage capacity, etc.) and market developments are needed and will result in cost reductions of the various sub-processes. PHA-production from sewage sludge at this stage is just a technology; every further research is needed to incorporate the backward integration approach, taking into account the market demand including associated product quality aspects.

Comparison of patency and cost-effectiveness of self-expandable metal and plastic stents used for malignant biliary strictures: a Polish single-center study.

INTRODUCTION: Most patients with malignant biliary obstruction are suited only for palliation by endoscopic drainage with plastic stents (PS) or self-expandable metal stents (SEMS). OBJECTIVE: To compare the clinical outcome and costs of biliary stenting with SEMS and PS in patients with malignant biliary strictures. PATIENTS AND METHODS: A total of 114 patients with malignant jaundice who underwent 376 endoscopic retrograde biliary drainage (ERBD) were studied. RESULTS: ERBD with the placement of PS was performed in 80 patients, with one-step SEMS in 20 patients and two-step SEMS in 14 patients. Significantly fewer ERBD interventions were performed in patients with one-step SEMS than PS or the two-step SEMS technique (2.0±1.12 vs. 3.1±1.7 or 5.7±2.1, respectively, P<0.0001). The median hospitalization duration per procedure was similar for the three groups of patients. The patients' survival time was the longest in the two-step SEMS group in comparison with the one-step SEMS and PS groups (596±270 vs. 276±141 or 208±219 days, P<0.001). Overall median time to recurrent biliary obstruction was 89.3±159 days for PS and 120.6±101 days for SEMS (P=0.01). The total cost of hospitalization with ERBD was higher for two-step SEMS than for one-step SEMS or PS (1448±312, 1152±135 and 977±156&OV0556;, P<0.0001). However, the estimated annual cost of medical care for one-step SEMS was higher than that for the two-step SEMS or PS groups (4618, 4079, and 3995&OV0556;, respectively). CONCLUSION: Biliary decompression by SEMS is associated with longer patency and reduced number of auxiliary procedures; however, repeated PS insertions still remain the most cost-effective strategy.

Cost-effectiveness and clinical efficacy of biliary stents in patients undergoing neoadjuvant therapy for pancreatic adenocarcinoma in a randomized controlled trial.

BACKGROUND AND AIMS: The optimal type of stent for the palliation of malignant biliary obstruction in patients with pancreatic adenocarcinoma undergoing neoadjuvant chemoradiotherapy with curative intent is unknown. We performed a prospective trial comparing 3 types of biliary stents-fully covered self-expandable metal (fcSEMS), uncovered self-expandable metal (uSEMS), and plastic-to determine which best optimized cost-effectiveness and important clinical outcomes. METHODS: In this prospective randomized trial, consecutive patients with malignant biliary obstruction from newly diagnosed pancreatic adenocarcinoma who were to start neoadjuvant chemoradiotherapy were randomized to receive fcSEMSs, uSEMSs, or plastic stents during the index ERCP. The primary outcomes were time to stent occlusion, attempted surgical resection, or death after the initiation of neoadjuvant therapy, and the secondary outcomes were total patient costs associated with the stent, including the index ERCP cost, downstream hospitalization cost due to stent occlusion, and the cost associated with procedural adverse event. RESULTS: Fifty-four patients were randomized and reached the primary end point: 16 in the fcSEMS group, 17 in the uSEMS group, and 21 in the plastic stent group. No baseline demographic or tumor characteristic differences were noted among the groups. The fcSEMSs had a longer time to stent occlusion compared with uSEMSs and plastic stents (220 vs 74 and 76 days, P < .01), although the groups had equivalent rates of stent occlusion, attempted surgical resection, and death. Although SEMS placement cost more during the index ERCP (uSEMS = $24,874 and fcSEMS = $22,729 vs plastic = $18,701; P < .01), they resulted in higher procedural AE costs per patient (uSEMS = $5522 and fcSEMS = $12,701 vs plastic = $0; P < .01). Conversely, plastic stents resulted in an $11,458 hospitalization cost per patient due to stent occlusion compared with $2301 for uSEMSs and $0 for fcSEMSs (P < .01). CONCLUSIONS: In a prospective trial comparing fcSEMSs, uSEMSs, and plastic stents for malignant biliary obstruction in patients undergoing neoadjuvant therapy with curative intent for pancreatic adenocarcinoma, no stent type was superior in optimizing cost-effectiveness, although fcSEMSs resulted in fewer days of neoadjuvant treatment delay and a longer time to stent occlusion. (Clincial trial registration number: NCT01038713.).

Hybrid materials offer new perspectives.

Dental materials, especially in restorative dentistry, must not only be cost-effective, they must also meet many other requirements: biocompatibility, durability, excellent shade and light effects, abrasion resistance, hardness, mechanical strength under pressure, chemical resistance, surface density, ease of manufacture, and easy intraoral maintenance.