Techno-economic modeling and assessment of cultivated meat: Impact of production bioreactor scale.

Increases in global meat demands cannot be sustainably met with current methods of livestock farming, which has a substantial impact on greenhouse gas emissions, land use, water consumption, and farm animal welfare. Cultivated meat is a rapidly advancing technology that produces meat products by proliferating and differentiating animal stem cells in large bioreactors, avoiding conventional live-animal farming. While many companies are working in this area, there is a lack of existing infrastructure and experience at commercial scale, resulting in many technical bottlenecks such as scale-up of cell culture and media availability and costs. In this study, we evaluate theoretical cultivated beef production facilities with the goal of envisioning an industry with multiple facilities to produce in total 100,000,000 kg of cultured beef per year or ~0.14% of the annual global beef production. Using the computer-aided process design software, SuperPro Designer®, facilities are modeled to create a comprehensive analysis to highlight improvements that can lower the cost of such a production system and allow cultivated meat products to be competitive. Three facility scenarios are presented with different sized production reactors; ~42,000 L stirred tank bioreactor (STR) with a base case cost of goods sold (COGS) of $35/kg, ~211,000 L STR with a COGS of $25/kg, and ~262,000 L airlift reactor (ALR) with a COGS of $17/kg. This study outlines how advances in scaled up bioreactors, alternative bioreactor designs, and decreased media costs are necessary for commercialization of cultured meat products.

Compensation incentives and heat exposure affect farm worker effort.

Farm workers are exposed to high risk of heat-related illness, especially when their jobs require working outside at a fast pace during hot days. Climate change has increased the number of days with high temperatures, and thereby the amount of time that farm workers are likely exposed to extreme heat. To better understand how high heat exposure affects farm workers, this study investigates how crop workers respond to heat exposure and estimates the effects of different pay and work arrangements on workers' responses to heat exposure. We explore, specifically, whether piece-rate arrangements increase workers' effort during periods with high heat exposure compared to workers paid by hourly wages. We use observational data from detailed measurements of localized heat exposure and individual workers' effort in the field. First, these results show workers adjust their effort in response to heat exposure when the heat exposure level changes. Second, piece-rate arrangements increase workers' effort during work shifts. Third, piece-rate arrangements allow workers to modify their effort more easily during different heat exposure levels. When facing low levels of heat exposure, workers who were paid by piece-rate arrangements exert a higher effort than workers paid by hourly wages, up until WBGT is 26.6˚C. When facing high levels of heat exposure (with WBGT exceeding 29.6˚C), workers paid by piece-rate arrangements lower their effort compared to workers paid by hourly wage arrangements.

Costs of cannabis testing compliance: Assessing mandatory testing in the California cannabis market.

Most U.S. states that have regulated and taxed cannabis have imposed some form of mandatory safety testing requirements. In California, the country's largest and oldest legal cannabis market, mandatory testing was first enforced by state regulators in July 2018, and additional mandatory tests were introduced at the end of 2018. All cannabis must be tested and labeled as certified by a state-licensed cannabis testing laboratory before it can be legally marketed in California. Every batch that is sold by licensed retailers must be tested for more than 100 contaminants, including 66 pesticides with tolerance levels lower than the levels allowable for any other agricultural product in California. This paper estimates the costs of compliance with mandatory cannabis testing laws and regulations, using California's testing regime as a case study. We use state government data, data collected from testing laboratories, and data collected from lab equipment suppliers to run a set of Monte Carlo simulations and estimate the cost per pound of compliance with California's new cannabis testing regulations. We find that cost per pound is highly sensitive to average batch size and testing failure rates. We present results under a variety of different assumptions about batch size and failure rates. We also find that under realistic assumptions, the loss of cannabis that must be destroyed if a batch fails testing accounts for a larger share of total testing costs than does the cost of the lab tests. Using our best estimates of average batch size (8 pounds) and failure rate (4%) in the 2019 California market, we estimate testing cost at $136 per pound of dried cannabis flower, or about 10 percent of the reported average wholesale price of legal cannabis in the state. Our findings explain effects of the testing standards on the cost of supplying legal licensed cannabis, in California, other U.S. states, and foreign jurisdictions with similar testing regimes.

Effects and feasibility of a prehabilitation programme incorporating a low-carbohydrate, high-fat dietary approach in patients with type 2 diabetes: A retrospective study.

BACKGROUND AND AIMS: We performed a retrospective study of diabetic patients undergoing a targeted multimodal prehabilitation programme to assess changes in their diabetic control and functional capacity prior to surgery. As part of the programme, patients were encouraged to follow a low-carbohydrate, high-fat (LCHF) dietary approach. We aimed to assess the feasibility and effects of this programme on our cohort of patients. METHODS: From 79 patients attending prehabilitation, 17 (13 males, age (median [interquartile range]): 71 [63-79] years) had Type 2 diabetes and none had Type 1. Patients had undergone a targeted multimodal prehabilitation programme prior to surgery, which comprised supervised exercise sessions (aerobic or resistance training), nutritional education (LCHF suggestion, correct protein intake, and avoidance of processed food), psychological support and medical optimization. Weight, body mass index (BMI), glycosylated haemoglobin (HbA1c), fasting glucose, and functional capacity were measured prior to and after prehabilitation. Data were compared with a Wilcoxon signed-rank test. RESULTS: There were significant improvements in HbA1c (P = 0.000), fasting glucose (P = 0.006), weight (P = 0.002), and BMI (P = 0.002). There were no significant improvements in functional capacity. CONCLUSIONS: We have shown that in the preoperative period, a targeted multimodal prehabilitation programme incorporating a LCHF diet improves diabetes control in patients with T2D awaiting elective surgery. Our approach is novel as a LCHF diet has not previously been utilized in patients with diabetes within this context. Prospective studies are required in the context of post-operative outcomes.

A rare case of hyperammonaemic encephalopathy.

A 75-year-old female patient presented to the accident and emergency department following a collapse. She was treated for a saddle pulmonary embolism and underlying urinary tract infection. However, 48 hours later she was found to have reduced consciousness with no apparent cause (Glasgow Coma Scale of 8 out of 15). Subsequent blood results revealed a highammonia level. After reflection into her medical history, it was found that she had bladder exstrophy, which was managed with urinary diversion surgery as an infant, and her presentation was a rare complication of this operation.

Recurrence of an NSAID-induced diaphragmatic disease of the small intestine.

A 74-year-old woman was referred to the surgical team from clinic, reporting of a 1-week history of vomiting and abdominal distension on a background of previous large bowel resection for a flare up of diverticulitis with a suspicion of diaphragm disease of the small intestine diagnosed at the same time. She was initially managed conservatively owing to the likely diagnosis of adhesion(s) leading to small bowel obstruction, but a CT of the abdomen a day later revealed a recurrence of diaphragmatic disease of the small bowel causing an obstruction, most likely due to chronic non-steroidal anti-inflammatory drug use. She was taken to theatre for an emergency laparotomy and small bowel resection due to previous resections, from which she made a good recovery; she was discharged from hospital 8 days later.

Bilateral ureteric stones: an unusual cause of acute kidney injury.

A 49-year-old man presented to the accident and emergency department, with a short history of vague abdominal pain, abdominal distension and two episodes of frank haematuria. A plain chest film showed dilated loops of large bowel and blood results on admission showed an acute kidney injury (stage 3). A diagnosis of bowel obstruction was made initially but a CT scan of the abdomen showed bilateral obstructing calculi. After initial resuscitation, the patient had bilateral ultrasound-guided nephrostomies and haemofiltration. He later underwent bilateral antegrade ureteric stenting. A decision will later be made on whether or not he is fit enough to undergo ureteroscopy and laser stone fragmentation.