Collection behaviour of lightweight packaging waste by individual households and implications for the analysis of collection schemes.

The separate collection behaviour of 21 Dutch households was explored. Their lightweight packaging waste (LWP) and mixed municipal solid waste (MSW) was studied twice in detail. The derived net collection yields for plastic packages and beverage cartons were high (mostly between 80 and 100%). A detailed analysis revealed that several packaging types were almost completely separate collected by these households. This observation led to the hypothesis that several packaging types will always be completely separate collected by participating civilians. Five indicator items were chosen and their concentrations in mixed MSW and LWP were used to calculate the minimal participation rate (PRmin) for collection areas. This PRmin is an underestimation of the true participation rate since the population within a collection area will also contain non-ideal separating individuals. Analysis of 15 different municipalities with this new methodology revealed that the PRmin varied strongly from roughly 30% for a municipality with a drop-off collection scheme for only plastic packaging and no PAYT financial trigger to almost 90% for municipalities with a kerbside collection scheme for LWP and a PAYT financial trigger. Surprisingly, participating civilians in all collection schemes kept roughly the same share of desired plastic packages (DPP) separate (73 ±â€¯11%) in all collection schemes. This share is derived from the PRmin and hence a slight over-estimation. The latter was named the maximum selection rate for desired plastic packages (SRmaxDPP). The PRmin and SRmaxDPP form the basis of a new set of technical performance indicators for separate collection schemes of LWP.

Effect of neonatal bacille Calmette-Guérin on the tuberculin skin test reaction in the first 2 years of life.

SETTING: Latent tuberculous infection (LTBI) is an important reservoir of disease reactivation that is sufficient to generate new cases for decades. The tuberculin skin test (TST) is an important tool to diagnose LTBI; however, neonatal bacille Calmette-Guérin (BCG) vaccination may impact interpretation of TST data. OBJECTIVES: To analyse the effect of the neonatal BCG vaccine on TST reaction in the first 2 years of life in children with no identified contact with tuberculosis (TB). DESIGN: This was a cross-sectional study in children up to 2 years of age who received neonatal BCG vaccination. In the absence of baseline comorbidities or contact with the bacillus, the children were given the TST. RESULTS: Seventy-nine children participated in the study. A decline in TST reactivity was observed in the first 12-24 months of age in patients who had been vaccinated with neonatal BCG but with no contact with TB. After the age of 10 months, no patient showed a TST reaction of >5 mm. CONCLUSION: BCG had low impact on the TST in children with no TB contact. This finding suggests the need to reassess the cut-off point to 5 mm of induration to improve TST specificity in LTBI identification.

Childhood tuberculosis in Mauritania, 2010-2015: diagnosis and outcomes in Nouakchott and the rest of the country.

Setting: The National Tuberculosis Programme, Mauritania. Objective: To compare the diagnosis and treatment outcomes of childhood tuberculosis (TB) cases (aged <15 years) registered between 2010 and 2015 inside and outside Nouakchott, the capital city. Design: This was a retrospective comparative cohort study. Results: A total of 948 children with TB were registered. The registration rate was 10 times higher in Nouakchott. The proportion of children among all TB cases was higher inside than outside Nouakchott (7.5% vs. 4.6%, P < 0.01). Under-fives represented 225 (24%) of all childhood TB cases, of whom 204 (91%) were registered in Nouakchott. Extra-pulmonary TB was more common in Nouakchott, while smear-negative TB was less common. Treatment success was similar inside and outside Nouakchott (national rate 61%). The principal unsuccessful outcomes were loss to follow-up outside Nouakchott (21% vs. 11%, P < 0.01) while transfers out were more common in the city (25% vs. 14%, P = 0.01). Being aged <5 years (OR 1.2, 95%CI 1.1-1.5) was associated with an unsuccessful outcome. Conclusion: This study indicates problems in the diagnosis and treatment of childhood TB in Mauritania, especially outside the city of Nouakchott. We suggest strengthening clinical diagnosis and management, improving communications between TB treatment centres and health services and pressing the TB world to develop more accurate and easy-to-use diagnostic tools for children.

Contexte : Programme National Tuberculose, Mauritanie.Objectif : Comparer les résultats en termes de diagnostic et de traitement des cas de tuberculose (TB) de l'enfant (<15 ans) enregistrés entre 2010 et 2015 dans la capitale, Nouakchott, et à l'extérieur de la capitale.Schéma : Une étude rétrospective comparative de cohorte.Résultats : Au total, 948 enfants atteints de TB ont été enregistrés. Le taux d'enregistrement a été 10 fois plus élevé à Nouakchott. La proportion des enfants parmi tous les cas de TB a été plus élevée à Nouakchott qu'à l'extérieur (7,5% contre 4,6% ; P < 0,01). Les enfants âgés de <5 ans ont constitué 225 cas, soit 24% de tous les cas de TB de l'enfant, dont 204 (91%) ont été enregistrés à Nouakchott. La TB extra-pulmonaire a été plus fréquente à Nouakchott, tandis que la TB à frottis négatif a été moins fréquente. Le taux de réussite du traitement a été similaire à Nouakchott et à l'extérieur (taux national de 61%). Les principaux résultats défavorables ont été les pertes de vue à l'extérieur de Nouakchott (21% vs. 11% ; P < 0,01), tandis que les transferts ont été plus fréquents dans la capitale (25% vs. 14% ; P = 0,01). L'âge inférieur à 5 ans a été associé à un résultat défavorable (OR 1,2 ; IC95% 1,1­1,5).Conclusion : Cette étude a mis en évidence les problèmes de diagnostic et de traitement de la TB de l'enfant en Mauritanie, surtout hors de Nouakchott. Nous suggérons de renforcer le diagnostic clinique et la prise en charge, d'améliorer la communication entre les centres de traitement de la TB et les services de santé et de pousser le milieu de la TB à élaborer des outils de diagnostic plus précis et faciles à utiliser pour les enfants.

Marco de referencia: El Programa Nacional contra la Tuberculosis de Mauritania.Objetivo: Comparar los diagnósticos y los desenlaces terapéuticos de los casos de TB en los niños (<15 años de edad) registrados del 2010 al 2015 en la capital Nouakchot y fuera de esta ciudad.Método: Estudio de cohortes retrospectivo comparativo.Resultados: En general, se registraron 948 niños con TB. La tasa de registro fue 10 veces más alta en Nouakchot. La proporción de niños en todos los casos de TB fue más alta en Nouakchot que fuera de la capital (7,5% contra 4,6%; P < 0,01). De todos los casos de TB en la infancia, 225 fueron niños <5 años de edad (24%), de los cuales 204 se registraron en Nouakchot (9%). La TB extrapulmonar fue más frecuente en la capital y se observó allí una menor frecuencia de casos con baciloscopia negativa. La tasa de éxito terapéutico fue equivalente en Nouakchot y fuera de la ciudad (tasa nacional 61%). Fuera de la capital, el principal desenlace desfavorable fue la pérdida durante el seguimiento (21% contra 11%; P < 0,01) y en Nouakchot fueron las transferencias a otros centros (25% contra 14%; P = 0,01). La edad <5 años se asoció con un desenlace desfavorable (cociente de posibilidades 1,2; IC95% 1,1­1,5).Conclusión: El presente estudio pone de manifiesto los problemas del diagnóstico y el tratamiento de la TB en Mauritania, sobre todo fuera de la capital Nouakchot. Se recomienda fortalecer el diagnóstico clínico y el tratamiento, con una mejor comunicación entre los centros de tratamiento de la TB y los servicios de salud y urgir en el mundo de la TB el desarrollo de medios diagnósticos dirigidos a los niños que sean más exactos y de utilización sencilla.

Fine grain separation for the production of biomass fuel from mixed municipal solid waste.

The main goal of the project MARSS (Material Advanced Sustainable Systems) is to build a demonstration plant in order to recover a renewable biomass fuel suitable for the use in biomass power plants out of mixed municipal solid waste (MMSW). The demonstration plant was constructed in Mertesdorf (Germany), working alongside an existing mechanical-biological treatment plant, where the MMSW is biological dried under aerobe conditions in rotting boxes. The focus of the presented sorting campaign was set on the processing of fine grain particles minor than 11.5mm which have the highest mass content and biogenic energy potential of the utilized grain size fractions. The objective was to produce a biomass fuel with a high calorific value and a low content of fossil (plastic, synthetic) materials while maximizing the mass recovery. Therefore, the biogenic components of the dried MMSW are separated from inert and fossil components through various classification and sifting processes. In three experimental process setups of different processing depths, the grain size fraction 4-11.5mm was sifted by the use of air sifters and air tables.

Technical assessment of processing plants as exemplified by the sorting of beverage cartons from lightweight packaging wastes.

The recovery of beverage cartons (BC) in three lightweight packaging waste processing plants (LP) was analyzed with different input materials and input masses in the area of 21-50Mg. The data was generated by gravimetric determination of the sorting products, sampling and sorting analysis. Since the particle size of beverage cartons is larger than 120mm, a modified sampling plan was implemented and targeted multiple sampling (3-11 individual samplings) and a total sample size of respectively 1200l (ca. 60kg) for the BC-products and of about 2400l (ca. 120kg) for material-heterogeneous mixed plastics (MP) and sorting residue products. The results infer that the quantification of the beverage carton yield in the process, i.e., by including all product-containing material streams, can be specified only with considerable fluctuation ranges. Consequently, the total assessment, regarding all product streams, is rather qualitative than quantitative. Irregular operation conditions as well as unfavorable sampling conditions and capacity overloads are likely causes for high confidence intervals. From the results of the current study, recommendations can basically be derived for a better sampling in LP-processing plants. Despite of the suboptimal statistical results, the results indicate very clear that the plants show definite optimisation potentials with regard to the yield of beverage cartons as well as the required product purity. Due to the test character of the sorting trials the plant parameterization was not ideal for this sorting task and consequently the results should be interpreted with care.

[Hydrocolpos and hydrometrocolpos in newborns]. / Hydrocolpos et hydrométrocolpos du nouveau-né

Hydrocolpos and the hydrometrocolpos are anomalies resulting from vaginal and uterine retention and accumulation of cervicovaginal secretions caused by congenital malformation. It is a rare pathology affecting the female newborn and infant and much less often young girls. It appears clinically as an abdominal mass associated with absence or abnormality of the vaginal opening. The diagnosis is confirmed by abdominal echography and CT scan. Treatment varies from the simple X-shaped hymenotomy for the isolated imperforate hymen to major surgery for substantial retentions and complex urogenital abnormalities. The authors report two cases of hydrocolpos and hydrometrocolpos discovered in the neonatal period. These were two newborn babies resulting from poorly followed pregnancies at which the clinical examination noted in both cases a large abdominal mass. The physical examination, imagery and surgical exploration demonstrated the existence of enormous hydrocolpos with imperforate hymen in 1 case and hydrometrocolpos with distal vaginal atresia in the second case. The treatment consisted of draining the secretions for both patients, after an X-shaped hymenotomy for the first and after section anastomosis of the vaginal atresia for the second. Both cases progressed favorably.

Risk assessment of coccidostatics during feed cross-contamination: animal and human health aspects.

Coccidiosis, an intestinal plasmodium infection, is a major infectious disease in poultry and rabbits. Eleven different coccidiostats are licensed in the EU for the prevention of coccidiosis in these animal species. According to their chemical nature and main biological activity, these compounds can be grouped as ionophoric (monensin, lasalocid sodium, salinomycin, narasin, maduramicin and semduramicin) or non-ionophoric (robenidine, decoquinate, nicarbazin, diclazuril, and halofuginone) substances. Coccidiostats are used as feed additives, mixed upon request into the compounded feed. During the technical process of commercial feed production, cross-contamination of feed batches can result in the exposure of non-target animals and induce adverse health effects in these animals due to a specific sensitivity of mammalian species as compared to poultry. Residue formation in edible tissues of non-target species may result in unexpected human exposure through the consumption of animal products. This review presents recent risk assessments performed by the Scientific Panel on Contaminants in the Food Chain (CONTAM) of the European Food Safety Authority (EFSA). The health risk to non-target species that would result from the consumption of cross-contaminated feed with coccidostats at levels of 2, 5 or 10% was found to be negligible for most animal species with the exception of salinomycin and monensin in horses because of the particular sensitivity for which toxicity may occur when cross-contamination exceeds 2% and 5% respectively. Kinetic data and tissue analyses showed that residues of coccidiostats may occur in the liver and eggs in some cases. However, the level of residues of each coccidiostat in edible animal tissues remained sufficiently low that the aggregate exposure of consumers would not exceed the established acceptable daily intake (ADI) of each coccidiostat. It could be concluded that technical cross-contamination of animal feeds would not be expected to adversely affect the health of consumers.

Antagonists of GHRH decrease production of GH and IGF-I in MXT mouse mammary cancers and inhibit tumor growth.

The involvement of IGF-I in mammary carcinogenesis is well established, but the role of GH, as an autocrine growth factor for breast cancers is poorly understood. The goal of our study was to investigate whether antagonists of GHRH can interfere with the effects of GH and IGF-I in MXT mouse mammary cancers. GHRH antagonists JV-1-36 and JV-1-38 inhibited growth of estrogen-independent MXT mouse mammary cancers in vivo, producing about 50% reduction in tumor volume (P < 0.05). This growth inhibition was associated with a decrease in cell proliferation and an increase in apoptosis in MXT cancers. RIA and RT- PCR analyses showed that the concentrations of GH and IGF-I and the levels of mRNA for GH and IGF-I in MXT tumors were reduced by the therapy with GHRH antagonists. Messenger RNA for GH receptors was also decreased. In vitro, the proliferation of MXT cancer cells was strongly stimulated by GH and less effectively by IGF-I, indicating that both GH and IGF-I may act as growth factors for this mammary carcinoma. GHRH antagonist JV-1-38 inhibited the autonomous growth of MXT cells and the proliferation induced by IGF-I or GH and diminished (3)H-thymidine-incorporation stimulated by IGF-I and GH. These findings and a sustained increase in cyclin B2 concentrations in the cells shown by immunoblotting indicate that JV-1-38 causes a block at the end of the G(2) phase of cell cycle. Our results demonstrate that GHRH antagonists decrease the local production of both GH and IGF-I in MXT mouse mammary cancers, the resulting growth inhibition being the consequence of reduced cell proliferation and increased apoptosis.

[Neonatal tetanus in Dakar. Epidemiologic, clinical and prognostic aspects (apropos of 1,159 cases, 1979-1989)]. / Le tétanos néonatal a Dakar. Aspects épidémiologiques, cliniques et pronostiques (à propos de 1,159 cas, 1979-1989).

Tetanus in general, particularly tetanus neonatorum is a great public health problem in tropical area. Our study concerned 1,159 cases admitted at the Infectious Diseases Department of Fann Hospital (Dakar, Senegal) from January 1979 to December 1989. The high frequency of tetanus neonatorum in developing countries was related to certain delivery conditions and lack of generalized antitetanus immunization. Therefore it is necessary to emphasize on health education to decrease the frequency of the disease and to improve tetanus neonatorum prognosis which mortality rate fluctuated between 60% and 90%.

[Thromboembolus of the right heart. Sonographic detection over 6 hours]. / Thromboembolus im rechten Herzen. Sonographischer Nachweis über sechs Stunden.

A 75-year old female with chronic bronchitis and cor pulmonale was admitted because of massive pulmonary thromboembolism. Echocardiography showed a 9 cm embolus in the dilated right atrium changing in form and position. It was not fixed to the wall and was prolapsing and relapsing through the tricuspid valve. The tromboembolus was visible in the right heart for a period of at least 6 h. The patient survived without operation or fibrinolytic therapy.