Strategies to control pH in the dark fermentation of sugarcane vinasse: Impacts on sulfate reduction, biohydrogen production and metabolite distribution.

pH is notably known as the main variable defining distinct metabolic pathways during sugarcane vinasse dark fermentation. However, different alkalinizing (e.g. sodium bicarbonate; NaHCO3) and/or neutralizing (e.g. sodium hydroxide; NaOH) approaches were never directly compared to understand the associated impacts on metabolite profiles. Three anaerobic structured-bed reactors (AnSTBR) were operated in parallel and subjected to equivalent operational parameters, except for the pH control: an acidogenic-sulfidogenic (R1; NaOH + NaHCO3) designed to remove sulfur compounds (sulfate and sulfide), a hydrogenogenic (R2; NaOH) aimed to optimize biohydrogen (bioH2) production, and a strictly fermentative system without pH adjustment (R3) to mainly evaluate lactic acid (HLa) production and other soluble metabolites. NaHCO3 dosing triggered advantages not only for sulfate reduction (up to 56%), but also to enhance the stripping of sulfide to the gas phase (75-96% of the theoretical sulfide produced) by the high and constant biogas flow resulting from the CO2 released during NaHCO3 dissociation. Meanwhile, molasses-based vinasse presented higher potential for bioH2 (up to 4545 mL-H2 L-1 d-1) and HLa (up to 4800 mg L-1) production by butyric-type and capnophilic lactic fermentation pathways. Finally, heterolactic fermentation was the main metabolic route established when no pH control was provided (R3), as indicated by the high production of both HLa (up to 4315 mg L-1) and ethanol (1987 mg L-1). Hence, one single substrate (from which one single source of inoculum was originated) offers a wide range of metabolic possibilities to be exploited, providing substantial versatility to the application of anaerobic digestion in sugarcane biorefineries.

Metal Contamination of Water and Sediments of the Vieira River, Montes Claros, Brazil.

Vieira River is the main recipient of domestic and industrial wastewater in the city of Montes Claros, MG, Brazil. Until 2010, domestic sewage was dumped in it without any kind of treatment. Concentrations of arsenic (As), chrome (Cr), copper (Cu), nickel (Ni), lead (Pb), and zinc (Zn) were determined in water and sediment samples in eight locations along the Vieira River during the dry season of 2015. Concentrations of Cu, Ni, and Zn detected in the water at some sites along the Vieira River were superior to the reference limits for toxicity. The concentration of Cu and Ni restricts the use of water for irrigation in some sites of the river. The level of sediment contamination was assessed by five approaches, including contamination factor (CF), pollution load index (PLI), geo-accumulation index (Igeo), cluster analysis (CA), and principal component analysis/factor analysis (PCA/FA). The results showed that Cr and the downstream sampling site nearest to the Wastewater Treatment Plant of the city of Montes Claros had the highest values of PLI, Igeo, and CF, which reinforces the influence of domestic and industrial wastewater discharge in pollution of the Vieira River. In addition, CA and PCA/FA reinforced the assumption that Cr comes from anthropogenic pollution sources.

Biogas from aquatic plants: A bioenergetics incentive for constructed wetlands usage.

Our study demonstrated the energy gains when using biomass from three macrophyte, used commonly in constructed wetlands for wastewater treatment, the water hyacinth, cattail, and dwarf papyrus, as a substrate for biogas generation. The biochemical methane potential for the three biomass was evaluated in batch and at bench at 37 °C. A kinetic analysis of anaerobic digestion was also conducted for these substrates, evaluating the biogas composition and energy potential. Anaerobic digestion resulted in 94.27, and 25 mLCH4/gVSsubstrate of dry mass; and 19,569.65, 5617.88, and 6068.45 kJ/t of cattail, water hyacinth, and dwarf papyrus, respectively. Biomass from water hyacinth did sustain the fastest degradation, indicating that models considering the lag phase are more adequate to evaluate the anaerobic digestion of this type of substrate. Higher digestion speed resulted in the generation of 2901.88 kJ/t more energy with biomass from water hyacinth versus cattail, highlighting its value for use in constructed wetlands.

Psychiatric comorbidities of chronic migraine in community and tertiary care clinic samples.

Although the association between episodic migraine and psychiatric comorbidities is well documented, few studies have focused on the comorbidity with chronic migraine (CM) and discrepancies exist between population-based and clinic-based data. The objective of this study is to compare demographic and psychiatric comorbidity correlates between CM samples drawn from the community and tertiary care. All inhabitants from a city borough were interviewed for the presence of headaches occurring 15 or more days per month. CM was diagnosed after subjects had been interviewed and examined by a headache doctor. Participants were also assessed with a structured interview by a psychiatrist, who assigned diagnoses based on the DSM-IV. The same investigators assessed all patients consecutively seen in a university-based outpatient headache center over a 4-month period. The samples consist of 41 individuals from the community and 43 from the headache center. Sociodemographic profiles were similar between groups with the exception of the mean number of years of formal education. Among individuals from the community, psychiatric diagnoses were present in 65.9 % of cases, relative to 83.7 % in those from the headache center (p = 0.06). Phobias (41.9 vs. 29.3 %) and depression (32.6 vs. 29.3 %) were more frequent in patients from the headache center, but this difference did not reach statistical significance. Thus the frequency of psychiatric disorders in patients with CM was elevated in both settings, being higher in the specialty care clinic.

Effect of initial pH and substrate concentration on the lactic acid production from cassava wastewater fermentation by an enriched culture of acidogenic microorganisms.

Recently, cassava processing wastewater has been considered an alternative substrate for lactic acid production due to its appreciable carbohydrate levels. The authors carried out different batch reactor trials aiming to favor the production of lactic acid through the fermentation of non-sterilized cassava wastewater by an enriched culture of acidogenic microorganisms. To this end, the impact of different initial pHs (4.5, 5.0, 5.7, 6.5, and 7.0) and different initial substrate concentrations (10, 15.8, 30, 44.2, and 50 g/L) in terms of glucose on lactic acid production yield (Y) was evaluated by applying the design of experiment (DoE) known as central composite rotatable design (CCRD). The highest rate of lactic acid production (40 g/L) occurred with an initial pH of 6.5 and an initial substrate concentration of 50 g/L. The maximum yield was higher in trials T1, T2, T4, T5, and T8, reaching values of 0.80, 0.62, 0.60, 0.96, and 0.70 g/g, respectively. The maximum lactic acid productivity (P), of 0.60 and 0.73 g L-1  hr-1 , was observed in trials T5 and T8, respectively. The enriched culture of acidogenic microorganisms was shown to favor the production of lactic acid, since the production of other acids, such as acetic and propionic acid, did not exceed 3.5 and 4.5 g/L, respectively. © 2020 Water Environment Federation PRACTITIONER POINTS: Cassava wastewater presented potential to lactic acid production. The CCRD showed that highest lactic acid concentrations (40 g/L). The adoption of cassava wastewater or manipueira as a substrate resulted in important information on the tendency to obtain value-added products such as lactic acid.

Chronic headache and comorbidities: a two-phase, population-based, cross-sectional study.

BACKGROUND: Studies using resources of a public family health program to estimate the prevalence of chronic daily headaches (CDH) are lacking. OBJECTIVES: To estimate the 1-year prevalence of CDH, as well as the presence of associated psychiatric and temporomandibular disorders (TMD) comorbidities, on the entire population of a city representative of the rural area of Brazil. METHODS: This was a cross-sectional, population-based, 2-phase study. In the first phase, health agents interviewed all individuals older than 10 years, in a rural area of Brazil. In the second stage, all individuals who reported headaches on 4 or more days per week were then evaluated by a multidisciplinary team. CDH were classified according to the second edition of the International Classification of Headache Disorders (ICHD-2). Medication overuse headache was diagnosed, as per the ICHD-2, after detoxification trials. Psychiatric comorbidities and TMD were diagnosed based on the DSM-IV and on the Research Diagnostic Criteria for Temporomandibular Disorders criteria, respectively. RESULTS: A total of 1631 subjects participated in the direct interviews. Of them, 57 (3.6%) had CDH. Chronic migraine was the most common of the CDH (21, 36.8%). Chronic tension-type headache (10, 17.5%), medication overuse headache (13, 22.8%) and probable medication overuse headache (10, 17.5%) were also common. Psychiatric disorders were observed in 38 (67.3%) of the CDH subjects. TMD were seen in 33 (58.1)% of them. CONCLUSIONS: The prevalence of CDH in the rural area of Brazil is similar to what has been reported in previous studies. A significant proportion of them have psychiatric comorbidities and/or TMD. In this sample, comorbidities were as frequent as reported in convenience samples from tertiary headache centers.

Enriched microbial consortia for dark fermentation of sugarcane vinasse towards value-added short-chain organic acids and alcohol production.

The role of sugarcane vinasse as a nutrient source and the impacts of different inoculum pretreatment methods (acid-thermal and thermal treatment) were assessed in acidogenic systems aiming to produce value-added short-chain organic acids (SCOA) and alcohols. In-depth microbiome characterization was also conducted by high-throughput sequencing of the 16S rRNA gene using the Miseq Illumina platform. SCOA production was 47.3 % higher in vinasse-fed reactors, with isobutyric (up to 10.3 g L-1) and butyric (up to 10.6 g L-1) acids as the primary metabolites most likely resulting from lactate conversion. Ethanol comprised the main product from solventogenic pathways in all conditions, with values ranging between 2.7 and 5.2 g L-1, whereas no butanol was detected. Microbial analyses revealed high relative abundance values for the Clostridium, Lactobacillus, Bacillus and Ruminococcus genera, with the predominance of the Clostridium genus (17%) in acid-thermal treatment reactors and the Lactobacillus genus (37%) in thermal treatment reactors. Overall, vinasse proved to be a suitable substrate for value-added SCOA production, which characterizes a potential management approach to this wastewater stream. In this sense, the biochemical production of butyrate from vinasse could diversify the product portfolio of sugarcane biorefineries, also minimizing bioenergy losses by converting residual carbon fractions.

Ophthalmoplegic migraine: a case with recurrent palsy of the abducens nerve.

Ophthalmoplegic migraine (OM) is a rare disorder characterized by recurrent episodes of migraine-like headaches associated with extrinsic ocular musculature palsy. In this article, we report a patient with OM that presented recurrent palsy of the abducens nerve and other atypical features. Case reports of OM with abducens nerve palsy were also reviewed.

Amyotrophic lateral sclerosis: combined nutritional, respiratory and functional assessment.

OBJECTIVE: To establish correlations between nutritional, functional and respiratory indices of patients with amyotrophic lateral sclerosis (ALS). METHOD: Twenty patients (13 appendicular-GA and 7 bulbar-GB) were included in the multidisciplinary study at the Neurological Clinic Ambulatory of the University of Campinas Hospital. RESULTS: Among the GA type significant correlation was observed between maximal inspiratory (MIP) and expiratory (MEP) pressure (r=-0.76), MEP and pulse oxymetry (r=0.58), MIP and percent weight loss (%WL; r=0.59), and between MIP, total and subscale respiratory scores (ALSFRS-R) with %WL. With regard to the GB, correlation was found between MEP and body mass index (BMI) (r=0.97). In both GA and GB correlations were noticed between the BMI and the variables mass (kg), fat (%), arm and wrist circumference (cm), and tricipital, subscapular and supra-iliac skinfolds (mm), as well as the arm muscle circumference (cm) and fatty arm muscular area (mm2). CONCLUSION: It is suggested that the application of simple anthropometric measurements could be useful in routine monitoring of patients with ALS.

Correlation between migraine subtypes and depression.

This study has evaluated depression in patients with episodic migraine (n=98), chronic migraine without medication overuse (n=23), and chronic migraine with medication overuse (n=57). The Beck Depression Inventory (BDI) was used to evaluate depressive symptoms in these three groups. The mean BDI score obtained in all patients was higher than that observed in asymptomatic subjects (episodic migraine=16.09+/-11.79, chronic migraine with medication overuse=18.91+/-12.53, chronic migraine without medication overuse=19.83+/-14.79). This finding corroborates previous studies suggesting a co-morbid association between migraine and depression. Depression did not seem to be crucial in the transformation of migraine as the median BDI scores did not differ significantly between patients with episodic and chronic migraine. The median BDI scores of the patients with chronic migraine with medication overuse and that patients with chronic migraine without medication overuse were similar as well. Therefore, medication overuse behavior may not be related with depression.

Bioavailability and dosing strategies of mineral in anaerobic mono-digestion of maize straw.

The influence of the bonding form distribution of Fe, Ni, Co and Mn and their potential bioavailability during the anaerobic degradation of maize straw was investigated. Two reactors were operated over 117 days at 37°C and different dosage strategies of mineral were studied in reactor (R2). Control reactor (R1) was metal-limited over time. mineral supplementation (1 g L-1) once a week reported the highest methane yield (257 mL g-1 VS) with 30% of increment. Ni and Co predominated in their oxidizable bonding forms and Fe mainly existed as residual and oxidizable fractions. The potential bioavailability (Mn ˃˃ Co ≈ Ni ˃ Fe) of R2 was higher comparing to R1. Metal deprivation in R1 led to depletion of both sequential extraction fractions and total metal concentrations until the end of the process. This study confirmed that the dosage strategy of mineral has a stimulatory effect on methane production from crop maize waste.

Lysine clonixinate vs naproxen sodium for the acute treatment of migraine: a double-blind, randomized, crossover study.

BACKGROUND AND OBJECTIVES: The process of inflammation is crucial in migraine, and several nonsteroidal anti-inflammatory drugs (NSAIDs) are effective in the treatment of migraine attacks. Despite their efficacy, the routine use of NSAIDs is limited by side effects as well as incomplete efficacy in some patients. Among the available options, lysine clonixinate (LC) and naproxen sodium (NS) have proved effective in migraine. The aim of this study was to compare the efficacy and tolerability of oral formulations of LC and NS in the treatment of moderate or severe migraine attacks, with a double-blind, crossover design. METHODS: Seventy subjects (62 women, 8 men) between ages 18 and 71 years (mean age, 41) with migraine according to the criteria of the International Headache Society were prospectively enrolled. The patients were randomized into 2 groups and each participant treated 2 migraine attacks. Group 1 treated the first attack with LC and the second attack with NS. Group 2 treated 2 attacks in a counterbalanced order. Doses were 250 mg of LC or 550 mg of NS, which were encapsulated for equal appearance. Headache intensity, nausea, photophobia, and side effects were evaluated at baseline, 1 hour, and 2 hours after drug administration. Rescue drugs were allowed after 2 hours for those who didn't respond, and this was also compared between groups. RESULTS: Sixty patients (54 women, 6 men) completed the study. At 1 hour, 13.6% patients who used LC were pain-free compared with 11.9% who used NS (P = .78). At 2 hours, 35.6% patients who took LC and 32.2% who took NS were pain-free (P = .69). At baseline, 52.5% of the patients randomized to group 1 reported nausea, compared with 33.9% in group 2, and both drugs eliminated nausea: At both 1 hour and 2 hours, nausea diminished significantly for those taking LC, but only after 2 hours for those who took NS (P < .0001). Both drugs eliminated photophobia at 1 hour and 2 hours; however, LC was superior to NS in reducing photophobia at 2 hours (P = .027). Ten patients who took LC and 8 who took NS required rescue drugs after 2 hours. Twelve patients who used LC and 16 who took NS reported side effects. COMMENTS: Although this study did not include a placebo arm, which impairs any definitive efficacy claims, we found LC and NS to be similarly effective and well tolerated in patients presenting moderate or severe attacks of migraine.

[Characteristics of the communication in individuals with fragile X syndrome]. / Características da comunicaço em indivíduos com a síndrome do X frágil.

The aim of this study was to make a characterization of the communication in a group with fragile X syndrome (FXS), based on normal development scale. The sample has 10 boys, between 6 and 13 years and with FXS. All of them were submitted to language evaluation. The most part of them had the communication in linguistic form (80%), until 3 years old. It was considered that the data confirmed the significant delay in the acquisition and development of the communication, being necessary an early and specialized intervention.

[The functional evaluation of dysphagia in the neonatal intensive care unit]. / Avaliação funcional da disfagia de lactentes em UTI neonatal.

BACKGROUND: The objectives of this study were: 1) to detect clinical criteria on the evaluation of dysphagy in preterm newborns; 2) to analyze the association between the functional and the videoendoscopy findings and 3) to show the relevance of the joint work of the Speech Therapist and the Otolaryngologist criteria on the evaluation of dysphagy in preterm syndromic and pathologic newborns. METHODS: The sample comprised fifteen infants born in Maternity Campinas Hospital, Campinas-SP, to whom was requested a Speech Therapist evaluation by the Neonatologist. All the infants were evaluated once by the same Speech Therapist and the Otolaryngologist. The functional evaluation of swallowing considered: a) the extra oral tactile sensibility, b) the intra oral tactile sensibility, c) the nauseous reflex and d) the buccinator movement. The evaluation of the videoendoscopy swallowing analyzed a) the sensibility in the arytenoid cartilage, b) the crying, c) the aspiration, d) desaturation and e) the penetration. The exact test of Fisher was applied for small samples and each hypothesis was tested with significance level of 0.05. RESULTS: At the end of the study, a statistically dependence relation between the variants was noticed: 1) aspiration after pharyngeal phase and penetration (high and low) and 2) extra oral sensibility on the cheeks and the sensibility on the arytenoid cartilage. CONCLUSION: This last result shows the association between a functional finding obtained by the Speech Therapist and a videoendoscopy finding achieved by the Otolaryngologist, that shows clearly the relevance of the team work among these two health professionals.

Temporo-mandibular disorders are an important comorbidity of migraine and may be clinically difficult to distinguish them from tension-type headache.

UNLABELLED: Clinical differentiation between the primary headaches and temporomandibular disorders (TMD) can be challenging. OBJECTIVES: To investigate the relationship between TMD and primary headaches by conducting face to face assessments in patients from an orofacial pain clinic and a headache tertiary center. METHOD: Sample consists of 289 individuals consecutively identified at a headache center and 78 individuals seen in an orofacial pain clinic because of symptoms suggestive of TMD. RESULTS: Migraine was diagnosed in 79.8% of headache sufferers, in headache tertiary center, and 25.6% of those in orofacial pain clinic (p<0.001). Tension-type headache was present in 20.4% and 46.1%, while the TMD painful occurred in 48.1% and 70.5% respectively (p<0.001). CONCLUSION: TMD is an important comorbidity of migraine and difficult to distinguish clinically from tension-type headache, and this headache was more frequent in the dental center than at the medical center.

Latin American consensus on guidelines for chronic migraine treatment.

Chronic migraine is a condition with significant prevalence all around the world and high socioeconomic impact, and its handling has been challenging neurologists. Developments for understanding its mechanisms and associated conditions, as well as that of new therapies, have been quick and important, a fact which has motivated the Latin American and Brazilian Headache Societies to prepare the present consensus. The treatment of chronic migraine should always be preceded by a careful diagnosis review; the detection of possible worsening factors and associated conditions; the stratification of seriousness/impossibility to treat; and monitoring establishment, with a pain diary. The present consensus deals with pharmacological and nonpharmacological forms of treatment to be used in chronic migraine.

Frequency of types of headache in the tertiary care center of the Hospital das Clínicas of the Universidade Federal de Minas Gerais, MG, Brazil.

OBJECTIVE: To assess the frequency of different diagnoses of headaches in the Headache Outpatient Clinic of the Hospital das Clínicas of the Universidade Federal de Minas Gerais (AmbCef-UFMG). METHODS: Cross sectional study with 289 patients consecutively attended to at AmbCef-UFMG. Headaches were diagnosed based on the criteria established by the International Classification of Headache Disorders (ICDH-2004). RESULTS: The average age of patients was 42.6 years, mostly women (86.9%) with less than nine years of education. Primary headaches were the most common type, with migraine found in 79.8% of cases, and tension-type headache (TTH) in 20.4%. Among the secondary types, the most common was headache caused by overuse of analgesics (16.6%), followed by less common types, such as idiopathic intracranial hypertension. Chronic daily headache (CDH) was found in 31.8% of cases. CONCLUSION: This study confirms literature data showing migraine as the most common headache in tertiary care centers. The expressive number of cases of CDH and headaches caused by overuse of analgesics indicates that, starting at the primary care level, patients should be advised to avoid the abuse of symptomatic drugs.

Effect of nutritional supplementation with milk whey proteins in amyotrophic lateral sclerosis patients.

OBJECTIVE: We evaluated the efficacy of oral supplementation with milk whey proteins and modified starch (70%WPI:30%MS), on nutritional and functional parameters of patients with ALS. METHOD: A prospective randomized double-blind study was performed with 16 ALS patients, divided in two groups, the treatment group received (70%WPI:30%MS) and the control group received (maltodextrin). They underwent prospective nutritional and functional assessment for 4 months. RESULTS: Patients in the treatment group presented weight gain, increased body mass index (BMI), increased arm muscle area and circumference, higher albumin, white blood cell and total lymphocyte counts, and reduced creatine-kinase, aspartate aminotransferase and alanine aminotransferase. In the control group, biochemical parameters did not change, but weight and BMI declined. CONCLUSION: Our results indicate that the agglomerate 70%WPI:30%MS may be useful in the nutritional therapy of patients with ALS.

Interdisciplinary evaluation of dysphagia: clinical swallowing evaluation and videoendoscopy of swallowing.

UNLABELLED: Patients with dysphagia have impairments in many aspects, and an interdisciplinary approach is fundamental to define diagnosis and treatment. A joint approach in the clinical and videoendoscopy evaluation is paramount. AIM: To study the correlation between the clinical assessment (ACD) and the videoendoscopic (VED) assessment of swallowing by classifying the degree of severity and the qualitative/descriptive analyses of the procedures. STUDY DESIGN: cross-sectional, descriptive and comparative. MATERIALS AND METHODS: held from March to December of 2006, at the Otolaryngology/Dysphagia ward of a hospital in the country side of São Paulo. 30 dysphagic patients with different disorders were assessed by ACD and VED. The data was classified by means of severity scales and qualitative/ descriptive analysis. RESULTS: the correlation between severity ACD and VED scales pointed to a statistically significant low agreement (KAPA = 0.4) (p=0,006). The correlation between the qualitative/descriptive analysis pointed to an excellent and statistically significant agreement (KAPA=0.962) (p<0.001) concerning the entire sample. CONCLUSION: the low agreement between the severity scales point to a need to perform both procedures, reinforcing VED as a doable procedure. The descriptive qualitative analysis pointed to an excellent agreement, and such data reinforces our need to understand swallowing as a process.

Avaliação da dispersão de efluente líquido de refinaria de petróleo / Evaluation of the dispersion of oil refinery liquid effluent

Neste trabalho são apresentadas duas técnicas para a avaliação da dispersão, num corpo d'água receptor, do efluente líquido de uma refinaria de petróleo. Assim, a pluma de dispersão foi caracterizada por medidas em campo de condutividade elétrica e por simulação computacional (simulador Cormix). Como caso de estudo, escolheu-se uma refinaria de petróleo cujo efluente é lançado no rio Atibaia (Paulínia/SP). O comportamento do efluente foi avaliado em um trecho de 1000 m após o ponto de lançamento. Os resultados demonstraram que a medição da condutividade elétrica é uma técnica adequada para a avaliação da dispersão de efluentes líquidos de refinaria de petróleo, pois apresentam alta condutividade elétrica e, com isso, há um forte contraste entre os valores do efluente e do rio. Além disso, outros parâmetros de qualidade da água do rio seguiram comportamento de dispersão semelhante ao da condutividade. A pluma de dispersão gerada pelo simulador computacional apresentou uma elevada concordância com os dados obtidos em campo. Nesse sentido, a simulação computacional pode ser uma ferramenta útil para a avaliação da dispersão do efluente considerando-se cenários hipotéticos, e para projetos de emissários.

In this paper, two techniques to evaluate the dispersion of the effluent of an oil refinery are presented. Thus, the dispersion plume was characterized by field measurements of electrical conductivity and by computational simulation (Cormix simulator). An oil refinery whose effluent is discharged on the Atibaia river (Paulínia/SP) is taken as study case. The behavior of the effluent was evaluated until 1000 m after the discharge. The results show that the measurement of electrical conductivity is a suitable technique to evaluate the dispersion of oil refinery wastewaters, since they have high conductivity and for this reason there is a strong contrast between the values of the wastewater and the ambient background. Furthermore, other water quality parameters had a dispersion behavior similar to that shown by the conductivity. The dispersion plume generated by the computational simulator showed high concordance with the field data. In this manner, computational simulation can be a useful tool to evaluate the dispersion of discharges considering hypothetic scenarios, as well as to design the discharge channel.