Unlocking integrated waste biorefinery approach by predicting calorific value of waste biomass.

The current study analyzed the high heating values (HHVs) of various waste biomass materials intending to the effective management and more sustainable consumption of waste as clean energy source. Various biomass waste samples including date leaves, date branches, coconut leaves, grass, cooked macaroni, salad, fruit and vegetable peels, vegetable scraps, cooked food waste, paper waste, tea waste, and cardboard were characterized for proximate analysis. The results revealed that all the waste biomass were rich in organic matter (OM). The total OM for all waste biomass ranged from 79.39% to 98.17%. Likewise, the results showed that all the waste biomass resulted in lower ash content and high fixed carbon content associated with high fuel quality. Based on proximate analysis, various empirical equations (HHV=28.296-0.2887(A)-656.2/VM, HHV=18.297-0.4128(A)+35.8/FC and HHV=22.3418-0.1136(FC)-0.3983(A)) have been tested to predict HHVs. It was observed that the heterogeneous nature of various biomass waste considerably affects the HHVs and hence has different fuel characteristics. Similarly, the HHVs of waste biomass were also determined experimentally using the bomb calorimeter, and it was observed that among all the selected waste biomass, the highest HHVs (21.19 MJ kg-1) resulted in cooked food waste followed by cooked macaroni (20.25 MJ kg-1). The comparison revealed that experimental HHVs for the selected waste biomass were slightly deviated from the predicted HHVs. Based on HHVs, various thermochemical and biochemical technologies were critically overviewed to assess the suitability of waste biomass to energy products. It has been emphasized that valorizing waste-to-energy technologies provides the dual benefits of sustainable management and production of cleaner energy to reduce fossil fuels dependency. However, the key bottleneck in commercializing waste-to-energy systems requires proper waste collection, sorting, and continuous feedstock supply. Moreover, related stakeholders should be involved in designing and executing the decision-making process to facilitate the global recognition of waste biorefinery concept.

Tribological interaction between polytetrafluoroethylene and silicon oxide surfaces.

We investigated the tribological interaction between polytetrafluoroethylene (PTFE) and silicon oxide surfaces. A simple rig was designed to bring about a friction between the surfaces via sliding a piece of PTFE on a thermally oxidized silicon wafer specimen. A very mild inclination (~0.5°) along the sliding motion was also employed in order to monitor the tribological interaction in a gradual manner as a function of increasing contact force. Additionally, some patterns were sketched on the silicon oxide surface using the PTFE tip to investigate changes produced in the hydrophobicity of the surface, where the approximate water contact angle was 45° before the transfer. The nature of the transferred materials was characterized by X-ray photoelectron spectroscopy (XPS) and scanning electron microscopy (SEM). XPS results revealed that PTFE was faithfully transferred onto the silicon oxide surface upon even at the slightest contact and SEM images demonstrated that stable morphological changes could be imparted onto the surface. The minimum apparent contact pressure to realize the PTFE transfer is estimated as 5 kPa, much lower than reported previously. Stability of the patterns imparted towards many chemical washing processes lead us to postulate that the interaction is most likely to be chemical. Contact angle measurements, which were carried out to characterize and monitor the hydrophobicity of the silicon oxide surface, showed that upon PTFE transfer the hydrophobicity of the SiO2 surface could be significantly enhanced, which might also depend upon the pattern sketched onto the surface. Contact angle values above 100° were obtained.

Performance of anaerobic sequencing batch reactor in the treatment of pharmaceutical wastewater containing erythromycin and sulfamethoxazole mixture.

This study evaluates the joint effects of erythromycin-sulfamethoxazole (ES) combinations on anaerobic treatment efficiency and the potential for antibiotic degradation during anaerobic sequencing batch reactor operation. The experiments involved two identical anaerobic sequencing batch reactors. One reactor, as control unit, was fed with synthetic wastewater while the other reactor (ES) was fed with a synthetic substrate mixture including ES antibiotic combinations. The influence of ES antibiotic mixtures on chemical oxygen demand (COD) removal, volatile fatty acid production, antibiotic degradation, biogas production, and composition were investigated. The influent antibiotic concentration was gradually increased over 10 stages, until the metabolic collapse of the reactors, which occurred at 360 days for the ES reactor. The results suggest that substrate/COD utilization and biogas/methane generation affect performance of the anaerobic reactors at higher concentration. In addition, an average of 40% erythromycin and 37% sulfamethoxazole reduction was achieved in the ES reactor. These results indicated that these antibiotics were partly biodegradable in the anaerobic reactor system.

Inducible nitric oxide synthase (iNOS) in sinonasal polyp pathogenesis.

OBJECTIVES: We investigated the role of inducible nitric oxide synthase (iNOS) in the pathogenesis of sinonasal polyps. METHODS: Adult patients (21 men, 3 women) with nasal polyposis underwent functional endoscopic sinus surgery. Nine adults without polyps (6 men) who underwent septoplasty and/or rhinoplasty served as controls. Polyp specimens came from three regions: the maxillary sinus (10), ethmoid sinus (14), and nasal cavity (10). Control group samples (9) came from the inferior turbinate. Specimens were evaluated in eight mucosal layers for count and distribution of inflammatory cells and iNOS expression. An iNOS positivity index (PI) was determined for the epithelium (E), subepithelial layer of the lamina propria (SE), and deep paraglandular layer of the mucosa (D). RESULTS: Polymorphonuclear cell (PMNC) % values of the ethmoid and maxillary sinus and overall ethmoid sinus PI were significantly higher in the polyp group. Patients with longer polyp duration, D-perivascular (D-pv), and a higher Brinkmann index had decreased ethmoid sinus D PIs. However, in older patients and patients with longer polyp duration, perivascular PIs increased in maxillary sinus SE and D, respectively. Furthermore, as PMNC % and iNOS-PMNC PI increased, SE_glandular and epithelial_apical iNOS values decreased. In the ethmoid and maxillary sinuses, iNOS_D_. endothelial values increased but decreased in the nasal cavity. CONCLUSIONS: iNOS may play a role in sinonasal polyp pathogenesis, especially in mucosal SE and D layers. Increased vascular permeability, stromal edema, inflammatory cell migration into the stroma of the mucosa, and increased mucosal gland secretion may result in polyp formation.

Expressions of MMP2, MMP9, and TIMP-1 in the inflammatory cells of nasal polyps: granulocytes, monocytes, and mast cells.

OBJECTIVE: We investigated the role of matrix metalloproteinase-2 (MMP-2) and MMP-9 in nasal polyp (NP) pathogenesis. PATIENTS AND METHODS: In group 1 (n = 24), polyp specimens were obtained from maxillary sinus, ethmoid sinus, and nasal cavity. In group 2 without NP (control) (n = 11), inferior turbinate samples were taken. Inflammatory cell count and MMP2, MMP9 and tissue inhibitor of metalloproteinase-1 (TIMP-1), positivity indexes (PIs) were evaluated. RESULTS: Granulocyte and mast cell-MMP2 and MMP9-PI were higher than the rate of monocyte-MMP2-PI and monocyte-MMP9-PI, respectively, in the ethmoid sinus, maxillary sinus, and nasal cavity. Mast Cell-TIMP1-PI was higher than the rates of granulocyte-TIMP1-PI and monocyte-TIMP1-PI in the maxillary sinus and was higher than the rate of monocyte-TIMP1-PI in the ethmoid sinus. CONCLUSIONS: Excessive MMP2 and MMP9, compared to TIMP1, are present in granulocytes and mast cells, respectively. With matrix MMPs, the extracellular matrix is destroyed, leading inflammatory cells to pass through, causing polypoid degeneration.

Is there any correlation between chronic noise-induced hearing loss and mastoid pneumatization volume? A preliminary study.

OBJECTIVES: To investigate the possible association between chronic noise-induced hearing loss and the volume of mastoid pneumatization. METHODOLOGY: The study involved 46 subjects employed in the press and montage department of a gun factory: 28 in the study group with noise-induced hearing loss and 18 in the control group with no hearing loss. The volume of mastoid pneumatization was measured with computed tomography. Student's t test was used in the comparison of the mastoid volumes of the study and the control groups. RESULTS: The intergroup evaluations showed no significant difference between the study and control group with regards to age, use of substances or ototoxic drugs, systemic diseases, use of personal hearing protectors, duration of occupational and non-occupational noise exposure was observed (P > 0.05). The mean values of mastoid pneumatization in the study and the control groups were 9717.6 mm3 and 11005.8 mm3, respectively. Although the volume of mastoid pneumatization was smaller in the study group than in the control group, this difference was not statistically significant (P > 0.05). CONCLUSIONS: This preliminary study showed that there was no significant correlation between mastoid pneumatization volume and chronic noise-induced hearing loss. However, this correlation could be significant in further studies with a larger number of subjects.

Treatment of rhinophyma with radiofrequency: a case report.

PROBLEM: Rhinophyma is characterized by a slow progressive enlargement of the nasal skin that cannot resolve spontaneously. Clinically, the lower two-thirds of the nose becomes enlarged and hypervascular, developing a reddish-purple discoloration and a nodular appearance. It is believed that rhinophyma represents the end stage of acne rosacea. The treatment modalities are medical and surgical. CASE: This study describes a 62-year-old man with rhinophyma that was treated with a radiofrequency technique. The pathological examination was compatible with acne rosacea. After surgery, a broad-spectrum sunscreen was applied until reepithelialization was complete. CONCLUSION: We recommend the radiofrequency technique for treatment of rhinophyma.

Effects of subjective tinnitus on sleep quality and Mini Mental Status Examination scores.

OBJECTIVES: We investigated the effects of subjective tinnitus on sleep quality and Mini Mental Status Examination (MMSE) scores of participants. METHODS: The study group consisted of 15 patients, including 21 ears with tinnitus (6 bilateral, 9 unilateral). The control group consisted of 8 healthy patients with normal hearing and no tinnitus (16 ears). We assessed sleep quality using the Mini Sleep Questionnaire (MSQ) and mental health using the MMSE. RESULTS: Sleep delay (SD) was significantly higher in tinnitus patients (5.28 +/- 2.23) compared to controls (3.25 +/- 2.56) (p = 0.018). Subjective tinnitus loudness level (STLL) scores were higher and sleep quality was impaired in females, older patients, and patients with lower MMSE scores. Sleep quality was also worse in patients with longer tinnitus duration. In younger and well educated patients, MMSE scores were higher. Higher STLL scores and shorter tinnitus duration were associated with lower MMSE scores. Patients with newly developed tinnitus reported more disturbances and showed greater effects on mental and cognitive functioning. CONCLUSION: In subjective tinnitus patients, sleep delay values increased. Long tinnitus duration and high STLL scores may affects patients' cognitive functions as shown by decreased MMSE scores. Furthermore, mental status changes in tinnitus patients were frequently overlooked.

Bruck syndrome: osteogenesis imperfecta and arthrogryposis multiplex congenita.

Bruck syndrome is characterised by osteogenesis imperfecta and arthrogryposis multiplex. In some patients, mutations in the lysyl hydroxylase 2 gene (PLOD2, 3q23-q24) have been demonstrated. A male newborn with Bruck syndrome is reported.

Is there a relationship between mastoid pneumatisation and facial canal dimensions?

OBJECTIVE: To evaluate mastoid pneumatisation and facial canal dimensions. METHOD: In this retrospective study, 169 multidetector computed tomography scans of temporal bone were reviewed. Facial canal dimensions were evaluated at the labyrinthine, tympanic and mastoid segments using axial and coronal multidetector computed tomography scans of temporal bone. Mastoid pneumatisation and facial canal dehiscence were evaluated. Facial canal dehiscence was measured if it was found to be present. RESULTS: This study showed that facial canal dimensions decreased in pneumatised mastoids. Facial canal dimensions in females were smaller than in males. Facial canal dehiscence was detected in 5.9 per cent and 6.5 per cent of the patients on the right and left sides, respectively. No correlations were found between facial canal dehiscence and mastoid pneumatisation. The length of dehiscence was 1.92 ± 0.44 mm (range, 0.86-2.51 mm) on the left side. In older subjects, left facial canal dehiscence was detected more, and the length of the dehiscence increased. CONCLUSION: This study concluded that during surgery, facial canal dehiscence should be kept in mind in order to avoid complications.

Olfactory bulb volume and olfactory sulcus depth in patients with Behçet's disease.

OBJECTIVE: To investigate olfactory bulb volume and olfactory sulcus depth in patients with Behçet's disease, using magnetic resonance imaging. METHODS: Cranial magnetic resonance imaging scans of 27 adults with Behçet's disease (10 males and 17 females) and 27 healthy controls were examined. Olfactory bulb volume and olfactory sulcus depth were measured on coronal, T2-weighted, spectral pre-saturation with inversion recovery sequences. RESULTS: Bilateral olfactory bulb volume and right-sided olfactory sulcus depth were significantly lower in the Behçet's disease group than in the control group (p < 0.05). Left-sided olfactory sulcus depth increased with Behçet's disease duration. In both groups, olfactory bulb volume was significantly higher in the left than the right side. There were no gender differences for olfactory bulb volume and olfactory sulcus depth. Positive correlations were determined between right- and left-sided olfactory bulb volume values and between right- and left-sided olfactory sulcus depth values. CONCLUSION: Behçet's disease may decrease olfactory functions, related to lower olfactory bulb volume and olfactory sulcus depth. The affected vascular system and possibly damaged neural system, nasal mucosal lesions, and prolonged nasal mucociliary clearance time may cause olfactory dysfunction. Patient follow up is recommended, with magnetic resonance imaging examinations of the olfactory system if necessary.

Device-associated hospital-acquired infection rates in Turkish intensive care units. Findings of the International Nosocomial Infection Control Consortium (INICC).

We conducted a prospective study of targeted surveillance of healthcare-associated infections (HAIs) in 13 intensive care units (ICUs) from 12 Turkish hospitals, all members of the International Nosocomial Infection Control Consortium (INICC). The definitions of the US Centers for Disease Control and Prevention National Nosocomial Infections Surveillance System (NNISS) were applied. During the three-year study, 3288 patients for accumulated duration of 37 631 days acquired 1277 device-associated infections (DAI), an overall rate of 38.3% or 33.9 DAIs per 1000 ICU-days. Ventilator-associated pneumonia (VAP) (47.4% of all DAI, 26.5 cases per 1000 ventilator-days) gave the highest risk, followed by central venous catheter (CVC)-related bloodstream infections (30.4% of all DAI, 17.6 cases per 1000 catheter-days) and catheter-associated urinary tract infections (22.1% of all DAI, 8.3 cases per 1000 catheter-days). Overall 89.2% of all Staphylococcus aureus infections were caused by methicillin-resistant strains, 48.2% of the Enterobacteriaceae isolates were resistant to ceftriaxone, 52.0% to ceftazidime, and 33.2% to piperacilin-tazobactam; 51.1% of Pseudomonas aeruginosa isolates were resistant to fluoroquinolones, 50.7% to ceftazidime, 38.7% to imipenem, and 30.0% to piperacilin-tazobactam; 1.9% of Enterococcus sp. isolates were resistant to vancomycin. This is the first multi-centre study showing DAI in Turkish ICUs. DAI rates in the ICUs of Turkey are higher than reports from industrialized countries.

Comparison of propofol-remifentanil and propofol-ketamine combination for dilatation and currettage: a randomized double blind prospective trial.

OBJECTIVE: The purpose of this study was to compare the propofol-remifentanil combination and propofol-ketamine combination for Dilatation and Curettage (DC) procedure. PATIENTS AND METHODS: This prospective, double blind, and randomized study comprised 81 female patients undergoing diagnostic DC. Patients were randomly allocated to one of two groups; propofol-remifentanil (Group PR, n= 44) or propofol-ketamine (Group PK, n= 37). The level of sedation was assessed with the Ramsay Sedation Score (RSS). The patients' RSS scores were maintained at 4-5 with an additional 0.5 mg/kg bolus dose of propofol. Heart rate (HR), mean blood pressure (MBP), peripheral oxygen saturation (SpO2), and RSS were recorded. The Modify Aldrete Score (MAS) was used for postoperative recovery evaluation, and the time to reach MAS score of 10 was recorded. Total dose of propofol, procedure time, side effects, and satisfaction scores of patient and surgeon were also recorded. RESULTS: The mean HR and MBP values of Group PR were lower than those of Group PK, at all recording times. Sedation levels were significantly higher in Group PK. The total dose of propofol consumed was significantly higher in Group PR. The recovery time of Group PK was significantly longer than that of Group PF (p<0.05). Nausea-vomiting and bradycardia were more frequent in the Group PR. There was no difference in patient and surgeon satisfaction between the two groups. CONCLUSIONS: Ketamine-propofol combination provides better hemodynamic stability and better quality of sedation than propofol-remifentanil combination. Ketamine still seems as an advantageous and safe drug for such procedure.

The role of endothelial nitric oxide synthase (eNOS) in the pathogenesis of sinonasal polyps.

OBJECTIVE: The pathogenesis of sinonasal polyps has not been known completely. We investigated the role of endothelial Nitric Oxide Synthase (eNOS) in the pathogenesis of sinonasal polyps. PATIENTS AND METHODS: Study group (Groups 1-3) consisted of nasal polyp samples of patients with sinonasal polyps; and control group consisted of inferior turbinate samples of patients without nasal polyp. In Group 1: 14 specimens from ethmoid sinus; in Group 2: 10 specimens from nasal cavity; in Group 3: 10 specimens from maxillary sinus; and in Group 4 (Control): 9 specimens from inferior turbinate were included. By immunohistochemical staining technique, eNOS Positivity Index in mucosal layers; and in the inflammatory cells were assessed. RESULTS: eNOS Positivity Index was higher at apical layer of epithelium; and perivascular and glandular parts of subepithelial layer. As a rate of mononuclear cells increased, eNOS positivity increased at basal part of epithelium. In eNOS Positivity Index of mononuclear cells increased ones, eNOS values also increased at glands of subepithelial layer. In nasal cavity, eNOS positivity index of all cells was significantly higher than that of the control group. Increased eNOS all cells positivity index values were seen with decreased glandular and endothelial eNOS values. In all cells group, fibroblasts were seen beside the mononuclear cells. It was observed that eNOS was not expressed in PMNC (mainly neutrophils), growing more in acute inflammatory process; and was expressed in MNCs and all cells group with fibroblasts which were the cells of chronic inflammatory process. Especially MNCs and fibroblasts may play a role in the polyp formation process. In males and in patients with longer polyp duration, eNOS values decreased. CONCLUSIONS: We concluded that eNOS Positivity Index was higher at apical layer of epithelium; and perivascular and glandular parts of subepithelial layer. eNOS plays role in vascular dilatation, increases in vascular permeability; increases in nasal secretion due to glandular secretion; and edema in subepithelial and deep layers of the mucosa by affecting glands. Irritant agents in the breathing air and environment may cause increase in eNOS values at apical part of epithelium and may promote polyp formation by vasodilatation and increased glandular secretion due to increased nitric oxide values. In elderly patients and in long standing polyps, eNOS values decreased causing more fibrotic polyps.

Antimicrobial resistance in gram-negative hospital isolates: results of the Turkish HITIT-2 Surveillance Study of 2007.

Resistance rates to amikacin, ciprofloxacin, ceftazidime, cefepime, imipenem, cefoperazone/sulbactam and piperacillin/tazobactam in Escherichia coli (n= 438), Klebsiella pneumoniae (n= 444), Pseudomonas aeruginosa (n= 210) and Acinetobacter baumanni (n=200) were determined with e-test in a multicenter surveillance study (Hitit-2) in 2007. ESBL production in Escherichia coli and K. pneumoniae was investigated following the CLSI guidelines. Overall 42.0% of E.coli and 41.4% of K. pneumoniae were ESBL producers. In E. coli , resistance to imipenem was not observed, resistance to ciprofloxacin and amikacin was 58.0% and 5.5% respectively. In K. pneumoniae resistance to imipenem, ciprofloxacin and amikacin was 3.1%, 17.8% 12.4% respectively. In P. aeruginosa the lowest rate of resistance was observed with piperacillin/tazobactam (18.1%). A. baumanni isolates were highly resistant to all the antimicrobial agents, the lowest level of resistance was observed against cefoperazone/sulbactam (52.0%) followed by imipenem (55.5%). this study showed that resistance rates to antimicrobials are high in nosocomial isolates and show variations among the centers.

MR spectroscopy in a cervical abscess.

MR spectroscopy (MRS) has been used to analyse noninvasively tissues at a molecular level. Hydrogen and phosphorus MRS have been used for characterisation of intracranial solid and cystic masses, gynaecological tumours and lymph nodes. We report a cystic, tick-walled mass in the soft tissues of the neck. Single-voxel proton MRS revealed a prominent acetate peak at 1.92 ppm and a diagnosis of abscess was suggested. At operation a pyogenic neck abscess was confirmed, with culture of the pus.

Quality of the bottom sediment prior to dredging in the Golden Horn of Istanbul.

The Golden Horn has experienced severe pollution due to uncontrolled domestic and industrial wastewater discharges until recent years. A restoration project has been developed by our universities, upon a request from Istanbul Metropolitan Municipality. Two principal alternatives for the dredging and disposal of the bottom sediments were considered: disposing on the land and disposing in the sea. Both of these alternatives include several sub-alternatives. Characterization of the sediment quality is crucially important for selecting the best alternative considering the cost, environmental impact and public acceptance. However, only a few and rather old studies were present with which it was not possible to get a comprehensive information on the critical sediment characteristics. Therefore, the aim of this study was determination of spatial distribution of sediment characteristics. The project area, at which the sediment quality determined, covers the part of the Golden Horn remaining at the upstream of Valide Sultan Bridge. The number of sampling stations were thirteen and the sediment samples were collected from 0.0m, 5.0m and 10.0m from the bottom surface. The following parameters were measured on each sample: Total solids, organic matter, total phosphorus, TKN, oil and grease, total sulphur, and sediment oxygen demand (SOD). Sediment oxygen demand parameter was further divided into three fractions, namely, biological (SOD-B) and chemical (SOD-C). Average organic content of the bottom sediment was around 10% while ammonia and sulfur exhibit very high levels. It is found that the bottom sediment is well stabilized with very low organic content below 5.0m from the bottom surface. It can be said that, removing the upper 5m of the bottom sediment will be enough for creating a relatively stable bottom surface which will cause oxygen depletion in the overlaying water at acceptable levels. High SOD values of the bottom sediment makes the alternatives considering disposal in the Marmara Sea and Black Sea inapplicable. High SOD-C values, especially, indicate that the sediment will cause a tremendous reduction in the oxygen concentration in a very short time at any marine environment, and even it may create anaerobic conditions. Therefore, disposal of dredged sediment into abandoned mines 4km from the Golden Horn by a pressure pipeline has been chosen as the best applicable alternative.