...training programs and trainees were faced with unexpected challenges. In spite of the significant limitations such as diminished gastroenterology practice activity, the current situation might ...enhance scientific opportunities, allow for the acquisition of a wide range of theoretical knowledge and reinforce competences in the ability to adapt to a dynamic hospital reorganization, procedure eligibility and judicious use of PPE. A tremendous impact on training plans is already a reality but is also expected in the postpandemic gastroenterology activity, resulting from the increased pressure on clinical services to respond to the postponed and time-sensitive medical procedures.
Abstract
Background and study aims Effective bowel cleansing is critical
for detecting lesions during colonoscopy, highlighting the importance of bowel preparations.
1L polyethylene glycol (PEG) + ...ascorbate (Asc) is the only recommended 1L PEG product in
Europe and the United States. Its efficacy was demonstrated in large-scale controlled trials
and confirmed in smaller-scale real-world studies. However, no large-scale real-world data
exist.
Patients and methods This observational, retrospective,
multicenter study, used outpatient follow-up data from medical records from 10 centers in
Spain and two in Portugal. Outpatients aged ≥18 years using 1L PEG + Asc as bowel preparation
were included. The main outcome measures were overall adequate colon cleansing (Boston Bowel
Preparation Scale BBPS score ≥6 with BBPS score ≥2 in each segment) and high-quality
cleansing of the right colon (BBPS score=3).
Results Data from 13169 eligible patients were included. Overall
cleansing success was achieved in 89.3% (95%CI 88.7%-89.8%) and high-quality cleansing in the
right colon in 49.3% (95%CI 48.4%–50.2%) of patients. For the overnight split-dose and
same-day regimens, overall adequate quality cleansing success rate was 94.7% and 86.7% (P<0.0001) and high-quality cleansing of the right colon rate was
65.4% and 41.4% (P<0.0001), respectively. Colonoscopy was
completed in 97.3% of patients, with non-completion due to poor preparation in only 0.8%; 2.3%
of patients experienced at least one adverse event (AE).
Conclusions This large-scale, real-world study demonstrates the
effectiveness of 1L PEG + Asc in the total and right colon, with a low percentage of patients
with AEs in routine clinical practice.
Acacia dealbata is an invasive species whose spreading must be controlled but with industrial applications as a source of concretes, tannins, wood materials and biofuels. Both removal operations and ...industrial applications generate biomass wastes that could be further valorized. The main goal of this thesis was to study the integral exploitation ofA. dealbatabiomass (flowers, leaves, twigs, wood, and bark) from a biorefinery perspective.Extraction of terpenic and phenolic components from flowers collectd at different locations, was evaluated using different solvents and extraction methods. Lipophilic extracts (absolutes) were characterized by SPME-GC-TOFMS showing the presence of organic acids, hydrocarbons and pentacyclic triterpenes. The phenolic fraction obtained from flowers had high levels of total phenolics and its characterization by HPLC-DAD and HPLC-DAD-MS/MS revealed the presence of flavonoid glycosides with relevant biological activities. Polar extracts obtained from leaves, twigs, wood, and bark showed high levels of total phenolics, flavonoids and proanthocyanidins. Leaves were also a source of lipophilic extracts rich in phytol, lupenone and lupeol. All phenolic extracts presented antioxidant properties (in DPPH and FRAP tests) and antimicrobial activity against gram-positive bacteria. The composition and properties of raw and spent biomass fractions were evaluated to validate their use as biofuels after extraction with solvents. Torrefaction and hydrothermal carbonization were used to convert these spent biomasses into biochars and hydrochars with improved fuel properties. Spent biomasses and corresponding chars were tested as adsorbents for cationic and anionic dyes, reaching removal efficiencies higher than 90%. The incorporation of the different Acacia biomass fractions in mortars to replace fillers was tested as a contribution to incorporate renewable resources in building materials.The results obtained demonstrate multiple conversion pathways that can be used to valorise Acaciabiomass producing energy and various marketable products, thus promoting bioeconomy and the sustainability of the forestry sector.
A torrefação é vista como um pré-tratamento térmico que introduz modificações na biomassa, ou em resíduos de biomassa, que facilitam o seu processamento mecânico e aumentam a sua estabilidade e ...densidade energética, potenciando, assim, uma valorização posterior.Neste trabalho, estudou-se o impacte da torrefação na gama de 200 a 350 ºC e tempos de residência entre 15 e 90 min nas propriedades da biomassa proveniente da herbácea Arundo donax L. e das palmeiras Phoenix canariensis,espécies muito abundantes em vários locais do país, tendo em vista a sua posterior valorização. A proliferação descontrolada do arundo e a praga do escaravelho das palmeiras leva a que estas espécies sejam alvo de frequentes operações de remoção. A sua estrutura altamente fibrosa dificulta e encarece estas operações, que acarretam custos significativos para as câmaras municipais, e não se conhecem medidas para a sua valorização material ou energética. A torrefação foi também aplicada a peletes de resíduos de pinheiro, na gama de 200 a 250 ºC e com tempos de residência de 30 e 60 min, para averiguar o seu impacte na qualidade desse biocombustível sólido.A torrefação permitiu obter peletes mais resistentes à biodegradação, devido à redução do teor de humidade para valores residuais, sem aumentar significativamente o seu teor de cinzas e sem afetar de forma relevante a sua durabilidade, o teor de finos ou a densidade aparente. Com a biomassa de arundo e de palmeira obtiveram-se produtos com maior poder calorífico e com melhor moabilidade. No entanto, a acentuada diminuição dos rendimentos mássico e energético e o elevado teor de cinzas constrangem a sua utilização como biocombustíveis sólidos. Desta forma, optou-se por testar a sua valorização como adsorventes do corante azul de metileno, bastante comum, por exemplo, na indústria têxtil, nos curtumes ou nas industrias do papel.Os estudos de adsorção revelaram maior afinidade pelo corante por parte da biomassa sujeita a torrefação mais ligeira, com eficiências de remoção muito próximas das do carvão ativado comercial, para concentrações iniciais de corante até 200 mg/L. As isotérmicas foram melhor ajustadas ao modelo de Langmuir, que revelou capacidades máximas de adsorção na monocamada entre 59,92 e 92,68 mg/g, tendo as curvas de cinética sido melhor descritas pelo modelo de pseudosegunda ordem. A adsorção é bastante rápida nos primeiros minutos, essencialmente devido a atrações eletrostáticas, sendo inicialmente controlada pela difusão no filme e depois pela difusão nos poros. Os adsorventes revelaram seletividade por um corante catiónico e permitiram dessorção de corante, ao contrário do verificado com o carvão ativado comercial, o que é um aspeto da maior relevância tendo em mente a regeneração do adsorvente e a recuperação do corante.
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