Excess of renewable electricity from wind turbines or solar panels is used for electrolysis of water. To store this renewable energy as methane, the hydrogen is fed to an anaerobic digester to stimulate biological methanation by hydrogenotrophic methanogens. These work packages focus on the best ways for hydrogen delivery and the community changes in a biomethanation reactor as a result of hydrogen supply.
Background: Mechanically ventilated patients are at risk of developing inspiratory muscle weakness (IMW), which is associated with failure to wean and poor outcomes. Inspiratory muscle training (IMT) is a recommended intervention during and after extubation but has not been widely adopted in Dutch intensive care units (ICUs). Objectives: The objective of this study was to explore the potential, barriers, and facilitators for implementing IMT as treatment modality for mechanically ventilated patients. Methods: This mixed-method, proof-of-concept study was conducted in a large academic hospital in the Netherlands. An evidence-based protocol for assessing IMW and training was applied to patients ventilated for ≥24 h in the ICU during an 8-month period in 2021. Quantitative data on completed measurements and interventions during and after ICU-stay were collected retrospectively and were analysed descriptively. Qualitative data were collected through semistructured interviews with physiotherapists executing the new protocol. Interview data were transcribed and thematically analysed. Findings: Of the 301 screened patients, 11.6% (n = 35) met the inclusion criteria. Measurements were possible in 94.3% of the participants, and IMW was found in 78.8% of the participants. Ninety-six percent started training in the ICU, and 88.5% continued training after transfer to the ward. Follow-up measurements were achieved in 73.1% of the patients with respiratory muscle weakness. Twelve therapists were interviewed, of whom 41.7% regularly worked in the ICU. When exploring reasons for protocol deviation, three themes emerged: “professional barriers”, “external factors”, and “patient barriers”. Conclusions: Implementation of measurements of and interventions for IMW showed to be challenging in this single centre study. Clinicians' willingness to change their handling was related to beliefs regarding usefulness, effectiveness, and availability of time and material. We recommend that hospitals aiming to implement IMT during or after ventilator weaning consider these professional and organisational barriers for implementation of novel, evidence-based interventions into daily clinical practice.
MULTIFILE
BACKGROUND AND AIMS: Patients with COVID-19 infection presents with a broad clinical spectrum of symptoms and complications. As a consequence nutritional requirements are not met, resulting in weight- and muscle loss, and malnutrition. The aim of the present study is to delineate nutritional complaints, the (course of the) nutritional status and risk of sarcopenia of COVID-19 patients, during hospitalisation and after discharge.METHODS: In this prospective observational study in 407 hospital admitted COVID-19 patients in four university and peripheral hospitals, data were collected during dietetic consultations. Presence of nutrition related complaints (decreased appetite, loss of smell, changed taste, loss of taste, chewing and swallowing problems, nausea, vomiting, feeling of being full, stool frequency and consistency, gastric retention, need for help with food intake due to weakness and shortness of breath and nutritional status (weight loss, BMI, risk of sarcopenia with SARC-F ≥4 points) before, during hospital stay and after discharge were, where possible, collected.RESULTS: Included patients were most men (69%), median age of 64.8 ± 12.4 years, 60% were admitted to ICU at any time point during hospitalisation with a median LOS of 15 days and an in-hospital mortality rate of 21%. The most commonly reported complaints were: decreased appetite (58%), feeling of being full (49%) and shortness of breath (43%). One in three patients experienced changed taste, loss of taste and/or loss of smell. Prior to hospital admission, 67% of the patients was overweight (BMI >25 kg/m2), 35% of the patients was characterised as malnourished, mainly caused by considerable weight loss. Serious acute weight loss (>5 kg) was showed in 22% of the patents during the hospital stay; most of these patients (85%) were admitted to the ICU at any point in time. A high risk of sarcopenia (SARC-F ≥ 4 points) was scored in 73% of the patients during hospital admission.CONCLUSION: In conclusion, one in five hospital admitted COVID-19 patients suffered from serious acute weight loss and 73% had a high risk of sarcopenia. Moreover, almost all patients had one or more nutritional complaints. Of these complaints, decreased appetite, feeling of being full, shortness of breath and changed taste and loss of taste were the most predominant nutrition related complaints. These symptoms have serious repercussions on nutritional status. Although nutritional complaints persisted a long time after discharge, only a small group of patients received dietetic treatment after hospital discharge in recovery phase. Clinicians should consider the risks of acute malnutrition and sarcopenia in COVID-19 patients and investigate multidisciplinary treatment including dietetics during hospital stay and after discharge.
About 35-40 kton used mattresses available yearly for the recycling only in the Netherlands. Mattresses that are offered at recycling companies, municipal yards and retailers often find their way to incinerators. However, several fraction components of used mattresses can be reused/resale in a useful manner. One of the mattress fractions is textile cover with residue of Polyurethane (PU) foam. Effective removal of PU foam would enable further reuse of textile materials. Use of harsh chemicals/ thermo-, photo-, oxidative, processes including hydrolysis, aminolysis, phosphorolysis, glycolysis etc [1,2] for PU foam degradation is not a good solution, since it will cause non-specific damage to textiles and other parts, making recycle/ reuse difficult. Therefore, Mattress Recycling Europe BV (MRE) is looking for an eco-friendly mild process for selective degradation of PU foam component. PU is a mixed polymer; therefore, it is important to establish the physio-chemical nature of PU before identifying suitable and sustainable degradation route. The proposed solution is selective degradation of PU polymer using biotechnology. Enzymatic bio-catalysis enables a targeted, specific reaction at mild process conditions (pH, temperature) without harming other components in the process. Primarily hydrolase class of enzymes is assumed to be among the most effective options for the proposed degradation of PU foam residue [3,4]. From previous research, adding mechanical shear provides a synergistic effect for enzyme catalysed reaction [5-7]. Therefore, within the scope of this exploratory practice-oriented project, technical feasibility of bio-catalyst and shear (including well established PU degradation techniques) towards the selective degradation of PU foam residue attached to textile part from used mattresses will be explored together with cost estimation of the overall process and re-usability of enzymes using suitable immobilisation technique, addressing an urgent industrial need in the field of green chemistry.
About half of the e-waste generated in The Netherlands is properly documented and collected (184kT in 2018). The amount of PCBs in this waste is projected to be about 7kT in 2018 with a growth rate of 3-4%. Studies indicate that a third of the weight of a PCB is made or recoverable and critical metals which we need as resources for the various societal challenges facing us in the future. Recycling a waste PCB today means first shredding it and then processing it for material recovery mostly via non-selective pyrometallurgical methods. Sorting the PCBs in quality grades (wastebins) before shredding would however lead to more flexibility in selecting when and which recovery metallurgy is to be used. The yield and diversity of the recovered metals increases as a result, especially when high-grade recycling techniques are used. Unfortunately, the sorting of waste PCBs is not easily automated as an experienced operator eye is needed to classify the very inhomogeneous waste-PCB stream in wastebins. In this project, a knowledge institution partners with an e-waste processor, a high-grade recycling technology startup and a developer of waste sorting systems to investigate the efficiency of methods for sensory sorting of waste PCBs. The knowledge gained in this project will lead towards a waste PCB sorting demonstrator as a follow-up project.
