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Background: Long-term outcomes of patients treated with helmet noninvasive ventilation (NIV) are unknown: safety concerns regarding the risk of patient self-inflicted lung injury and delayed intubation exist when NIV is applied in hypoxemic patients. We assessed the 6-month outcome of patients who received helmet NIV or high-flow nasal oxygen for COVID-19 hypoxemic respiratory failure. Methods: In this prespecified analysis of a randomized trial of helmet NIV versus high-flow nasal oxygen (HENIVOT), clinical status, physical performance (6-min-walking-test and 30-s chair stand test), respiratory function and quality of life (EuroQoL five dimensions five levels questionnaire, EuroQoL VAS, SF36 and Post-Traumatic Stress Disorder Checklist for the DSM) were evaluated 6months after the enrollment. Results: Among 80 patients who were alive, 71 (89%) completed the follow-up: 35 had received helmet NIV, 36 high-flow oxygen. There was no inter-group difference in any item concerning vital signs (N = 4), physical performance (N = 18), respiratory function (N = 27), quality of life (N = 21) and laboratory tests (N = 15). Arthralgia was significantly lower in the helmet group (16% vs. 55%, p = 0.002). Fifty-two percent of patients in helmet group vs. 63% of patients in high-flow group had diffusing capacity of the lungs for carbon monoxide < 80% of predicted (p = 0.44); 13% vs. 22% had forced vital capacity < 80% of predicted (p = 0.51). Both groups reported similar degree of pain (p = 0.81) and anxiety (p = 0.81) at the EQ-5D-5L test; the EQ-VAS score was similar in the two groups (p = 0.27). Compared to patients who successfully avoided invasive mechanical ventilation (54/71, 76%), intubated patients (17/71, 24%) had significantly worse pulmonary function (median diffusing capacity of the lungs for carbon monoxide 66% [Interquartile range: 47–77] of predicted vs. 80% [71–88], p = 0.005) and decreased quality of life (EQ-VAS: 70 [53–70] vs. 80 [70–83], p = 0.01). Conclusions: In patients with COVID-19 hypoxemic respiratory failure, treatment with helmet NIV or high-flow oxygen yielded similar quality of life and functional outcome at 6months. The need for invasive mechanical ventilation was associated with worse outcomes. These data indicate that helmet NIV, as applied in the HENIVOT trial, can be safely used in hypoxemic patients. Trial registration Registered on clinicaltrials.gov NCT04502576 on August 6, 2020

Il capitolo analizza le problematiche di natura chimica relative ai suoli che, a causa di particolari fenomeni ambientali e di specifiche pratiche agronomiche, finiscono con l’acquisire alcune proprietà particolari che si discostano da quelle della maggior parte dei suoli di comune uso agrario. Nella fattispecie, sono stati presi in considerazione: a) i suoli acidi, con l’analisi delle cause di acidificazione e delle metodiche per la correzione di tale limite; b) le varie tipologie di suoli sommersi, con le varie controindicazioni che la sommersione comporta; c) i suoli alomorfi, cioè affetti da vari tipi di salinità (suoli salini, salino-sodici e sodici), con particolare riferimento alla loro genesi, correzione e gestione.

2 páginas.-- 1 figura.-- 7 referencias.-- Comunicación presentada en el 19th International Conference of Humic Substances and their Contribution to the Climate Change Mitigation 16–21 September 2018 Albena Resort, Bulgaria, Restoring humus in soil represents a key factor for improving soil quality. Digestates from anaerobic digestion (AD) can be successfully applied as soil amendments. Here, we investigated changes of the organic matter (OM) composition of digestates from solid-state anaerobic digestion (AD) of straw and pig slurry at different percolate recirculation frequency. Atomic ratios, thermostability indexes, O-alkyl C/alkyl C ratio and Py-GC/MS results consistently showed a positive effect of the highest number (4) of percolate recirculations per day on OM features, resulting in a more stable OM in digestate.

Pig slurry is a source of organic matter (OM) and nutrients, nevertheless nowadays its disposal represents a serious problem at national scale due to both the large volume to be managed (ca. 18 million m3 y-1) and the insufficient land on which it could be spread. Anaerobic digestion (AD) could solve this environmental issue as it allows converting organic residues into biogas, a renewable source of energy, and digestate, a by-product with enhanced fertilizer and amendment properties. This is particularly true when the AD is performed at the solid state where the more recalcitrant fraction of OM may be accumulated. In this study, we investigated the changes in the OM composition during AD at different percolate recirculation frequency, thus providing information on the agronomic potential of resulting digestate samples. Solid-state anaerobic digestion (S-SAD) of pig slurry and straw (3:1 w/w) was carried out for this purpose. To avoid inhibition phenomena caused by volatile fatty acids accumulation during S-SAD, percolate recirculation technology was adopted. Three tests were carried out using 1, 2 and 4 recirculations day-1, respectively. A control test (i.e., without percolate recirculation) was also performed. The initial mixture and digestate samples (control, 1S-SAD, 2S-SAD, 4S-SAD) were characterized by elemental (CHNS), thermogravimetric (TG) and differential thermogravimetric (DTG) analysis, pyrolysis coupled to gas chromatography and mass spectrometry (Py-GC/MS) and 13C nuclear magnetic resonance (13C NMR) spectroscopy. Preliminary results suggested an increase of the OM degradation due to percolate recirculation. In particular, among digestate samples, 4S-SAD showed the lowest C/N and O/C values, as well as the lowest TG weight loss between 250 and 350°C (WL1), the latter one due to the greater consumption of sugars and cellulosic materials. 2S-SAD and 4S-SAD exhibited also a slight enhancement of TG weight loss between 350 and 550°C (WL2), which may be ascribed to a relative enrichment in humic-like substances and non-hydrolyzable residues. As a result, the thermostability index (WL2/WL1), generally used to describe chemical changes induced by OM biotransformation, was highest for 4S-SAD, followed by 2S-SAD, 1S-SAD and the control. Pyrolysis products at 400°C were grouped into 8 families according to their chemical nature, i.e. aromatics (Ar), lignin-derived aromatics (Lig), polysaccharides (Ps), ketones, n-alkane/ene, fatty acids (FA), sterols and terpenoids and N-compounds. Digestate samples exhibited lower contribution of Ps (the lowest in 4S-SAD) and higher Ar and Lig contents (the highest in 4S-SAD), as compared to the initial mixture. Likewise, 13C NMR spectra of the digestates evidenced a preferential degradation of O-alkyl C. This was particularly true for 4S-SAD that showed also the lowest O-alkyl C/alkyl C ratio, commonly used as an index of OM stability. On the opposite, this ratio was highest for the sample with 1 recirculation day-1 (1S-SAD), indicating its low degradation degree. In conclusion, atomic ratios, thermostability index, O-alkyl C/alkyl C ratio and preliminary Py-GC/MS results consistently showed a positive effect of the highest number (4) of percolate recirculations per day on the degree of OM degradation, resulting in a more stable OM in the corresponding digestate.