Comparison of filter media materials for heavy metal removal from urban stormwater runoff using biofiltration systems.

The filter media in biofiltration systems play an important role in removing potentially harmful pollutants from urban stormwater runoff. This study compares the heavy metal removal potential (Cu, Zn, Cd, Pb) of five materials (potting soil, compost, coconut coir, sludge and a commercial mix) using laboratory columns. Total/dissolved organic carbon (TOC/DOC) was also analysed because some of the test materials had high carbon content which affects heavy metal uptake/release. Potting soil and the commercial mix offered the best metal uptake when dosed with low (Cu: 44.78 µg/L, Zn: 436.4 µg/L, Cd, 1.82 µg/L, Pb: 51.32 µg/L) and high concentrations of heavy metals (Cu: 241 µg/L, Zn: 1127 µg/L, Cd: 4.57 µg/L, Pb: 90.25 µg/L). Compost and sludge also had high removal efficiencies (>90%). Heavy metal leaching from these materials was negligible. A one-month dry period between dosing experiments did not affect metal removal efficiencies. TOC concentrations from all materials increased after the dry period. Heavy metal removal was not affected by filter media depth (600 mm vs. 300 mm). Heavy metals tended to accumulate at the upper 5 cm of the filter media although potting soil showed bottom-enriched concentrations. We recommend using potting soil as the principal media mixed with compost or sludge since these materials perform well and are readily available. The use of renewable materials commonly found in Singapore supports a sustainable approach to urban water management.

A transperineal approach to perineal hernia repair using suture anchors and acellular porcine dermal mesh.

Perineal hernia following major pelvic surgery is a rare but recognised complication. Various surgical approaches to the repair of a symptomatic perineal hernia have been described. We describe the first reported use of the Mitek suture anchors to secure an acellular porcine dermal graft to the ischia during the transperineal repair of a large perineal hernia.

Outcome of Surgical Fixation for Midfoot Charcot Neuroarthropathy - A Systematic Review.

Introduction: Charcot arthropathy is a condition which is progressive, non-infectious, destructive and debilitating that commonly affect foot and ankle. This systematic review is to evaluate the occurrence of common outcomes associated with each intervention of Charcot neuroarthropathy in midfoot. Materials and methods: A systematic review on literatures that were published from Jan 2010 to Jan 2020 were collected, reviewed and selected regarding the surgical treatment procedures of Charcot neuroarthropathy in midfoot. Results: The initial search yielded 231 reports and after exclusion, nine out of the total studies were included in the outcome analysis for review. These were studies that included data concerning surgical reconstruction of Charcot arthropathy in the midfoot. Conclusion: It is suggested that soft tissue preparation and usage of combination of implants thus reduce the risk of infection as well as increase rigidity of construct, respectively. These factors will aid to improve outcome of midfoot Charcot arthropathy reconstruction.

Fe-Mn doped powdered activated carbon pellet as ozone catalyst for cost-effective phenolic wastewater treatment: Mechanism studies and phenol by-products elimination.

A novel bimetallic doped PAC (Fe-Mn/PAC) pellet was prepared with a facile sol-gel method and used as an ozone catalyst for phenolic wastewater (PWW) treatment. Adoption of Fe-Mn/PAC pellet in microbubble ozonation enhanced the 1-h chemical oxygen demand (COD) and phenol removal in PWW to 79% and 95%, respectively. With ozone dosage of 10 mg/L, 1 g/L Fe-Mn/PAC pellet exhibited ozone conversion of 92%. In comparison to microbubble ozonation process, Fe-Mn/PAC induced microbubble-catalytic ozonation process promoted ozone decomposition rate by 1.9 times. In terms of •OH production, Fe-Mn/PAC pellet enhanced •OH exposure by 10 times, with a Rct value of 2.92 × 10 -8. Rct kinetic model also suggested that Fe-Mn/PAC pellet obtained higher kinetic rate constants for initiating and promoting •OH generation. Usage of Fe-Mn/PAC pellet in microbubble ozonation for phenolic wastewater treatment also reduced the total ozone consumption by 70%. In Fe-Mn/PAC induced microbubble-catalytic ozonation process, the ratio between ozone consumption and COD removal (ΔO3/ΔCOD) was 0.91. Fe-Mn/PAC pellet characterization with X-ray photoelectron spectroscopy (XPS), Fourier-transform infrared (FT-IR) and X-ray powder diffraction (XRD) analysis revealed successful doping of Fe-Mn on PAC substrate and larger numbers of carbon-oxygen/hydroxyl surface groups, which played key roles in ozone decomposition and •OH production.

Organics removal in high strength petrochemical wastewater with combined microbubble-catalytic ozonation process.

Ozonation is a well-known and widely applied advanced oxidation process (AOP) for industrial wastewater treatment, while the ozonation efficiency might be limited by low mass transfer, poor solubility, and rapid decomposition rate of ozone molecules in the aqueous phase. The present study aims to investigate the feasibility of combined microbubble-catalytic ozonation process (M-O3/Fe/GAC) for improving the ozonation efficiency during treatment of petrochemical wastewater (PCW). M-O3/Fe/GAC process optimization was carried out with different pH conditions, ozone dosages and catalyst loadings. The optimum operating conditions were identified as 50 mg L-1 ozone dosage, real PCW pH (7.0-7.5) and 4 g L-1 catalyst loading. Among different ozonation processes, M-O3/Fe/GAC process achieved the highest chemical oxidation demand (COD) removal efficiency of 88%, which is 18% and 43% higher than those achieved by the microbubble and macrobubble ozonation processes, respectively. Phenolic compounds presented in PCW could be reduced by 63% within 15 min in M-O3/Fe/GAC treatment process. Long-term continuous flow studies suggested M-O3/Fe/GAC process to be the most cost-effective technology for PCW treatment with an operating cost of S$0.18 kg-1 COD and S$0.4 m-3 with good catalyst stability. Liquid size exclusion chromatography with organic carbon detection (LC-OCD) data suggested humic substances to be the dominant organic species in PCW, M-O3/Fe/GAC could achieve significant humic substances removal and biodegradability enhancement in PCW. Kinetics and mechanism studies revealed that organics removal in M-O3/Fe/GAC was 1.8 times higher than that in microbubble ozonation process, and hydroxyl radical (●OH) was the dominant oxidant specie for organics removal in M-O3/Fe/GAC process.

Simulation of FBR-Fenton/GAC process for recalcitrant industrial wastewater treatment with a computational fluid dynamics-kinetic model framework.

An integrated computational fluid dynamics (CFD)-kinetic model framework was developed to numerically describe the hydrodynamic and kinetic phenomena in a liquid-solid two phases Fluidized-bed reactor Fenton/granular activated carbon (FBR-Fenton/GAC) system. The model obtained excellent accuracy for predicting chemical oxygen demand (COD) removal in reverse osmosis concentrate (ROC) treatment under different operation conditions. Hydrodynamic evaluation demonstrated that under the quasi-steady state, the GAC particles were uniformly circulated in the bed region with two pairs of counter-rotating recirculation cells, and a clear interface layer formed between the solid and the liquid phases. Superficial liquid velocity highly affected the fluidized bed expansion and solid volume fraction, while its impact on the overall COD removal efficiency was negligible. Chemical evaluation revealed that GAC/H2O2 catalytic reaction enhanced the •OH production in FBR-Fenton/GAC process by 2.7 folds as compared to homogenous Fenton process. Fenton reaction mainly occurred in the upper liquid region and its kinetics for •OH generation significantly diminished by 75% within the first 10 min. GAC/H2O2 reaction took place in the fluidized bed region for continuous •OH generation with a relatively stable rate from 1.21 × 10-6 to 0.60 × 10-6 M/s. Along the ROC treatment with FBR-Fenton/GAC process, the simulated COD degradation rate decreased along the reaction time with 2.05 × 10-6 M/s and 2.93 × 10-7 M/s at 2 min and 60 min, respectively. Faster COD removal was attained in the fluidized bed region due to combining effects of •OH oxidation and GAC adsorption. The overall predicted COD concentration reduced from 122 to 35 mg/L, •OH oxidation and GAC adsorption contributed 59% and 41%, respectively, to the total COD removal.

Fluidized-bed Fenton technologies for recalcitrant industrial wastewater treatment-Recent advances, challenges and perspective.

In recent years, fluidized-bed Fenton (FBR-Fenton) process has gained more attention in treating recalcitrant industrial wastewater. FBR-Fenton combines the effectiveness of homogeneous Fenton and sludge reduction of heterogeneous Fenton. Comparing to other modified Fenton processes, FBR-Fenton has greater economical and scaling up potential. However, large consumption of Fenton reagents and strict pH control are still the bottlenecks hampering the full-scale application of FBR-Fenton. While prior reviews mainly focused on the operation and performance of FBR-Fenton process, the present study critically discussed the challenges and bottlenecks for its full-scale industrial application. This study also comprehensively reviewed the development strategies for tackling these drawbacks, mainly over the recent five years. Homogeneous FBR-Fenton, heterogeneous FBR-Fenton and heterogeneous FBR-photo-Fenton processes were classified for the first time according to their reaction mechanisms and system designs. Important operational and design parameters affecting the cost-effectiveness of all FBR-Fenton technologies were reviewed, including the fundamentals, common practices and even innovative steps for enhancing the process performance. Up-to-date applications of FBR-Fenton technologies in recalcitrant wastewater/compounds treatment were also summarized, and it was found that upscaling of heterogeneous FBR-Fenton and heterogeneous FBR-photo-Fenton processes was still very challenging. Strategies to overcome the key technical limitations and enhance process cost-effectiveness were discussed in the future perspective part. Furthermore, modelling techniques such as computational fluid dynamics model and artificial neural network were suggested to be promising modelling techniques for speeding up the full-scale applications of FBR-Fenton technologies.

Reverse osmosis concentrate treatment by microbubble ozonation-biological activated carbon process: Organics removal performance and environmental impact assessment.

Reverse osmosis (RO) is being used in many water reclamation facilities to produce high quality water that can be reused for different purposes. As a part of the RO process, a reject stream is produced as the reverse osmosis concentrate (ROC), which contains elevated levels of contaminants compared to the source water. Effective treatment and safe disposal of ROC via cost-effective means is very challenging. This study aims to develop a robust microbubble ozonation-biological process for industrial ROC treatment with a target effluent chemical oxygen demand (COD) lower than 60 mg/L. As compared to macrobubble ozonation, microbubble ozonation exhibited better ozone dissolution and 29% higher COD removal efficiency with the same ozone dosage. Under the optimum operating conditions with ozone dosage of 30 mg/L, ROC natural pH of 8.67 and ozonation duration of 1 h, microbubble ozonation achieved 42% COD removal efficiency while increasing the BOD5/COD ratio (ratio of biological oxygen demand over 5 days to the corresponding chemical oxygen demand) in ROC from 0.042 to 0.216. A biological activated carbon (BAC) column with an empty bed contact time (EBCT) of 120 min was combined with microbubble ozonation for continuous ROC treatment. Over the 100-day operation, the combined system performed consistent organics removal with an average effluent COD of 45 mg/L. Both LC-OCD data and fluorescence EEM spectra confirmed humic substances were the dominant organic species in ROC. Ozone pre-treatment could achieve significant removal of humic substances in raw ROC. ATP analysis found that ozone pre-treatment enhanced BAC biofilm activity by around 5 folds. 5 min acute toxicity assessment with Aliivibrio fischeri showed 4 times reduction of bioluminescence inhibition in ozone treated ROC. From the environmental point of view, Life cycle assessment (LCA) results demonstrated that Ozone-BAC system had significant environmental burdens on climate change and human toxicity due to the electricity production process. These environmental impacts can be mitigated by optimizing the ozonation process with reduced ozone dosage or utilizing renewable energy sources for electricity generation.

Organics removal and in-situ granule activated carbon regeneration in FBR-Fenton/GAC process for reverse osmosis concentrate treatment.

Fluidized bed reactor Fenton (FBR-Fenton) process was adopted for reverse osmosis concentrate (ROC) treatment with three types of carriers, including sand, zeolite and granular activated carbon (GAC). Adsorption studies demonstrated that GAC achieved the best adsorption performance (maximum COD removal of 78% in 15 h) among the three carriers, and the adsorption of ROC organic matters followed a two-stage adsorption model. Fenton oxidations were carried out in three fluidized beds after column saturation, and FBR-Fenton/GAC process achieved highest COD removal (72%) and most BOD5/COD ratio enhancement (from 0.03 to 0.3) in ROC. Long-term operation data demonstrated good performance stability of GAC as the carrier. In addition, GAC fluidized bed obtained highest total iron removal rate via iron crystallization process. Continuous in-situ GAC regeneration with more than 90% recoveries of surface area, pore volume and adsorption capacity were observed along the ROC treatment with FBR-Fenton/GAC process. Mechanism studies revealed that better COD removal performance in FBR-Fenton/GAC process was attributed to the combining effects of homogenous Fenton reaction, GAC adsorption and GAC/H2O2 catalytic reaction.

Prediction of mortality in acute pancreatitis: a systematic review of the published evidence.

OBJECTIVE: In this review, we focus on studies that examined such prognostic indices in relation to predicting a fatal outcome from pancreatitis. SUMMARY BACKGROUND DATA: Acute pancreatitis (AP) is a common emergency, and early identification of high-risk patients can be difficult. For this reason, a plethora of different prognostic variables and scoring systems have been assessed to see if they can reliably predict the severity of pancreatitis and/or subsequent mortality. METHODS: All studies that focused on AP, including retrospective series and prospective trials, were retrieved and analysed for factors that could influence mortality. Articles that analysed factors influencing the severity of the disease or the manifestation of disease-related complications were excluded. RESULTS: 58 articles meeting the inclusion criteria were identified. Among the various factors investigated, APACHE II seemed to have the highest positive predictive value (69%). However, most prognostic variables and scores showed high negative predictive values but suboptimal values for positive predictive power. CONCLUSIONS: Despite the proliferation of scoring systems for grading AP, none are ideal for the prediction of mortality. With the exception of the APACHE II, the other scores and indexes do not have a high degree of sensitivity, specificity and predictive values.

A fuller understanding of pancreatic neuroendocrine tumours combined with aggressive management improves outcome.

BACKGROUND: Neuroendocrine tumours of the pancreas (PNETs) represent 1-2% of all pancreatic tumours. The terms 'islet cell tumours' and 'carcinoids' of the pancreas should be avoided. The aim of this review is to offer an overview of the history and diagnosis of PNETs followed by a discussion of the available treatment options. METHODS: A search on PubMed using the keywords 'neuroendocrine', 'pancreas' and 'carcinoid' was performed to identify relevant literature over the last 30 years. RESULTS: The introduction of a revised classification of neuroendocrine tumours by the World Health Organisation (WHO) in 2000 significantly changed our understanding of and approach to the management of these tumours. Advances in laboratory and radiological techniques have also led to an increased detection of PNETs. Surgery remains the only treatment that offers a chance of cure with increasing number of non-surgical options serving as beneficial adjuncts. The better understanding of the behaviours of PNETs together with improvements in tumour localisation has resulted in a more aggressive management strategy with a concomitant improvement in symptom palliation and a prolongation of survival. CONCLUSION: Due to their complex nature and the wide range of therapeutic options, the involvement of specialists from all necessary disciplines in a multidisciplinary team setting is vital to provide optimal treatment of this disease.

Influence of phosphorus on biofilm formation in model drinking water distribution systems.

AIMS: This study investigated the effects of phosphorus on biofilm formation via annular reactor systems in terms of biofilm cell growth, exopolysaccharide (EPS) production, biofilm structure and cell metabolic potential. METHODS AND RESULTS: Drinking water biofilms were developed in annular reactors with supplement of carbon and different levels of phosphorus. The biofilm formation was monitored over a period of 30 days. Biofilm related parameters were examined by various methods, which included heterotrophic plate count, total carbohydrate content, confocal laser scanning microscopy and GN2 microplate assay. Our results showed that phosphorus addition can promote the biofilm cell growth (cell count increased about 1 log with addition of 30 and 300 microg l(-1) of phosphorus). However, the addition of 30 and 300 microg l(-1) of phosphorus caused 81% and 77% decrease in EPS production, respectively. The results of biofilm structure analysis showed that the addition of 30 and 300 microg l(-1) of phosphorus can induce thicker and less homogeneous biofilms with more biomass. Furthermore, the addition of 30 and 300 microg l(-1) of phosphorus dramatically increased the biofilm cell metabolic potential. The addition of 3 microg l(-1) of phosphorus was found to have minor effects on the parameters examined. CONCLUSIONS: The results indicate phosphorus addition to drinking water distribution system (DWDS) has a complicated effect on the biofilm formation. SIGNIFICANCE AND IMPACT OF THE STUDY: As the addition of phosphorus at certain levels can affect the biofilm growth in DWDS, care should be taken when phosphate-based corrosion inhibitors are used in the DWDS.

Palliation of malignant obstructive jaundice.

Peri-ampullary and hepatic malignancies will frequently present with obstructive jaundice. For unresectable tumors, effective and lasting decompression of the biliary tree is essential to improve quality of life and survival. An overview of present treatment modalities for palliation of obstructive jaundice is provided, including a systematic review of the English literature regarding the optimum choice of palliation.

Cystic lesions of the pancreas. A diagnostic and management dilemma.

BACKGROUND/AIMS: Due to enhanced imaging modalities, pancreatic cysts are being increasingly detected, often as an incidental finding. They comprise a wide range of differing underlying pathologies from completely benign through premalignant to frankly malignant. The exact diagnostic and management pathway of these cysts remains problematic and this review attempts to provide an overview of the pathology underlying pancreatic cystic lesions and suggests appropriate methods of management. METHODS: A search was undertaken with a Pubmed database to identify all English articles using the keywords 'pancreatic cysts', 'serous cystadenoma', 'intraductal papillary mucinous tumour', 'pseudocysts', 'mucinous cystic neoplasm' and 'solid pseudopapillary tumour'. RESULTS: The mainstay of assessment of pancreatic cysts is cross-sectional imaging incorporating CT and MRI. Fine-needle aspiration (FNA) (often with endoscopic ultrasound) may provide valuable additional information but can lack sensitivity. Symptomatic cysts, increasing age and multilocular cysts (with a solid component and thick walls) are predictors of malignancy. A raised cyst aspirate CEA, CA 19-9 and mucin content (including abnormal cytology), if present, can accurately distinguish premalignant and malignant cysts from benign ones. CONCLUSION: In summary, all patients with pancreatic cystic lesions, whether asymptomatic or symptomatic, must be thoroughly investigated to ascertain the underlying nature of the cyst. Small asymptomatic cysts (<3 cm) with no suspicious features on imaging or FNA may be safely followed up. Follow-up should continue for at least 4 years, with a repeat FNA if needed. An algorithm for the management of pancreatic cystic tumours is also suggested. and IAP.

Surrogate markers of resectability in patients undergoing exploration of potentially resectable pancreatic adenocarcinoma.

Despite extensive preoperative staging, a significant number of pancreatic cancers are unresectable at surgical exploration. Patients undergoing pancreatic exploration with a view to resection were studied and comparisons are then made between those undergoing resection and a bypass procedure to identify surrogate markers of unresectability. One hundred thirteen consecutive patients underwent pancreatic exploration for head-of-pancreas (HOP) adenocarcinoma with curative intent. Fifty-five underwent pancreaticoduodenectomy and 58 underwent a bypass procedure. Student's t test, receiver operator characteristics (ROC) and logistic regression were used to compare the predictive value of preoperative patient variables collected retrospectively. The bypass group had a significantly higher median CA19.9 than the resection group (P = 0.003). Platelet count and neutrophil-lymphocyte ratio (NLR) were also significantly different (P = 0.013 and P = 0.026, respectively). ROC analysis indicated that age < or =65, platelet count >297 x 10(9)/l, CA19.9 < or =473 Ku/l, and CA19.9-bilirubin ratio were predictive variables for resectable disease. NLR and CA19.9-bilirubin ratio had specificity values of 92.9 and 97.0%, respectively. From logistic regression, a raised CA19.9 was found to be an independent risk factor for unresectable disease (P = 0.031). A significant proportion of patients with HOP adenocarcinoma are understaged preoperatively. Preoperative serology including platelet count, NLR, CA19.9, and CA19.9-bilirubin ratio may be used as additional discriminators of resectability particularly for high-risk patients.

Simultaneous ammonium-nitrogen and copper removal, and copper recovery using nitrifying biofilm from the ultra-compact biofilm reactor.

Simultaneous ammonium-nitrogen (NH(4)(+)-N) and copper removal, and copper recovery in synthetic wastewater using nitrifying biofilm from an ultra-compact biofilm reactor (UCBR) was demonstrated in batch studies, which consisted of three phases: Phase 1 for NH(4)(+)-N and copper removals, Phase 2 for copper recovery, and Phase 3 for NH(4)(+)-N removal. The results showed that more than 96.3% of copper was removed within 60min, while 60.1% of the adsorbed copper was recovered through rinsing the biofilms with 0.1mM of ethylenediaminetetraacetic acid (EDTA). The nitrifying biofilm was able to adsorb 0.245mg of copper/g of biofilms. After recovery treatment, 29.4% of copper remained bound within the nitrifying biofilms. No significant inhibitory effects towards NH(4)(+)-N removal in the presence of 0.92mg copper/L was noted in Phase 1 compared with the control test. However, lower initial pH condition in the recovery process and the accumulation of copper on the biofilm led to 50% inhibition on NH(4)(+)-N removal efficiency in the subsequent phase.

Progression of early warning scores (EWS) in patients with acute pancreatitis: a re-evaluation of a retrospective cohort of patients.

INTRODUCTION: Early warning scores (EWS) is a physiological scoring system measured hourly. This study determined how progression of EWS affected outcome in acute pancreatitis. METHODS: The single worst EWS score for each 24 h period following admission was recorded for 110 patients with acute pancreatitis. Scores falling below 3 were defined as improving; scores which remained at 3 or rising were considered deteriorating. RESULTS: Deteriorating EWS values were associated with a greatly increased risk of mortality (p<0.001). All patients within the groups, who died, had an adverse outcome or had severe pancreatitis, demonstrated a failure to improve on a median admission EWS of >or=3 or a deterioration of their median EWS to above this. This progression occurred within 48 h of admission. Evaluating the progression of EWS (that is, improving or deteriorating scores) resulted in an improvement in the sensitivity and specificity in predicting adverse outcome, mortality or severe pancreatitis when compared to previously published data on EWS scores alone, on days 1 to 3 following admission. CONCLUSION: Deteriorating EWS values within the 48 h from admission are associated with adverse outcome or death in acute pancreatitis. Measuring progression of EWS over 72 h from admission can further improve accuracy of this monitoring system for acute pancreatitis.

Feasibility of submerged anaerobic membrane bioreactor (SAMBR) for treatment of low-strength wastewater.

Two 6-L submerged anaerobic membrane bioreactors (SAMBR) with SRT of 30 and 60 d (denoted as R30 and R60, respectively) were set up and operated for five months, with a mixture of glucose as substrate. Feasibility of SAMBR was studied for treatment of low-strength wastewater. First two months were identified as acclimation stage. A COD removal efficiency was achieved stably at around 99% and biogas productions were maintained at 0.023 and 0.028 L CH4/gMLVSSd for R30 and R60, respectively. Even though R60 contained higher MLVSS concentration, no significant difference of treatment performances between both reactors was found due to the low organic loading rate and high purification function of membrane. In the investigation of membrane fouling, less irreversible fouling was observed for R30 compared to R60. High non-flocculent concentration of R60 would be responsible for membrane internal pore blocking and deteriorated effluent quality.

Improving rejection of organic fractions in reclaimed water based on intermolecular interaction effect.

The interactions of complex organic matters in reclaimed water were studied for the rejection mechanisms for organics removal by nanofiltration (NF) membrane. Rejection study on single organic fractions showed that base fractions are the most difficult ones to be removed, with the removal efficiencies of 40.08-47.73% for hydrophobic-base (Hpo-B) and 75.51-79.14% for hydrophilic-base (Hpi-B), respectively. Experimental results for interaction studies showed that with the presence of hydrophilic-acid (Hpi-A) and hydrophobic-acid (Hpo-A) at a concentration ratio of 1, the average rejections for acid + base fractions were 11-30% and 9-26% higher than those for the two corresponding single fractions, respectively. It was noted that after the ratio reaches a certain range (> 2 for Hpo-A in our case) the beneficial effects become less significant since the saturation of opportunities for interactions. With presence of acid and base fractions, the neutralization reactions and hydrophilic interactions would be the major beneficial interaction among different components. With the presence of hydrophobic-neutral (Hpo-N) at a concentration ratio of 1, the average rejections for neutral + base fractions were improved by 9-35% and when at a ratio of 2, the rejections only increased 2.28-8.87% more. The interaction between neutral organics and base organics would be due to the effect of coupling of different permeable components.

Treatment of RO brine-towards sustainable water reclamation practice.

Treatment and disposal of RO brine is an important part in sustaining the water reclamation practice. RO brine generated from water reclamation contains high concentration of organic and inorganic compounds. Cost-effective technologies for treatment of RO brine are still relatively unexplored. Thus, this study aim to determine a feasible treatment process for removal of both organic and inorganic compounds in RO brine generated from NEWater production. The proposed treatment consists of biological activated carbon (BAC) column followed by capacitive deionization (CDI) process for organic and inorganic removals, respectively. Preliminary bench-scale study demonstrated about 20% TOC removal efficiency was achieved using BAC at 40 mins empty bed contact time (EBCT) while the CDI process was able to remove more than 90% conductivity reducing it from 2.19 mS/cm to only about 164 microS/cm. More than 90% cations and anions in the BAC effluent were removed using CDI process. In addition, TOC and TN removals of 78% and 91%, respectively were also attained through this process. About 90% water recovery was achieved. This process shows the potential of increased water recovery in the reclamation process while volume for disposal can be further minimized. Further studies on the sustainable operation and process optimization are ongoing.