Performance and onsite regeneration of natural zeolite for ammonium removal in a field-scale non-sewered sanitation system.

Natural zeolite clinoptilolite was used as the primary ammonium removal method from the permeate of an anaerobic membrane bioreactor (AnMBR) treating high-strength blackwater generated from a community toilet facility. This zeolite-based nutrient capture system (NCS) was a sub-component of a non-sewered sanitation system (NSSS) called the NEWgenerator and was field tested for 1.5 years at an informal settlement in South Africa. The NCS was operated for three consecutive loading cycles, each lasting 291, 110, and 52 days, respectively. Both blackwater (from toilets) and blackwater with yellow water (from toilets and urinals) were treated during the field trial. Over the three cycles, the NCS was able to remove 80 ± 28%, 64 ± 23%, and 94 ± 11%, respectively, of the influent ammonium. The addition of yellow water caused the rapid exhaustion of zeolite and the observed decrease of ammonium removal during Cycle 2. After Cycles 1 and 2, onsite regeneration was performed to recover the sorption capacity of the spent zeolite. The regenerant was comprised of NaCl under alkaline conditions and was operated as a recycle-batch to reduce the generation of regenerant waste. Modifications to the second regeneration process, including an increase in regenerant contact time from 15 to 30 h, improved the zeolite regeneration efficiency from 76 ± 0.7% to 96 ± 1.0%. The mass of recoverable ammonium in the regenerant was 2.63 kg NH4-N and 3.15 kg NH4-N after Regeneration 1 and 2, respectively. However, the mass of ammonium in the regenerant accounted for only 52.8% and 54.4% of the estimated NH4-N originally sorbed onto the zeolite beds after Cycles 1 and 2, respectively. The use of zeolite clinoptilolite is a feasible method for ammonium removal by NSSS that observe variable nitrogen loading rates, but further research is still needed to recover the nitrogen from the regenerant waste.

Closure of tracheocutaneous fistula using prefabricated conchal bowl cartilage and a supraclavicular flap.

BACKGROUND: Tracheocutaneous fistula represents one of the most troublesome complications of prolonged tracheostomy. Simple closure of a fistula can be ineffective, particularly in the context of prior surgery and adjuvant radiation. As such, modes of repair have expanded to include locoregional flaps and even free tissue transfers. OBJECTIVE: This paper describes a case of persistent tracheocutaneous fistula in an irradiated patient who had undergone previous unsuccessful attempts at repair. METHOD AND RESULTS: The use of regional fasciocutaneous supraclavicular flap with prefabricated conchal bowl cartilage resulted in successful closure of the tracheocutaneous fistula. CONCLUSION: This represents a novel technique for closure of such fistulas in patients for whom previous attempts have failed. This mode of repair should be added to the surgeon's repertoire of reparative techniques.

Formation of optical supramolecular structures in a fibre laser by tailoring long-range soliton interactions.

Self-assembly of fundamental elements through weak, long-range interactions plays a central role in both supramolecular DNA assembly and bottom-up synthesis of nanostructures. Optical solitons, analogous in many ways to particles, arise from the balance between nonlinearity and dispersion and have been studied in numerous optical systems. Although both short- and long-range interactions between optical solitons have attracted extensive interest for decades, stable soliton supramolecules, with multiple aspects of complexity and flexibility, have thus far escaped experimental observation due to the absence of techniques for enhancing and controlling the long-range inter-soliton forces. Here we report that long-range soliton interactions originating from optoacoustic effects and dispersive-wave radiations can be precisely tailored in a fibre laser cavity, enabling self-assembly of large numbers of optical solitons into highly-ordered supramolecular structures. We demonstrate several features of such optical structures, highlighting their potential applications in optical information storage and ultrafast laser-field manipulation.

Anaerobic biodegradability of Tween surfactants used as a carbon source for the microbial reductive dechlorination of hexachlorobenzene.

Three structurally-related, nonionic, polysorbate surfactants (Tween 60, 61, and 65) were used as the sole carbon source to sustain the microbial, sequential reductive dechlorination of hexachlorobenzene (HCB) in a mixed, methanogenic culture derived from a contaminated estuarine sediment. The surfactants were partially degraded and fermented to methane with no measurable accumulation of volatile fatty acids, indicating that methanogenesis was rapid relative to the rates of hydrolysis and acidogenesis. Addition of the methanogenesis inhibitor 2-bromoethanesulfonic acid resulted in acetate accumulation without impact on the sequential dechlorination of HCB. An anaerobic biodegradability assay was performed and the following data were obtained for the Tween 60, 61, and 65, respectively: 53, 62, and 62% COD destruction; 35, 57, and 48% COD to methane conversion; and 38, 38, and 45% COD to acetate conversion. These data suggest that the hydrophobic moiety (stearate) of the surfactants was preferentially degraded, most likely through beta-oxidation, to acetate and ultimately to methane and carbon dioxide. Between 38 and 47% of the initial surfactant COD remained after 46 d incubation, which most likely corresponds to the hydrophilic polyoxyethylene moiety. An anaerobic biodegradation pathway of the Tween surfactants is proposed.

Transoral robotic surgery vs. radiotherapy for management of oropharyngeal squamous cell carcinoma - A systematic review of the literature.

BACKGROUND: Intensity-modulated radiation therapy (IMRT) with or without concurrent chemotherapy is widely utilized for the treatment of oropharyngeal squamous cell carcinoma (OPSCC). However, due to significant acute and late toxicities there has been increasing interest in minimally invasive surgical approaches, particularly transoral robotic surgery (TORS) in an attempt to preserve patient quality of life while maintaining oncologic outcomes. The aim of this study was to review the current literature in order to compare primary IMRT versus TORS in the management of OPSCC. METHODS: A MEDLINE search was conducted to identify studies reporting on the outcomes of TORS or IMRT in the treatment of OPSCC. Reference lists were also reviewed for relevant articles. Oncologic, functional, and quality of life data is summarized and discussed. RESULTS: One hundred-ninety papers were identified through the MEDLINE search. An additional 52 papers were retrieved by hand searching the reference lists. Ultimately, 44 papers were identified that discussed outcomes after IMRT or TORS for OPSCC. No outcomes from randomized trials were identified. CONCLUSION: No randomized trials comparing TORS versus IMRT to each other were identified. Uncontrolled reports from the current literature suggest comparable oncologic outcomes with TORS compared to IMRT and functional outcomes may be superior. However, the median follow-up was relatively short and the TORS studies included patients with earlier stage OPSCC on average compared to IMRT studies. Prospective, randomized controlled trials and direct, well-matched comparisons are needed to further elucidate the role for TORS in the treatment of oropharyngeal squamous cell carcinoma.

Development of hexachlorobenzene-dechlorinating mixed cultures using polysorbate surfactants as a carbon source.

The use of three nonionic polysorbate surfactants--Tween 60, 61 or 65--as the sole carbon source to sustain methanogenesis and dechlorination, as well as the effect of long-term exposure of enriched cultures to these surfactants, was investigated through the development of three sediment-derived cultures. Over a one-year period, the carbon source in these cultures was gradually switched from glucose and methanol to surfactant only, while the surfactant concentration was increased from an initial concentration of 100 mg/L to 400 mg/L. In each feeding cycle, the surfactants were partially degraded and converted to methane. Transition from glucose to Tween surfactants as the electron donor did not affect the rate, extent, and pathway of HCB transformation. These surfactants sustained the reductive dechlorination of HCB even after one year of continuous addition to the enriched cultures. This study demonstrated that reductive dechlorination of HCB sustained by the fermentation of Tween surfactants is feasible. The results support the use of anaerobically degradable Tween surfactants for the biotransformation of polychlorinated organic compounds. In principle, these surfactants could be used to simultaneously increase the bioavailability of subsurface contaminants while serving as the carbon and electron source for microbial reductive dechlorination.