Clinical treatment outcomes and their changes in extremely preterm twins: a multicenter retrospective study in Guangdong Province, China. / è¶ æœªæˆç†ŸåŒèƒŽå„¿ä¸´åºŠæ•‘æ²»ç»“å±€åŠå˜åŒ–åˆ†æžï¼šä¸€é¡¹å¹¿ä¸œçœå¤šä¸­å¿ƒå›žé¡¾æ€§ç ”ç©¶.

OBJECTIVES: To investigate the clinical treatment outcomes and the changes of the outcomes over time in extremely preterm twins in Guangdong Province, China. METHODS: A retrospective analysis was performed for 269 pairs of extremely preterm twins with a gestational age of <28 weeks who were admitted to the department of neonatology in 26 grade A tertiary hospitals in Guangdong Province from January 2008 to December 2017. According to the admission time, they were divided into two groups: 2008-2012 and 2013-2017. Besides, each pair of twins was divided into the heavier infant and the lighter infant subgroups according to birth weight. The perinatal data of mothers and hospitalization data of neonates were collected. The survival rate of twins and the incidence rate of complications were compared between the 2008-2012 and 2013-2017 groups. RESULTS: Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of severe asphyxia and smaller head circumference at birth (P<0.05). The mortality rates of both of the twins, the heavier infant of the twins, and the lighter infant of the twins were lower in the 2013-2017 group compared with the 2008-2012 group (P<0.05). Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of pulmonary hemorrhage, patent ductus arteriosus (PDA), periventricular-intraventricular hemorrhage (P-IVH), and neonatal respiratory distress syndrome (NRDS) and a higher incidence rate of bronchopulmonary dysplasia (P<0.05). CONCLUSIONS: There is a significant increase in the survival rate over time in extremely preterm twins with a gestational age of <28 weeks in the 26 grade A tertiary hospitals in Guangdong Province. The incidences of severe asphyxia, pulmonary hemorrhage, PDA, P-IVH, and NRDS decrease in both the heavier and lighter infants of the twins, but the incidence of bronchopulmonary dysplasia increases. With the improvement of diagnosis and treatment, the multidisciplinary collaboration between different fields of fetal medicine including prenatal diagnosis, obstetrics, and neonatology is needed in the future to jointly develop management strategies for twin pregnancy.

Advances in technological control of greenhouse gas emissions from wastewater in the context of circular economy.

This review paper aims to identify the main sources of carbon dioxide (CO2) emissions from wastewater treatment plants (WWTPs) and highlights the technologies developed for CO2 capture in this milieu. CO2 is emitted in all the operational units of conventional WWTPs and even after the disposal of treated effluents and sludges. CO2 emissions from wastewater can be captured or mitigated by several technologies such as the production of biochar from sludge, the application of constructed wetlands (CWs), the treatment of wastewater in microbial electrochemical processes (microbial electrosynthesis, MES; microbial electrolytic carbon capture, MECC; in microbial carbon capture, MCC), and via microalgal cultivation. Sludge-to-biochar and CW systems showed a high cost-effectiveness in the capture of CO2, while MES, MECC, MCC technologies, and microalgal cultivation offered efficient capture of CO2 with associate production of value-added by-products. At the state-of-the-art, these technologies, utilized for carbon capture and utilization from wastewater, require more research for further configuration, development and cost-effectiveness. Moreover, the integration of these technologies has a potential internal rate of return (IRR) that could equate the operation or provide additional revenue to wastewater management. In the context of circular economy, these carbon capture technologies will pave the way for new sustainable concepts of WWTPs, as an essential element for the mitigation of climate change fostering the transition to a decarbonised economy.

Efficient Cu removal from CuEDTA complex-containing wastewater using electrochemically controlled sacrificial iron anode.

In this study, an electro-replacement/precipitation/deposition/direct reduction (ERPDD) process with scrap iron packed in a Ti mesh cage as a sacrificial anode was investigated for the treatment of wastewater containing CuEDTA complexes. The ERPDD mechanisms were responsible for the removal of Cu from CuEDTA complexes and were verified by a series of experiments using either iron or carbon plates as anodes for the Cu-containing solutions with and without EDTA. A complete Cu removal was achieved with electrical current density applied (1.18-2.36 mA/cm2), whereas only 60% of the Cu was removed without electricity. Dissolved oxygen (DO) was found to have a significant impact on Cu removal. Aeration reduced Cu removal (i.e., only 60% of the Cu was removed), whereas complete Cu removal was achieved with negligible DO concentration under mechanical mixing and N2 purging conditions. Compared to chemical replacement/precipitation (CRP) process, the ERPDD was able to save approximately 60-75% of the total operational costs during the treatment of CuEDTA-containing wastewater, due to the electrochemically controlled dosing of inexpensive sacrificial scrap iron and additional removal mechanisms not found in the CRP process.

Short-term outcomes of extremely preterm infants at discharge: a multicenter study from Guangdong province during 2008-2017.

BACKGROUND: An increasing number of extremely preterm (EP) infants have survived worldwide. However, few data have been reported from China. This study was designed to investigate the short-term outcomes of EP infants at discharge in Guangdong province. METHODS: A total of 2051 EP infants discharged from 26 neonatal intensive care units during 2008-2017 were enrolled. The data from 2008 to 2012 were collected retrospectively, and from 2013 to 2017 were collected prospectively. Their hospitalization records were reviewed. RESULTS: During 2008-2017, the mean gestational age (GA) was 26.68 ± 1.00 weeks and the mean birth weight (BW) was 935 ± 179 g. The overall survival rate at discharge was 52.5%. There were 321 infants (15.7%) died despite active treatment, and 654 infants (31.9%) died after medical care withdrawal. The survival rates increased with advancing GA and BW (p < 0.001). The annual survival rate improved from 36.2% in 2008 to 59.3% in 2017 (p < 0.001). EP infants discharged from hospitals in Guangzhou and Shenzhen cities had a higher survival rate than in others (p < 0.001). The survival rate of EP infants discharged from general hospitals was lower than in specialist hospitals (p < 0.001). The major complications were neonatal respiratory distress syndrome, 88.0% (1804 of 2051), bronchopulmonary dysplasia, 32.3% (374 of 1158), retinopathy of prematurity (any grade), 45.1% (504 of 1117), necrotizing enterocolitis (any stage), 10.1% (160 of 1588), intraventricular hemorrhages (any grade), 37.4% (535 of 1431), and blood culture-positive nosocomial sepsis, 15.7% (250 of 1588). The multivariate logistic regression analysis indicated that improved survival of EP infants was associated with discharged from specialist hospitals, hospitals located in high-level economic development region, increasing gestational age, increasing birth weight, antenatal steroids use and a history of premature rupture of membranes. However, twins or multiple births, Apgar ≤7 at 5 min, cervical incompetence, and decision to withdraw care were associated with decreased survival. CONCLUSIONS: Our study revealed the short-term outcomes of EP infants at discharge in China. The overall survival rate was lower than the developed countries, and medical care withdrawal was a serious problem. Nonetheless, improvements in care and outcomes have been made annually.

Cryolite (Na3AlF6) crystallization for fluoride recovery using an electrolytic process equipped with a sacrificial aluminum anode.

An electro-crystallization process equipped with a sacrificial aluminum anode was operated under an optimum condition to promote the formation of crystalline cryolite for the recovery of fluoride from synthetic F-containing wastewater. The effects of pH, Al/F molar ratio, initial F concentration, and electrolytes were investigated experimentally, and the results were compared with data obtained from chemical equilibrium modeling. Cryolite was successfully produced under optimum pH values of 5 to 6 and Al/F molar ratios of less than 1/6. The F removal increased with increasing Al/F molar ratio until reaching the molar ratio of 1/6 and decreased thereafter due to the formation of AlFn3-n species. The adsorption of AlFn3-n by Al(OH)3 precipitates contributed part of F removal. The removal efficiency reached 100% when the initial fluoride concentration was high while it was around 90% with the low initial fluoride concentration. XRD and SEM/EDX analysis showed that the obtained solids matched well to the commercial cryolite. Finally, the operating costs of chemical-crystallization (the process with Al ions added chemically) and electro-crystallization were compared, and the cost of the former was less than the latter. Energy consumption was the main contributor to the operating cost of the electro-crystallization process.

Pressurized CO2/zero valent iron system for nitrate removal.

A fluidized zero valent iron (ZVI) reactor pressurized by CO(2) gas for controlling pH was employed for nitrate reduction. The proposed CO(2) pressurized system potentially has advantages of using less CO(2) gas and reaching equilibrium pH faster than CO(2)-bubbled system. However, due to weak acid nature of carbonic acid, system pH gradually increased with increasing oxidation of ZVI and reduction of nitrate. As pH increased with progress of reaction, nitrate removal rate decreased continuously. The results indicate that nitrate removal efficiency increases with increasing initial ZVI dosage but reaches plateau at ZVI doses of higher than 8.25gl(-1), and initial nitrate concentration up to 100mg l(-1) as N has minimal impact on the removal efficiency. Unlike the fluidized system with pH control by strong acid reported in our pervious study, near 100% of nitrogen recovery was observed in the current process, indicating that nitrate reduction by ZVI with different pH controlled mechanisms will have different reaction routes.

Reduction of chromate from electroplating wastewater from pH 1 to 2 using fluidized zero valent iron process.

Fluidized zero valent iron (ZVI) process was conducted to reduce hexavalent chromium (chromate, CrO(4)(2-)) to trivalent chromium (Cr(3+)) from electroplating wastewater due to the following reasons: (1) Extremely low pH (1-2) for the electroplating wastewater favoring the ZVI reaction. (2) The ferric ion, produced from the reaction of Cr(VI) and ZVI, can act as a coagulant to assist the precipitation of Cr(OH)(3(s)) to save the coagulant cost. (3) Higher ZVI utilization for fluidized process due to abrasive motion of the ZVI. For influent chromate concentration of 418 mg/L as Cr(6+), pH 2 and ZVI dosage of 3g (41 g/L), chromate removal was only 29% with hydraulic detention time (HRT) of 1.2 min, but was increased to 99.9% by either increasing HRT to 5.6 min or adjusting pH to 1.5. For iron species at pH 2 and HRT of 1.2 min, Fe(3+) was more thermodynamically stable since oxidizing agent chromate was present. However, if pH was adjusted to 1.5 or 1, where chromate was completely removed, high Fe(2+) but very low Fe(3+) was present. It can be explained that ZVI reacted with chromate to produce Fe(2+) first and the presence of chromate would keep converting Fe(2+) to Fe(3+). Therefore, Fe(2+) is an indicator for complete reduction from Cr(VI) to Cr(III). X-ray diffraction (XRD) was conducted to exam the remained species at pH 2. ZVI, iron oxide and iron sulfide were observed, indicating the formation of iron oxide or iron sulfide could stop the chromate reduction reaction.

Dye wastewater treated by Fenton process with ferrous ions electrolytically generated from iron-containing sludge.

Fenton process was employed to treat synthetic dye wastewater with supply of Fe(II) electrolytically generated from iron-containing sludge which was recycled and reused throughout the study. Treated water quality and properties of iron sludge after being repeatedly used were reported and discussed. Experimental results showed that COD was mainly removed by oxidation other than coagulation. Although, the process was quite effective for COD and color removal, conductivity of treated water was enormously high. Meanwhile, repeated use of iron-containing sludge results in accumulation of organic materials embedded in the sludge as indicated by increasing volatile suspended solid (VSS)/TSS ratio and decreasing zeta potential.

Fluidized zero valent iron bed reactor for nitrate removal.

A fluidized zero valent iron (ZVI) reactor is examined for nitrate reduction. Using the system, the pH of solution can be maintained at optimal conditions for rapid nitrate reduction. For hydraulic retention times of 15 min, the nitrate reduction efficiency increases with increasing ZVI dosage. At ZVI loadings of 33 gl-1, results indicate that the nitrate removal efficiency increases from less than 13% for systems without pH control to more than 92% for systems operated at pH of 4.0. By maintaining pH at 4.0, we are able to decrease the hydraulic retention time to 3 min and still achieve more than 87% nitrate reduction. The recovery of total nitrogen added as nitrate, ammonium, and nitrite was less than 50% for the system operated at pH4.0, and was close to 100% for a system without pH control. The possibility of nitrate and ammonium adsorption onto iron corrosion products was ruled out by studying the behavior of their adsorption onto freshly hydrous ferric oxide at variable pH. Results indicate the probable formation of nitrogen gas species during reaction in pH4.0.