The association between referral by specialists in oral diagnosis on survival rates of patients with oral cancer: A retrospective cohort study.

BACKGROUND: To assess the influence of diagnosis and referral provided by specialists in oral diagnosis on disease-free survival and overall survival of patients with oral cancer. METHODS: A cohort of 282 patients with oral cancer treated at a regional cancer hospital from 1998 to 2016 was analyzed retrospectively. The referral register of the patients was analyzed and assigned to two groups: (1) those referred by oral diagnosis specialists (n = 129), or (2) those referred by nonspecialized professionals (n = 153). The cancer treatment evolution was assessed from the patients' records, and the outcome was registered concerning cancer recurrence and death. Sociodemographic and clinicopathological variables were explored as predictors of disease-free survival and overall survival. RESULTS: Group 1 exhibited lower T stages and a reduced incidence of regional and distant metastases. Surgery was performed in 75.2% of cases in Group 1, while in Group 2, the rate was 60.8%. Advanced T stages and regional metastases reduced the feasibility of surgery. Higher TNM stages and tumor recurrence were associated with decreased disease-free survival, while surgical intervention was a protective factor. Higher TNM stage had a negative impact on the overall survival. CONCLUSION: Specialized oral diagnosis did not directly impact disease-free survival and overall survival and did not influence the indication of surgery in oral cancer; however, it was associated with the diagnosis of early tumors and better prognosis.

Oral mucositis management with photobiomodulation, Bidens pilosa L. (Asteraceae) and Curcuma longa L. (Zingiberaceae), the FITOPROT herbal medicine, and its influence on inflammatory cytokine levels: a randomized clinical trial.

PURPOSE: This randomized clinical trial aimed to compare the effects of a mucoadhesive formula, containing curcuminoids from Curcuma longa L. and glycerinated extract of Bidens pilosa L. (FITOPROT), associated with photobiomodulation (PBM), and of PBM exclusively, on the incidence of oral mucositis (OM)-induced by radiotherapy (RT) in the head and neck region, and the salivary expression of inflammatory cytokines, in patients with head neck cancer. METHODS: Patients were randomly assigned into two intervention groups-FITOPROT + PBM (n = 25) or PBM (n = 27). PBM protocol comprised a wavelength of 660 nm, 25 mW, 0.25 J/point, and daily irradiation from the first until the last day of RT. FITOPROT was gargled twice a day. All patients underwent a preventive oral care program throughout the study. OM degree, salivary concentration of nitrite, and inflammatory (IL-1, TNFα, IL-6, IL-8, and IL-12p70), and anti-inflammatory (IL-10) cytokines were assessed at baseline, and at the 7th, 14th, 21st, and 30th RT sessions. RESULTS: There were no differences in the OM degree between groups, but the RT dose significantly affected the OM. The RT significantly affected the salivary nitrite, TNFα, IL-1ß, and IL-10 concentrations. CONCLUSION: FITOPROT associated with PBM showed limited effects on preventing the incidence of severe OM compared to PBM alone. However, FITOPROT + PBM may be associated with nitrite and cytokine balance, which may contribute to the occurrence of fewer cases of severe OM. TRIAL REGISTRATION: Brazilian Clinical Trials database (ReBEC; RBR-9vddmr), registered UTN code: U1111-1193-2066, registered in August 8th, 2017.

Phenolic compounds in water: Review of occurrence, risk, and retention by membrane technology.

Phenolic compounds are one of the main contributors to water source contamination worldwide. In this review, the data collected on Elsevier, Scopus, and Pubmed, considering papers published between 2000 and 2023, showed more than 60 different phenols have been identified in water matrix (<0.065-179,000,000 ng L-1). The highest concentration reported was in surface water canals in India. The most recurrent and studied compound was bisphenol A (n = 93) in concentrations ranging from 0.45 to 2,970,000 ng L-1. The solid phase extraction (HBL Oasis cartridge) and methanol as solvent was the method of pre-concentration most used followed by gas chromatography for the determination of phenols in water samples. The importance of drinking water guidelines incorporating more phenolic compounds was emphasized given the variety of these compounds quantified in water matrix. The human health risk assessment (HRA) was performed for the min-max concentrations of the pollutants reported in the literature. High HRA even at the lowest concentrations for 2-nitrophenol, 2,6-dichlorophenol, 3,4,5-trichlorophenol, 2,3,4,6-tetrachlorophenol, and 2,4-dinitrophenol was recognized. The cancer risk estimated was considered possible for 3-methylphenol, 2,4-dimethylphenol, 2,4,6-trichlorophenol, pentachlorophenol, and 2,4-dinitrophenol in the highest concentrations. The in-depth discussion of mechanisms, advantages, challenges, and carbon footprint of membrane technologies in water treatment and phenols retention demonstrated the great potential and trends for the production of safe drinking water, highlighting reverse osmosis, as a mature technology, and membrane distillation, as an emergent technology.

Potential for nutrients reuse, carbon sequestration, and CO2 emissions reduction in the practice of domestic and industrial wastewater recycling into agricultural soils: A review.

This review assesses the feasibility of reusing treated wastewater for irrigation in agricultural soils as a strategy for nutrients recycling and mitigation of CO2 emissions. Through a literature review, it was examined wastewater sources enriched with carbon and nutrients, including municipal wastewater and associated sludge, vinasse, swine wastewater, as well as wastewater from the food industry and paper and pulp production. The review also explores the dynamics of organic matter within the soil, discussing the aspects related to its potential conversion to CO2 or long-term storage. It was found that industrial wastewaters, owing to their higher organic matter and recalcitrance, exhibit greater potential for carbon storage. However, the presence of pollutants in wastewater necessitates careful consideration, particularly concerning their impact on soil quality. Toxic metals, microplastics, and organic compounds emerged as significant contaminants that could accumulate in the soil, posing risks to ecosystem health. To mitigate the environmental impacts, it was evaluated various wastewater treatment technologies and their associated carbon emissions. While advanced treatments may effectively reduce the contaminant load and mitigate soil impacts, their adoption is often associated with an increase in CO2 emissions. Membrane bioreactors, microfiltration, ultrafiltration, and up-flow anaerobic sludge blanket reactors were identified as promising technologies with lower carbon footprints. Looking ahead, future research should aim to enhance the understanding of carbon dynamics in soil and validate the environmental impacts of treated wastewater disposal. Despite remaining uncertainties, the literature indicates a positive outlook for wastewater recycling in soil, offering a viable strategy for carbon storage and mitigation of greenhouse gas emissions.

Photoaccelerated Water Dissociation Across One-Atom-Thick Electrodes.

Recent experiments demonstrated that interfacial water dissociation (H2O ⇆ H+ + OH-) could be accelerated exponentially by an electric field applied to graphene electrodes, a phenomenon related to the Wien effect. Here we report an order-of-magnitude acceleration of the interfacial water dissociation reaction under visible-light illumination. This process is accompanied by spatial separation of protons and hydroxide ions across one-atom-thick graphene and enhanced by strong interfacial electric fields. The found photoeffect is attributed to the combination of graphene's perfect selectivity with respect to protons, which prevents proton-hydroxide recombination, and to proton transport acceleration by the Wien effect, which occurs in synchrony with the water dissociation reaction. Our findings provide fundamental insights into ion dynamics near atomically thin proton-selective interfaces and suggest that strong interfacial fields can enhance and tune very fast ionic processes, which is of relevance for applications in photocatalysis and designing reconfigurable materials.

Tunable Spin Injection in High-Quality Graphene with One-Dimensional Contacts.

Spintronics involves the development of low-dimensional electronic systems with potential use in quantum-based computation. In graphene, there has been significant progress in improving spin transport characteristics by encapsulation and reducing impurities, but the influence of standard two-dimensional (2D) tunnel contacts, via pinholes and doping of the graphene channel, remains difficult to eliminate. Here, we report the observation of spin injection and tunable spin signal in fully encapsulated graphene, enabled by van der Waals heterostructures with one-dimensional (1D) contacts. This architecture prevents significant doping from the contacts, enabling high-quality graphene channels, currently with mobilities up to 130 000 cm2 V-1 s-1 and spin diffusion lengths approaching 20 µm. The nanoscale-wide 1D contacts allow spin injection both at room and at low temperature, with the latter exhibiting efficiency comparable with 2D tunnel contacts. At low temperature, the spin signals can be enhanced by as much as an order of magnitude by electrostatic gating, adding new functionality.

A conceptual model to establish preventive and corrective actions to guarantee water safety following scenarios of tailing dam failure.

One of the impacts related to mining dam failures is the change in water quality downstream of the rupture and a knowledge gap is observed in terms of methodologies aimed at the prognosis of impact in water abstractions, a vulnerability that can be identified before a rupture event. Thus, the present work aims to describe a novel methodological proposal, not currently considered by control agencies, of a standard protocol that enables a comprehensive prognosis of the impacts on water quality impact in scenarios of dam failure. Initially, extensive bibliographic research was carried out on the main disruptions events since 1965 intended to better comprehend the impacts on water quality and to identify mitigatory actions proposed by the time. The information provided a framework to propose a conceptual model for the prognosis of water abstractions, with the suggestion of software and studies to comprehend the different scenarios in the event of dam failure. A protocol was prepared to obtain information on potentially affected inhabitants and a multicriteria analysis was developed using the Geographic Information System (GIS) to suggest the employment of preventive and corrective actions. The methodology was demonstrated in the Velhas River basin considering a hypothetical scenario of tailing dam failure. Changes in water quality would be observed in 274 km of its extension, mainly related to alterations in solids, metals, and metalloids' concentration, in addition to the impact on important water treatment plants. The map algebra and the results suggest the need for structuring actions in cases where the water abstraction is intended for human supply and in populations greater than 100,000 inhabitants. Populations smaller than these, or usages other than human supply, could be supplied by water tank trucks or mixed alternatives. The methodology pointed out the necessity for structuring supply actions with due notice, with the potential to prevent water shortages in scenarios of tailing dam failure and to complement the enterprise resource planning of mining companies.

Integrated proteomics, phosphoproteomics and metabolomics analyses reveal similarities among giant cell granulomas of the jaws with different genetic mutations.

BACKGROUND: Giant cell granuloma of the jaws are benign osteolytic lesions of the jaws. These lesions are genetically characterized by mutually exclusive somatic mutations at TRPV4, KRAS, and FGFR1, and a fourth molecular subgroup which is wild-type for the three mutations. Irrespective of the molecular background, giant cell granulomas show MAPK/ERK activation. However, it remains unclear if these mutations lead to differences in their molecular signaling in giant cell granulomas. METHODS: Metabolomics, proteomics, and phosphoproteomics analyses were carried out in formalin-fixed paraffin-embedded samples of giant cell granuloma of the jaws. The study cohort consisted of five lesions harboring mutations in FGFR1, six in KRAS, five in TRPV4, and five that were wild-type for these mutations. RESULTS: Lesions harboring KRAS or FGFR1 mutations showed overall similar proteomics and metabolomics profiles. In all four groups, metabolic pathways showed similarity in apoptosis, cell signaling, gene expression, cell differentiation, and erythrocyte activity. Lesions harboring TRPV4 mutations showed a greater number of enriched pathways related to tissue architecture. On the other hand, the wild-type group presented increased number of enriched pathways related to protein metabolism compared to the other groups. CONCLUSION: Despite some minor differences, our results revealed an overall similar molecular profile among the groups with different mutational profile at the metabolic, proteic, and phosphopeptidic levels.

Unveiling metabolic changes in marsupialized odontogenic keratocyst: A pilot study.

OBJECTIVE: We aimed to assess which metabolic pathways would be implicated in the phenotypic changes of the epithelial lining of odontogenic keratocyst after marsupialization, comparing pre- and post-marsupialized lesions with adjacent oral mucosa. MATERIALS AND METHODS: Eighteen formalin-fixed and paraffin-embedded tissues from six subjects were divided into three paired groups: odontogenic keratocyst pre- (n = 6) and post-marsupialization (n = 6), and adjacent oral mucosa (n = 6). The metabolic pathways found in these groups were obtained by high-performance liquid chromatography-mass spectrometry-based untargeted metabolomics performed. RESULTS: Through putative metabolite annotation followed by pathway enrichment and predictive analysis with automated algorithms (Mummichog and Gene Set Enrichment Analysis), we found differences in many cellular processes that may be involved in inflammation, oxidative stress response, keratinocyte-basal membrane attachment, differentiation, and proliferation functions, all relevant to odontogenic keratocyst pathobiology and the phenotype acquired after marsupialization. CONCLUSION: Our study was able to identify several metabolic pathways potentially involved in the metaplastic changes induced by marsupialization of odontogenic keratocysts. An improved comprehension of this process could pave the way for the development of targeted therapies.

Direct contact membrane distillation as an approach for water treatment with phenolic compounds.

Membrane distillation is a well-established technology for non-volatile components retention, but the removal of volatile and semi-volatile substances in trace concentration, such as phenols derivates commonly found in surface waters, requires further comprehension. In this context, the direct contact membrane distillation (DCMD) performance was assessed for the retention of fifteen phenolic compounds in surface water by different operating conditions of temperature (40, 50, and 60 °C), feed concentration (3, 5, 7, and 10 µg L-1), and permeate recovery rate (30, 50 and 70%). Kruskal Wallis confirmed a significant difference (p < 0.05) between the global removal of phenolic compounds at different temperatures. The increase in temperature led to a reduction in all compound's removal. As expected, a positive correlation (rSpearman>0.8) between the compounds' volatility and their losses was observed. Regarding the feed concentration and the recovery rate, there was no statistical difference between the removal values obtained for the phenolic compounds. This indicates the DCMD strength for that application. However, a trend for flux decay was noticed as the recovery rate (RR) increased, confirmed by temporal trend analysis and Mann-Kendall tests, although the flux decay was relatively low (J/J0 = 0.89). Aiming for a greater removal and to avoid a reduction in process performance, it is recommended to work with 40 °C as feed temperature and a RR prior to the flux decay (RR<30%). Nonetheless, the technology was efficient and did not compromise the permeate quality with >90% efficiency in pollutants removal, even for higher temperatures and RR.

A survey on experiences in leachate treatment: Common practices, differences worldwide and future perspectives.

The necessity for landfill leachate treatment is a requisite to reduce the environmental impact related to municipal solid waste landfills and different aspects must be considered while deciding for an appropriate treatment process. For example, it was demonstrated that the landfill leachate stabilization in tropical regions is achieved right after its first year of operation, requiring technologies capable of treating leachates of a higher recalcitrant character if compared to those leachates from temperate regions and same landfill age. In view of its complexity and variability, stand-alone processes (either biological or physicochemical) are often ineffective in attaining the threshold values for its discharge in receiving bodies. Due to that fact, full-scale facilities have adopted integrated routes, harvesting the benefits of both biological and physicochemical processes. The implementation of membrane bioreactors followed by polishing membrane separation process (nanofiltration and reverse osmosis) seems to be a trend in leachate treatment by full-scale treatment plants. This technology is widely employed in China, European countries, and tropical countries as Brazil, generally with a treatment cost lower than the costs related to its disposal in domestic effluent collection systems. From the technologies already employed by full-scale facilities, four integrated routes were proposed for a sensitive analysis considering the treatment of a landfill leachate of different physicochemical characteristics. From all routes, those employing the membrane separation process as a polishing step had a better efficacy in attaining the threshold values for leachate disposal, being that an interesting alternative for leachate polishing by full-scale facilities.

Influence of humic substances on the landfill leachate biodegradability with a focus on temporal seasonality.

The high resilience to biological treatments from the landfill leachate is generally associated with the presence of humic substances (HS). The brown color characteristic of this effluent is also related to these substances. Landfill leachate with low biodegradability can make biological treatments unfeasible, which can drive up the cost for the treatment of large leachate volumes. In this context, this research aimed to characterize the leachate in different seasonal periods, and verify the influence of HS species on the biodegradability of the effluent to assist in the selection of adequate treatment techniques. The HS quantification was performed using the modified Lowry method and speciation through fractionation according to the molar masses of the HS species. The tropical regions can be the precursor for the rapid stabilization of biodegradable organic matter. The warmer climate contributed to a reduced BOD/COD ratio (0.03) and the predominance of compounds of lower mass (e.g.: fulvic acids). The tests showed an HS concentration of 26.9% of the total COD in the raw leachate in the rainy season, which increased to 37.3% in the dry season. Approximately 70% of HS species refer to fulvic acids, a fraction identified as having the highest biologic treatment resilience.

Phenolic compounds in surface water: methodology and occurrence in Doce River, Brazil.

Phenolic compounds are widely spread in surface water, mainly in developing countries, where sewage and wastewater treatment are still reduced. Thus, this work quantified these pollutants in the Doce River analyzing the associated risk for the environment and human health. This river is in the state of Minas Gerais in Brazil and was recently impacted by the collapse of a mining dam that compromised the resilience of the entire watershed. For that purpose, a methodology for simultaneous identification and quantification of 17 different phenols was developed. It was possible to verify phenolic compounds' occurrence with concentration ranging from 0.13 to 24.16 µg·L-1. 2-Nitrophenol and bisphenol A appeared in all samples analyzed. The analytical method was processed using solid-phase extraction (SPE) (C18 cartridge), gas chromatography with FID, and mass spectrometry to define the analytes' retention time. For case validation, the selectivity, linearity, detection and quantification limits, sensitivity, precision, accuracy, resolution, matrix effect, and peak quality were assessed. Four different solvents were tested in the recovery-grade trials, which were dichloromethane, methanol, acetonitrile, and ethyl acetate. Among them, methanol had a better performance and was used throughout all analyses. The phenolic compounds had a recovery degree higher than 50% after SPE, regardless of the matrices.

Diazepam, metformin, omeprazole and simvastatin: a full discussion of individual and mixture acute toxicity.

High consumption of drugs, combined with their presence in the environment, raises concerns about its consequences. Even though researches are often engaged in analyzing substances separately, that is not the environmental reality. Therefore, the aim of this study was to investigate the acute toxicity of the pharmaceuticals simvastatin, metformin, omeprazole and diazepam, and all possible mixtures between them, to the organism Aliivibrio fischeri, verifying possible synergistic or antagonistic effects and assessing byproducts formation. In terms of individual toxicity, omeprazole is the most toxic of the active ingredients, followed by simvastatin, diazepam and, finally, metformin. When the toxicity of mixtures was tested, synergism, antagonism and hormesis were perceived, most probably generated due to byproducts formation. Moreover, it was observed that even when compounds are at concentrations below the non-observed effect concentration (NOEC), there may be toxicity to the mixture. Hence, this work points to the urgent need for more studies involving mixtures, since chemicals are subject to interactions and modifications, can mix, and potentiate or nullify the toxic effect of each other.

Total factor productivity change in dairy farming: Empirical evidence from southern Chile.

Despite the importance of productivity growth, many studies carried out at the farm level focus primarily on the technical efficiency (TE) component of farm productivity. Therefore, the general purpose of this paper is to measure total factor productivity change and then to decompose this change into several distinct elements. The data were an unbalanced panel for the period from 2005 to 2010 containing 477 farms and 1,426 observations obtained from TODOAGRO, a farm-management center created in 1996 in the southern part of Chile. The region where the data come from accounts for 20% of the total milk processed in the country. Stochastic production frontiers along with the translog functional form were used to analyze total factor productivity change. The econometric evidence indicates that farms exhibit decreasing returns to size implying that costs of production rise as farm size increases, which suggests that the motivation for farm growth stems from the search for income rather than from lowering costs. The main results indicated that productivity gains through TE improvements are limited, with an average TE for the whole sample of 91.0%, and average technical efficiency change of 0.05% per year. By contrast, average technological progress at the sample mean was rather high at 1.90%, which suggests that additional investments in research and subsequent adoption of improved technologies would have a positive effect on productivity growth. The findings also revealed that farm size is not associated with productivity growth for the dairy farms in the sample.

Integrating reverse osmosis to a conventional river water treatment plant as a strategy to produce drinking water after mining dam rupture events: a case study.

Incidents of mining dam failure have compromised the water quality, threatening the water supply. Different strategies are sought to restore the impacted area and to guarantee the water supply. One example is water treatment plants that treat high-polluted waters within the required limits for their multiple usages. The current study assesses the integration of reverse osmosis (RO) to a river water treatment plant (RWTP) installed in Brumadinho (Minas Gerais, Brazil) to treat the water from the Ferro-Carvão stream impacted by the B1 dam rupture in 2019. The RWTP started eleven months after the mining dam rupture and is equipped with eight coagulation-flocculation tanks followed by eight pressurised filters. A pilot RO plant was installed to polish the water treated by the RWTP. Water samples were collected at different points of the water treatment plant and were characterised by their physical, chemical, and biological parameters (160 in total). The results were compared with the historical data (1997-2022) to reveal the alterations in the water quality after the rupture event. The compliance with both parameters was only achieved after the RO treatment, which acted as an additional barrier to 30 contaminants. The water quality indexes (WQI) suggested that the raw surface water, even eleven months after the incident, was unfit for consumption (WQI: 133.9) whereas the reverse osmosis permeate was ranked as excellent in the rating grid (WQI: 23.7).

Effects of Terbufos (Organophosphate) on Larval Behaviour of Two Forensically Important Diptera Species: Contributions for Entomotoxicology.

Neurotoxicant compounds interfere with the behaviour and biology of insects, significantly altering their locomotion patterns. However, little is known about the effect of organophosphates, neurotoxicants for agricultural, domestic and industrial use, on the larval movement of necrophagous flies, although being responsible for frequent cases of poisoning and accidental or intentional deaths. Thus, we aimed to study the influence of Terbufos (organophosphate) on the activity and mobility patterns of Lucilia eximia (Wiedemann 1819) (Calliphoridae) and Peckia (Peckia) chrysostoma (Wiedemann 1830) (Sarcophagidae) immatures collected from rat carcasses intoxicated with 5, 10 or 20 mg/kg of Terbufos, to evaluate (i) peristaltic movements and body contractions, and (ii) distance and shape of the trajectory travelled by the larva. Behavioural parameters were analysed in loco and through videos. We observed that the presence of Terbufos altered poisoned larvae's activity and body mobility in both taxon and dose-dependent manner. Lucilia eximia larvae were more active, with greater frequency of body movements and lateral contractions when intoxicated with high and intermediate doses of Terbufos. On the other hand, P. (P.) chrysostoma immatures were less active, with fewer body and lateral contractions when intoxicated with the high dose of the compound. This work experimentally demonstrates that the presence of Terbufos can alters the mobility and movement of intoxicated necrophagous Diptera, essential components of the cadaveric fauna.

Exploring room temperature spin transport under band gap opening in bilayer graphene.

We study the room-temperature electrical control of charge and spin transport in high-quality bilayer graphene, fully encapsulated with hBN and contacted via 1D spin injectors. We show that spin transport in this device architecture is measurable at room temperature and its spin transport parameters can be modulated by opening of a band gap via a perpendicular displacement field. The modulation of the spin current is dominated by the control of the spin relaxation time with displacement field, demonstrating the basic operation of a spin-based field-effect transistor.

The altered metabolic pathways of diffuse large B-cell lymphoma not otherwise specified.

Altered metabolic fingerprints of Diffuse large B-cell lymphoma, not otherwise specified (DLBCL NOS) may offer novel opportunities to identify new biomarkers and improve the understanding of its pathogenesis. This study aimed to investigate the modified metabolic pathways in extranodal, germinal center B-cell (GCB) and non-GCB DLBCL NOS from the head and neck. Formalin-fixed paraffin-embedded (FFPE) tissues from eleven DLBCL NOS classified according to Hans' algorithm using immunohistochemistry, and five normal lymphoid tissues (LT) were analyzed by high-performance liquid chromatography-mass spectrometry-based untargeted metabolomics. Partial Least Squares Discriminant Analysis showed that GCB and non-GCB DLBCL NOS have a distinct metabolomics profile, being the former more similar to normal lymphoid tissues. Metabolite pathway enrichment analysis indicated the following altered pathways: arachidonic acid, tyrosine, xenobiotics, vitamin E metabolism, and vitamin A. Our findings support that GCB and non-GCB DLBCL NOS has a distinct metabolomic profile, in which GCB possibly shares more metabolic similarities with LT than non-GCB DLBCL NOS.

Membrane technology as an emergency response against drinking water shortage in scenarios of dam failure.

With dam failure events, there can be changes in water quality and difficulties in the operation of water treatment plants (WTPs) since they were not designed for water treatment under severe pollution conditions. To avoid that, it was investigated two strategies based on pre-oxidation, ultrafiltration (UF) and reverse osmosis (RO) integrated into a conventional treatment process (coagulation, flocculation, and sand filtration) or with each other, with the potential to reduce the risks of drinking water shortage and guarantee a safe drinking water supply. The study considered the context of the Velhas river basin (Brazil), where water quality is compromised by high turbidities (500-3000 NTU) and excessive arsenic (∼0.4 mg/L), iron (∼50 mg/L), and manganese (∼3 mg/L) levels. They were only partially removed by conventional treatments (removals: 74 ± 21%) and potability standards were only achieved after the membrane separation processes were considered (As: <0.01 mg/L, Mn: <0.1 mg/L, and Fe: <0.3 mg/L). The high water quality after RO enables its blend with the stream obtained after sand filters and would allow for greater flexibility during the operation of WTPs operation. Despite the susceptibility to fouling and most frequent maintenance, the pre-oxidation-UF-RO system would also guarantee a safe drinking water supply. The decision for the most adequate strategy was then based on a multicriteria analysis. A retrofit of conventional WTPs by their integration with UF-RO was classified as the best strategy for centralized facilities, whereas pre-oxidation-UF-RO better fits the reality of decentralized treatments given the lower costs and deployment time. The methodology based on multicriteria analysis and water treatment technologies, exemplified by membranes in this study, presented satisfactory results for different scenarios of critical treatment.