UV/TiO2 photocatalytic oxidation of recalcitrant organic matter: effect of salinity and pH.

Photocatalytic oxidation processes have interest for water treatment since these processes can remove recalcitrant organic compounds and operate at mild conditions of temperature and pressure. However, performance under saline conditions present in many water resources is not well known. This study aims to explore the basic effects of photocatalysis on the removal of organic matter in the presence of salt. A laboratory-scale photocatalytic reactor system, employing ultraviolet (UV)/titanium dioxide (TiO2) photocatalysis was evaluated for its ability to remove the humic acid (HA) from saline water. The particle size and zeta potential of TiO2 under different conditions including solution pH and sodium chloride (NaCl) concentrations were characterized. The overall degradation of organics over the NaCl concentration range of 500-2,000 mg/L was found to be 80% of the non-saline equivalent after 180 min of the treatment. The results demonstrated that the adsorption of HA onto the TiO2 particles was dependent on both the pH and salinity due to electrostatic interaction and highly unstable agglomerated dispersion. This result supports UV/TiO2 as a viable means to remove organic compounds, but the presence of salt in waters to be treated will influence the performance of the photocatalytic oxidation process.

Long Term Outcomes of Computer-Navigated Lateral Opening Wedge Distal Femoral Osteotomy for Lateral Compartment Knee Arthrosis.

Objective The primary aim of the present study was to evaluate the long-term outcomes including survivorship of computer navigated distal femoral lateral opening wedge osteotomy (DFLOWO). The secondary aim was to identify the potential factors that may influence its survivorship. Methods A retrospective analysis of prospectively collected data for patients with lateral compartment arthritis who underwent navigated DFLOWO from December 2006 to November 2012 was performed. The International Knee Documentation Committee (IKDC) and Knee Injury and Osteoarthritis Outcome Score (KOOS) scores were analyzed for outcome measures. Conversion to arthroplasty during the follow-up was the end point. Results A total of 19 DFLOWOs were performed in 17 patients with a mean age of 46.6 ± 6.5 years formed the study cohort. The coronal alignment was corrected from a mean of 7.1° (2-11°) valgus to a mean of 2.1° (0.5°-3°) varus. The IKDC scores improved from mean of 39 preoperatively to 53 at the mean long-term follow-up of 9.1 years. The mean KOOS scores at the long-term follow-up were pain 71, symptoms 56, activities of daily living 82, sports and recreation 59, quality of life 43. Survivorship of the DFLOWO was 78.9% at a follow-up of 9.1 years. Presence of ≥ grade 2 according to the International Cartilage Repair Society (ICRS) cartilage degeneration in the medial compartment of the knee and >7° preoperative valgus deformity were strongly correlated with conversion to total knee arthroplasty (TKA) at the long-term follow-up ( r = 0.66). Conclusions Computer navigated DFLOWO has satisfactory clinical outcomes and 79% survivorship in long-term follow-up. Presence of more than ICRS ≥ grade 2 degenerative changes in the medial compartment of knee with > 7° preoperative valgus deformity negatively affects the survivorship of DFLOWO in the long-term follow-up.

Should Sequential Bilateral Total Knee Arthroplasty Be Limited to Patients Younger than 80? A Two-Arm Propensity Matched Study.

Despite multiple studies, there remains a debate on the safety of bilateral total knee arthroplasty (BTKA) in the average age patient, with a paucity of data on the outcome of BTKA in an elderly population. This study included 89 patients aged 80 years and older undergoing sequential BTKA over 14 years were identified in a prospectively collected database. Two matched comparison groups were created: patients under 80 undergoing sequential BTKA and patients over 80 undergoing unilateral TKA (UTKA). An analysis of complications, mortality, revision, and patient-reported outcome measures was performed. Mean age of the elderly cohorts was similar: 82.6 for BTKA and 82.9 for UTKA. The average age BTKA cohort had a mean age of 69.1. Complication rates were higher in bilateral cohorts, more so in the elderly BTKA cohort. Pulmonary embolism (PE) was observed in bilateral cohorts only. In these patients, history of PE and ischemic heart disease was a strong predictive factor for developing a major complication. There was no difference in revision rates and infection rates between the three cohorts, and no difference in patient survivorship between the two elderly cohorts. Through the combination of low revision and high survivorship rates and comparable clinical outcomes, this article demonstrates that simultaneous BTKA is an appropriate option to consider for an elderly patient, with proper patient selection and perioperative management. The demonstrated risk groups show that emphasis on patient selection should be focused on medical history rather than chronological age.

The Use of Navigation in Osteotomies Around the Knee.

Osteotomies around the knee for treating osteoarthritis or knee instability are currently well-established procedures. Success of these realignment procedures is based on the accuracy and the reliability of correction angles in the coronal and sagittal alignment. In this context of improving precision and adapting the correction to each patient, navigation is currently being widely used. The rationale for its use is based on understanding the advantages and limitations, technical principles, and potential pitfalls. This article describes these areas and the overall clinical outcomes of this system for knee osteotomies.

Multiligament Knee Injury: Injury Patterns, Outcomes, and Gait Analysis.

Multiligament knee injuries remain a challenge for the treating surgeon and little is known about the injury patterns and factors determining clinical and gait outcomes after multiligament knee reconstruction (MLKR). This article aims to identify specificities of this complex injury, in terms of demographics, mechanisms of injury, injury pattern, and associated lesions. The time frame between injury and surgery and distribution of repair versus reconstruction procedures have been analyzed. This study reports functional and clinical outcomes, providing an overview of expected results. Using motion capture gait analysis, knee kinematics and gait characteristics of MLKR patients have been assessed.

Long Term Outcomes of Computer-Navigated Lateral Opening Wedge Distal Femoral Osteotomy for Lateral Compartment Knee Arthrosis / Resultados a longo prazo de osteotomia varizante femoral distal (OVFD) com cunha de abertura lateral para artrose do compartimento lateral do joelho utilizando navegação computadorizada

Abstract Objective The primary aim of the present study was to evaluate the long-term outcomes including survivorship of computer navigated distal femoral lateral opening wedge osteotomy (DFLOWO). The secondary aim was to identify the potential factors that may influence its survivorship. Methods A retrospective analysis of prospectively collected data for patients with lateral compartment arthritis who underwent navigated DFLOWO from December 2006 to November 2012 was performed. The International Knee Documentation Committee (IKDC) and Knee Injury and Osteoarthritis Outcome Score (KOOS) scores were analyzed for outcome measures. Conversion to arthroplasty during the follow-up was the end point. Results A total of 19 DFLOWOs were performed in 17 patients with a mean age of 46.6 ± 6.5 years formed the study cohort. The coronal alignment was corrected from a mean of 7.1° (2-11°) valgus to a mean of 2.1° (0.5°-3°) varus. The IKDC scores improved from mean of 39 preoperatively to 53 at the mean long-term follow-up of 9.1 years. The mean KOOS scores at the long-term follow-up were pain 71, symptoms 56, activities of daily living 82, sports and recreation 59, quality of life 43. Survivorship of the DFLOWO was 78.9% at a follow-up of 9.1 years. Presence of ≥ grade 2 according to the International Cartilage Repair Society (ICRS) cartilage degeneration in the medial compartment of the knee and >7° preoperative valgus deformity were strongly correlated with conversion to total knee arthroplasty (TKA) at the long-term follow-up (r= 0.66). ConclusionsComputer navigated DFLOWO has satisfactory clinical outcomes and 79% survivorship in long-term follow-up. Presence of more than ICRS ≥ grade 2 degenerative changes in the medial compartment of knee with > 7° preoperative valgus deformity negatively affects the survivorship of DFLOWO in the long-term follow-up.

Resumo Objetivo O objetivo principal do presente estudo foi avaliar os resultados a longo prazo, incluindo a sobrevivência em Osteotomia Varizante Femoral Distal com Cunha de Abertura Lateral (OVFD-CAL) utilizando navegação computadorizada. O objetivo principal do presente estudo foi avaliar os resultados a longo prazo, incluindo a sobrevivência. Métodos Foi realizada uma análise retrospectiva dos dados coletados prospectivamente de pacientes com artrite do compartimento lateral submetidos a OVFD-CAL por navegação de dezembro de 2006 a novembro de 2012. As pontuações International Knee Documentation Committee (IKDC, na sigla em inglês) e Knee Injury and Osteoarthritis Outcome Score (KOOS, na sigla em inglês) foram analisadas para medição de resultados. Conversão para artroplastia durante o acompanhamento foi o ponto final. Resultados Um total de 19 OVFD-CAL foram realizados em 17 pacientes com média de idade de 46,6 ± 6,5 anos formaram a coorte do estudo. O alinhamento coronal foi corrigido a partir de uma média de 7,1° (2-11°) de valgo para uma média de 2,1° (0,5°-3°) de varo. As pontuações do IKDC melhoraram de uma média pré-operatória de 39 para 53 no acompanhamento de médio de longo prazo de 9,1 anos. Os escores do KOOS no acompanhamento a longo prazo foram: dor 71, sintomas 56, atividades da vida diária 82, esportes e recreação 59, qualidade de vida 43. A sobrevivência do OVFD-CAL foi de 78,9% em um acompanhamento de 9,1 anos. Presença de degeneração da cartilagem segundo a Sociedade Internacional de Reparação de Cartilagem (International Cartilage Repair Society [ICRS, na sigla em inglês])≥ grau 2 no compartimento medial do joelho e deformidade pré-operatória em valgo > 7° fortemente correlacionado com a conversão para artroplastia total do joelho (ATJ) no acompanhamento a longo prazo (r - 0,66). ConclusõesA OVFD-CAL por navegação computadorizada apresentou resultados clínicos satisfatórios e sobrevida de 79% no acompanhamento a longo prazo. Presença de alterações degenerativas ICRS ≥ grau 2 no compartimento medial do joelho com > 7° de deformidade pré-operatória em valgo afeta negativamente a sobrevivência da OVFD-CAL no acompanhamento de longo prazo.

A structural basis for the amphiphilic character of alginates - Implications for membrane fouling.

Ostensibly hydrophilic alginates are known to foul hydrophobic membranes, under various conditions. Here, controlled experiments have been conducted at high and low pH on the fouling of a polypropylene membrane by alginate and the results suggest that the observed fouling is due to an intrinsic property of the alginate. Thus quantum chemical calculations on the M and G monomers of alginate reveal that M adopts an equilibrium geometry that is hydrophilic on one face and hydrophobic on the other, i.e. is potentially amphiphilic. Molecular dynamics simulations on short alginate chains of different sequences interacting with a modelled polypropylene surface, show that this characteristic is carried over to the polymer and results in hydrophobic patches along the chain that facilitate attractive interactions with the polypropylene surface. This concept is buttressed by an analysis of the binding characteristics of a previously reported X-ray structure of the mannuronan C-5 epimerase AlgE4 enzyme.

Experimental and computational investigations of the interactions between model organic compounds and subsequent membrane fouling.

The formation of aggregates of sodium alginate and bovine serum albumin (BSA) (as representative biopolymers) with humic acid were detected by Liquid Chromatography (LC) UV254 response in the biopolymer region for mixture solutions. BSA interaction with humic acid showed that aggregation occurred both in the presence and absence of calcium, suggesting that multivalent ions did not play a part in the aggregation process. Similar analyses of the alginate interaction with humic acid also showed a positive interaction, but only in the presence of calcium ions. The fouling characteristics for the BSA-humic acid mixture appeared to be significantly greater than the fouling characteristics of the individual solutions, while for the sodium alginate-humic acid mixture, the fouling rate was similar to that of the sodium alginate alone. The effectiveness of hydraulic backwashing, 10-15% reversibility, was observed for the BSA-humic acid mixture, while the % reversibility was 20-40% for the sodium alginate-humic acid mixture. Increased humic acid and DOC rejection were observed for both BSA-humic acid and sodium alginate-humic acid solutions compared to the individual solutions, indicating that the biopolymer filter cakes were able to retain humic acids. When compared with BSA-humic acid mixture solution, greater removal of humic acid was observed for alginate-humic mixture, suggesting that sodium alginate may have a greater capacity for associations with humic acid when in the presence of calcium than BSA. Complementary molecular dynamics simulations were designed to provide insights into the specific mechanisms of interaction between BSA and humic acid, as well as between alginate and humic acid. For the BSA-humic acid system; electrostatic, hydrophobic and hydrogen bonding were the dominant types of interactions predicted, whilst divalent ion-mediated bonding was not identified in the simulations, which supported the LC-results. Similarly for the alginate-humic acid system, the interactions predicted were divalent ion-mediated interactions only and this was also supported the LC results. This work suggests that LC-UV254 might be used to identify aggregated biopolymers, and that combined with current characterisation techniques, be used to better explain performance variations between water sources.

A pervaporation study of ammonia solutions using molecular sieve silica membranes.

An innovative concept is proposed to recover ammonia from industrial wastewater using a molecular sieve silica membrane in pervaporation (PV), benchmarked against vacuum membrane distillation (VMD). Cobalt and iron doped molecular sieve silica-based ceramic membranes were evaluated based on the ammonia concentration factor downstream and long-term performance. A modified low-temperature membrane evaluation system was utilized, featuring the ability to capture and measure ammonia in the permeate. It was found that the silica membrane with confirmed molecular sieving features had higher water selectivity over ammonia. This was due to a size selectivity mechanism that favoured water, but blocked ammonia. However, a cobalt doped silica membrane previously treated with high temperature water solutions demonstrated extraordinary preference towards ammonia by achieving up to a 50,000 mg/L ammonia concentration (a reusable concentration level) measured in the permeate when fed with 800 mg/L of ammonia solution. This exceeded the concentration factor expected by the benchmark VMD process by four-fold, suspected to be due to the competitive adsorption of ammonia over water into the silica structure with pores now large enough to accommodate ammonia. However, this membrane showed a gradual decline in selectivity, suspected to be due to the degradation of the silica material/pore structure after several hours of operation.

Effect of IX dosing on polypropylene and PVDF membrane fouling control.

The performance of ion exchange (IX) resin for organics removal from wastewater was assessed using advanced characterisation techniques for varying doses of IX. Organic characterisation using liquid chromatography with a photodiode array (PDA) and fluorescence spectroscopy (Method A), and UV254, organic carbon and organic nitrogen detectors (Method B), was undertaken on wastewater before and after magnetic IX treatment. Results showed partial removal of the biopolymer fraction at high IX doses. With increasing concentration of IX, evidence for nitrogen-containing compounds such as proteins and amino acids disappeared from the LC-OND chromatogram, complementary to the fluorescence response. A greater fluorescence response of tryptophan-like proteins (278 nm/343 nm) for low IX concentrations was consistent with aggregation of tryptophan-like compounds into larger aggregates, either by self-aggregation or with polysaccharides. Recycling of IX resin through multiple adsorption steps without regeneration maintained the high level of humics removal but there was no continued removal of biopolymer. Subsequent membrane filtration of the IX treated waters resulted in complex fouling trends. Filtration tests with either polypropylene (PP) or polyvinylidene fluoride (PVDF) membranes showed higher rates of initial fouling following treatment with high IX doses (10 mL/L) compared to filtration of untreated water, while treatment with lower IX doses resulted in decreased fouling rates relative to the untreated water. However, at longer filtration times the rate of fouling of IX treated waters was lower than untreated water and the relative fouling rates corresponded to the amount of biopolymer material in the feed. It was proposed that the mode of fouling changed from pore constriction during the initial filtration period to filter cake build up at longer filtration times. The organic composition strongly influenced the rate of fouling during the initial filtration period due to competitive adsorption processes, while at longer filtration times the rate of fouling appeared to depend upon the amount of biopolymer material in the feed water.

Characterisation of organic matter in IX and PACl treated wastewater in relation to the fouling of a hydrophobic polypropylene membrane.

Extensive organic characterisation of a wastewater using liquid chromatography with a photodiode array and fluorescence spectroscopy (Method A), and UV(254) and organic carbon detector (Method B) was undertaken, as well as with fluorescence excitation emission spectroscopy (EEM). Characterisation was performed on the wastewater before and after ion exchange (IX) treatment and polyaluminium chlorohydrate (PACl) coagulation, and following microfiltration of the wastewater and pre-treated wastewaters. Characterisation by EEM was unable to detect biopolymers within the humic rich wastewaters and was not subsequently used to characterise the MF permeates. IX treatment preferentially removed low molecular weight (MW) organic acids and neutrals, and moderate amounts of biopolymers in contrast to a previous report of no biopolymer removal with IX. PACl preferentially removed moderate MW humic and fulvic acids, and large amounts of biopolymers. PACl showed a great preference for removal of proteins from the biopolymer component in comparison to IX. An increase in the fluorescence response of tryptophan-like compounds in the biopolymer fraction following IX treatment suggests that low MW neutrals may influence the structure and/or inhibit aggregation of organic compounds. Fouling rates for IX and PACl treated wastewaters had high initial fouling rates that reduced to lower fouling rates with time, while the untreated Eastern Treatment Plant (ETP) wastewater displayed a consistent, high rate of fouling. The results for the IX and PACl treated wastewaters were consistent with the long-term fouling rate being determined by cake filtration while both pore constriction and cake filtration contributed to the higher initial fouling rates. Higher rejection of biopolymers was observed for PACl and IX waters compared to the untreated ETP water, suggesting increased adhesion of biopolymers to the membrane or cake layer may lead to the higher rejection.