Quality of life and anxiety 12 and 36 months after surgical SUI treatment in postmenopausal women.

BACKGROUND: Stress urinary incontinence (SUI) is a common condition that affects a significant group of postmenopausal women, lowering quality of life, leading to embarrassment, social isolation, and decreased physical activity. SUI can be treated with medication, behavioral changes, pelvic floor muscle exercises, or surgical intervention. This study aimed to assess the changes in quality of life, acceptance of illness, and impact on physical activity, in patients after the transobturator tape (TOT) procedure following long-term assessment. MATERIAL AND METHODS: Forty-five women aged 71.52 ± 4.12 years took part in our follow-up project at 12 and 36 months after surgical intervention. The World Health Organization Quality of Life Questionnaire (WHOQOL-BREF), Acceptance of Illness Scale Questionnaire (AIS), and International Physical Activity Questionnaire (IPAQ) were used in the study. RESULTS: At 36 months after surgery, SUI using TOT showed a significant improvement in health acceptance. Also, there was a number of patients who reported a high level of acceptance according to the AIS. CONCLUSION: Elderly women with SUI, after treatment by TOT, showed a significant improvement in health acceptance 3 years after the procedure.

Over 200,000 kilometers of free-flowing river habitat in Europe is altered due to impoundments.

European rivers are disconnected by more than one million man-made barriers that physically limit aquatic species migration and contribute to modification of freshwater habitats. Here, a Conceptual Habitat Alteration Model for Ponding is developed to aid in evaluating the effects of impoundments on fish habitats. Fish communities present in rivers with low human impact and their broad environmental settings enable classification of European rivers into 15 macrohabitat types. These classifications, together with the estimated fish sensitivity to alteration of their habitat are used for assessing the impacts of six main barrier types (dams, weirs, sluices, culverts, fords, and ramps). Our results indicate that over 200,000 km or 10% of previously free-flowing river habitat has been altered due to impoundments. Although they appear less frequently, dams, weirs and sluices cause much more habitat alteration than the other types. Their impact is regionally diverse, which is a function of barrier height, type and density, as well as biogeographical location. This work allows us to foresee what potential environmental gain or loss can be expected with planned barrier management actions in rivers, and to prioritize management actions.

The Relationship between Anxiety and Depression Levels and General Health Status before and 12 Months after SUI Treatment in Postmenopausal Women from the Lower Silesian Population.

Menopause is often the cut-off point from which most cases of stress urinary incontinence (SUI) in women begin. This dysfunction affects not only the physical experience of the patient, but is also related to the psychological aspects, leading to a reduced quality of life. Despite the large number of patients with SUI and the frequent use of surgical treatment for this condition, there are few scientific reports evaluating the effectiveness of the procedure in terms of reducing depressive symptoms or improving overall health. The aim of this study was to evaluate the relationship between anxiety and depression and general health status before and 12 months after surgical treatment for SUI in postmenopausal women. Seventy-five patients qualified for the study, but due to the long study duration, both sets of questionnaires were eventually obtained from 60 postmenopausal patients. All patients that qualified for the study had a trans obturator tape (TOT) procedure. All patients enrolled in the project were given the Hospital Anxiety and Depression Scale (hAdS) and King's Health Questionnaire (KHQ). After 12 months of surgery with midurethral slings, symptoms of depression were present in only a small number of subjects, 11.7%, and anxiety was present in 13.3% of the entire group. The study confirms that patients with a general poor health condition may suffer from depression or anxiety, and therefore may also need psychological treatment. Patients with SUI should therefore receive therapeutic care from a multidisciplinary team, in which therapeutic activities are divided between doctors, nurses, physiotherapists and psychologists. As a result of the treatment, after 12 months, we confirmed a significant improvement in patients with depression and anxiety disorders.

Assessment of the Effectiveness of the Sonofeedback Method in the Treatment of Stress Urinary Incontinence in Women-Preliminary Report.

Urinary incontinence is a common problem that affects postmenopausal women. This ailment has a negative impact on many aspects of life, significantly limiting everyday functioning related to professional work, physical activity or the intimate sphere. The aim of the study was to assess the effectiveness of the sonofeedback method in reducing the severity of urinary incontinence in postmenopausal women with a urinary incontinence problem. A total of 60 patients aged 45-65 with stress urinary incontinence, confirmed by a gynecologist, were qualified for the study. All persons qualified for the study were randomly assigned to study group A (n = 20), comparative B (n = 20) and control C (n = 20). Patients from group A were treated with sonofeedback of the pelvic floor muscles. In group B, the combined electrostimulation method was used with biofeedback training. Group C was a control group in which only the measured parameters were measured at the same time interval as those carried out in groups A and B. In all patients, three times: before the therapy, after the fifth procedure and after the end of the therapy, the incidence and severity of stress urinary incontinence were assessed-Gaudenz questionnaire and the intensity of urinary incontinence-a modified 1 h pad test. The obtained results have an application value giving the possibility of using effective therapy with sonofeedback in women in whom the recommended electrostimulation method cannot be used due to health and behavioral reasons.

Quality of Life of Physically Active and Inactive Women Who Are Older after Surgery for Stress Urinary Incontinence Using a Transobturator Tape (TOT).

Urinary incontinence is a major health problem. According to various authors, it concerns 30-40% of the population and grows with age, affecting approximately 50% of women aged over 70. According to the recommendations of the International Continence Society, the treatment of urinary incontinence should commence with conservative treatment and, above all, with physiotherapy. If the conservative treatment fails or the level of urinary incontinence is too high, surgery is recommended. With regard to female patients examined at work, the TOT method was applied. The aim of this study was to assess the relationship between regular physical activity and the quality of life of women aged 65-87 who underwent surgical treatment for stress urinary incontinence (SUI) using the TOT method. The study group involved 60 postmenopausal women, patients of the Department of Gynaecology of the Hospital of Ministry of the Interior and Administration in Wroclaw, with SUI diagnosed during ultrasonography. The female patients were surveyed before and 12 months after the surgery using standardised IPAQ and WHOQOL-BREF.FL questionnaires. Significant positive relationships between quality of life and physical activity before and 12 months after the surgery were demonstrated in the somatic and social domains. Physically active postmenopausal women presented higher values in all domains and total quality of life according to the WHOQOL-BREF compared with physically inactive women, both before and 12 months after the procedure using the TOT method.

A Prospective Study of the Quality of Life of Patients with Stress Incontinence before and after a Transobturator Tape (TOT) Procedure-Preliminary Report.

BACKGROUND: Urinary incontinence (UI) is a significant social problem. The latest figures show that it affects as many as 17-60% of the female population, and it is one of the most common chronic diseases. Incontinence substantially decreases the quality of patients' lives. The transobturator tape (TOT) procedure is the gold standard in surgical treatment due to its high efficacy and low complication rate. OBJECTIVE: The aim of this study was to assess the quality of life (QoL) of patients with stress incontinence before and after the TOT procedure. METHOD: The study included 57 patients diagnosed with stress incontinence on the basis of ultrasonography and history. The QoL before and after surgery was measured using the Incontinence Impact Questionnaire (IIQ-7) and the Incontinence Quality of Life (I-QOL) standardised questionnaires. RESULTS: The IIQ-7 scores for each question were higher (indicating poorer quality of life) before surgery than after surgery. The results for almost all domains were statistically significant. The I-QOL results also showed that, in most cases, the quality of patients' lives improved after the surgery. Statistically significant changes were observed in all three questionnaire domains of avoidance/limiting behaviour, psychosocial impact, and social embarrassment. CONCLUSION: Surgical treatment of stress incontinence with TOT results in resolution of bothersome symptoms in the majority of patients, leading to improved comfort in life.

The enhancement of valley water retentiveness in climate change conditions.

River system retentiveness must be enhanced to increase multidimensional environmental sustainability and thus ameliorate the effects of climate change and the occurrence of extreme hydrological events. The aim of the article is to demonstrate how ecohydrological Nature-Based Solutions can be combined with conventional infrastructure to improve WBSRCE benefits (Water, Biodiversity, ecosystem Services, Resilience, Culture, Education) by taking a holistic approach to multifunctional reservoir design. The paper proposes a new form of lateral reservoir, which is built without disturbing the meandering river and is supplied with good quality water through a monitoring and regulatory system; its design is based on thorough analysis of hydrological pulses and suspended matter and nutrients fluxes. The regulatory system also includes an innovative Sequential Sedimentation and Biofiltration System. Lateral reservoirs increase water retentiveness in the river valley by lifting ground water level and restoring surrounding wetlands, thus enhancing biodiversity, ecosystem services for society and the resilience of the river system to climate change. An integrative understanding of the interplay between hydrology and biocenosis can be used to enhance river system sustainability potential (WBSR) and harmonise societal needs with biosphere sustainability through culture and education (CE).

Comparative Assessment of Female Sexual Function Following Transobturator Midurethral Sling for Stress Urinary Incontinence.

Urinary incontinence (UI) is a significant social problem. According to the World Health Organization, UI affects as much as 30% of premenopausal women and 60% of postmenopausal women. Urinary incontinence can lead to certain problems that negatively affect a woman's sex life. They result from the fact that certain processes take place in the body during intercourse. As a result of orgasm, the intra-abdominal pressure increases, which in women with urinary incontinence can cause an uncontrolled leakage of urine. The discomfort that this causes, in turn, lowers sexual attractiveness, as well as causes embarrassment. The study involved 50 patients hospitalized in the period from February to May 2019 at the Gynecology Department of the Independent Public Healthcare Center of the Ministry of the Interior and Administration in Wroclaw. All patients underwent surgical treatment of stress urinary incontinence using the transobturator tape (TOT) method. To assess sexuality, the international standardized Female Sexual Function Index (FSFI) questionnaire. Analysis of the results obtained from the FSFI questionnaire shows that the operation significantly affects the reduction in pain sensation during intercourse, a reduction in the sensation of sexual arousal, and a worsening vaginal wetness. Stress urinary incontinence significantly affects women's sex life.

Peak grain forecasts for the US High Plains amid withering waters.

Irrigated agriculture contributes 40% of total global food production. In the US High Plains, which produces more than 50 million tons per year of grain, as much as 90% of irrigation originates from groundwater resources, including the Ogallala aquifer. In parts of the High Plains, groundwater resources are being depleted so rapidly that they are considered nonrenewable, compromising food security. When groundwater becomes scarce, groundwater withdrawals peak, causing a subsequent peak in crop production. Previous descriptions of finite natural resource depletion have utilized the Hubbert curve. By coupling the dynamics of groundwater pumping, recharge, and crop production, Hubbert-like curves emerge, responding to the linked variations in groundwater pumping and grain production. On a state level, this approach predicted when groundwater withdrawal and grain production peaked and the lag between them. The lags increased with the adoption of efficient irrigation practices and higher recharge rates. Results indicate that, in Texas, withdrawals peaked in 1966, followed by a peak in grain production 9 y later. After better irrigation technologies were adopted, the lag increased to 15 y from 1997 to 2012. In Kansas, where these technologies were employed concurrently with the rise of irrigated grain production, this lag was predicted to be 24 y starting in 1994. In Nebraska, grain production is projected to continue rising through 2050 because of high recharge rates. While Texas and Nebraska had equal irrigated output in 1975, by 2050, it is projected that Nebraska will have almost 10 times the groundwater-based production of Texas.

The impact of WWTP size and sampling season on the prevalence of antibiotic resistance genes in wastewater and the river system.

There is a growing concern about the fate of antibiotic resistance genes (ARGs) during wastewater treatment and their potential impacts on the receiving water bodies. We hypothesised that the quantity of ARGs in effluents may be related to the size of wastewater treatment plants (WWTPs) and sampling season. To date, only several attempts have been made to investigate the impact of the above factors at the catchment scale. Therefore, the goal of the present study was to explore possible differences in the quantity of ARGs in treated wastewater from small, medium-sized and large WWTPs in the catchment of the Pilica River (9258 km2). The impact of treated wastewater on the concentration of ARGs was also determined along the river continuum from upland to lowland segments to the point of confluence with the Vistula (342 km). Treated effluent was sampled in 17 WWTPs, and river water was sampled in 7 sampling sites in four seasons. The concentrations of blaTEM, tet(A), ermF, sul1 and aac(6')-Ib-cr genes, the integrase gene intI1 and the 16S rRNA gene were analysed by quantitative PCR. The physical and chemical parameters and nutrient concentrations (23 various parameters) in the analysed samples were determined. The highest absolute concentrations of the studied genes were noted in effluent samples from small WWTPs (p < 0.01). The concentration of ARGs (gene copies/mL) peaked in winter and spring samples (p < 0.04). The results of statistical analyses indicate that in small WWTPs, the absolute concentration of ARGs can be predicted based on the biochemical oxygen demand, in routine water analyses. However, none of the studied parameters supported predictions of ARG abundance in medium-sized and large WWTPs or in river water.

The assessment of quality of life and satisfaction with life of patients before and after surgery of an isolated apical defect using synthetic materials.

BACKGROUND: Pelvic floor static disorders constitute a significant clinical and social problem. The incidence of the problem increases with the age of female patients up to 80 years of age. Due to various methods of procedural treatment, eligibility for surgery should be carefully discussed with the patient. Ideally, the surgery should be effective and with the least possible number of complications. The objective of this study was to assess the quality of life of patients before and after the surgery of an isolated apical defect with the use of BSC mesh. METHODS: The study involved 60 patients who were diagnosed with pelvic floor static disorder on the basis of physical examination. Standardised questionnaires were used to assess the quality of life and satisfaction with life: the Perceived Quality of Life (P-QOL) and the Satisfaction With Life Scale (SWLS). RESULTS: The P-QOL results for each domain were higher in patients before surgery compared to the results obtained after the surgery. For almost all domains, the results obtained were statistically significant. The results obtained in the SWLS questionnaire in most answers also show that after the procedure there was an improvement in satisfaction with life in the examined female patients. CONCLUSION: In most patients, surgical treatment of an isolated apical defect using BSC mesh results in the subsidence of bothersome symptoms and improves the quality of life.

The ecohydrological approach, SWAT modelling, and multi-stakeholder engagement - A system solution to diffuse pollution in the Pilica basin, Poland.

The reduction of diffused nutrient pollution from agriculture is one of the defining challenges of our time, demanding system solutions. A nitrogen and phosphorus (N&P) reduction strategy at the catchment scale is the most realistic and effective long-term approach to eutrophication management. In this study, a voluntary programme for the reduction of diffuse pollution was developed for the Pilica catchment and the Sulejów Reservoir in Poland. The Action Plan was based on the ecohydrological approach, which strives to use ecosystem processes as a management tool. One fundamental element of the Plan was a SWAT model, used to estimate N&P emissions and to determine the priority areas in the catchment. Strong cooperation between water managers, interdisciplinary researchers, and stakeholders helped to catalyse the capacity-building process of public participation, through dialogical interaction including a critical exchange of knowledge. Finally, a list of selected spatially-targeted mitigation measures was generated based on the modelling results and following measure acceptance by stakeholders. The key assumption in the creation of the measure list was that ecohydrological nature-based solutions (NBS) should be used complementarily to good agricultural practices. Such an approach has contributed to a faster achievement of 'good ecological status' of water bodies.

Urinary incontinence in postmenopausal women - causes, symptoms, treatment.

Urinary incontinence (UI) is an important social problem that affects more than 50% of postmenopausal women. The number of patients increases from year to year. According to recent data, UI affects women twice as often as men. This condition occurs in about 20-30% of young women, 30-40% in middle age and up to 50% of women in old age. There are five types of urinary incontinence. The etiology of the problem of incontinence is not fully understood, because the problem can affect men and women of all ages and can be due to many changes in the human body. International Continence Society Guidelines indicate that treatment of urinary incontinence should begin with conservative treatment. Surgical treatment should be used when conservative treatment will not bring positive results. According to guidelines, conservative treatment should include pharmacotherapy, physiotherapy, and behavioral therapy. Numerous scientific reports indicate efficacy of physiotherapy in the treatment of urinary incontinence. Most recent reports indicate that physiotherapy gives a positive result in up to 80% of patients with stage I or stress urinary incontinence (SUI) and mixed form, and in 50% of patients with stage II SUI. Urinary incontinence is an interdisciplinary problem because in addition to the sphere directly related to medicine, it also concerns the economic and social spheres. The latest data show that incontinence in postmenopausal women occurs more often than other civilization diseases such as diabetes, hypertension or depression.

Valspodar-modulated chemotherapy in human ovarian cancer cells SK-OV-3 and MDAH-2774.

Overcoming drug resistance in ovarian cancer is the overarching goal in gynecologic oncology. One way to increase drug cytotoxicity without increasing the drug dose is to simultaneously apply multidrug resistance modulator. Valspodar is the second generation P-glycoprotein 1 modulator capable of reversing multidrug resistance in different cancers. In this study, we evaluated the effect of valspodar and cisplatin co-treatment on cell viability, cell death and oxidative status in ovarian cancer cells. Two human ovarian cancer cell lines SK-OV-3 and MDAH-2774 were treated with cisplatin, valspodar, or cisplatin + valspodar for 24 or 48 hours. Untreated cells were used as control group. Cell viability was evaluated by MTT assay. Cell death was assessed by TUNEL and comet assay. Lipid peroxidation (malondialdehyde) and protein thiol groups were analyzed as oxidative stress markers. The expression of mitochondrial superoxide dismutase (MnSOD) was assessed by immunocytochemistry. Valspodar effectively reduced the resistance of SK-OV-3 cells to cisplatin, as demonstrated by increased oxidative stress, decreased cell viability and increased apoptosis in SK-OV-3 cells co-treated with valspodar and cisplatin compared to other groups. However, valspodar did not significantly affect the resistance of MDAH-2774 cells to cisplatin. Stronger staining for MnSOD in MDAH-2774 vs. SK-OV-3 cells after co-treatment with cisplatin and valspodar may determine the resistance of MDAH-2774 cell line to cisplatin.

Effect of electrochemotherapy with betulinic acid or cisplatin on regulation of heat shock proteins in metastatic human carcinoma cells in vitro.

Betulinic acid (BTA) is naturally occurring triterpene that has received interest as a novel therapeutic substance with cytotoxicity towards a number of cancer cell lines. Despite the wide spectrum of biological and pharmacological effects, its effect may be limited its lipophobic properties. Therefore, strategies to improve the access of BTA to the cells are required to enhance the anticancer effects. Electroporation (EP) enables increased inflow of drugs into cancer cells, even at low doses, which may reduce the side effects caused by high doses of chemotherapy. The potential application of BTA in electrochemotherapy (ECT) in metastatic type of cancers was investigated in the present study. The efficacy of BTA with EP was estimated using a cell survival assay (MTT assay), microscopical morphology analysis and the immunocytochemical expression of heat shock proteins (HSPs). HSPs are molecules that protect the cell from harmful environmental, chemical and physical stresses, and ensure cell survival, recovery and proper functioning. HSP expression is induced various stress factors. Therefore, the expression of HSP27 and HSP70 was evaluated after cells were exposed to an external pulsed electric field and anticancer drugs. Facilitated drug delivery and the anticancer effect on metastatic tumor cells were evaluated in vitro. The effect of BTA was compared with cisplatin (CP), a standard cytostatic agent. Two different metastatic cancer cell lines were used, an ovary adenocarcinoma cell line (SW626) and melanoma cell line (Me45). BTA combined with EP exhibited similar efficacy to CP with EP after 24 and 48 h in SW626 and Me45 cancer cells. Me45 cells also had high HSP27 and low HSP70 immunosignals post­ECT treatment. ECT caused increased expression of HSP27 and HSP70 proteins in SW626 cells, which were less sensitive to ECT than the Me45 melanoma cell line. The results indicate that BTA may be efficiently applied instead of CP in ECT approaches, but its activity differs between tumor cell lines.

Calophyllum inophyllum in vaginitis treatment: Stimulated by electroporation with an in vitro approach.

BACKGROUND: Vaginitis is one of the most common problems in clinical medicine and is cited most often during visits to obstetricians and gynecologists. Most of the inflammation cases are caused by candidiasis trichomoniasis and bacterial vaginosis. Therefore, treatment of vaginal infections must use antibiotic or antifungal drugs, which often provide quick relief to the patient. The real cause of the problem - disrupting the ecosystem of the vagina - remains unchanged. Thus, new therapeutic compounds are being explored. OBJECTIVES: The aim of our study was to evaluate the effect of a natural substance: tamanu oil, an extract from the plant Calophyllum inophyllum, applied to the human fibroblast cell line (normal human dermal fibroblasts - NHDFs) and to the isolated human fibroblasts from the vagina (human vaginal fibroblasts - HVFs) in vitro. MATERIAL AND METHODS: We evaluated the viability of cells by 3-(4,5-dimethylthiazol-2-yl)-2,5 diphenyl tetrazolium bromide (MTT) assay after incubation only with tamanu oil and with electroporation (EP). We also examined the immunocytochemical reaction of collagen type III and mitochondrial superoxide dismutase (MnSOD) under established conditions. RESULTS: Tamanu oil increased the proliferation of cells and the amount of collagen III. It has been shown that the C. inophyllum extract stimulates the proliferation of commercial fibroblasts. For direct application in patients, one should use C. inophyllum extract in the range of 1:10-1:100 (saline dilution). CONCLUSIONS: The use of this extract (at concentrations indicated by the studies presented here) stimulates the healing processes (increased expression of collagen type III), and has anti-inflammatory, analgesic and antiseptic qualities.

Comprehensive approach to restoring urban recreational reservoirs. Part 2 - Use of zooplankton as indicators for the ecological quality assessment.

The presented research is part of the LIFE project ("EH-REK" LIFE08 ENV/PL/000517) on innovative restoration methods for small urban impoundments in the city of Lódz (Poland). The objective was to evaluate the usefulness of zooplankton as a biological quality element, when assessing the effectiveness of restoration efforts in three urban reservoirs and a one pond. The fifth unrestored pond was used as an example of the progressive eutrophication of an urban ecosystem. Studies were conducted during two periods: before (2010-2012) and after (2013-2016) restoration. A selection of zooplankton indices, including the rotifer trophic state index (TSIROT), was used. The influence of the supplying river resulted in the negligible responses of biological parameters to the restoration efforts in the Upper Arturówek (UA) reservoir, which is the first in cascade of reservoirs. However, clear symptoms of water quality improvements were observed in the other two reservoirs (the Middle Arturówek, MA; the Lower Arturówek, LA) and in the Bzura-17 (B17) pond. After restoration, the contribution of species indicative of high trophic levels decreased in these ecosystems. The TSIROT was strongly positively correlated with the trophic state index based on chlorophyll a, and both parameters significantly decreased in the MA, LA and B17. In the unrestored pond (B11), the successive increase in the concentrations of chemical parameters indicated progressing eutrophication. Interestingly, since 2013, the TSIROT values clearly decreased in B11, but the strong negative correlation between ammonium concentration and rotifer density indicated that the reduced TSIROT values didn't result from improvements in water quality; rather, they resulted from the increases in pollution and the associated harmful impacts on Rotifera. In conclusion, the TSIROT can be a useful tool for assessing the ecological quality of small urban ecosystems; however, the use of biological indices must be supported by also monitoring physicochemical parameters.

Restoration of a shady urban pond - The pros and cons.

The Bzura-7 pond (Lódz, Poland) is a typical shallow and shady urban reservoir situated on the Bzura River that is exposed to pollutants introduced mainly by internal loads and the supply from the catchment. In 2010-2012, the following characteristics were observed in the pond: a high allochthonous input of organic matter, high concentration of ammonium, low concentration of dissolved oxygen and low diversity of zooplankton, dominated mainly by Daphnia spp. From January to June 2013, restoration measures were performed, including sediment removal, increasing light access to the pond and construction of a sequential sedimentation-biofiltration system (SSBS). The aim of the present study was to investigate how the water quality in the Bzura-7 pond was affected by the restoration process, which included reducing pollutant inflows and enhancing habitat potential, thus increasing the diversity of this ecosystem. Restoration efforts improved the chemical and physical parameters of the water. The oxygen concentration increased, and the concentrations of TN and ammonium significantly decreased. Despite the increase in pond lighting, the growth of cyanobacteria was limited. However, we observed increased abundance of green algae and diatoms but less than adequate changes in the zooplankton community structures. Although we observed a significant increase in the zooplankton species richness after restoration, this increase was related to the small-bodied groups of zooplankton, rotifers and bosminiids, characteristic of eutrophic ecosystems. In addition, a planktivorous fish - sunbleak (Leucaspius delineatus) - was identified as an unintended side effect of the restoration effort. Further conservation efforts in the Bzura-7 pond and monitoring of results are still needed.

The use of a hybrid Sequential Biofiltration System for the improvement of nutrient removal and PCB control in municipal wastewater.

This article aims to evaluate the efficiency of an innovative hybrid Sequential Biofiltration System (SBS) for removing phosphorus and nitrogen and polychlorinated biphenyls (PCBs) from original municipal wastewater produced by a Wastewater Treatment Plant under authentic operating conditions. The hybrid SBS was constructed with two barriers, a geochemical (filtration beds with limestone, coal and sawdust) and a biological barrier (wetlands with Glyceria, Acorus, Typha, Phragmites), operating in parallel. Significant differences were found between inflow and outflow from the SBS with regard to wastewater contaminant concentrations, the efficiency of removal being 16% (max. 93%) for Total Phosphorus (TP), 25% (max. 93%) for Soluble Reactive Phosphorus (SRP), 15% (max. 97%) for Total Nitrogen (TN), 17% (max. 98%) for NO3-N, and 21% for PCB equivalency (PCB EQ). In the case of PCB EQ concentration, the highest efficiency of 43% was obtained using beds with macrophytes. The SBS removed a significant load of TP (0.415 kg), TN (3.136 kg), and PCB EQ (0.223 g) per square meter per year. The use of low-cost hybrid SBSs as a post-treatment step for wastewater treatment was found to be an effective ecohydrological biotechnology that may be used for reducing point source pollution and improving water quality.

Assessing and managing multiple risks in a changing world-The Roskilde recommendations.

Roskilde University (Denmark) hosted a November 2015 workshop, Environmental Risk-Assessing and Managing Multiple Risks in a Changing World. This Focus article presents the consensus recommendations of 30 attendees from 9 countries regarding implementation of a common currency (ecosystem services) for holistic environmental risk assessment and management; improvements to risk assessment and management in a complex, human-modified, and changing world; appropriate development of protection goals in a 2-stage process; dealing with societal issues; risk-management information needs; conducting risk assessment of risk management; and development of adaptive and flexible regulatory systems. The authors encourage both cross-disciplinary and interdisciplinary approaches to address their 10 recommendations: 1) adopt ecosystem services as a common currency for risk assessment and management; 2) consider cumulative stressors (chemical and nonchemical) and determine which dominate to best manage and restore ecosystem services; 3) fully integrate risk managers and communities of interest into the risk-assessment process; 4) fully integrate risk assessors and communities of interest into the risk-management process; 5) consider socioeconomics and increased transparency in both risk assessment and risk management; 6) recognize the ethical rights of humans and ecosystems to an adequate level of protection; 7) determine relevant reference conditions and the proper ecological context for assessments in human-modified systems; 8) assess risks and benefits to humans and the ecosystem and consider unintended consequences of management actions; 9) avoid excessive conservatism or possible underprotection resulting from sole reliance on binary, numerical benchmarks; and 10) develop adaptive risk-management and regulatory goals based on ranges of uncertainty. Environ Toxicol Chem 2017;36:7-16. © 2016 SETAC.