Continuous UV-C/H2O2 and UV-C/Chlorine applied to municipal secondary effluent and nanofiltration retentate: Removal of contaminants of emerging concern, ecotoxicity, and reuse potential.

As global effects of water scarcity raise concerns and environmental regulations evolve, contemporary wastewater treatment plants (WWTPs) face the challenge of effectively removing a diverse range of contaminants of emerging concern (CECs) from municipal effluents. This study focuses on the assessment of advanced oxidation processes (AOPs), specifically UV-C/H2O2 and UV-C/Chlorine, for the removal of 14 target CECs in municipal secondary effluent (MSE, spiked with 10 µg L-1 of each CEC) or in the subsequent MSE nanofiltration retentate (NFR, no spiking). Phototreatments were carried out in continuous mode operation, with a hydraulic retention time of 3.4 min, using a tube-in-tube membrane photoreactor. For both wastewater matrices, UV-C photolysis (3.3 kJ L-1) exhibited high efficacy in removing CECs susceptible to photolysis, although lower treatment performance was observed for NFR. In MSE, adding 10 mg L-1 of H2O2 or Cl2 enhanced treatment efficiency, with UV-C/H2O2 outperforming UV-C/Chlorine. Both UV-C/AOPs eliminated the chronic toxicity of MSE toward Chlorella vulgaris. In the NFR, not only was the degradation of target CECs diminished, but chronic toxicity to C. vulgaris persisted after both UV-C/AOPs, with UV-C/Chlorine increasing toxicity due to potential toxic by-products. Nanofiltration permeate (NFP) exhibited low CECs and microbial content. A single chlorine addition effectively controlled Escherichia coli regrowth for 3 days, proving NFP potential for safe reuse in crop irrigation (<1 CFU/100 mL for E. coli; <1 mg L-1 for free chlorine). These findings provide valuable insights into the applications and limitations of UV-C/H2O2 and UV-C/Chlorine for distinct wastewater treatment scenarios.

Ozone membrane contactor for tertiary treatment of urban wastewater: Chemical, microbial and toxicological assessment.

A membrane ozone contactor, operated under continuous mode, was applied to promote the tertiary treatment of urban wastewater (UWW), targeting the removal of contaminants of emerging concern (CECs), bacterial disinfection, and toxicity reduction. This system relies on the homogeneous radial distribution of ozone (O3) in the reaction zone by "titration" through a microfiltration borosilicate tubular membrane, while the UWW swirls around the membrane and drags the O3 microbubbles generated in the membrane shell-side. The membrane is coated with titanium dioxide (TiO2-P25) and radiation can be externally supplied via four UV lamps. The ozonation tests were carried out with secondary-treated UWW collected in different seasons (winter and summer) and spiked with a mix of 19 CECs (10 µg L-1 each). For an O3 dose of 18 g m-3, the best performance was obtained by increasing the O3 concentration (maximum [O3]G,inlet of 200 g Nm-3) and decreasing the gas flow rate (minimum QG of 0.15 Ndm3 min-1), providing the highest ozone transfer yield (88 %) and, thus higher specific ozone dose (g O3 per g dissolved organic carbon). Under these conditions, removals >80 % or concentrations below the limit of quantification were obtained for up to 13 of the 19 CECs and reductions up to 5 log units for total heterotrophs and below the limit of detection for enterobacteria and enterococci. Tests including a UVC dose of 0.10 kJ L-1 enhanced disinfection ability but had no impact on CECs oxidation. After ozonation, the abundance of antibiotic resistant bacteria was reduced but not eliminated, and microbial regrowth after 3-day storage was observed. No toxic effect was detected on zebrafish embryos using a dilution factor of 4 for the ozonized UWW and when granular activated carbon adsorption was subsequently applied the dilution factor decreased to 2.

Do Childcare Teachers Evaluate Children's Weight Status More Accurately Than Parents? A Brief Report.

PURPOSE: Parents' underestimation of young children's weight can reduce their engagement and readiness to implement changes in children's diet and physical activity. Childcare teachers can support parents' identification of children at risk for being overweight only if they can accurately do this themselves. DESIGN: Quantitative, cross-sectional study. SETTING: Fifteen kindergartens near Lisbon, Portugal. SUBJECTS: 319 parents, 32 teachers (47.5% and 100% response rate, respectively), and 319 children. MEASURES: Caregivers classified the children's weight, considering their height and age as underweight, healthy weight, or overweight; children's body mass index (BMI) status for age and sex was assessed. ANALYSIS: Differences in caregivers' accuracy of children's weight perception were assessed. Multilevel multivariate logistic regression models were used to analyze the predictors of the accuracy of teachers' and parents' weight perception as a binary outcome. RESULTS: The proportion of children with overweight correctly assessed differed significantly (P = 0.004) between teachers (31.1%) and parents (17.5%). The child's BMI percentile was the only significant positive predictor for both caregivers' weight perception accuracy (P < 0.001 and P = 0.004, for parents and teachers, respectively), holding the child's age and sex constant. CONCLUSION: Although childcare teachers were better raters than parents when evaluating children's weight status, the percentage of children with overweight that childcare teachers misclassified was still relatively high.

Tracking pollutants in a municipal sewage network impairing the operation of a wastewater treatment plant.

This work provides a screening of organic contaminants and characterization of the dissolved organic matter in the sewer network until the municipal wastewater treatment plant (WWTP), identifying the network areas with a higher degree of contamination and their impact on the WWTP performance, particularly in the activated sludge reactor. Three monitoring campaigns were carried out at six selected locations of the sewage system (PVZ-1, PVZ-2, PS-F, PS-VC, CP-VC, and PS-T), influent (WWTPINF) and effluent (WWTPEFF) of the WWTP. Advanced analytical techniques were employed, namely excitation/emission matrix fluorescence-parallel factor analysis (EEM-PARAFAC), size exclusion chromatography with organic carbon detector (SEC-OCD), and liquid chromatography with high-resolution-mass spectrometric detection (LC-HRMS). EEM-PARAFAC showed higher fluorescence intensity for the protein-like component (C2), particularly at CP-VC (near seafood industries) associated with the presence of surfactants (~50 mg/L). SEC-OCD highlighted the WWTP efficiency in removing low molecular weight acids and neutrals. LC-HRMS tentatively identified 108 compounds of emerging concern (CEC) and similar detection patterns were obtained for all wastewater samples, except for PVZ-2 (lower detection), many of which occurred in the effluent. Eight CECs included on relevant Watch-Lists were detected in all WWTPEFF samples. Furthermore, 111 surfactants were detected, the classes more frequently found being alcohol ethoxylates (AEOs), nonylphenol polyethoxylates (NPEOs) and linear alkylbenzene sulphonates (LAS). The continuous presence of LAS and NPEOs allied to surfactants concentrations in the WWTPINF of 15-20 mg/L, with CP-VC location (linked with food industries) as an important contributor, explain the morphological changes in the activated sludge and high LAS content in the dewatered sludge, which may have impacted WWTP performance.

A tubular ceramic membrane coated with TiO2-P25 for radial addition of H2O2 towards AMX removal from synthetic solutions and secondary urban wastewater.

This work aims to integrate several hydrogen peroxide (H2O2) activation mechanisms, photolysis (UVC irradiation), chemical electron transfer (TiO2-P25 photocatalysis), and reaction with TiO2-P25 in dark conditions, for reactive oxygen species (ROS) generation towards the removal of contaminants of emerging concern (CECs), in a single unit operated in continuous-flow mode. An H2O2 stock solution is fed by the lumen side of a tubular ceramic membrane, delivering the oxidant to the (i) catalyst immobilized in the membrane shell-side and (ii) annular reaction zone (ARZ, space between membrane shell-side and outer quartz tube) where CECs contaminated water flows with a helix trajectory, being activated by UV light provided by four lamps placed symmetrically around the reactor. First, the effect of several parameters in the removal of a CEC target molecule, amoxicillin (AMX), was evaluated using a synthetic solution ([AMX]inlet = 2.0 mg L-1): (i) light source (UVA or UVC radiation), (ii) H2O2 dose, (iii) H2O2 injection method (radial permeation vs. upstream injection), and (iv) number of TiO2-P25 layers deposited on the membrane. The UVC/H2O2/TiO2 system with radial addition of H2O2 (20 mg L-1) and 9-TiO2-P25 layers provided the highest AMX removal efficiency (72.2 ± 0.5%) with a UV fluence of 45 mJ cm-2 (residence time of 4.6 s), due to the synergic effect of four mechanisms: (i) AMX photolysis, (ii) H2O2 photocleavage, (iii) TiO2-P25 photoactivation, and (iv) chemical reactions between H2O2 and TiO2-P25. The urban wastewater matrix showed a negative effect on AMX removal (~44%) due to the presence of ROS scavengers and light-filtering species.

How does the pre-treatment of landfill leachate impact the performance of O3 and O3/UVC processes?

In this study, O3 and O3/UVC processes were evaluated for the treatment of landfill leachate after biological nitrification/denitrification, coagulation, or their combinations. The O3-driven stage efficiency was assessed by the removal of color, organic matter (dissolved organic carbon (DOC) and chemical oxygen demand (COD)), and biodegradability increase (Zahn-Wellens test). Also, fluorescence excitation-emission matrix (EEM) and size exclusion chromatography coupled with OC detector (SEC-OCD) analysis were carried out for each strategy. The bio-nitrified-leachate (LN) was not efficiently mineralized during the O3-driven processes since the high nitrites content consumed ozone rapidly. In turn, carbonate/bicarbonate ions impaired the oxidation of the bio-denitrified-leachate (LD), scavenging hydroxyl radicals (HO•) and inhibiting the O3 decomposition. For both bio-leachates, only O3/UVC significantly enhanced the effluent biodegradability (>70%), but COD legal compliance was not reached. EEM and SEC-OCD results revealed differences in the organic matter composition between the nitrified-coagulated-leachate (LNC) and denitrified-coagulated-leachate (LDC). Nonetheless, the amount of DOC and COD removed per gram of ozone was similar for both. Cost estimation indicates the O3-driven stage as the costliest among the treatment processes, while coagulation substantially reduced the cost of the following ozonation. Thus, the best treatment train strategy comprised LDC (with methanol addition for denitrification and coagulated with 300 mg Al3+/L, without pH adjustment), followed by O3/UVC (transferred ozone dose of 2.1 g O3/L and 12.2 kJUVC/L) and final biological oxidation, allowed legal compliance for direct discharge (for organic and nitrogen parameters) with an estimated cost of 8.9 €/m3 (O3/UVC stage counting for 6.9 €/m3).

The role of ozone combined with UVC/H2O2 process for the tertiary treatment of a real slaughterhouse wastewater.

The main goal of this work is to evaluate the usage of ozone (O3) as a pre-treatment or simultaneously combined with UVC/H2O2 process for the polishing stage treatment of real bio-treated slaughterhouse wastewater. Two different treatment strategies were tested: i) pre-ozonation of the wastewater followed by an UVC/H2O2 process (two-step treatment); ii) simultaneous application of O3/UVC/H2O2 combined process (one-step treatment). For the two-step strategy, the pre-treatment with 30 mg O3/min for 10 min reduces significantly total suspended solids (TSS), turbidity and colour, reducing light filtering effects and increasing the efficiency of the following UVC/H2O2 process. In turn, the one-step treatment strategy (O3/UVC/H2O2) allows a more efficient use of injected O3 by reducing the amount of O3 required (from 273 to 189 mg O3/Leffluent) to achieve similar mineralization levels. The real bio-treated slaughterhouse wastewater treated by O3/UVC/H2O2 process achieved final colour values of 20 Pt/Co, TSS of 35 mg/L and COD of 61 mg O2/L, allowing its direct discharge into water compartments according to European Council Directive 91/271/EEC.

A tube-in-tube membrane microreactor for tertiary treatment of urban wastewaters by photo-Fenton at neutral pH: A proof of concept.

This work presents a disruptive approach to promote highly-efficient photo-Fenton process at neutral pH under continuous mode operation. The system consists of a tube-in-tube membrane reactor designed for continuous-flow titration of low iron doses to the annular reaction zone (ARZ). A concentrated acidic ferrous ion (Fe2+) solution is fed by the lumen-side of the membrane, permeating through the membrane pores (inside-out mode), being dosed and uniformly delivered to the membrane shell-side. Polluted water, containing amoxicillin (AMX) and oxidant (H2O2), flows continuously in the reactor annulus (space between the membrane shell-side and an outer quartz tube). The catalyst radial dispersion is enhanced by the helicoidal movement of water around the membrane shell-side, efficiently promoting its contact with H2O2 and UV light. The efficiency of photochemical and photocatalytic oxidation was evaluated as a function of catalyst dose, catalyst injection mode (radial permeation vs injection upstream from the reactor inlet), light source (UVA vs UVC) and aqueous solution matrix (synthetic vs real wastewater). At steady-state, photo-Fenton reaction with Fe2+ radial addition, driven by UVC light, showed the highest AMX removal for synthetic (∼65%, removal rate of 44 µMAMX/min, using [Fe2+]ARZ = 2 mg/L and [H2O2]inlet = 10 mg/L) and real municipal wastewaters (∼45%, removal rate of 31 µMAMX/min, with [Fe2+]ARZ = 5 mg/L and [H2O2]inlet = 40 mg/L), with a residence time of only 4.6 s.

Ozone-driven processes for mature urban landfill leachate treatment: Organic matter degradation, biodegradability enhancement and treatment costs for different reactors configuration.

In this work, the application of ozone-driven processes for the treatment of mature landfill leachate was investigated by testing different system setups. As a first approach, ozonation (O3-only) was tested, using a porous ceramic diffuser combined with a bubble column (BC), and the best operational conditions were established for leachate treatment (initial pH = 9.0; inlet ozone dose = 18 mg O3/min). Then, a novel photoreactor (FluHelik) was coupled in series with the bubble column, using a diffuser or a Venturi to inject ozone into the fluid stream. The FluHelik/BC-Venturi setup led to the highest efficiency, treating 50% more leachate than BC-alone using the same ozone dose and reaction time (3 h). Following, the oxidation ability of ozone combined with H2O2 and/or UVC for leachate treatment was assessed. The highest synergistic effect was obtained for the O3/UVC process, with pseudo-first-order rate constant for DOC and COD removal, 2.0 and 1.4 times higher than for the O3-only, respectively. Ozone-driven processes considerably enhanced the leachate biodegradability from 17% to 79% (O3/H2O2), 81% (O3-only), 85% (O3/H2O2/UVC) and 91% (O3/UVC), after a 3 h reaction period. With FluHelik/BC-Venturi system, the O3/UVC process stands out as the most efficient and cost-effective (6.0 €/m3), ensuring an effluent that meets discharge legal limit for COD (150 mg/L) after further biological oxidation.

First day of radiotherapy for women with breast cancer: predictors of anxiety.

PURPOSE: Radiotherapy treatment may generate anxiety, especially on the first day of treatment. This study aimed to identify potential predictors of radiotherapy-related anxiety in women  with breast cancer before treatment initiation, in terms of treatment concerns and trait anxiety. METHODS: This transversal study included 94 patients from one Radiation Oncology Department, who had been diagnosed with primary breast cancer and who had been prescribed external radiotherapy for the first time. Patients completed a Treatment Concerns Questionnaire and the State-Trait Anxiety Inventory (STAI) before the  first treatment session. RESULTS: Women identified radiation involved in the procedure and treatment efficacy as major concerns surrounding radiotherapy. No significant differences were found between patients with higher and lower state anxiety scores, or by age, level of education, cancer treatment protocol used, prior information given about treatment, or report of doubts before treatment initiation. In the final model, the combination of trait anxiety (49.1% of the total variance) with two treatment-related concerns, regarding radiation and the duration of treatment (plus 10.8% of the total variance), significantly predicted treatment-related anxiety experienced on the first day of treatment. CONCLUSION: Our findings highlight the need to identify women with moderate or higher levels of trait anxiety before radiotherapy initiation and to provide them with a more approach to personalized care, adjusted to their specific concerns and susceptibility to anxious reactions. Effective education sessions involving the discussion of specific treatment concerns, and anxiety coping strategies training should be developed and applied in initial interactions with breast cancer patients.

Long-term Negative Psychological Impact of Presymptomatic Testing on Familial Amyloid Polyneuropathy / Efecto psicológico negativo a largo plazo de las pruebas genéticas presintomáticas en la polineuropatía amiloide familiar

This study addresses the profile of at-risk subjects whose long-term psychological impact of presymptomatic testing (PST) for Familial Amyloid Polyneuropathy (FAP) TTR V30M is negative. The sample consisted of 177 subjects, aged over 20 years that were 50% at-risk for FAP, and performed the PST at least three years ago. Participants were contacted by mail, one time only, to answer the sociodemographic questionnaire and the Brief Symptom Inventory (BSI), the Self-Rating Anxiety Scale of Zung (SAS), and the Beck Depression Inventory (BDI). From the sample, 22.6% (BSI), 16.4% (SAS), and 9% (BDI) subjects presented negative psychological impact, after having performed the PST for more than 3 years. Subjects with clinically significant values in BSI, SAS, and BDI have an overlapping profile concerning the total sample, except regarding age, since clinically depressed subjects have a higher mean age. Married women or living in unmarried unions, aged between 30 and 45 years, employed, carriers, and having performed the PST test for 6-7 years are a group raising higher concern and requiring a more active role with respect to the psychological impact of the PST for FAP. The role of the clinical and health psychologist with these patients is critical in the adjustment to the presymptomatic test result as well as in adherence to the available treatments conducive to a better quality of life, in carriers

Este estudio aborda el perfil de sujetos en riesgo cuyo impacto psicológico a largo plazo de las pruebas presintomáticas (PST) para la polineuropatía amiloide familiar (FAP) TTR V30M es negativo. La muestra consistió en 177 sujetos mayores de 20 años que tenían un 50% de riesgo de FAP, que habían realizado el PST hacía al menos tres años. Se contactó con los participantes por correo, solo una vez, para responder el cuestionario sociodemográfico y el Inventario de síntomas breves (BSI), la Escala de ansiedad de autoclasificación de Zung (SAS) y el Inventario de depresión de Beck (BDI). El 22.6% (BSI), el 16.4% (SAS) y el 9% (BDI) de los sujetos de la muestra presentaron un impacto psicológico negativo después de haber realizado el PST durante más de 3 años. Los sujetos con valores clínicamente significativos en BSI, SAS y BDI tienen un perfil superpuesto con respecto a la muestra total, excepto con respecto a la edad, ya que los sujetos clínicamente deprimidos tienen una edad media más alta. Las mujeres casadas o que viven en pareja, con edades entre 30 y 45 años, que trabajan, son portadoras y han realizado la prueba PST durante 6-7 años son un grupo que suscita una mayor preocupación y requiere un papel más activo con respecto al impacto psicológico del PST para FAP. El papel del psicólogo clínico y de la salud con estos pacientes es decisivo en el ajuste del resultado de la prueba presintomática, así como en la adhesión a los tratamientos disponibles que conducen a una mejor calidad de vida en los portadores

Treatment train for mature landfill leachates: Optimization studies.

In the current study, a treatment train strategy for urban mature leachates, comprising biological and physicochemical processes, was tested for full legal compliance. The leachate presents a high organic and nitrogen content (1.1g C/L; 3.6g O2/L; 2.0gN/L) and low biodegradability (BOD5/COD=0.05). In the first stage, a sequential batch reactor (SBR), operated in a 24h-cycle mode (15h aeration +8.5h anoxic, with methanol as external carbon source +0.5h settling), was tested for total nitrogen (TN) removal. The maximum daily TN load that could be treated, reaching the legal limit (< 15mgN/L), increased by 50% with the rise in temperature from 20 to 30°C. For the following coagulation stage, the highest dissolved organic carbon (DOC) removal (64%) and lower final turbidity (33 NTU) were obtained with 240mg Fe3+/L, at pH3.0. The jar-tests, comparing nitrified (LNIT.) and nitrified/denitrified (LN/D.) leachate, stressed the effect of the leachate alkalinity, generated during the denitrification reaction, on process efficiency. For the coagulated LN/D., with alkalinity of 1.1g CaCO3/L, the final concentration of sulfate was only slightly below the legal limit (< 2g/L). A photo-Fenton (PF) oxidation process (pH range of 2.8-3.0, 60mg Fe2+/L), as third treatment step, promoted a significant enhancement on leachate biodegradability, consuming 75mM of H2O2 and 8.9 kJ/L of accumulated UV energy, to achieve an effluent that can be further biologically treated in compliance with the COD discharge limit (150mg O2/L) into water bodies. Biological continuous mode tests using a conventional activated sludge process, with an hydraulic retention time (HRT) of 12h, allowed to obtain COD and TSS values (107±3 and 50±2mg/L, respectively) below the legal limit.

Multiple linear and principal component regressions for modelling ecotoxicity bioassay response.

The ecotoxicological response of the living organisms in an aquatic system depends on the physical, chemical and bacteriological variables, as well as the interactions between them. An important challenge to scientists is to understand the interaction and behaviour of factors involved in a multidimensional process such as the ecotoxicological response. With this aim, multiple linear regression (MLR) and principal component regression were applied to the ecotoxicity bioassay response of Chlorella vulgaris and Vibrio fischeri in water collected at seven sites of Leça river during five monitoring campaigns (February, May, June, August and September of 2006). The river water characterization included the analysis of 22 physicochemical and 3 microbiological parameters. The model that best fitted the data was MLR, which shows: (i) a negative correlation with dissolved organic carbon, zinc and manganese, and a positive one with turbidity and arsenic, regarding C. vulgaris toxic response; (ii) a negative correlation with conductivity and turbidity and a positive one with phosphorus, hardness, iron, mercury, arsenic and faecal coliforms, concerning V. fischeri toxic response. This integrated assessment may allow the evaluation of the effect of future pollution abatement measures over the water quality of Leça River.

Assessment of nursing students and nurses' orientation towards patient-centeredness.

BACKGROUND: Being patient centered is a core value for nursing. Patient centered-care has been related to patient and health provider satisfaction, better health outcomes, higher quality of care and more efficient health care delivery. OBJECTIVES: The purpose was to assess the orientation adopted by nurses and students in patient care, using The Patient-Practitioner Orientation Scale, as well as to compare the results between resident nurses and students from different academic years. SETTINGS: Public School of Nursing and a Central Hospital, in Lisbon (Portugal). PARTICIPANTS: Students in the first, second and fourth year of nursing school and nurses participated in the study. METHODS: For data collection, we used The Patient-Practitioner Orientation Scale (European Portuguese version), an instrument designed to measure individual preferences toward the dimension of caring a sharing in health professional-patient relationship. Students and nurses also filled out two additional questions about their perception of competence in technical and communication skills. Additional demographic information was also collected, including gender, age, academic year and length of professional experience. RESULTS: A total of 525 students (84.7% female) and 108 nurses (77.8% female) participated in this study. In general, caring sub-scores, measuring the preference of about attending to patient emotional aspects, were higher than sharing sub-scores, measuring beliefs about giving information and perceiving patient as a member of the health team. Students were significantly more patient-centered throughout their nursing education (p<0.001). Comparing to students in the second and fourth academic years (p<0.001) nurses' scores were significantly lower both in total PPOS and in caring and sharing subscales. CONCLUSIONS: These results reinforce the idea that patient centeredness may be developed in academic context. The scores obtained highlight the importance of studies that aim to identify factors that may explain the decrease of patient centeredness in professional practice.

Solar photocatalysis of a recalcitrant coloured effluent from a wastewater treatment plant.

A photocatalytic study of a coloured effluent from a wastewater treatment plant was carried out in a pilot plant using compound parabolic collectors (CPC) in order to find out the best conditions for colour removal, since the discharge limit for this parameter is not achieved after conventional wastewater treatment. The interaction between ultraviolet natural radiation and TiO(2) strongly enhanced the colour degradation rate. Different TiO(2) concentrations were tested and the optimum concentration achieved was 200 mg L(-1). The use of peroxydisulfate (S(2)O(8)(2-)) as an additional electron scavenger gave a noticeable effect on colour and dissolved organic carbon (DOC) removal due to the formation of additional powerful oxidant species (OH and SO(4) (-)). However, hydrogen peroxide (H(2)O(2)) as additional oxidant was more efficient on colour degradation than S(2)O(8)(2-). The amount of energy necessary for the same colour removal (C/C(0) < 0.1) was 6, 14 and 80 kJ(UV) L(-1), respectively, for the following systems using sunlight: 200 mg L(-1) TiO(2) + 5 mM H(2)O(2), 200 mg L(-1) TiO(2) + 2 mM S(2)O(8)(2-) and 200 mg L(-1) TiO(2). The first-order kinetic constants (0.487, 0.207 and 0.053 L kJ(-1)) and initial degradation rates (32.1, 10.0 and 2.2 mg kJ(-1)) showed the same behaviour.