A pilot-scale study of a novel system for simultaneous nitrogen and carbon removal: technological advancement of a structured bed reactor with intermittent aeration (SBRIA) in real domestic sewage treatment.

This study outlines the development of an effective pilot-scale simultaneous denitrification and nitrification (SDN) system using intermittent aeration for the removal of carbon and nitrogen from real domestic sewage. Given the limited research in this area, the main objective was to evaluate the overall performance of the SBRIA system on a pilot scale and show its benefits in domestic wastewater treatment. The structured bed reactor with intermittent aeration (SBRIA) notably achieved 57% efficiency in removing total nitrogen without requiring external carbon sources. It also demonstrated impressive removal rates of 56% for total chemical oxygen demand (CODT) and 82% for biochemical oxygen demand (BOD5), indicating its effectiveness in degrading organic matter. In addition, the SBRIA showed high pH control and managed the consumption of alkalinity without the need for an alkalizer, maintaining consistent mean values of 7.7 ± 0.8 for pH and 166.8 ± 79.8 mg·L-1 for alkalinity. The system also proved resilient against toxic shocks caused by significant variations in influent characteristics. This study offers valuable insights and compelling results into a cost-effective and efficient treatment approach using an innovative technology not previously applied at the pilot scale. Its potential to remediate polluted water is substantial.

Microbial interactions and nitrogen removal performance in an intermittently rotating biological contactor treating mature landfill leachate.

Developing efficient landfill leachate treatment is still necessary to reduce environmental risks. However, nitrogen removal in biological treatment systems is often poor or costly. Studying biofilms in anoxic/aerobic zones of rotating biological contactors (RBC) can elucidate how microbial interactions confer resistance to shock loads and toxic substances in leachate treatment. This study assessed the nitritation-anammox performance in an intermittent-rotating bench-scale RBC treating mature leachate (diluted). Despite the leachate toxicity, the system achieved nitritation with an efficiency of up to 34 % under DO values between 0.8 and 1.8 mg.L-1. The highest average ammoniacal nitrogen removal was 45.3 % with 10 h of HRT. The 16S rRNA sequencing confirmed the presence of Nitrosonomas, Aquamicrobium, Gemmata, and Plantomyces. The coexistence of these bacteria corroborated the selective pressure exerted by leachate in the community structure. The microbial interactions found here highlight the potential application of RBC to remove nitrogen in landfill leachate treatment.

Prevalence of Sarcopenia in Older Patients in Rehabilitation Wards.

The multidisciplinary assessment of hospitalized patients via validated scales and tools has become crucial in the early identification of sarcopenia. The objective of this study was to determine the prevalence of sarcopenia and its related factors in patients aged ≥65 years admitted to the neurological rehabilitation departments of cognitive motor disorders and functional motor rehabilitation at the IRCCS Hospital San Raffaele in Milan. Using the algorithm reported by the European Working Group on Sarcopenia in Older People (EWGSOP2), the prevalence of sarcopenia in patients was investigated from 2019-2020. Definite sarcopenia was detected in 161 of 336 recruited patients (47.9%). Age was significantly higher in sarcopenic patients than in those without sarcopenia (median 81 vs. 79 years, p < 0.001) and height, weight, and body mass index were lower (p < 0.001 for all). The malnutrition screening test (MUST) was higher but still negative in most sarcopenic patients (47.8% vs. 20.6%, p < 0.001). Patients with sarcopenia had significantly reduced life autonomy (by Barthel index, median 55 vs. 60 points, p < 0.001) and increased mental impairment (tested by MMSE and MOCA, p < 0.005 for both). In conclusion, sarcopenic patients were more cognitively impaired and less autonomous in their daily life, but the majority presented with a negative malnutrition screening test.

SARCOPENIA IS A FREQUENT DISEASE IN SARS-COV-2 INFECTION.

Objective: We aimed to investigate the clinical symptoms and specific care requirements of SARS-CoV-2 patients who were admitted to a COVID-19 Rehabilitation Unit while still infectious for SARS-CoV-2 and in the subacute phase of the disease. Methods: Patients admitted to our COVID-19 Rehabilitation Unit from March 2020 to December 2020 were evaluated for sarcopenia, and they also completed the following assessments: functional independence measure, short physical performance battery and Hamilton Rating Scale for Depression. Age and body mass index and symptoms of dysosmia or dysgeusia were also recorded. Results: A total of 126 patients were enrolled (50 women, median age 72 years, 18.7 years), of whom 82% of patients presented with low grip strength. Sarcopenia was diagnosed in 52 patients. Sarcopenic patients were older than non-sarcopenic ones (median age 73.4 years, IQR 13.2 vs 63.9 years, IQR 14.5, respectively, p = 0.014). Sarcopenia was associated with the presence of depression (p = 0.008), was more common in women (p = 0.023) and was associated with greater functional deficits (functional independence measure and short physical performance battery analyses, p < 0.05). Sarcopenic patients also had a lower body mass index than other patients (p < 0.01). Conclusion: More than 40% of our patients suffered from sarcopenia, which was associated with ageing, depression, low body mass index, reduction in functional autonomy and being a woman. Such data provide evidence for the need to assist hospitalized COVID-19 patients by means of a multidisciplinary specialist team.

Biofilm stratification and autotrophic-heterotrophic interactions in a structured bed reactor (SBRIA) for carbon and nitrogen removal.

The structured-bed reactor with intermittent aeration (SBRIA) is a promising technology for simultaneous carbon and nitrogen removal from wastewater. An in depth understanding of the microbiological in the reactor is crucial for its optimization. In this research, biofilm samples from the aerobic and anoxic zones of an SBRIA were analyzed through 16S rRNA sequencing to evaluate the bacterial community shift with variations in the airflow and aeration time. The control of the airflow and aeration time were essential to guarantee reactor performances to nitrogen removal close to 80%, as it interfered in nitrifying and denitrifying communities. The aeration time of 1.75 h led to establishment of different nitrogen removal pathways by syntrophic relationships between nitrifier, denitrifier and anammox species. Additionally, the predominance of these different species in the internal and external parts of the biofilm varied according to the airflow.

Intermittent rotation as an innovative strategy for achieving nitritation in rotating biological contactors.

The nitritation step is essential when the anammox process is focused, and alternative technologies to achieve partial nitritation-anammox are required. Rotating Biological Contactors (RBCs) are a promising and cost-effective technology, allowing the development of aerobic and anoxic zones in the biofilm, coupled to low energy consumption. This study evaluated nitritation in a RBC with two discs rotation strategies: continuous and intermittent. Continuous rotation resulted in high dissolved oxygen (DO) concentrations and was not favorable for achieving stable nitritation. However, intermittent rotation, coupled with a nitrogen load of 1000 g N·m-3·d-1 and a HRT of 12 h, decreased DO by 77.8% and resulted in nitritation efficiencies of 45.3%. FISH analyses suggested that simultaneous partial nitritation/anammox (PN/A) could also be favored. These results indicated that intermittent rotation may be a core strategy for producing an anammox-suitable effluent or even to promote PN/A in RBCs, upgrading their applicability for wastewater treatment.

A Mobile Application for Exercise Intervention in People Living with HIV.

PURPOSE: This study aimed to assess 16-wk improvements of physical fitness, metabolic, and psychological parameters in people living with HIV (PLWH) exercising with the support of a smartphone application, as compared with a control group exercising without application. METHODS: This was a randomized, open-label, pilot study enrolling PLWH in a 16-wk protocol consisting of moderate physical activity three times per week, which included an initial coach-supervised period of 4 wk, followed by 12 wk where participants trained independently. Participants were allocated to either an experimental group that trained using a smartphone application (APP) or a control group that practiced following a hard copy training program (No-APP). At baseline (BL) and after 16 wk (W16), patients were assessed for cardiorespiratory fitness, body composition, blood lipid profile, and POMS. RESULTS: Forty-eight PLWH were screened and 38 were eligible: 20 were allocated to the APP group and 18 to the No-APP group. Two APP and two No-APP participants were lost to follow-up. Intention-to-treat analysis showed a W16 improvement from BL of ≥15% V˙ O2peak in 13 (72%) of 18 in APP, but only in 3 (19%) of 16 in No-APP participants (P = 0.025). Significant W16 improvements were observed in APP, but not in No-APP participants, in V˙O2peak; fat mass and fat-free mass percent; total cholesterol, LDL cholesterol, and triglycerides; vigor; and total mood by POMS. Accordingly, significant percent change differences between the APP and the No-APP groups were observed in V˙O2peak; fat and fat-free mass percent; total cholesterol, LDL cholesterol, and triglycerides; and depression, vigor, anger, and total mood by POMS. CONCLUSIONS: Exercising using a smartphone application improved cardiorespiratory fitness, body composition, cholesterol profiles, and psychological outcomes in PLWH.