Evaluating the effectiveness of a low fidelity, easily available simulator to teach basic arthroscopy skills to novice learners: A prospective cohort study.

BACKGROUND: Arthroscopy proficiency is key to being a competent orthopaedic surgeon and acquiring arthroscopic skills takes years of exposure and diligent practice. However, today's graduating consultants have had considerably less time in operating theatre than their senior colleagues at the same point of their careers. OBJECTIVES: To evaluate whether: (1) Students could improve their arthroscopic technique using a low fidelity arthroscopic training tool (2) students enjoyed the use of the simulator (3) If certain demographics correlate to performance on the simulator. METHODS: Medical students who have no previous training in arthroscopy were included. A combined left- and right-handed timed run with a low-fidelity arthroscopic triangulation simulator was recorded before and after 40-minutes of practice. RESULTS: 84 participants took part with an average improvement of was 66.8%. Students felt that their arthroscopic skills increased on average by 36.4%. 73 of the 84 participants gave the maximum score of 5 when asked if they enjoyed the session and 74 participants gave the maximum score of 5 as to whether they would be interested in participating in further sessions. Factors such as biological sex, video game play and sports were found to be statistically significant to performance. CONCLUSIONS: This study showed a statistically significant improvement in students' arthroscopic performance with a low-fidelity arthroscopic simulator. Students found the experience useful with the vast majority indicating interest in completing further training sessions to help improve practical surgical skills. Video gamers, sports players and males were found to have a correlation with performance on the simulator.

Study protocol for IMPRoVE: a multicentre prospective observational cohort study of the incidence, impact and mechanisms of perioperative right ventricular dysfunction in non-cardiac surgery.

INTRODUCTION: Perioperative myocardial injury evidenced by elevated cardiac biomarkers (both natriuretic peptides and troponin) is common after major non-cardiac surgery. However, it is unclear if the rise in cardiac biomarkers represents global or more localised cardiac injury. We have previously shown isolated right ventricular (RV) dysfunction in patients following lung resection surgery, with no change in left ventricular (LV) function. Given that perioperative RV dysfunction (RVD) can manifest insidiously, we hypothesise there may be a substantial burden of covert yet clinically important perioperative RVD in other major non-cardiac surgical groups. The Incidence, impact and Mechanisms of Perioperative Right VEntricular dysfunction (IMPRoVE) study has been designed to address this knowledge gap. METHODS AND ANALYSIS: A multicentre prospective observational cohort study across four centres in the West of Scotland and London. One hundred and seventy-five patients will be recruited from five surgical specialties: thoracic, upper gastrointestinal, vascular, colorectal and orthopaedic surgery (35 patients from each group). All patients will undergo preoperative and postoperative (day 2-4) echocardiography, with contemporaneous cardiac biomarker testing. Ten patients from each surgical specialty (50 patients in total) will undergo T1-cardiovascular magnetic resonance (CMR) imaging preoperatively and postoperatively. The coprimary outcomes are the incidence of perioperative RVD (diagnosed by RV speckle tracking echocardiography) and the effect that RVD has on days alive and at home at 30 days postoperatively. Secondary outcomes include LV dysfunction and clinical outcomes informed by Standardised Endpoints in Perioperative Medicine consensus definitions. T1 CMR will be used to investigate for imaging correlates of myocardial inflammation as a possible mechanism driving perioperative RVD. ETHICS AND DISSEMINATION: Approval was gained from Oxford C Research Ethics Committee (REC reference 22/SC/0442). Findings will be disseminated by various methods including social media, international presentations and publication in peer-reviewed journals. TRIAL REGISTRATION NUMBER: NCT05827315.

Prospective randomised unblinded comparison of sputum viscosity for three methods of saline nebulisation in mechanically ventilated patients: A pilot study protocol.

INTRODUCTION: Heat and moisture exchanger (HME) filters are commonly used as passive circuit humidifiers during mechanical ventilation, however, are only ~80% efficient. As a result, patients that undergo mechanical ventilation in critical care with HME filter circuits will be exposed to partial airway humidification. This is associated with detrimental effects including increased secretion load which has been shown to be an independent predictor of failed extubation. Nebulised normal saline is commonly utilised to supplement circuit humidification in ventilated patients with high secretion loads, although there are no randomised control trials evaluating its use. Novel vibrating mesh nebulisers generate a fine aerosol resulting in deeper lung penetration, potentially offering a more effective means of nebulisation in comparison to jet nebulisers. The primary aim of this study is to compare the viscosity of respiratory secretions after treatment with nebulised normal saline administered via vibrating mesh nebuliser or jet nebuliser. METHODS AND ANALYSIS: This randomised controlled trial is enrolling 60 mechanically ventilated adult critical care patients breathing on HME filter circuits with high secretion loads. Recruited patients will be randomised to receive nebulised saline via 3 modalities: 1) Continuous vibrating mesh nebuliser; 2) Intermittent vibrating mesh nebuliser or 3) Intermittent jet nebuliser. Over the 72-hr study period, the patients' sputum viscosity (measured using a validated qualitative sputum assessment tool) and physiological parameters will be recorded by an unblinded assessor. A median reduction in secretion viscosity of ≥0.5 on the qualitative sputum assessment score will be deemed as a clinically significant improvement between treatment groups at analysis. DISCUSSION: At the conclusion of this trial, we will provisionally determine if nebulised normal saline administered via vibrating mesh nebulisation is superior to traditional jet nebulisation in terms of reduced respiratory secretion viscosity in intubated patients. Results from this pilot study will provide information to power a definitive clinical study. TRIAL REGISTRATION: ClinicalTrails.Gov Registry (NCT05635903).

The use of joints of meat as phantoms for ultrasound-guided needling skills: a prospective blinded study.

BACKGROUND: Needle visualisation during ultrasound-guided procedures is a skill that can be difficult to practise, with commercially available phantoms being expensive and often unrealistic. Our aim was to find an inexpensive, reproducible model that could be used to assist in developing this skill. METHODS: Pork shoulder, beef brisket, and lamb shoulder joints were compared to a standard blue ultrasound phantom. Five 'chunky' yarn pieces were twisted together and threaded through each joint to simulate hyperechoic nerves. Participants were instructed to ultrasound each specimen and insert a needle close to a nerve like structure. Using a visual analogue scale, specimens were scored based on realism of appearances of ultrasound images and 'feel' of needling. RESULTS: 38 people participated. All specimens of meat scored significantly higher than the blue phantom (p = 0.01). There was no significant difference between the different types of meat. CONCLUSIONS: Pork, beef and lamb joints are an effective model to use for simulation training for needling skills. They have limited lifespan, but due to its relatively low cost, it is feasible to discard the meat after each training workshop. We hope the use of inexpensive meat products will make ultrasound simulation training simpler to organise and more effective.

Repurposing spent filter sand from iron and manganese removal systems as an adsorbent for treating arsenic contaminated drinking water.

Waterworks which utilise river bank filtration water sources often have to apply aeration and sand filtration to remove iron and manganese during the drinking water treatment process. After some time, the sand becomes saturated and the spent filter sand (SFS) must be disposed of and replaced. In order to valorize this waste stream, this paper investigates the reuse of SFS as an adsorbent for the treatment of arsenic contaminated drinking water. The arsenic removal performance of SFS is compared with two synthetic iron oxide coated sands (IOCS). The sorbents were first characterized by SEM, EDS, BET specific surface area, and point of zero charge (pHpzc) measurements, and then investigated under a variety of conditions. The surface of the SFS was revealed to be coated with iron manganese binary oxide. The Freundlich model best described the isotherm experiment data, indicating a non monolayer adsorption model for arsenic adsorption on the three IOCS investigated. As(III) and As(V) removals were negatively effected by the presence of PO43- and HA anions as they competed with the arsenic species for adsorption sites. However, given the status of SFS as a waste material, the results obtained in this paper suggest it may be successfully reused as a very economically and environmentally sustainable solution for small waterworks requiring both As(V) and As(III) removal during drinking water treatment.

A Metabolomics approach for the diagnosis Of SecondAry InfeCtions in COVID-19 (MOSAIC): a study protocol.

BACKGROUND: Critically ill patients with COVID-19 are at an increased risk of developing secondary bacterial infections. These are both difficult to diagnose and are associated with an increased mortality. Metabolomics may aid clinicians in diagnosing secondary bacterial infections in COVID-19 through identification and quantification of disease specific biomarkers, with the aim of identifying underlying causative microorganisms and directing antimicrobial therapy. METHODS: This is a multi-centre prospective diagnostic observational study. Patients with COVID-19 will be recruited from critical care units in three Scottish hospitals. Three serial blood samples will be taken from patients, and an additional sample taken if a patient shows clinical or microbiological evidence of secondary infection. Samples will be analysed using LC-MS and subjected to bioinformatic processing and statistical analysis to explore the metabolite changes associated with bacterial infections in COVID-19 patients. Comparisons of the data sets will be made with standard microbiological and biochemical methods of diagnosing infection. DISCUSSION: Metabolomics analyses may provide additional strategies for identifying secondary infections, which might permit faster initiation of specific tailored antimicrobial therapy to critically ill patients with COVID-19.

Roots of Apium graveolens and Petroselinum crispum-Insight into Phenolic Status against Toxicity Level of Trace Elements.

Celery (Appium graveolens L.) and parsley (Petroselinum crispum (Mill.) Fuss) are herbs utilized in the everyday diet as spices and culinary flavorings, often used in the chemical and medicinal industries. Despite the knowing benefits of different plants from the Apiaceae family, their chemical composition is closely associated with various extrinsic factors. Environmental loading with trace elements (TEs) can modify a plant's metabolic pathways, change bioactive compounds production, cause plant pollution, and consequently provoke human health issues. Therefore, we established this research aiming to unravel the linkage between TEs accumulation and phenolic status in celery and parsley. Higher As, Cd, and Ni levels were observed in celery, which was followed by greater DPPH∙ radical scavenging activity and higher coumarins content. Contrary, parsley accumulated chromium to a greater extent, was richer in flavonoids, apigenin, and its glucosides. No significant difference between species was found in total phenolic contents, where ferulic and chlorogenic acid dominated in both species. A direct relationship between TEs and selected secondary metabolites was proven by the standardized major axis model. Besides abundant bioactive compounds, analyzed plant species showed a moderate hazard index in the children population, since the hazard index was higher than 1. Therefore, future perspectives should be turned towards the production of genotypes with a lower potential for toxic elements accumulation, so the health benefits of plant food will be more prominent.

Fate of natural organic matter and oxidation/disinfection by-products formation at a full-scale drinking water treatment plant.

This paper investigates the fate of natural organic matter (NOM) during the full-scale drinking water treatment plant supplied by Danube river bank filtration. After the recent reconstruction of the plant, special attention was devoted to the effects of ozone dose and granulated activated carbon (GAC) filtration on the formation and behaviour of oxidation by-products (carbonyl compounds and bromate), as well as carbonaceous and nitrogenous chlorination by-products. For the oxidation of aromatic NOM moieties that absorb light at UV254, a lower ozone dose (1.0 g O3/m3) is sufficient, whereas to achieve a measurable reduction (about 20%) of total organic carbon, an ozone dose of 1.5 g O3/m3 is required. The content of carbonyl compounds in the water after ozonation increases relative to the content before oxidation treatment, and is up to 12 times higher in the case of aldehydes and up to 2 times higher in the case of carboxylic acids. Seasonal variations, including changes in temperature and the amount of precipitation, were also shown to affect the content of organic matter in the raw water, with slight effects on the quality of the treated water. In the winter, the organic matter content is slightly higher, meaning their transformation products aldehydes and carboxylic acids, are also higher during the winter than the summer.

Synthesis, characterization and application of magnetic nanoparticles modified with Fe-Mn binary oxide for enhanced removal of As(III) and As(V).

Arsenic contamination of drinking water sources is a widespread global problem. Of the As species commonly found in groundwater, As(III) is generally more mobile and toxic than As(V). In this work, magnetic nanoparticles (MNp) modified with Fe-Mn binary oxide (MNp-FeMn) were synthesized in order to develop a low cost adsorbent with high removal efficiency for both arsenic species which can be readily separated from water using a magnetic field. MNp-FeMn were characterized using different techniques including SEM/EDS, XRD and BET analysis. Adsorption of As(III) and As(V) on MNp-FeMn was studied as a function of initial arsenic concentration, contact time, pH, and coexisting anions. The BET specific surface area of MNp-FeMn was 109 m2/g and maghemite (γ-Fe2O3) was the dominant precipitated phase. The adsorption rate of As(III) and As(V) on MNp-FeMn was controlled by surface diffusion. FTIR analysis confirms that surface complexation through ligand exchange was the main mechanism for As(III) and As(V) removal on MNp-FeMn, with As(III) conversion to As(V) occurring on the adsorbent surface. The maximal adsorption capacity qmax of MNp for As(III) (26 mg/g) was significantly improved after modification with Fe-Mn binary oxide (56 mg/g), while qmax for As(V) was 51 and 54 mg/g, respectively. PO43-, SiO32- and CO32- reduced As(III) and As(V) uptake at higher concentrations. MNp-FeMn can be easily regenerated and reused with only a slight reduction in adsorption capacity. The high oxidation and sorption capacity of MNp-FeMn, magnetic properties and reusability, suggest this material is a highly promising adsorbent for treatment of arsenic contaminated groundwater.

Application of UV-activated persulfate and peroxymonosulfate processes for the degradation of 1,2,3-trichlorobenzene in different water matrices.

The presence of a large number of micropollutants in the environment, including priority and emerging substances, poses a significant risk to surface and groundwater quality. Among them, trichlorobenzenes are widely used in the syntheses of dyes, pesticides, solvents, and other chemicals and have been identified as priority pollutants by the European Water Framework Directive. The main goal of this study was to investigate the behavior of 1,2,3-trichlorobenzene (TCB) during the sulfate radical-based advanced oxidation processes (SR-AOPs) involving UV activation of persulfate or peroxymonosulfate (UV/S2O82- and UV/HSO5- processes). For this purpose, TCB was subjected to SR-AOPs in synthetic water matrices containing humic acids or hydrogencarbonate and natural water samples and a comparative evaluation of the degradation process was made. The toxicity of the oxidation by-products was also assessed. The evaluation of TCB degradation kinetics results using principal component analysis indicates that the efficacy of the SR-AOPs was highly dependent on the pH, initial oxidant concentration, UV fluence, and matrix characteristics. In natural waters, TCB degradation by the UV/S2O82- process proved to be most effective in acidic conditions (pH 5), while the UV/HSO5- process showed the highest efficacy in basic conditions (pH 9.5), achieving a maximum TCB degradations of 97-99%. The obtained results indicate that UV/S2O82- and UV/HSO5- as new generation oxidation processes have significant potential for TCB removal from water and result in only minor toxicity after treatment (14-23% of Vibrio fischeri bioluminescence inhibition).

Propofol Target-Controlled Infusion in Emergency Department Sedation (ProTEDS): a multicentre, single-arm feasibility study.

BACKGROUND: Procedural sedation is a core skill of the emergency physician. Bolus administration of propofol is widely used in UK EDs. Titrated to an end point of sedation, it has a rapid effect but has been associated with adverse incidents. The use of a target-controlled infusion (TCI) of propofol is not routine but may reduce the incidence of adverse incidents.The primary aims of this single-arm feasibility study were patient satisfaction and to establish recruitment rates for a randomised controlled trial comparing propofol TCI to bolus administration. METHODS: Four EDs in Scotland, UK, participated. Patients aged 18-65 years, with anterior shoulder dislocation, weight ≥ 50kg, fasted ≥ 90 min were screened. Patients underwent reduction of their dislocated shoulder using TCI propofol. The primary end point was patient satisfaction recorded on a Visual Analogue Scale. RESULTS: Between 3 April 2017 and 31 December 2018, 25 patients were recruited with a recruitment rate of 20% for the 16-month recruitment window, with a temporary pause to allow amendment of drug dosage.Two patients were excluded. Twenty achieved adequate sedation, defined as a Modified Observer's Assessment of Alertness/Sedation Scale (OAA/S) 3. Successful reduction was achieved in all adequately sedated. Patient satisfaction was documented in 14 patients, mean±SD of 97±9 and time to sedation was 25±8 min. No adverse events were recorded using the Society of Intravenous Anaesthesia adverse event reporting tool. CONCLUSION: Propofol TCI was acceptable as a method of procedural sedation for patients. The lower than expected recruitment rates highlight the need for dedicated research support. TRIAL REGISTRATION NUMBER: NCT03442803.

Ionic Liquids: Review of their Current and Future Industrial Applications and their Potential Environmental Impact.

BACKGROUND: Over the last two decades, thousands of scientific papers and many patents have been written relating to applications of ionic liquids, a family of compounds that garnered such huge interest due to their reputation as "green chemicals". This work reviews the recent literature to investigate the progress ionic liquids have made in their transition from academia to full-scale application in a variety of industries. METHODS: For this review, keywords related to ionic liquids and their possible applications were used to search patent databases such as Google patents. The recent patents thus discovered were tabulated and sorted by application, and the most significant patents were identified. For each application of ionic liquids identified in the patent search, an additional review of the recent scientific literature was carried out, focussing on the relevant ionic liquids and their potential environmental impact. RESULTS: Patents involving ionic liquids were found for various industrial applications, including in chemical industry production technologies, nanotechnology, gas storage and environmental remediation. Despite the widespread interest of the chemical industry, which hopes to improve the environmental sustainability of their technologies by utilising ionic liquids, to date, only a handful of full-scale processes which utilise ionic liquids have been successfully commercialised. That said, a large number of pilot studies have been carried out in recent years, and 62 patents and 270 scientific texts are summarised herein and other industrial applications are also approaching the market. CONCLUSION: The properties of ionic liquids inhibit their entry into the atmosphere. However, their annual production is expected to increase drastically, raising urgent questions about their environmental impact, especially in water bodies. More research is thus required to identify and mitigate any risks ionic liquids might pose to the environment.

Application of Nanomaterials in Water Treatment: Arsenic and Natural Organic Matter Removal.

BACKGROUND: Globally, around 150 million people are still supplied with arsenic contaminated drinking water. The groundwaters effected often contain problematic concentrations of natural organic matter (NOM), which plays an important role in releasing As into the aquifer. Thus, this review explores the recent literature relating to the application of various nanomaterials to solve these drinking water supply problems and highlights the work that still needs to be done. METHODS: After an extensive initial search patent papers were selected based on their quality and relevance to the topic of this review: the use of magnetic nanomaterials based on pure magnetic materials, magnetic composites of carbon/graphene/biochars, polymeric matrices, metal-organic frameworks and mixed-oxide magnetic nanocomposites, as As adsorbents and as photocatalysts for NOM removal. RESULTS: 160 papers relating to the application of nanomaterials for As removal were reviewed and 38 papers covering photocatalysts for NOM removal. These papers were organised by type of nanomaterial, and their important findings summarised. Although many authors have demonstrated effective solutions in the laboratory, the following areas still need to be addressed: the challenges posed by larger pilot and full scale continuously operated processes; the treatment of complex natural water matrices; which technologies will be required to economically separate nanoparticles from the treated water; whether the nanoparticles will be more economically and environmentally sustainable than other techniques available. CONCLUSION: Despite these significant gaps in the literature, the body of work carried out thus far, as summarised in this review paper, strongly suggests that full scale treatment solutions applying (magnetic) nanomaterials may prove highly effective in the future for both arsenic and NOM removal.

Effect of target-controlled propofol infusion to reduce the incidence of adverse events for procedural sedation in the emergency department: a systematic review.

The administration of propofol target-controlled infusion (TCI) for procedural sedation is standard in a range of hospital settings except for the Emergency Department (ED). Propofol TCI could be an alternative, safer way to provide procedural sedation in the ED compared with other methods of propofol administration. We compare the incidence of adverse events using propofol TCI compared with other methods of propofol administration. We conducted a systematic review of the literature from 1946 to January 2019 identifying studies that compared propofol TCI with other propofol regimens for procedural sedation in the adult population. Studies were assessed for risk of bias using the Cochrane Collaboration risk of bias tool. Seven articles were included. There was significant methodological heterogeneity in all aspects of study designs and definitions of adverse events which precluded a meta-analysis. A systematic review of the studies demonstrated fewer respiratory and cardiovascular adverse outcomes in three of the seven studies. It was not possible to determine if propofol TCI reduces the incidence of adverse events when compared with other sedating regimens using propofol using a descriptive systematic review of the relevant literature. Further research is required to compare the incidence of adverse events using propofol TCI for procedural sedation with other methods of administration in the ED. Future systematic reviews and meta-analysis comparisons would be aided by the use of standard adverse event reporting tools such as that of the Society of Intravenous Anaesthesia.

Corporal Punishment and Child Aggression: Ethnic-Level Family Cohesion as a Moderator.

Ethnicity has been examined as a putative moderator between parents' use of corporal punishment and children's externalizing behaviors. Yet, the reasons for this potential ethnic-level moderator have not been fully examined. The primary objective of this study was to examine whether the effect of corporal punishment on aggression is ethnic-specific using major racial groups inside and outside the U.S. samples and how the mean levels of cohesion in family relationships as found in different ethnic groups moderate the association between mothers' use of corporal punishment and children's aggression. A total of 729 mothers who had children aged 7 to 13 years were sampled from five ethnic groups (i.e., European American, African American, Hispanic American, Korean, and Chinese). Several hypotheses were tested to examine the moderating effect of ethnic-level, family cohesion on the relation of corporal punishment to children's aggression. As expected, the mean level of family cohesion was significantly different across ethnicities. Consistent results across parallel multilevel and fixed effect models showed that high corporal punishment was associated with more aggression in all ethnicities, but there was a significant variation in the association across ethnicities, and the variation was explained by ethnic-level family cohesion. There were weaker associations between corporal punishment and child aggression among ethnic groups with high family cohesion and stronger associations among ethnic groups with low family cohesion. Ethnic/cultural variation in this study emphasizes the importance of understanding family environment of diverse ethnic groups when evaluating the influence of corporal punishment on child behavior in different ethnic/cultural contexts.

Staphylococcus aureus products subvert the Burkholderia cenocepacia-induced inflammatory response in airway epithelial cells.

Introduction. Chronic pulmonary infection is associated with colonization with multiple micro-organisms but host-microbe and microbe-microbe interactions are poorly understood.Aim. This study aims to investigate the differences in host responses to mono- and co-infection with S. aureus and B. cenocepacia in human airway epithelial cells.Methodology. We assessed the effect of co-infection with B. cenocepacia and S. aureus on host signalling and inflammatory responses in the human airway epithelial cell line 16HBE, using ELISA and western blot analysis.Results. The results show that B. cenocepacia activates MAPK and NF-κB signalling pathways, subsequently eliciting robust interleukin (IL)-8 production. However, when airway epithelial cells were co-treated with live B. cenocepacia bacteria and S. aureus supernatants (conditioned medium), the pro-inflammatory response was attenuated. This anti-inflammatory effect was widely exhibited in the S. aureus isolates tested and was mediated via reduced MAPK and NF-κB signalling, but not via IL-1 receptor or tumour necrosis factor receptor modulation. The staphylococcal effectors were characterized as small, heat-stable, non-proteinaceous and not cell wall-related factors.Conclusion. This study demonstrates for the first time the host response in a S. aureus/B. cenocepacia co-infection model and provides insight into a staphylococcal immune evasion mechanism, as well as a therapeutic intervention for excessive inflammation.

Arsenic adsorption on Fe-Mn modified granular activated carbon (GAC-FeMn): batch and fixed-bed column studies.

Granular activated carbon (GAC) was modified with Fe-Mn binary oxide to produce a novel effective hybrid adsorbent (GAC-FeMn) for simultaneous removal of As(III) and As(V) from water. After characterization (including BET, SEM/EDS and XRD analyses) of the raw and modified GAC, FTIR analysis before and after As removal showed that ligand exchange was the major mechanism for As removal on GAC-FeMn. Sorption kinetics followed pseudo-second order kinetics for both As(III) and As(V) and were not controlled by intraparticle diffusion. Batch equilibrium experiments yielded adsorption capacities for As(III) and As(V) of 2.87 and 2.30 mg/g, and demonstrated that better sorption was achieved at low pH. Of the competitive anions investigated (PO43-, SiO32-, CO32-, SO42-, NO3-, Cl-), phosphate had the greatest negative effect on As(III) and As(V) adsorption. Three sorption/desorption cycles were conducted in continuous column tests with a real arsenic contaminated groundwater, with subsequent TCLP leaching tests confirming the stability of the spent sorbent. In the column tests, breakthrough curves were also obtained for phosphates, which were present at a relatively high concentration (1.33 mg/L) in the investigated groundwater. The phosphates limited the effective operational bed life of GAC-FeMn for arsenic removal. Nonetheless, the maximum arsenic adsorption capacities for GAC-FeMn obtained by the Thomas model during the three sorption cycles were high, ranging from 18.8 to 29.8 mg/g, demonstrating that even under high phosphate loads, with further process improvements, GAC-FeMn may provide an excellent solution for the economic removal of arsenic from real groundwaters.

Preremedial assessment of the municipal landfill pollution impact on soil and shallow groundwater in Subotica, Serbia.

Most regional municipal solid waste landfills in Serbia are operated without control of landfill leachate and gas or with no regard for implementation of national and European legislation. For the first time in Serbia, groundwater and soil at a landfill were subject to systematic annual monitoring according to national, European legislation and adopted methodologies. Characterisation of the groundwater and soil samples from the landfill included ten metals (Fe, Mn, As, Zn, Cd, Pb, Ni, Cr, Cu and Hg), 16 EPA PAHs, nutrients and certain physicochemical parameters, in order to assess the risks such poorly controlled landfills pose to the environment. This impact assessment was performed using specially adapted pollution indices: LWPI, the Single factor pollution index and the Nemerow index for groundwater, and geo-accumulation index, ecological risk factor and selected rations of PAHs for soil. The data analysis included multivariate statistical methods (factor analysis of principal component analysis (PCA/FA)) in order to assess the extent of the contaminants detected in the groundwater and soil samples. The pollution indices (LWPI: 3.56-8.89; Nemerow index: 2.02-3.78) indicate the quality of the groundwater at the landfill is degrading over time, with PAH16, TOC, Cr, Cu, Pb and Zn as the substances of greatest concern. Heavy metals Hg (Igeo≤3.14), Pb (Igeo≤2.22), Cr (Igeo≤3.31) and Cu (Igeo≤2.16) represent the worst soil contamination. Hg has moderate (52.9) to very high (530.0) potential ecological risk, demonstrating the long-term potential effects of bioaccumulation and biomagnification. The results of this work indicate that Cr and Cu should possibly be added to the EU Watch List of emerging substances. This proposition is substantiated by relevant state and alike environmental information from nations in the region. This study demonstrates the need to develop a model for prioritization of landfill closure and remediation based on environmental risk assessment.

Arginase overexpression and NADPH oxidase stimulation underlie impaired vasodilation induced by advanced glycation end products.

BACKGROUND: Advanced glycation endproducts (AGEs) play a major role in the development of many vascular complications that are mediated by endothelial dysfunction. The present work aimed to investigate the mechanism by which AGEs impair vasodilation. METHODS: The effect of AGEs on vasodilation induced by acetylcholine or D NONOate was examined by incubating isolated rat aortae with different AGEs concentrations. ACh-induced nitric oxide generation was assessed using the fluorescent probe diaminofluorecein (DAF-FM). The effect of AGEs on expression of mRNA for arginase 2, NADPH oxidase and endothelial nitric oxide synthase (eNOS) were determined by real-time PCR. RESULTS: One-hour in vitro incubation of rat aortae with AGEs impaired endothelial-dependent vasodilation produced by ACh, while increasing D NONOate-induced vasodilation. Preincubation of aortae with l-ornithine, an arginase 2-inhibitor, prevented the impairment effect induced by AGEs on endothelial-dependent vasodilation. Superoxide scavenging by tempol or NADPH oxidase inhibition by apocynin also blocked the effect of AGEs. AGEs decreased ACh-induced NO production and this was inhibited by both l-ornithine and apocynin. Furthermore, AGEs exposure increased arginase mRNA expression but decreased mRNA expression for eNOS in isolated rat aortae. CONCLUSION: The present results indicate that AGEs impairs endothelial-dependent vasodilation, and this effect is mediated via arginase overexpression and NADPH oxidase stimulation.

Distribution and ecological risk assessment of organic and inorganic pollutants in the sediments of the transnational Begej canal (Serbia-Romania).

This research is designed to determine the level and types of pollution in the highly contaminated sediments of the international Begej canal in Timis district, Romania and north-eastern Serbia. The cross-border canal stretch investigated is currently not navigable, but represents an important waterway between the Danube River in Serbia and the city of Timisoara. Surface sediments were monitored annually from 2008 to 2016 at 36 representative sampling locations, with a wide range of analyses, including eight heavy metals of long-term monitoring concern (Ni, Zn, Cd, Cr, Cu, Pb, As and Hg) and the 16 USEPA PAHs. The purpose of this study was to determine the diversity and impact of anthropogenic and natural sources of pollution at the pollution hot spots on the canal: at the Itebej lock (near the border with Romania) and downstream at the Klek lock. Sediment quality and ecological risk were assessed in order to determine pollutants of concern. Several multi-proxies were applied (e.g. geo-accumulation index (Igeo), ecological risk index (RI) and total benzo[a]pyrene equivalent (B[a]Peq)). To determine and predict trends, multivariate statistical methods (factor analysis of principal component analysis (PCA/FA)) were carried out on the organic and inorganic parameters analysed. In the near-border region, acute and significant ecological impacts were observed. The heavy metals Hg, Cr, Pb, Cu and Zn, and the carcinogenic PAH dibenzo[a,h]anthracene, were historically the most frequently detected harmful substances to biota in this and the wider Pannonia region. This is the first long-term study to quantify and derivate the most frequently detected harmful substances of concern for this and similar sites in the wider region, and is additionally supported by significant national and similar environmental data from previous studies in the region.