Combination of advanced biological systems and photocatalysis for the treatment of real hospital wastewater spiked with carbamazepine: A pilot-scale study.

Over the past few decades, the increase in dependency on healthcare facilities has led to the generation of large quantities of hospital wastewater (HWW) rich in chemical oxygen demand (COD), total suspended solids (TSS), ammonia, recalcitrant pharmaceutically active compounds (PhACs), and other disease-causing microorganisms. Conventional treatment methods often cannot effectively remove the PhACs present in wastewater. Hence, hybrid processes comprising of biological treatment and advanced oxidation processes have been used recently to treat complex wastewater. The current study explores the performance of pilot-scale treatment of real HWW (3000 L/d) spiked with carbamazepine (CBZ) using combinations of moving and stationary bed bio-reactor-sedimentation tank (MBSST), aerated horizontal flow constructed wetland (AHFCW), and photocatalysis. The combination of MBSST and AHFCW could remove 85% COD, 93% TSS, 99% ammonia, and 30% CBZ. However, when the effluent of the AHFCW was subjected to photocatalysis, an enhanced CBZ removal of around 85% was observed. Furthermore, the intermediate products (IPs) formed after the photocatalysis was also less toxic than the IPs formed during the biological processes. The results of this study indicated that the developed pilot-scale treatment unit supplemented with photocatalysis could be used effectively to treat HWW.

Mapping of a soybean rust resistance in PI 594756 at the Rpp1 locus.

Asian soybean rust (ASR), caused by the fungus Phakopsora pachyrhizi, is the main disease affecting soybean in Brazil. This study aimed at investigating and mapping the resistance of the PI 594756 to P. pachyrhizi, by using Bulked Segregant Analysis (BSA). The PI 594756 and the susceptible PI 594891 were crossed and the resulting F2 and F2:3 populations (208 and 1770 plants, respectively) were tested against ASR. Also, these PIs and differential varieties were tested against a panel of monosporic isolates. Plants presenting tan lesions were classified as susceptible (S) while plants presenting reddish-brown (RB) lesions were classified as resistant. DNA bulks were genotyped with Infinium BeadChips and the genomic region identified was further analyzed in the F2 individuals with target GBS (tGBS). PI 594,56 presented a unique resistance profile compared to the differential varieties. The resistance was monogenic dominant; however, it was classified as incompletely dominant when quantitatively studied. Genetic and QTL mapping placed the PI 594756 gene between the genomic region located at 55,863,741 and 56,123,516 bp of chromosome 18. This position is slightly upstream mapping positions of Rpp1 (PI 200492) and Rpp1-b (PI 594538A). Finally, we performed a haplotype analysis in a whole genomic sequencing-SNP database composed of Brazilian historical germplasm and sources of Rpp genes. We found SNPs that successfully differentiated the new PI 594756 allele from Rpp1 and Rpp1-b sources. The haplotype identified can be used as a tool for marker-assisted selection (MAS). Supplementary Information: The online version contains supplementary material available at 10.1007/s11032-023-01358-4.

Endothelial nitric oxide synthase rs1799983 gene polymorphism is associated with the risk of developing intracranial aneurysm.

PURPOSE: The intracranial aneurysm (IA) rupture is associated with a subarachnoid hemorrhage. One third of patients die, and one third remain depend for daily activities. Genetic factors are crucial in the formation and clinical evolution of IAs. Multiple loci have been associated with AIs, much of them implicating multiple pathways related to vascular endothelial maintenance and extracellular matrix integrity. Thus, the aim of our study was to characterize whether polymorphisms in genes implicated in the vascular endothelial maintenance could modify the risk of developing IAs. SUBJECTS AND METHODS: We have studied 176 patients with IA recruited in the Service of Neurosurgery at the University Hospital of Valladolid (Spain) and a control group if 150 sex-matched healthy subjects. Clinical variables were collected from each patient. We have analyzed VEGFA rs833061, VEGFR2 rs2071559, endothelin rs5370, endoglin rs3739817, and eNOS rs1799983 polymorphisms. RESULTS: Our results showed that allele T of the eNOS rs1799983 polymorphism is correlated with decreased risk of developing the disease; thus, allele G of the eNOS rs1799983 polymorphism increased the risk of developing IA. CONCLUSION: The association of eNOS rs1799983 polymorphism with the risk to suffer IA reinforces the hypothesis that genetic variants in eNOS gene could be crucial in the pathogenesis of IA.

Variation of the feeding/resting period in modified vertical treatment wetlands (depth, zeolite as medium) employed for treating rural domestic wastewater in tourist areas.

This work aimed to evaluate the performance of modified vertical flow treatment wetlands (VF-TWs) in terms of depth and medium to assess the effect of the feeding/resting periods and footprint (FP). The modifications were proposed for treating domestic wastewater in rural areas with flow variations such as tourist sites. The experimental setup included six laboratory-scale VF-TWs: (a) normal (VF-N), bed depth 1.0 m, filled with sand and (b) modified (VF-M), bed depth 0.5 m, filled with sand (upper) and zeolite (bottom, saturated). The operation was divided into three phases (3 months each), varying the feeding/resting period and FP: phase I, 5 d/10 d, 2.6 m2/person-equivalent (PE); phase II, 3.5 d/3.5 d, 1.7 m2/PE; and phase III, only feeding no resting, 0.85 m2/PE. Influent and effluent grab samples were taken every 2 weeks. The results showed effective removal (above 60%) of total solids, organic matter, and pathogens for both VF-N and VF-M. Regarding nutrients, VF-M showed a phosphate removal below 60%, but no consistent removal (15-60%) of total nitrogen. Thus, the results suggest that proposed modifications can be an option to be established in tourist sites, but further work should be conducted to improve and optimize total nitrogen removal.

Effect of intermittent induced aeration on nitrogen removal and denitrifying-bacterial community structure in Cork and gravel vertical flow pilot-scale treatment wetlands.

In this work, we have evaluated the impact of intermittent induced aeration in total nitrogen (TN), ammonia (NH4-N) and nitrate-nitrogen (NO3-N) removal in four pilot-scale vertical flow constructed wetlands (VFCW) (two aerated two non-aerated) using cork by-product or gravel as the filter material and planted with Phragmites australis. Both aerated and non-aerated systems achieved high COD and BOD5 elimination rates (≥ 90%) at the end of the 5-month test period. However, the aerated systems presented maximal COD and BOD5 removal from the third month of operation onwards since air supply favored the oxidative bioprocesses occurring within the wetlands. Cork and gravel aerated VFCW also proved to be more efficient (p < 0.05) in NO3-N removal than the non-aerated systems and this upgraded performance was correlated with a significant higher relative abundance of the nirS gene. The aerated systems also showed a slightly improved NH4-N removal. Noticeably, cork VFCW showed higher TN removal mean values (∼35%) than gravel wetlands (27-28%) regardless aeration. Moreover, cork VFCW showed higher relative abundance of the nosZ gene. Our results demonstrated a better nitrogen elimination for the aerated cork pilot-scale VFCW, and this behavior was correlated with a higher abundance of both nirS and nosZ, two of the key functional genes involved in nitrogen metabolism.

Characterization of Hydrocarbon-Degrading Bacteria in Constructed Wetland Microcosms Used to Treat Crude Oil Polluted Water.

Ten plant species were grown in constructed wetlands (CWs) to remediate water containing 2% (w/v) crude oil. The plant species with better growth and biomass production were Typha latifolia and Cyperus laevigatus, and they were significantly correlated (R2 = 0.91) with hydrocarbon degradation. From T. latifolia and C. laevigatus, 33 hydrocarbon-degrading bacterial strains were isolated from the rhizosphere, and root and shoot interiors. More diversified bacteria were found in the rhizosphere and endosphere of C. laevigatus than those of T. latifolia. The predominant cultural hydrocarbon-degrading bacteria were shown to belong to the genera Pseudomonas, Acinetobacter and Bacillus. In addition to genes involved in hydrocarbon degradation, most of the bacteria displayed multiple plant growth promoting (PGP) activities. This study suggests the importance of selecting suitable bacterial strains with hydrocarbon degradation and PGP activities for improving the efficacy of CWs used in remediating water contaminated with crude oil.

Hydraulic and hydrological aspects of an evapotranspiration-constructed wetland combined system for household greywater treatment.

Constructed wetlands systems demand preliminary and primary treatment to remove solids present in greywater (GW) to avoid or reduce clogging processes. The current paper aims to assess hydraulic and hydrological behavior in an improved constructed wetland system, which has a built-in anaerobic digestion chamber (AnC), GW is distributed to the evapotranspiration and treatment tank (CEvaT), combined with a subsurface horizontal flow constructed wetland (SSHF-CW). The results show that both the plants present in the units and the AnC improve hydraulic and volumetric efficiency, decrease short-circuiting and improve mixing conditions in the system. Moreover, the hydraulic conductivity measured on-site indicates that the presence of plants in the system and the flow distribution pattern provided by the AnC might reduce clogging in the SSHF-CW. It is observed that rainfall enables salt elimination, thus increasing evapotranspiration (ET), which promotes effluent reduction and enables the system to have zero discharge when reuse is unfeasible.

Cyanobacterial blooms in surface waters - Nature-based solutions, cyanotoxins and their biotransformation products.

Cyanobacterial blooms are expected to become more frequent and severe in surface water reservoirs due to climate change and ecosystem degradation. It is an emerging challenge that especially countries relying on surface water supplies will face. Nature-based solutions (NBS) like constructed wetlands and biofilters can be used for cyanotoxin remediation. Both technologies are reviewed and critically assessed for different types of water resources. The available information on cyanotoxins (bio)transformation products (TPs) is reviewed to point out the potential research gaps and to disclose the most reliable enzymatic degradation pathways. Knowledge gaps were found, such as information on the performance of the revised NBS in pilot and full scales, the removal processes covering different cyanotoxins (besides the most widely studied microcystin-LR), and the difficulties for real-world implementation of technologies proposed in the literature. Also, most studies focus on bacterial degradation processes while fungi have been completely overlooked. This review also presents an up-to-date overview of the transformation of cyanotoxins, where degradation product data was compiled in a unified library of 22 metabolites for microcystins (MCs), 7 for cylindrospermopsin (CYN) and 10 for nodularin (NOD), most of them reported only in a single study. Major gaps are the lack of environmentally relevant studies with TPs in pilot and full- scale treatment systems, information on TP's toxicity, as well as limited knowledge of environmentally relevant degradation pathways. NBS have the potential to mitigate cyanotoxins in recreational and irrigation waters, enabling the water-energy-food nexus and avoiding the degradability of the ecosystems.

Potential of nature-based solutions to reduce antibiotics, antimicrobial resistance, and pathogens in aquatic ecosystems. a critical review.

This comprehensive scientific review evaluates the effectiveness of nature-based solutions (NBS) in reducing antibiotics (ABs), combating antimicrobial resistance (AMR), and controlling pathogens in various aquatic environments at different river catchment levels. It covers conventional and innovative treatment wetland configurations for wastewater treatment to reduce pollutant discharge into the aquatic ecosystems as well as exploring how river restoration and saltmarshes can enhance pollutant removal. Through the analysis of experimental studies and case examples, the review shows NBS's potential for providing sustainable and cost-effective solutions to improve the health of aquatic ecosystems. It also evaluates the use of diagnostic indicators to predict NBS effectiveness in removing specific pollutants such as ABs and AMR. The review concludes that NBS are feasible for addressing the new challenges stemming from human activities such as the presence of ABs, AMR and pathogens, contributing to a better understanding of NBS, highlighting success stories, addressing knowledge gaps, and providing recommendations for future research and implementation.

Breast Reduction with Total Superior Pedicle.

Breast reduction for macromastia has been approached by several techniques. The standard criterion to consider in the procedure is the pedicle's length, wherein most surgeons prefer the inferior pedicle. This study is showing a different approach through total superior pedicle lifting for those patients requiring a long nipple-areola complex (NAC) ascending. Methods: A single-center descriptive study was performed in Santiago de los Caballeros, Dominican Republic, from 2006 to 2022. A total pedicle lifting technique from a vertical marking with horizontal modification was performed on approximately 283 patients, where 232 had a resection greater than or equal to 500 grams in one or both breasts with NAC descending lengths greater than 30 cm. Results: All cases were resolved without presenting tissue damage or NAC necrosis. The average patient's age was 34.5, and surgery time was approximately 3 hours. Considering both breasts, the average tissue extracted in the population was 1441.4 ± 589.6 grams (SD, 95%) with a median of 1211.5 grams. Conclusions: The total pedicle lifting approach is a safe and reproducible procedure, distinguished by the regard for the upper circulation of the breast.

Improved urban stormwater treatment and pollutant removal pathways in amended wet detention ponds.

Dissolved and colloidal bound pollutants are generally poorly removed from stormwater in wet detention ponds. These fractions are, however, the most bio-available, and therefore three wet detention ponds were amended with planted sand filters, sorption filters and addition of precipitation chemicals to enhance the removal of dissolved pollutants and pollutants associated with fine particles and colloids. The three systems treated runoff from industrial, residential and combined (residential and highway) catchments and had permanent volumes of 1,990, 6,900 and 2,680 m(3), respectively. The treatment performance of the ponds for elimination of total suspended solids (TSS), total nitrogen (Tot-N), total phosphorous (Tot-P), PO(4)-P, Pb, Zn, Cd, Ni, Cr, Cu, Hg were within the range typically reported for wet detention ponds, but the concentrations of most of the pollutants were efficiently reduced by the planted sand filters at the outlets. The sorption filters contributed to further decrease the concentration of PO(4)-P from 0.04 ± 0.05 to 0.01 ± 0.01 mg L(-1) and were also efficient in removing heavy metals. Dosing of iron sulphate to enrich the bottom sediment with iron and dosing of aluminium salts to the inlet water resulted in less growth of phytoplankton, but treatment performance was not significantly affected. Heavy metals (Pb, Zn, Cd, Ni, Cr and Cu) accumulated in the sediment of the ponds. The concentrations of Zn, Ni, Cu and Pb in the roots of the wetland plants were generally correlated to the concentrations in the sediments. Among 13 plant species investigated, Rumex hydrolapathum accumulated the highest concentrations of heavy metals in the roots (Concentration Factor (CF) of 4.5 and 5.9 for Zn and Ni, respectively) and Iris pseudacorus the lowest (CF < 1). The translocation of heavy metals from roots to the aboveground tissues of plants was low. Therefore the potential transfer of heavy metals from the metal-enriched sediment to the surrounding ecosystem via plant uptake and translocation is negligible.

Cervical spine ganglioneuroma and its relationship with neurofibromatosis type 1.

Ganglioneuromas are slow growing tumours arising from tissues of the neural crest, mainly in autonomic nervous system. They are frequently localized in the posterior mediastinum being the intraspinal involvement very uncommon. We present the case of a female patient with bilateral cervical ganglioneuroma, together with a review of the cases published to date, emphasizing in the main characteristics of these tumours and including them as part of neurofibromatosis type 1 spectrum.

Los ganglioneuromas son tumores de lento crecimiento que se originan en tejidos derivados de la cresta neural, principalmente en el sistema nervioso autónomo. Se localizan sobre todo en el mediastino posterior, siendo la afectación intraespinal muy poco frecuente. Presentamos el caso de una mujer intervenida de ganglioneuromas localizados en la columna cervical y agrupamos los casos descritos previamente en la literatura inglesa revisando las características principales de estas neoplasias e incluyéndolas en el espectro de manifestaciones de la neurofibromatosis tipo 1.

Effects of electroconductive materials on treatment performance and microbial community structure in biofilter systems with silicone tubings.

Biofilter systems coupling with microbial electrochemical technology can enhance the removal performance of pollutants. In this study, two types of coke (PK-A and PK-LSN) were used as electroconductive substrates in biofilter systems with silicone tubings. The results showed that the silicone tubings were beneficial for removing NH4+-N. The PK-A systems reached removal efficiencies up to 83.5-85.3% for NH4+-N without aeration. Compared to gravel systems, significantly higher removal efficiencies of NO3--N (84.8-95.4%) were obtained in coke systems, and better removal of PO43--P (91.9-95.7%) was also simultaneously achieved in PK-A systems. Redundancy analysis (RDA) indicated that the better performances of coke systems rely on the functions of both electroactive (Trichococcus and Sulfurovum) and non-electroactive bacteria (Clostridium_sensu_stricto_1, Propionicicella, and Acinetobacter). These findings highlight the important contribution of silicone tubings to oxygen supply and provide useful guidance for the application of coke in composite matrix systems.

Elimination and accumulation of polycyclic aromatic hydrocarbons in urban stormwater wet detention ponds.

The concentrations of polycyclic aromatic hydrocarbons (PAHS) in water and sediments of seven wet detention ponds receiving urban stormwater were investigated. The ponds comprised traditional wet detention ponds with a permanent wet volume and a storage volume as well as ponds that were expanded with sand filters and other means to improve the removal of micropollutants. The concentrations of sigmaPAH in the sediments varied between 6 +/- 5 and 2,222 +/- 603 ng g(-1) dry weight (mean +/- standard deviation), and were highest in the ponds with lower pond volume per catchment area and did not clearly reflect different activities in the catchments. In general, the concentrations of PAHS in the sediments decreased from inlet to outlet, especially in the systems with good conditions for sedimentation such as systems with flow perpendicular sand dikes and extensive submerged vegetation. High molecular weight PAHs were predominant in the sediments indicating the pyrogenic origin of the PAHS. There was no correlation between PAH species concentrations in water or sediments and their hydrophobicity (log K(ow)). PAH concentrations in water fluctuated in response to intensity and frequency of rain events, whereas concentrations in the sediments integrated the pollutant load over time. Pond systems expanded with sand filters and other technologies to enhance removal of micropollutants consistently had concentrations of PAHS in the effluents below the detection level.

Video-Assisted Thoracoscopy For Penetrating Cardiac Box Injury in Stable Patients.

INTRODUCTION: In high-volume trauma centers, especially in developing countries, penetrating cardiac box injuries are frequent. Although many aspects of penetrating chest injuries have been well established, video-assisted thoracoscopy is still finding its place in cardiac box trauma and algorithmic approaches are still lacking. The purpose of this manuscript is to provide a streamlined recommendation for penetrating cardiac box injury in stable patients. METHODS: Literature review was carried out using PubMed/ MEDLINE and Google Scholar databases to identify articles describing the characteristics and concepts of penetrating cardiac box trauma, including the characteristics of tamponade, cardiac ultrasound, indications and techniques of pericardial windows and, especially, the role of video-assisted thoracoscopy in stable patients. RESULTS: Penetrating cardiac box injuries, whether by stab or gunshot wounds, require rapid surgical consultation. Unstable patients require immediate open surgery, however, determining which stable patients should be taken to thoracoscopic surgery is still controversial. Here, the classification of penetrating cardiac box injury used in Colombia is detailed, as well as the algorithmic approach to these types of trauma. CONCLUSION: Although open surgery is mandatory in unstable patients with penetrating cardiac box injuries, a more conservative and minimally invasive approach may be undertaken in stable patients. As rapid decision-making is critical in the trauma bay, surgeons working in high-volume trauma centers should expose themselves to thoracoscopy and always consider this possibility in the setting of penetrating cardiac box injuries in stable patients, always in the context of an experienced trauma team.

Arm-only access for combined transarterial and transvenous neurointerventional procedures.

A simultaneous arterial and venous approach has been widely described for the endovascular treatment of dural arteriovenous fistula (DAVFs) and recently for arteriovenous malformation (AVMs). Conventional venous approaches are performed by direct internal jugular puncture or by femoral access. Although complication rates are low, there are potential life-threatening complications that should be avoided. The advantages of radial artery access have been widely proven, nevertheless the use of upper limb veins in neurointervention are rarely reported. We present five cases of the simultaneous arteriovenous approach through the radial artery and superficial veins of the forearm for the treatment of intracranial neurovascular diseases.

Novel bioelectrochemical strategies for domesticating the electron flow in constructed wetlands.

Constructed wetlands are an effective biofilter-based technology for treating wastewater in a sustainable way; however, their main disadvantage is a large area footprint. To cope with this limitation a new generation of constructed wetlands, the METlands®, have been recently reported. METlands® replace gravel with a granular electrically conductive material to enhance the oxidative metabolisms of electroactive bacteria by facilitating the flux of electron through the material and, consequently, increase bioremediation rates. In this work we evaluated the performance of a new electron sink (e-sink) device with the purpose of controlling and enhancing the electrochemical consumption of electrons from microbial metabolism without energy consumption. The e-sink device was integrated inside the biofilter bed and was tested using different electron acceptors with high redox potentials, like oxygen and hypochlorite. Interestingly, the presence of the e-sink allowed novel redox gradients to form inside the METland® and, consequently, a new electron flow was demonstrated by measuring both the electric potential and current density profiles of the bed. Three independent biofilters were constructed and operated under flooded conditions. Ec-coke and electroconductive biochar (ec-biochar) were used as electrically conductive bed materials, while gravel was used as an inert control. Furthermore, e-sink integration inside the electrically conductive bed outperformed METlands® for removing pollutants, already much more efficient than standard gravel biofilters. COD removal was increased from 90% in METland® to 95% in the e-sink METland® as compared to 75% for the control, while total nitrogen removal was enhanced from 64% in METland® to 71% in e-sink METland® as compared to 55% for the control. Our results indicate that increasing the electrochemical availability of electron acceptors by using the e-sink will be a suitable method for controlling the electron flow inside the filter bed and can be integrated in full scale METlands® for achieving high removal rates.

Community level physiological profiling of microbial electrochemical-based constructed wetlands.

The performance of constructed wetlands (CW) can be enhanced through the use of microbial electrochemical technologies like METland systems. Given its novelty, uncertainties exist regarding processes responsible for the pollutant removal and microbial activity within the systems. Genetic characterization of microbial communities of METlands is desirable, but it is a time and resource consuming. An alternative, is the functional analysis based on community-level physiological profile (CLPP), which allows to evaluate the diversity of microbial communities based on the carbon consumption patterns and derived indexes (average well color development - AWCD -, richness, and diversity). This study aimed to characterize the microbial community function of laboratory-scale METlands using the CLPP method. It encompassed the analysis of planted and non-planted set-ups of two carbon-based electroconductive materials (Coke-A and Coke-LSN) colonized with electroactive biofilms, and compared to Sand-filled columns. Variations in the microbial metabolic activity were found to depend on the characteristics of the material rather than to the presence of plants. Coke-A systems showed lower values of AWCD, richness, and diversity than Sand and Coke-LSN systems. This suggests that Coke-A systems provided more favorable conditions for the development of relatively homogeneous microbial biofilms. Additionally, typical parameters of water quality were measured and correlations between utilization of carbon sources and removal of pollutants were established. The results provide useful insight into the spatial dynamics of the microbial activity of METland systems.

Electroactive biofilm-based constructed wetland (EABB-CW): A mesocosm-scale test of an innovative setup for wastewater treatment.

Constructed wetlands (CWs) performance enhancement can be done with intensification strategies. A recent strategy still in study is the coupling with Microbial Electrochemical Technologies (MET). An alternative system using electro-conductive biofilters instead of electrodes and circuits used in MET, resulted in the development of a Microbial Electrochemical-based CW (METland). This system relies on electroactive bacteria (EAB) metabolism to transfer electrons to an electro-conductive material, thus boosting substrate consumption, and diminishing electron availability for biomass build-up and methane generation. In previous studies this biofilters have shown an improvement in biodegradation rates in comparison with subsurface flow CW. However, this set-up is still in development, hence there are uncertainties regarding the dynamics involve in the removal of pollutants. Considering that, this work aimed at establishing the capacity and removal kinetics of organic matter and nutrients in an Electroactive Biofilm-Based CW (EABB-CW). Two electro-conductive materials were tested (PK-A and PK-LSN) in planted and non-planted mesocosms and compared with sand. The systems were operated in a continuous upflow mode for 32 weeks and fed with real wastewater. The electro-conductive systems reached removal efficiencies up to 88% for BOD5, 90% for COD, 46% for NH4-N, and 86% for PO4-P. Organic matter removal in electro-conductive systems was possible even at loading rates 10-fold higher than recommended for horizontal flow CWs. First-order area-based removal constants (k), calculated for organic matter and nutrients are higher than values typically reported for saturated CW and in certain cases comparable with vertical flow CW. The organic removal was correlated with electron current densities measures, as indicator of the presence of EAB. The tested EABB-CW profiles as a promising CW type for the removal of organic matter and PO4-P with margin for modifications to improve nitrogen removal. Future studies with pilot/real scale systems are proposed to validate the findings of this study.