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Bioremediation can be an alternative or complementary approach to conventional soil and water treatment technologies. Determining the environmental and socio-economic impacts of bioremediation is important but rarely addressed. This work presents a comprehensive sustainability assessment for a specific groundwater bioremediation case study based on In-situ Metal(loid) Precipitation (ISMP) by conducting a social Cost-Benefit Analysis (CBA) using two different approaches: environmental Life Cycle Costing (eLCC) and Impact Pathway Approach (IPA). Externalities are calculated in two ways: i) using Environmental Prices (EP) to monetize Life Cycle Assessment (LCA) results and metal(loid)s removed at field scale, and ii) following the IPA steps to determine the social costs avoided by removing arsenic contamination at full scale. The results show that, in the baseline scenario, the project is not socio-economically viable in both cases as the Net Present Value (NPV) is -129,512.61 € and - 415,185,140 € respectively. Sensitivity and scenario analyses are performed to identify the key parameters and actions needed to reach a positive NPV. For instance, increasing the amount of water treated per year to 90 m 3 and assuming a 20 % increase in operation costs and a 60 % increase in construction costs can make the project socio-economically viable at the field scale, while a reduction in the social discount rate from a 4 % to a 2 % can lead to a positive NPV at the full scale. The approaches proposed in this work may be useful for practitioners and policymakers when evaluating the environmental and socio-economic impacts of bioremediation technologies at different scales and regions, as well as human health impacts caused by contaminants at the current legal limits., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

The present study reports findings related to the treatment of polluted groundwater using macrophyte-assisted phytoremediation. The potential of three macrophyte species (Phragmites australis, Scirpus holoschoenus, and Typha angustifolia) to tolerate exposure to multi-metal(loid) polluted groundwater was first evaluated in mesocosms for 7- and 14-day batch testing. In the 7-day batch test, the polluted water was completely replaced and renewed after 7 days, while for 14 days exposure, the same polluted water, added in the first week, was maintained. The initial biochemical screening results of macrophytes indicated that the selected plants were more tolerant to the provided conditions with 14 days of exposure. Based on these findings, the plants were exposed to HRT regimes of 15 and 30 days. The results showed that P. australis and S. holoschoenus performed better than T. angustifolia, in terms of metal(loid) accumulation and removal, biomass production, and toxicity reduction. In addition, the translocation and compartmentalization of metal(loid)s were dose-dependent. At the 30-day loading rate (higher HRT), below-ground phytostabilization was greater than phytoaccumulation, whereas at the 15-day loading rate (lower HRT), below- and above-ground phytoaccumulation was the dominant metal(loid) removal mechanism. However, higher levels of toxicity were noted in the water at the 15-day loading rate. Overall, this study provides valuable insights for macrophyte-assisted phytoremediation of polluted (ground)water streams that can help to improve the design and implementation of phytoremediation systems., (© 2024. The Author(s).)

A 30-month pilot study was conducted to evaluate the potential of in-situ metal(loid) removal through biostimulation of sulfate-reducing processes. The study took place at an industrial site in Flanders, Belgium, known for metal(loid) contamination in soil and groundwater. Biostimulation involved two incorporations of an organic substrate (emulsified vegetable oil) as electron donor and potassium bicarbonate to raise the pH of the groundwater by 1-1.5 units. The study focused on the most impacted permeable fine sand aquifer (8-9 m below groundwater level) confined by layers of non-permeable clay. The fine sands exhibited initially oxic conditions (50-200 mV), an acidic pH of 4.5 and sulfate concentrations ranging from 600 to 800 mg/L. At the central monitoring well, anoxic conditions (-200 to -400 mV) and a pH of 5.9 established shortly after the second substrate and reagent injection. Over the course of 12 months, there was a significant decrease in the concentration of arsenic (from 2500 to 12 μg/L), nickel (from 360 to <2 μg/L), zinc (from 78,000 to <2 μg/L), and sulfate (from 930 to 450 mg/L). Low levels of metal(loid)s were still present after 34 months (end of study). Mineralogical analysis indicated that the precipitates formed were amorphous in nature. Evidence for biologically driven metal(loid) precipitation was provided by compound specific stable isotope analysis of sulfate. In addition, changes in microbial populations were assessed using next-generation sequencing, revealing stimulation of native sulfate-reducing bacteria. These results highlight the potential of biostimulation for long-term in situ metal(loid) plume treatment/containment., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Objectives: Reflex anoxic syncope is the result of an overreaction of the vagal system, resulting in hypotension and bradycardia or brief cardiac arrest. Because of the benign character and the absence of complications in short or long term, treatment is only necessary in case of frequent or severe clinical presentation. Treatment options are anticholinergic drugs or cardiac pacemaker placement. We investigated atropine treatment and aimed to examine if pacemaker placement can be avoided., Methods: We retrospectively reviewed patients treated with atropine for severe reflex anoxic syncope in our centre from January 2017 until May 2023, and compared our results to those in the literature., Results: The study population consisted of 10 children, 70% female, with an age ranging from 5 months to 3 years (mean 14.5 months) when atropine treatment was started (dose 17-50 microg/kg/day). All patient's parents reported adequate symptom management during atropine treatment, with complete resolution in 10%. Minor side effects were reported in 60% (dry mucosa in 40%, obstipation in 20%, and nausea or blurry vision in 10%)., Discussion: We consider atropine a safe and effective treatment to manage reflex anoxic syncope with similar success rate to pacemaker implantation. However, pacemaker implantation entails substantial risk for complications (up to 25%) such as infection or technical problems and morbidity such as scar formation. This might be considered redundant for a benign and temporary condition, certainly given the possibility of other efficient treatment options. Consequently, we recommend atropine treatment over implantation of a cardiac pacemaker in children with severe reflex anoxic syncope.

Better understanding of macrophyte tolerance under long exposure times in real environmental matrices is crucial for phytoremediation and phytoattenuation strategies for aquatic systems. The metal(loid) attenuation ability of 10 emergent macrophyte species (Carex riparia, Cyperus longus, Cyperus rotundus, Iris pseudacorus, Juncus effusus, Lythrum salicaria, Menta aquatica, Phragmites australis, Scirpus holoschoenus, and Typha angustifolia) was investigated using real groundwater from an industrial site, over a 90-day exposure period. A "phytobial" treatment was included, with 3 plant growth-promoting rhizobacterial strains. Plants exposed to the polluted water generally showed similar or reduced aerial biomass compared to the controls, except for C. riparia. This species, along with M. aquatica, exhibited improved biomass after bioaugmentation. Phytoremediation mechanisms accounted for more than 60% of As, Cd, Cu, Ni, and Pb removal, whilst abiotic mechanisms contributed to ∼80% removal of Fe and Zn. Concentrations of metal(loid)s in the roots were generally between 10-100 times higher than in the aerial parts. The macrophytes in this work can be considered "underground attenuators", more appropriate for rhizostabilization strategies, especially L. salicaria, M. aquatica, S. holoschoenus, and T. angustifolia. For I. pseudacorus, C. longus, and C. riparia; harvesting the aerial parts could be a complementary phytoextraction approach to further remove Pb and Zn. Of all the plants, S. holoschoenus showed the best balance between biomass production and uptake of multiple metal(loid)s. Results also suggest that multiple phytostrategies may be possible for the same plant depending on the final remedial aim. Phytobial approaches need to be further assessed for each macrophyte species., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Rocio Barros reports financial support was provided by European Union’s Horizon 2020 research and innovation program. Sandra Curiel-Alegre reports financial support was provided by Junta de Castilla y León., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

Introduction: Developmental language disorder (DLD) is a common childhood condition negatively influencing communication and psychosocial development. An increasing number of pathogenic variants or chromosomal anomalies possibly related to DLD have been identified. To provide a base for accurate clinical genetic diagnostic work-up for DLD patients, understanding the specific genetic background is crucial. This study aims to give a systematic literature overview of pathogenic variants or chromosomal anomalies causative for DLD in children., Methods: We conducted a systematic search in PubMed and Embase on available literature related to the genetic background of diagnosed DLD in children. Included papers were critically appraised before data extraction. An additional search in OMIM was performed to see if the described DLD genes are associated with a broader clinical spectrum., Results: The search resulted in 15,842 papers. After assessing eligibility, 47 studies remained, of which 25 studies related to sex chromosome aneuploidies and 15 papers concerned other chromosomal anomalies (SCAs) and/or Copy Number Variants (CNVs), including del15q13.1-13.3 and del16p11.2. The remaining 7 studies displayed a variety of gene variants. 45 (candidate) genes related to language development, including FOXP2 , GRIN2A , ERC1 , and ATP2C2 . After an additional search in the OMIM database, 22 of these genes were associated with a genetic disorder with a broader clinical spectrum, including intellectual disability, epilepsy, and/or autism., Conclusion: Our study illustrates that DLD can be related to SCAs and specific CNV's. The reported (candidate) genes ( n  = 45) in the latter category reflect the genetic heterogeneity and support DLD without any comorbidities and syndromic language disorder have an overlapping genetic etiology., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 van Wijngaarden, de Wilde, Mink van der Molen, Petter, Stegeman, Gerrits, Smit and van den Boogaard.)