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Water Distribution Networks (WDNs) are critical infrastructures that ensure a continuous supply of safe water to homes. In the face of challenges, like water scarcity, establishing resilient networks is imperative, especially in regions vulnerable to water crises. This study evaluates the resilience of network designs through graph theory, including its hydraulic feasibility using EPANET software, an aspect often overlooked. Novel mathematical algorithms, including Resilience by Design (RbD) and Resilience-strengthening (RS) algorithms, provide cost-effective and resilient network designs, even with budget constraints. A novel metric, Water Availability (WA), is introduced to offer a comprehensive measure of network resilience, thereby addressing ongoing discrepancies in resilience evaluation methods. Practical benefits are illustrated through a case study in which a resilient-by-design reclaimed water network is created, and an existing equivalent non-resilient network is improved. The resilient-by-design network demonstrates remarkably better results compared to the equivalent non-resilient design, including up to a 36 % reduction in the probability of service disruptions and a nearly 65 % decrease in the annual average unserved water due to service disruptions. These findings underscore the enormous advantages of a resilience-focused network design approach. When compared to the equivalent non-resilient design, the resilient-by-design network generated effectively safeguards up to a significant 91,700m 3 of water from the impacts of water disruption events over a 50-year operational period. In addition, the resilient-by-design WDN solution incurs a subtle decrease in overall costs compared to consuming tap water from the drinking WDN baseline over a 50-year operational period. These findings highlight the cost-effectiveness of the approach, even offering financial benefits. This paper builds on our previous research by expanding its scope to include resilience considerations, providing algorithms that can be easily adapted from reclaimed to drinking WDNs. Ultimately, we contribute to the enhancement of water resource management and infrastructure planning in ever-evolving urban environments., Competing Interests: Declaration of competing interest There is no conflict of interest., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Normothermic regional perfusion (NRP) allows the in situ perfusion of organs with oxygenated blood in donation after the circulatory determination of death (DCDD). We aimed at evaluating the impact of NRP on the short-term outcomes of kidney transplants in controlled DCDD (cDCDD). This is a multicenter, nationwide, retrospective study comparing cDCDD kidneys obtained with NRP versus the standard rapid recovery (RR) technique. During 2012-2018, 2302 cDCDD adult kidney transplants were performed in Spain using NRP (n = 865) or RR (n = 1437). The study groups differed in donor and recipient age, warm, and cold ischemic time and use of ex situ machine perfusion. Transplants in the NRP group were more frequently performed in high-volume centers (≥90 transplants/year). Through matching by propensity score, two cohorts with a total of 770 patients were obtained. After the matching, no statistically significant differences were observed between the groups in terms of primary nonfunction (p = .261) and mortality at 1 year (p =  .111). However, the RR of kidneys was associated with a significantly increased odds of delayed graft function (OR 1.97 [95% CI 1.43-2.72]; p < .001) and 1-year graft loss (OR 1.77 [95% CI 1.01-3.17]; p = .034). In conclusion, compared with RR, NRP appears to improve the short-term outcomes of cDCDD kidney transplants., (© 2021 The American Society of Transplantation and the American Society of Transplant Surgeons.)

The concept of Nature-Based Solutions (NBS) has emerged to foster sustainable development by transversally addressing social, economic, and environmental urban challenges. However, there is still a considerable lack of agreement on the conceptualization of NBS, especially concerning typologies, nomenclature, and performance assessments in terms of ecosystem services (ES) and urban challenges (UC). Therefore, this article consolidates the knowledge from 4 European projects to set a path for a common understanding of NBS and thus, facilitate their mainstreaming. To do so, firstly, we performed elicitation workshops to develop an integrative list of NBS, based on the identification of overlaps among NBS from different projects. The terminologies were formalized via web-based surveys. Secondly, the NBS were clustered, following a conceptual hierarchical classification. Thirdly, we developed an integrative assessment of NBS performance (ES and UC) based on the qualitative evaluations from each project. Afterwards, we run a PCA and calculated the evenness index to explore patterns among NBS. The main conceptual advancement resides in providing a list of 32 NBS and putting forward two novel NBS categories: NBS units (NBS u ) that are stand-alone green technologies or green urban spaces, which can be combined with other solutions (nature-based or not); NBS interventions (NBS i ) that refer to the act of intervening in existing ecosystems and in NBS u , by applying techniques to support natural processes. The statistical analysis suggests that NBS u are more versatile than NBS i in terms of UC and ES. Moreover, the results of the integrative assessment of NBS performance suggest a greater agreement concerning the role of NBS in addressing environmental UC, cultural and regulating ES than regarding socio-economic UC and supporting and provision ES. Finally, the 'green factor' and the replication of non-intensive practices occurring in nature seem to be key criteria for practitioners to identify a particular solution as an NBS., 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 © 2021 Elsevier B.V. All rights reserved.)

Ultra-low pressure gravity-driven membrane (GDM) systems have the potential to be significantly less costly and complex than conventional membranes for water treatment applications. To build upon this inherent advantage, this study assesses the reuse of recycled membranes in GDM systems for producing drinking water. Two reverse osmosis spiral-wound modules were recycled into nanofiltration (NF)-like and ultrafiltration (UF)-like membranes via controlled exposure to free chlorine. To operate the recycled membranes, two housing devices, based on a simple fitting and an advanced end-caps design, were developed. The recycled membrane systems were tested under a range of conditions (submerged vs. external system configuration and continuous vs. intermittent filtration mode). Synthetic river water feed solutions were used in the tests where performance, fouling, and clogging were measured. NF-like recycled membranes resulted in poor salt rejection and low permeability (~1.7 L m -2  h -1  bar -1 ), but also in high rejection (>81%) of dissolved organic carbon. UF-like recycled membranes maintained their capacity to reject biopolymers (BP) (>74%) and featured up to 18-fold higher permeate rate than NF-like recycled membranes. The optimized operating conditions were found when the recycled membranes were housed in the end-caps device and operated intermittently (relaxation time plus forward flushing). Flushing reduced the fouling accumulation inside the membrane (only 12% and 40% of BP accumulation was observed in the NF-like and UF-like, respectively). However, the end-caps-based device was estimated to be more expensive during the economic analysis. To address this techno-economic trade-off, a decision-making tree was developed to select the appropriate configuration based upon the implementation context. Overall, this study concludes that these designs can serve as robust, low-cost (water production cost <1 USD ct. yr. L -1 ), and light-weight GDM alternatives. This study is beneficial for developing compact GDM systems based on recycled spiral-wound membranes for both rural areas and emergency response., 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 © 2020 Elsevier B.V. All rights reserved.)

The source control of pharmaceuticals involves influencing the everyday consumption volume and compound choice. This paper evaluates how source control contributes to protecting the environmental health and decreasing the investment needs in urban wastewater infrastructure. Different levels of reduction in diclofenac consumption (as recommended by the European Medicines Agency) compensated by equivalent increases in naproxen consumption (a less environmentally harmful compound) are evaluated. The different loads of compounds are fed into a microcontaminant fate and transport model of the Llobregat river basin (Spain) to assess the investment needs in tertiary treatment to reach diclofenac and naproxen concentrations below environmental quality standards. The results show that, despite the implementation of source control measures, tertiary treatment upgrades are still required in every scenario evaluated. Even though source control of pharmaceuticals decreases the investment needs in urban wastewater infrastructure, apparent concentrations reductions (i.e. statistically significant differences relative to the reference situation) are only observed in drastic substitutions of diclofenac by naproxen (a reduction in the total diclofenac consumption by 73% and a corresponding increase in naproxen consumption). The results also show that Spain is on good track with regards to the substitution of diclofenac by naproxen (among the top 5 in Europe), and this paper shows how positive this substitution can be for the environment., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Objective: Polyvalvularmyxomatous degeneration is a rare clinical condition. A 51-year-old male patient presented at our centre with all four heart valves with myxomatous degeneration and severe mitral and aortic regurgitation due to leaflet prolapse. The patient referred five further family members with valvular heart disease at different stages of presentation. The aim of this study was to investigate the genetic basis of this familial polyvalvularmyxomatous degeneration which was associated with mild dysmorphic facial anomalies and short stature., Design: A detailed family history was recorded. Nine members of the family, affected or not by valvular heart disease, were studied clinically, echocardiographically and by detailed genetic analyses., Results: Six of the nine family members had echocardiographic features of different degrees of degenerative heart valve disease. In addition, the affected subjects shared similar mild dysmorphic facial anomalies and short stature. Exome sequencing identified a rare heterozygous single nucleotide deletion in the TAB2 gene in all affected family members, which was absent in the unaffected members., Conclusions: A variant in the TAB2 gene is proposed as the cause of syndromic congenital heart disease, displaying congenital myxomatous degenerative heart valve disease, mild dysmorphic fascial anomalies and short stature in this family., Competing Interests: Declaration of competing interest Nothing to declare., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)

Ultraviolet radiation (UV)-activated peroxydisulfate (PDS) and peroxymonosulfate (PMS) advanced oxidation processes were examined for their capacity to remove nine pharmaceutically active compounds (PhACs) from secondary effluent. The effect of operational parameters (initial oxidant concentration, UV exposure time, pH, common coexisting anions and effluent organic matter (EfOM)) on UV/PDS and UV/PMS treatment efficiency was investigated in a collimated beam device housing a low-pressure mercury UV lamp emitting light at 253.7 nm. Both AOPs achieved high removals (>90%) when applied to pure water. Under otherwise similar conditions the removal percentage fell by 20-30% due to the scavenging of effluent organic matter (EfOM) in secondary effluent. Finally, eliminating EfOM but maintaining the inorganic composition, the radical scavenging effect was reduced and 98.3% and 85.6% average removals were obtained by UV/PDS and UV/PMS, respectively. Increasing pH improved degradation of several PhACs containing amine groups. Higher oxidant dosages created only a significant benefit in UV/PDS. The chloride anion produced a negligible effect on both processes, while higher nitrate concentrations increased removal percentage but did not affect degradation rate constants. Finally and surprisingly, the addition of bicarbonate had the strongest positive impact on the degradation kinetics observed, even stronger than the elimination of EfOM from secondary effluent., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Peri-urban horticulture performs environmental and socio-economic functions and provides ecological services to nearby urban areas. Nevertheless, industrialization and water pollution have led to an increase in the exposure of peri-urban vegetables to contaminants such as trace elements (TEs) and organic microcontaminants (OMCs). In this study, the occurrence of chemical contaminants (i.e., 16 TEs, 33 OMCs) in soil and lettuce leaves from 4 farm fields in the peri-urban area of the city of Barcelona was assessed. A rural site, outside the peri-urban area of influence, was selected for comparison. The concentration of TEs and OMCs ranged from non-detectable to 803 mg/kg dw and from non-detectable to 397 μg/kg dw respectively in the peri-urban soil, and from 6 · 10 -5 to 4.91 mg/kg fw and from non-detectable to 193 μg/kg fw respectively in lettuce leaves. Although the concentration of Mo, Ni, Pb, and As in the soil of the peri-urban area exceeded the environmental quality guidelines, their occurrence in lettuce complied with human food standards (except for Pb). The many fungicides (carbendazim, dimetomorph, and methylparaben) and chemicals released by plastic pipelines (tris(1-chloro-2-propyl)phosphate, bisphenol F, and 2-mercaptobenzothiazole) used in agriculture were prevalent in the soil and the edible parts of the lettuce. The occurrence of these chemical pollutants in the peri-urban area did not affect the chlorophyll, lipid, or carbohydrate content of the lettuce leaves. PCA (Principal Component Analysis) showed that soil pollution, fungicide application, and irrigation water quality are the most relevant factors determining the presence of contaminants in crops., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Through their release of effluents, conventional wastewater treatment plants (WWTPs) represent a major pollution point sources for pharmaceutically active compounds (PhACs) in water bodies. The combination of a biological activated carbon (BAC) filter coupled with an ultrafiltration (UF) unit was evaluated as an advanced treatment for PhACs removal at pilot scale. The BAC-UF pilot plant was monitored for one year. The biological activity of the biofilm that developed on the granular activated carbon (GAC) particles and the contribution of this biofilm to the overall removal of PhACs were evaluated. Two different phases were observed during the long-term monitoring of PhACs removal. During the first 9200 bed volumes (BV; i.e., before GAC saturation), 89, 78, 83 and 79% of beta-blockers, psychiatric drugs, antibiotics and a mix of other therapeutic groups were removed, respectively. The second phase was characterized by deterioration of the overall performances during the period between 9200 and 13,800 BV. To quantify the respective contribution of adsorption and biodegradation, a lab-scale setup was operated for four months and highlighted the essential role played by GAC in biofiltration units. Physical adsorption was indeed the main removal mechanism. Nevertheless, a significant contribution due to biological activity was detected for some PhACs. The biofilm contributed to the removal of 22, 25, 30, 32 and 35% of ciprofloxacin, bezafibrate, ofloxacin, azithromycin and sulfamethoxazole, respectively., (Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.)

Water scarcity and water pollution have increased the pressure on water resources worldwide. This pressure is particularly important in highly populated areas where water demand exceeds the available natural resources. In this regard, water reuse has emerged as an excellent water source alternative for peri-urban agriculture. Nevertheless, it must cope with the occurrence of chemical contaminants, ranging from trace elements (TEs) to organic microcontaminants. In this study, chemical contaminants (i.e., 15 TEs, 34 contaminants of emerging concern (CECs)), bulk parameters, and nutrients from irrigation waters and crop productivity (Lycopersicon esculentum Mill. cv. Bodar and Lactuca sativa L. cv. Batavia) were seasonally surveyed in 4 farm plots in the peri-urban area of the city of Barcelona. A pristine site, where rain-groundwater is used for irrigation, was selected for background concentrations. The average concentration levels of TEs and CECs in the irrigation water impacted by treated wastewater (TWW) were 3 (35±75μgL -1 ) and 13 (553±1050ngL -1 ) times higher than at the pristine site respectively. Principal component analysis was used to classify the irrigation waters by chemical composition. To assess the impact of the occurrence of these contaminants on agriculture, a seed germination assay (Lactuca sativa L) and real field-scale study of crop productivity (i.e., lettuce and tomato) were used. Although irrigation waters from the peri-urban area exhibited a higher frequency of detection and concentration of the assessed chemical contaminants than those of the pristine site (P1), no significant differences were found in seed phytotoxicity or crop productivity. In fact, the crops impacted by TWW showed higher productivity than the other farm plots studied, which was associated with the higher nutrient availability for plants., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Introduction: Variations in the use of healthcare services can be defined as systematic variations of adjusted rates for certain aggregation levels of the population. The study analyses how renal replacement therapy (RRT) is used, identifying RRT variability in Catalonia from 2002 to 2012., Material and Methods: Ecological study by health area using data from the Catalan renal registry. We present incident rates, standardised incidence ratios and prevalence, while variability was calculated through direct and indirect standardisation methods., Results: From 2002 until 31/12/2012, 10,784 patients initiated RRT in Catalonia: 9,238 on haemodialysis (HD) (50 treatments per 100,000 people 2010/2012), 1,076 on peritoneal dialysis (PD) (8.2 treatments per 100,000 people 2010/2012) and 470 received an early kidney transplant (KT) (4.4 treatments per 100,000 people 2010/2012). Over the 10 years, the HD cumulative incidence rate fell (7%), while the PD and KT incidence rates increased (63% and 177%, respectively); both are higher in young patients (<45 years). 4,750 patients received a kidney transplant in this period, 49% of which were aged between 45 and 65 years. There were no significant differences in variability in HD (RV 5-95 =1.3; Empirical Bayes [EB]∼ 0), or in the prevalence of KT (RV 5-95 =1.4; EB ∼ 0). Nevertheless, we found significant geographical variability in PD; notably in the districts of the province of Lérida, where the number of cases observed was greater than expected (RV 5-95 =4.01; EB=0.08)., Conclusion: Although there was a notable rise in PD and early KT incidence rates, PD is still underused when compared to international recommendations. No territorial variability was found for HD or KT, but the use of PD was found to be higher in Lérida than in other areas. To reduce PD territorial variability and increase the uptake of this technique in the other regions, we propose 3initiatives: The development of RRT support tools for shared decision-making, the encouragement of specific PD professional training and the promotion of PD through complementary reimbursement systems., (Copyright © 2016 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.)

Although crop uptake of emerging organic contaminants (EOC) from irrigation water and soils has been previously reported, successful mitigation strategies have not yet been established. In this study, soil was amended with a wood-based biochar (BC) at two rates (0, 2.5 and 5% w/w) to evaluate the effect on mitigation of EOC uptake (i.e. bisphenol A, caffeine, carbamazepine, clofibric acid, furosemide, ibuprofen, methyl dihydrojasmonate, tris(2-chloroethyl)phosphate, triclosan, and tonalide) in lettuce (Lactuca sativa L.). After 28 days of irrigation with water containing EOCs at 15μgL -1 , the average EOC concentration in roots and leaves decreased by 20-76% in biochar amended soil relative to non BC-amended soil. In addition, the enantiomeric fractions (EF) of ibuprofen (IBU) in biochar amended soils (EF=0.58) and unamended soils (EF=0.76) suggest that the IBU sorbed fraction in BC is more recalcitrant to its biodegradation., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Current approaches have failed to deliver a truly integrated management of the different elements of the urban water system, such as freshwater ecosystems, drinking water treatment plants, distribution networks, sewer systems and wastewater treatment plants. Because the different parts of urban water have not been well integrated, poor decisions have been made for society in general, leading to the misuse of water resources, the degradation of freshwater ecosystems and increased overall treatment costs. Some attempts to solve environmental issues have adopted the ecosystem services concept in a more integrated approach, however this has rarely strayed far away from pure policy, and has made little impact in on-the-ground operational matters. Here, we present an improved decision-making framework to integrate the management of urban water systems. This framework uses the ecosystem service concept in a practical way to make a better use of both financial and water resources, while continuing to preserve the environment., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Patients with end-stage renal disease have longer survival after kidney transplantation than they would by remaining on dialysis; however, outcome with kidneys from donors aged ≥75 years and the survival of recipients of these organs compared with their dialysis counterparts with the same probability of obtaining an organ is unknown. In a longitudinal mortality study, 2040 patients on dialysis were placed on a waiting list, and 389 of them received a first transplant from a deceased donor aged ≥75 years. The adjusted risk of death and survival were calculated by non-proportional hazards analysis with being transplanted as a time-dependent effect. Projected years of life since placement on the waiting list was almost twofold higher for transplanted patients. Nonproportional adjusted risk of death after transplantation was 0.44 (95% confidence interval [CI] 0.61-0.32; p < 0.001) in comparison with those that remained on dialysis. Stratifying by age, adjusted hazard ratios for death were 0.17 (95% CI 0.47-0.06; p = 0.001) for those aged <65 years, 0.56 (95% CI 0.92-0.34; p = 0.022) for those aged 65-69 years and 0.82 (95% CI 1.28-0.52; p = 0.389) for those aged ≥70 years. Although kidney transplantation from elderly deceased donors is associated with reduced graft survival, transplanted patients have lower mortality than those remaining on dialysis., (© Copyright 2016 The American Society of Transplantation and the American Society of Transplant Surgeons.)

The aim of the present work is to investigate the removal and transformation of the antidepressants venlafaxine (VFX) and its main metabolite O-desmethylvenlafaxine (DVFX) upon advanced oxidation with UV/H2O2 under lab conditions. High-resolution mass spectrometry (HRMS) analyses were carried out by means of ultra-high pressure liquid chromatography (UHPLC)-linear ion trap high resolution Orbitrap instrument (LTQ-Orbitrap-MS) in order to elucidate the different transformation products (TPs) generated. The depletion of both VFX and DVFX was very significant, with the 99.9% of both compounds eliminated after 5 and 30 min of reaction, respectively. Eleven TPs for VFX and six for DVFX were detected and their molecular structures elucidated by means of MS(2) and MS(3) scans, and the corresponding degradation pathways were proposed. The combined ecotoxicity at different treatment times was evaluated by means of bioluminescence inhibition assays with the marine bacteria Vibrio fischeri. Results showed an increase in the ecotoxicity during the UV/H2O2 experiment, especially at those reaction times where the total abundance of TPs was higher., (Copyright © 2016 Elsevier B.V. All rights reserved.)

The widespread distribution of emerging organic contaminants (EOCs) in the water cycle can lead to their incorporation in irrigated crops, posing a potential risk for human consumption. To gain further insight into the processes controlling the uptake of organic microcontaminants, Batavia lettuce (Lactuca sativa) grown under controlled conditions was watered with EOCs (e.g., non-steroidal anti-inflammatories, sulfonamides, β-blockers, phenolic estrogens, anticonvulsants, stimulants, polycyclic musks, biocides) at different concentrations (0-40μgL(-1)). Linear correlations were obtained between the EOC concentrations in the roots and leaves and the watering concentrations for most of the contaminants investigated. However, large differences were found in the root concentration factors ( [Formula: see text] =0.27-733) and leaf translocation concentration factors ( [Formula: see text] =0-3) depending on the persistence of the target contaminants in the rhizosphere and the specific physicochemical properties of each one. With the obtained dataset, a simple predictive model based on a linear regression and the root bioconcentration and translocation factors can be used to estimate the concentration of the target EOCs in leaves based on the dose supplied in the irrigation water or the soil concentration. Finally, enantiomeric fractionation of racemic ibuprofen from the initial spiking mixture suggests that biodegradation mainly occurs in the rhizosphere., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Patients on renal replacement therapy (RRT) infected with the human immunodeficiency virus (HIV) are a special group with growing interest. In order to study the epidemiological data of HIV+ patients on RRT in Spain, we collected individual information from 2004-2011 (period of use of highly active antiretroviral therapy [HAART] in the Autonomous Communities of Andalusia, Aragon, Asturias, Catalonia, Valencia, Castilla la Mancha, Castilla León, Galicia, Madrid, La Rioja and the Basque Country, comprising 85% of the Spanish population. A total of 271 incident and 209 prevalent patients were analysed. They were compared with the remaining patients on RRT during the same period. The annual incidence was 0.8 patients per one million inhabitants, with a significant increase during the follow-up period. The proportion of prevalent HIV+ patients was 5.1 per 1,000 patients on RRT (95% confidence interval [CI] 4.4-5.8. Although glomerular diseases constituted the majority of cases (42%), diabetic nephropathy was the cause in 14% of patients. The nation-wide totals for these percentages were 13 and 25%, respectively. Compared to the total of patients in treatment, the risk of death was significantly higher in the HIV+ group: hazard ratio (HR) adjusted for age, sex and diabetes was 2.26 (95% CI 1.74 - 2.91). Hepatitis C coinfection increased the risk of death in the HIV+ group (HR 1.77; 95% CI 1.10 - 2.85). The probability of kidney transplantation in HIV+ was only 17% after 7 years, comparing with total RTT patients (HR 0.15; 95% CI: 0.10-0.24). Despite the use of HAART, the incidence of HIV+ patients on dialysis has increased; their mortality still exceeds non-HIV patients, and they have a very low rate of transplantation. It is necessary to further our knowledge of this disease in order to improve results., (Copyright © 2015 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.)

The presence of emerging contaminants in the aquatic environment and their potential effects on living organisms has become an issue of growing concern. Among emerging contaminants, pharmaceuticals may enter the aquatic environment due to their high consumption and their incomplete removal in conventional municipal wastewater treatment plants (WWTPs). The main goal of this study was the assessment of the removal efficiency of pharmaceuticals found in municipal wastewater of a coastal WWTP (Castell-Platja d'Aro, Spain) using an integrated pilot scale membrane system (MBR-RO). Twenty multiple-class pharmaceuticals (including psychiatric drugs, macrolide antibiotics, β-blockers, sulfonamide and fluoroquinolone antibiotics, histamine H2 receptor antagonists, anti-inflammatories, nitroimidazole, β-agonist and antiplatelet agent) were measured in real influent with the lowest average concentration for psychiatric drugs (0.017 μg L(-1)) to the highest for macrolide antibiotics (2.02 μg L(-1)). Although some contaminants were in relatively high concentrations (even up to 2.90 μg L(-1) in the case of ofloxacin). The combination of MBR and RO treatment showed excellent overall removal of target emerging contaminants with removal rates above 99% for all of them. For some compounds (metronidazole, hydrocodone, codein, ranitidine) MBR provided high removal efficiency (up to 95%). Additionally RO membrane showed removal rates always higher than 99%., (Copyright © 2012 Elsevier B.V. All rights reserved.)

Pharmaceutically active compounds (PhACs) deserve attention because of their effect on ecosystems and human health, as well as their continuous introduction into the aquatic environment. Classification schemes are suggested to characterise their biological degradation, e.g., based on pseudo-first-order kinetics, but these schemes can vary significantly, presumably due to pharmaceutical loads, sludge characteristics and experimental conditions. Degradation data for PhAC transformation products (TPs) are largely lacking. The present work focuses not only on the biodegradation of the pharmaceutical compound ibuprofen but also on its best-known TPs (i.e., carboxyl ibuprofen and both hydroxyl ibuprofen isomers). Ibuprofen is one of the most commonly consumed PhACs and can be found in different environmental compartments. The experiment performed consisted of a set of aerated batch tests with different suspended solid and ibuprofen concentrations to determine the influence of these parameters on the calculated biodegradation constant (K(biol)). Sampling of the liquid phase at different scheduled times was assessed, removal efficiencies were calculated and pseudo-first-order kinetics were adjusted to obtain experimental K(biol) values for the parent compound and its TPs. The experimental data were successfully fitted to ASM-based models, with K(biol) values for the target compounds ranging from almost 1 to 17 L gSST(-1) d(-1), depending on the concentrations of the biomass and ibuprofen. This work provides innovative knowledge not only regarding the removal of TPs but also the formation kinetics of these TPs., (Copyright © 2012 Elsevier B.V. All rights reserved.)

Background: Infection in natural orifice transluminal endoscopic surgery (NOTES) remains controversial., Objective: To estimate the frequency of infection during NOTES peritoneoscopy with different routes of access and to compare with laparoscopy., Design: Prospective randomized controlled study (Canadian Classification type I)., Methods: Forty female pigs were randomly assigned to 3 NOTES (transgastric, transrectal, and transvaginal) and laparoscopic groups. Antiseptic technique was used for NOTES, whereas laparoscopy was performed in a sterile environment. Preoperative and postoperative intravenous antibiotics were administered. Closure of the transluminal access site was performed in all animals. Peritoneal fluid was collected for culture at the end of surgery and at necropsy at day 14., Results: Thirty-nine peritoneoscopies were successfully completed. Necropsy confirmed complete healing of NOTES incisions, but 2 animals in the laparoscopy group had small abscesses in the abdominal incisions. There were no statistical differences in the presence of peritoneal adhesions. Positive culture results were seen in all groups at the end of the procedure and in all animals at necropsy, but this did not lead to clinical signs of gross infection. The most common organisms that colonized the peritoneum were gram-positive cocci and gram-negative bacilli from the normal swine gastrointestinal flora., Limitations: Animal model and small sample size., Conclusions: In these small series of animals and with the careful lavage and preparation used, NOTES appeared to be comparable to laparoscopy in terms of peritoneal contamination and clinical infection. Despite the adherence to a strict antiseptic protocol, peritoneal contamination occurs but does not lead to septic complications in the swine., (Copyright © 2011 AAGL. Published by Elsevier Inc. All rights reserved.)

The aim of this study was to establish the validity of four lymphocyte isolation methods. The effects of three different erythrocyte lysing methods commonly used in the analysis of human cells, namely, lysis by ammonium chloride (AC), Becton Dickinson lysis (BDL) and the Coulter Q-Prep (CQP) preparation system were established by flow cytometry on rat lymphocyte subsets. The results were compared with those obtained with a Ficoll-Isopaque (FI) density gradient procedure adapted for use with rat cells. Lymphocyte isolation by AC or FI gradient was performed before labelling the lymphocyte subpopulations, whereas the BDL and CQP methods were performed after staining the cells in whole blood. The FI gradient yielded the lowest CD5+, CD4+ and CD25+ cell percentages. On the other hand AC lysis produced higher percentages of T cells and lower percentages of B cells than the other methods studied. The percentages obtained after BDL or CQP methods for T lymphocyte subsets and B cells were found to be reproducible. The commercial methods (BDL and CQP) are faster but rather expensive, whereas AC lysis and FI gradient separations are cheap and particularly useful when there is a requirement to culture the cells.