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This study investigated the purification of pollutants in runoff rainwater by constructing a micro-ecosystem using waste-activated sludge (WAS) and riverbed sludge (RBS) as inoculums in combination with pervious concrete. The research results showed that the best hydraulic retention time (HRT) was 9 h. The COD and ammonia nitrogen (NH4+-N) removal of the waste-activated sludge ecosystem (WASE) was 62.67% and 71.21%, respectively, while the riverbed sludge ecosystem (RBSE) showed COD and NH4+-N removal percentages of 46.05% and 66.55%, respectively. The analysis of the genetic metabolism of microbial genes showed that the system was microbially enhanced with extensive and diverse populations. At the phylum level, the microorganisms responsible for degrading organic matter were mainly Firmicutes and Actinobacteriota. At the genus level, the Trichococcus genus was dominant in the WASE, while the Dietzia, norank_f__Sporomusaceae and norank_f__norank_o__norank_c__BRH-c20a genera were the central bacterial populations in the RBSE. The proliferation of phylum-level bacteria in the WASE was relatively large, and the genus-level bacteria demonstrated a better removal efficiency for pollutants. The overall removal effect of the WASE was better than that of the RBSE. The application analyses showed that a WASE is capable of effectively accepting and treating all rainfall below rainstorm levels and at near-full rainstorm levels under optimal removal efficiency conditions. This study innovatively used wastewater plant waste-activated sludge combined with pervious concrete to construct a micro-ecosystem to remove runoff rainwater pollutants. The system achieved pollutant removal comparable to that of pervious concrete modified with adsorbent materials. An effective method for the collection and pollutant treatment of urban runoff rainwater is provided. [ABSTRACT FROM AUTHOR]

This study investigates the performance of sludge-added pervious concrete (SPC) at different curing temperatures by replacing some of the cement with activated sludge (AS). The results reveal that the incorporation of AS into pervious concrete had a favorable impact. At a curing temperature of 30 °C, the 28-day compressive strength and specific surface area reached 20.8 MPa and 9.14 m2/g, respectively, representing a 60% and 98.7% increase, in comparison to conventional concrete. Furthermore, the addition of AS to the concrete results in a notable reduction in the concentration of chemical oxygen demand (COD) in surface runoff water. The maximum rate of COD removal observed was 55.6%. A mechanism study revealed that the strength of concrete increased due to the reaction between reactive SiO2 in AS and CaO in the aggregate. At a temperature of 30 °C, the microorganisms in the activated sludge fermentation process exhibit a higher production rate of fermentation gas, resulting in a greater escape of gas and an increase in the number of micropores in the permeable concrete. This leads to an enhanced specific surface area, which in turn exhibits a superior adsorption effect on COD. [ABSTRACT FROM AUTHOR]

Polyurethane sponge particles were employed as bio-immobilized cell carriers for dark fermentation hydrogen production with heating-treated cow dung inoculum from epipremnum aureum waste and kitchen waste. This study explored the performance changes of batch dark fermentation hydrogen production systems under different influent substrates. Different influent total solids concentration and substrate types both had a large effect on the efficiency of the biological hydrogen production process. Based on the combined analysis of hydrogen production efficacy, VFA, and energy conversion efficiency, the optimal influent total solids concentration was 2 g/L and 10 g/L for epipremnum aureum waste and kitchen waste, respectively. For the epipremnum aureum waste, the energy conversion efficiency was 13.6% and the metabolic type was mixed fermentation at a total solids concentration of 2 g/L. For kitchen waste, the energy conversion efficiency was 14.4% and the metabolic type was ethanol/acetic fermentation at a total solids concentration of 10 g/L. The results indicate that epipremnum aureum waste and kitchen waste can be used as substrates for dark fermentation hydrogen production, and kitchen waste performed better than epipremnum aureum waste at the same influent total solids concentration. Compared to other nutrients, both epipremnum aureum waste and kitchen waste also showed better hydrogen production efficacy and energy conversion efficiency. The study can provide a more economical and efficient method for residential household waste recycling. [ABSTRACT FROM AUTHOR]

Aims: To investigate the beliefs and attitudes of intensive care unit (ICU) nurses and patients' family members towards an open visitation policy in the ICU in China and to explore the reasons that promote or hinder open visitation to improve visitation policy. Background: Open visitation policies are widely recommended in many countries. However, there are gaps between evidence and practice. Most ICUs in China still use a restrictive policy for family visits, which raises controversy. There are limited visiting times, and family visitors are not allowed to enter the ICU. Study Design: A multicentre survey was conducted in seven hospitals in China. The Beliefs and Attitudes towards Visitation in the Intensive Care Unit Questionnaire (BAVIQ) was administered to ICU nurses and patient families from 11 the ICUs of seven hospitals. A total of 275 questionnaires were completed and returned by ICU nurses and 139 by patients' family members. Results: Among nurses, the belief scale score was 2.87 ± 0.33 (range 2–4), and the attitude scale score was 5.53 ± 1.12 (range 2.33–7). The belief scale was divided into three subscales: nurses, patients, and patients' families. The subscale score for patients' families was the highest, and the nurses' subscale score was the lowest. Most (84.0%) of the nurses were satisfied with the current ICU visitation policy. The belief and attitude scores were 3.13 ± 0.39 (range 1.96–4) and 6.18 ± 1.20 (range 1.67–7), respectively, for family members. The scores of the three subscales, that is, patients, patients' families and nurses, were 3.13 ± 0.40, 3.26 ± 0.43, and 3.04 ± 0.49, respectively. Conclusion: Nurses' beliefs and attitudes towards implementing an open visitation policy in China are at a less positive level than those of patient family members. Relevance to Clinical Practice: The beliefs and attitudes of nurses towards open visitation policy in China need to be improved. The question of how to mobilize nurses' enthusiasm for an open visitation policy poses a challenge for ICU management. [ABSTRACT FROM AUTHOR]

Open in new tab Download slide OBJECTIVES Postoperative delirium is a common severe complication in patients in the intensive care unit after cardiac surgery. We developed a two-stage prediction model and quantified the risk of developing postoperative delirium to assist in early prevention before and after surgery. METHODS We conducted a prospective cohort study and consecutively recruited adult patients after cardiac surgery. The Confusion Assessment Method for patients in the intensive care unit was used to diagnose delirium 5 days postoperatively. The stage I model was constructed using patient demographics, health conditions and laboratory results obtained preoperatively, whereas the stage II model was built on both pre- and postoperative predictors. The model was validated internally using the bootstrap method and externally using data from an external cohort. RESULTS The two-stage model was developed with 654 patients and was externally validated with 214 patients undergoing cardiac surgery. The stage I model contained 6 predictors, whereas the stage II model included 10 predictors. The stage I model had an area under the receiver operating characteristic curve of 0.76 (95% confidence interval: 0.68–0.81), and the stage II model's area under the receiver operating characteristic curve increased to 0.85 [95% confidence interval (CI): 0.81–0.89]. The external validation resulted in an area under the curve of 0.76 (95% CI: 0.67–0.86) for the stage I model and 0.78 (95% CI: 0.69–0.86) for the stage II model. CONCLUSIONS The two-stage model assisted medical staff in identifying patients at high risk for postoperative delirium before and 24 h after cardiac surgery. This model showed good discriminative power and predictive accuracy and can be easily accessed in clinical settings. Trial registration The study was registered with the US National Institutes of Health ClinicalTrials.gov (NCT03704324; registered 11 October 2018). [ABSTRACT FROM AUTHOR]

The likelihood and uncertainty of severe rains and flooding in the middle basin of the Yangtze River have grown due to global warming and growing urbanization. A flood risk assessment index system is built based on resilience theory to assess community flood risk in a significantly changing environment, with communities serving as the primary body to manage flood risk in cities. The flood risk level of communities in Wuhan from 2011 to 2020 was assessed using the Analytic Hierarchical Process (AHP) and Dempster–Shafer (DS) evidence theory, utilizing an example of the typical Wuhan community. The findings indicate that: (1) The weight of hazard-causing factors is the largest and has the greatest influence on the risk of flooding in the community. (2) When looking at time series, the risk of hazard-causing factors gradually rises, while the risks associated with systemic governance, protective works, and community vulnerability steadily decline. Building resilient communities and enhancing flood risk management capability should be priorities for the government, local communities, and citizens. [ABSTRACT FROM AUTHOR]