Mitochondrial DNA Variations Modulate Alveolar Epithelial Mitochondrial Function and Oxidative Stress in Newborn Mice Exposed to Hyperoxia

Oxidative stress is an important contributor to bronchopulmonary dysplasia (BPD), a form of chronic lung disease that is the most common morbidity in very preterm infants. Mitochondrial functional differences due to inherited and acquired mutations influence the pathogenesis of disorders in which oxidative stress plays a critical role. We previously showed using mitochondrial-nuclear exchange (MNX) mice that mitochondrial DNA (mtDNA) variations modulate hyperoxia-induced lung injury severity in a model of BPD. In this study, we studied the effects of mtDNA variations on mitochondrial function including mitophagy in alveolar epithelial cells (AT2) from MNX mice. We also investigated oxidant and inflammatory stress as well as transcriptomic profiles in lung tissue in mice and expression of proteins such as PINK1, Parkin and SIRT3 in infants with BPD. Our results indicate that AT2 from mice with C57 mtDNA had decreased mitochondrial bioenergetic function and inner membrane potential, increased mitochondrial membrane permeability and were exposed to higher levels of oxidant stress during hyperoxia compared to AT2 from mice with C3H mtDNA. Lungs from hyperoxia-exposed mice with C57 mtDNA also had higher levels of pro-inflammatory cytokines compared to lungs from mice with C3H mtDNA. We also noted changes in KEGG pathways related to inflammation, PPAR and glutamatergic signaling, and mitophagy in mice with certain mito-nuclear combinations but not others. Mitophagy was decreased by hyperoxia in all mice strains, but to a greater degree in AT2 and neonatal mice lung fibroblasts from hyperoxia-exposed mice with C57 mtDNA compared to C3H mtDNA. Finally, mtDNA haplogroups vary with ethnicity, and Black infants with BPD had lower levels of PINK1, Parkin and SIRT3 expression in HUVEC at birth and tracheal aspirates at 28 days of life when compared to White infants with BPD. These results indicate that predisposition to neonatal lung injury may be modulated by variations in mtDNA and mito-nuclear interactions need to be investigated to discover novel pathogenic mechanisms for BPD.

Thyroid hormone modulates hyperoxic neonatal lung injury and mitochondrial function

Mitochondrial dysfunction at birth predicts bronchopulmonary dysplasia (BPD) in extremely low-birth weight (ELBW) infants. Recently, nebulized thyroid hormone (TH), given as triiodothyronine (T3), was noted to decrease pulmonary fibrosis in adult animals through improved mitochondrial function. In this study, we tested the hypothesis that TH may have similar effects on hyperoxia-induced neonatal lung injury and mitochondrial dysfunction by testing whether i.n. T3 decreases neonatal hyperoxic lung injury in newborn mice; whether T3 improves mitochondrial function in lung homogenates, neonatal murine lung fibroblasts (NMLFs), and umbilical cord-derived mesenchymal stem cells (UC-MSCs) obtained from ELBW infants; and whether neonatal hypothyroxinemia is associated with BPD in ELBW infants. We found that inhaled T3 (given i.n.) attenuated hyperoxia-induced lung injury and mitochondrial dysfunction in newborn mice. T3 also reduced bioenergetic deficits in UC-MSCs obtained from both infants with no or mild BPD and those with moderate to severe BPD. T3 also increased the content of peroxisome proliferator-activated receptor γ coactivator 1α in lung homogenates of mice exposed to hyperoxia as well as mitochondrial potential in both NMLFs and UC-MSCs. ELBW infants who died or developed moderate to severe BPD had lower total T4 (TT4) compared with survivors with no or mild BPD. In conclusion, TH signaling and function may play a critical role in neonatal lung injury, and inhaled T3 supplementation may be useful as a therapeutic strategy for BPD.

Platelet Activating Factor Activity Modulates Hyperoxic Neonatal Lung Injury Severity

Hyperoxia-induced inflammation contributes significantly to developmental lung injury and bronchopulmonary dysplasia (BPD) in preterm infants. Platelet activating factor (PAF) is known to be a major driver of inflammation in lung diseases such as asthma and pulmonary fibrosis, but its role in BPD has not been previously investigated. Therefore, to determine whether PAF signaling independently modulates neonatal hyperoxic lung injury and BPD pathogenesis, lung structure was assessed in 14 day-old C57BL/6 wild-type (WT) and PAF receptor knockout (PTAFR KO) mice that were exposed to 21% (normoxia) or 85% O ₂ (hyperoxia) from postnatal day 4. Lung morphometry showed that PTAFR KO mice had attenuated hyperoxia-induced alveolar simplification when compared to WT mice. Functional analysis of gene expression data from hyperoxia-exposed vs. normoxia-exposed lungs of WT and PTAFR KO showed that the most upregulated pathways were the hypercytokinemia/hyperchemokinemia pathway in WT mice, NAD signaling pathway in PTAFR KO mice, and agranulocyte adhesion and diapedesis as well as other pro-fibrotic pathways such as tumor microenvironment and oncostatin-M signaling in both mice strains, indicating that PAF signaling may contribute to inflammation but may not be a significant mediator of fibrotic processes during hyperoxic neonatal lung injury. Gene expression analysis also indicated increased expression of pro-inflammatory genes such as CXCL1, CCL2 and IL-6 in the lungs of hyperoxia-exposed WT mice and metabolic regulators such as HMGCS2 and SIRT3 in the lungs of PTAFR KO mice, suggesting that PAF signaling may modulate BPD risk through changes in pulmonary inflammation and/or metabolic reprogramming in preterm infants.

Mesenchymal stem cell bioenergetics and apoptosis are associated with risk for bronchopulmonary dysplasia in extremely low birth weight infants

Oxidant stress contributes significantly to the pathogenesis of bronchopulmonary dysplasia (BPD) in extremely low birth weight (ELBW) infants. Mitochondrial function regulates oxidant stress responses as well as pluripotency and regenerative ability of mesenchymal stem cells (MSCs) which are critical mediators of lung development. This study was conducted to test whether differences in endogenous MSC mitochondrial bioenergetics, proliferation and survival are associated with BPD risk in ELBW infants. Umbilical cord-derived MSCs of ELBW infants who later died or developed moderate/severe BPD had lower oxygen consumption and aconitase activity but higher extracellular acidification-indicative of mitochondrial dysfunction and increased oxidant stress-when compared to MSCs from infants who survived with no/mild BPD. Hyperoxia-exposed MSCs from infants who died or developed moderate/severe BPD also had lower PINK1 expression but higher TOM20 expression and numbers of mitochondria/cell, indicating that these cells had decreased mitophagy. Finally, these MSCs were also noted to proliferate at lower rates but undergo more apoptosis in cell cultures when compared to MSCs from infants who survived with no/mild BPD. These results indicate that mitochondrial bioenergetic dysfunction and mitophagy deficit induced by oxidant stress may lead to depletion of the endogenous MSC pool and subsequent disruption of lung development in ELBW infants at increased risk for BPD.

Comparison of suspected and confirmed internal EVD-related infections: a prospective multi-centre U.K. observational study

Background

Diagnosis of internal external ventricular drain (EVD)-related infections (iERI) is an area of diagnostic difficulty. Empiric treatment is often initiated on clinical suspicion. There is limited guidance around antimicrobial management of confirmed versus suspected iERI.

Methods

Data on patients requiring EVD insertion were collected from 21 neurosurgical units in the United Kingdom from 2014 to 2015. Confirmed iERI was defined as clinical suspicion of infection with positive cerebrospinal fluid (CSF) culture and/or Gram stain. Cerebrospinal fluid, blood, and clinical parameters and antimicrobial management were compared between the 2 groups. Mortality and Modified Rankin Scores were compared at 30 days post-EVD insertion.

Results

Internal EVD-related infection was suspected after 46 of 495 EVD insertions (9.3%), more common after an emergency insertion. Twenty-six of 46 were confirmed iERIs, mostly due to Staphylococci (16 of 26). When confirmed and suspected infections were compared, there were no differences in CSF white cell counts or glucose concentrations, nor peripheral blood white cell counts or C-reactive protein concentrations. The incidence of fever, meningism, and seizures was also similar, although altered consciousness was more common in people with confirmed iERI. Broad-spectrum antimicrobial usage was prevalent in both groups with no difference in median duration of therapy (10 days [interquartile range {IQR}, 7–24.5] for confirmed cases and 9.5 days [IQR, 5.75–14] for suspected, P = 0.3). Despite comparable baseline characteristics, suspected iERI was associated with lower mortality and better neurological outcomes.

Conclusions

Suspected iERI could represent sterile inflammation or lower bacterial load leading to false-negative cultures. There is a need for improved microbiology diagnostics and biomarkers of bacterial infection to permit accurate discrimination and improve antimicrobial stewardship.

Mitochondrial DNA variation modulates alveolar development in newborn mice exposed to hyperoxia

Hyperoxia-induced oxidant stress contributes to the pathogenesis of bronchopulmonary dysplasia (BPD) in preterm infants. Mitochondrial functional differences due to mitochondrial DNA (mtDNA) variations are important modifiers of oxidant stress responses. The objective of this study was to determine whether mtDNA variation independently modifies lung development and mechanical dysfunction in newborn mice exposed to hyperoxia. Newborn C57BL6 wild type (C57ⁿ/C57^mt, C57WT) and C3H/HeN wild type (C3Hⁿ/C3H^mt, C3HWT) mice and novel Mitochondrial-nuclear eXchange (MNX) strains with nuclear DNA (nDNA) from their parent strain and mtDNA from the other-C57MNX (C57ⁿ/C3H^mt) and C3HMNX (C3Hⁿ/C57^mt)-were exposed to 21% or 85% O₂ from birth to postnatal day 14 (P14). Lung mechanics and histopathology were examined on P15. Neonatal mouse lung fibroblast (NMLF) bioenergetics and mitochondrial superoxide (O₂^-) generation were measured. Pulmonary resistance and mitochondrial O₂^- generation were increased while alveolarization, compliance, and NMLF basal and maximal oxygen consumption rate were decreased in hyperoxia-exposed C57WT mice (C57ⁿ/C57^mt) versus C57MNX mice (C57ⁿ/C3H^mt) and in hyperoxia-exposed C3HMNX mice (C3Hⁿ/C57^mt) versus C3HWT (C3Hⁿ/C3H^mt) mice. Our study suggests that neonatal C57 mtDNA-carrying strains have increased hyperoxia-induced hypoalveolarization, pulmonary mechanical dysfunction, and mitochondrial bioenergetic and redox dysfunction versus C3H mtDNA strains. Therefore, mtDNA haplogroup variation-induced differences in mitochondrial function could modify neonatal alveolar development and BPD susceptibility.

P97 Utility of computer technology in management of non-syndromic craniosynostosis- is it cost effective?

Objectives

To discuss the utility of Computer technology for non-syndromic craniosynostosis (Metopic craniosynostosis) in the form of 3D printed models that could be utilised intraoperatively to aid fronto-orbital remodelling.

Design

Prospective study form 2015–2017.

Subjects

Paediatric non-syndromic metopic craniosynostosis cohort.

Methods

We present a series of 7 patients with non-syndromic metopic craniosynostosis operated on by the craniofacial team Edinburgh over a three year period. The Edinburgh Craniofacial service is supported by the Managed Service Network (MSN) for Neurosurgery, Scotland as a part of nationally delivered Craniofacial service. We utilised 3D printing models of the orbital bar to plan a fronto-orbital advancement technique. The models were then subsequently sterilised and used intra operatively. 3D printer utility is available to us as a part of the NHS Lothian craniomaxillofacial and plastics surgery service.

Results

No intra-operative or post operative complications were noted in our series. All patients undergo standardised pre and post operative 3D CT and photography follow up to objectively measure the outcome.

Conclusions

The utility of Computer technology is a useful and safe adjunct for non-syndromic craniosynostosis, particularly metopic craniosynostosis. A careful pre-operative planning and 3D printed model is helpful to achieve the desired bespoke surgical outcome and to reduce operative time. Post operative 3D CT and 3D photography were utilised to objectively measure the outcome. No extra costs were incurred to our service. We believe that this could be incorporated in preoperative planning as an essential tool.

Clinical deterioration despite syringomyelia resolution after successful foramen magnum decompression for Chiari malformation - Case series

INTRODUCTION

Neurosurgical treatment is recommended for symptomatic syringomyelia and the post-operative radiological resolution of the syringomyelia is associated with an improvement or at least stability of the patient's pre-operative symptoms.

METHODS

We reviewed syringomyelia treatment in our centre over the last five years for clinical outcome, surgical complications, post operative MRI and long term symptom resolution.

RESULTS

50 cases of symptomatic syringomyelia underwent foramen magnum decompression and expansile watertight duroplasty. While the outcomes for majority are similar to what published in literature, three of them developed typical syringomyelia symptoms after initial good recovery and radiological resolution of syrinx.

CONCLUSION

Syringomyelia symptoms may appear or worsen following successful surgical treatment and radiological resolution of syrinx and it is important to counsel young people and their family regarding this.

Early airway microbial metagenomic and metabolomic signatures are associated with development of severe bronchopulmonary dysplasia

The pathogenesis of bronchopulmonary dysplasia (BPD) is not well understood. We previously identified differences in the airway microbiome at birth between preterm infants who were BPD predisposed versus those who were BPD resistant. In this study, we attempted to identify mechanisms by which the airway microbiome could modify the risk for BPD. We used a software-based method to predict the metagenome of the tracheal aspirate (TA) microbiome from 16S rRNA sequencing data in preterm infants and to identify functional ortholog genes that were differentially abundant in BPD-predisposed and BPD-resistant infants. We also identified metabolites that were differentially enriched in these samples by use of untargeted mass spectrometry and mummichog to identify the metabolic pathways involved. Microbial metagenome analysis identified specific pathways that were less abundant in the functional metagenome of the microbiota of BPD-predisposed infants compared with BPD-resistant infants. The airway metabolome of BPD-predisposed infants was enriched for metabolites involved in fatty acid activation and androgen and estrogen biosynthesis compared with BPD-resistant infants. These findings suggest that in extremely preterm infants the early airway microbiome may alter the metabolome, thereby modifying the risk of BPD. The differential enrichment of sex steroid metabolic pathways supports previous studies suggesting a role for sexual dimorphism in BPD risk. This study also suggests a role for metabolomic and metagenomic profiles to serve as early biomarkers of BPD risk.

Vascular Endothelial Mitochondrial Function Predicts Death or Pulmonary Outcomes in Preterm Infants

RATIONALE

Vascular endothelial mitochondrial dysfunction contributes to the pathogenesis of several oxidant stress-associated disorders. Oxidant stress is a major contributor to the pathogenesis of bronchopulmonary dysplasia (BPD), a chronic lung disease of prematurity that often leads to sequelae in adult survivors.

OBJECTIVES

This study was conducted to identify whether differences in mitochondrial bioenergetic function and oxidant generation in human umbilical vein endothelial cells (HUVECs) obtained from extremely preterm infants were associated with risk for BPD or death before 36 weeks postmenstrual age.

METHODS

HUVEC oxygen consumption and superoxide and hydrogen peroxide generation were measured in 69 infants.

MEASUREMENTS AND MAIN RESULTS

Compared with HUVECs from infants who survived without BPD, HUVECs obtained from infants who developed BPD or died had a lower maximal oxygen consumption rate (mean ± SEM, 107 ± 8 vs. 235 ± 22 pmol/min/30,000 cells; P < 0.001), produced more superoxide after exposure to hyperoxia (mean ± SEM, 89,807 ± 16,616 vs. 162,706 ± 25,321 MitoSOX Red fluorescence units; P < 0.05), and released more hydrogen peroxide into the supernatant after hyperoxia exposure (mean ± SEM, 1,879 ± 278 vs. 842 ± 119 resorufin arbitrary fluorescence units; P < 0.001).

CONCLUSIONS

Our results indicating that endothelial cells of premature infants who later develop BPD or die have impaired mitochondrial bioenergetic capacity and produce more oxidants at birth suggest that the vascular endothelial mitochondrial dysfunction seen at birth in these infants persists through their postnatal life and contributes to adverse pulmonary outcomes and increased early mortality.

Ureaplasma infection-mediated release of matrix metalloproteinase-9 and PGP: a novel mechanism of preterm rupture of membranes and chorioamnionitis

BACKGROUND

Premature rupture of membranes and preterm delivery are associated with Ureaplasma infection. We hypothesized that Ureaplasma induced extracellular collagen fragmentation results in production of the tripeptide PGP (proline-glycine-proline), a neutrophil chemoattractant. PGP release from collagen requires matrix metalloproteases (MMP-8/MMP-9) along with a serine protease, prolyl endopeptidase (PE).

METHODS

Ureaplasma culture negative amniotic fluid (indicated preterm birth, n = 8; spontaneous preterm birth, n = 8) and Ureaplasma positive amniotic fluid (spontaneous preterm birth, n = 8) were analyzed by electro-spray ionization-liquid chromatography tandem mass spectrometry for PGP, and for MMP-9 by zymography. PE was evaluated in lysates of U. parvum serovar 3 (Up3) and U. urealyticum serovar 10 (Uu10) by western blotting and activity assay.

RESULTS

PGP and MMP-9 were increased in amniotic fluid from spontaneous preterm birth with positive Ureaplasma cultures, but not with indicated preterm birth or spontaneous preterm birth with negative Ureaplasma cultures. Human neutrophils cocultured with Ureaplasma strains showed increased MMP-9 activity. PE presence and activity were noted with both Ureaplasma strains.

CONCLUSION

Ureaplasma spp. carry the protease necessary for PGP release, and PGP and MMP-9 are increased in amniotic fluid during Ureaplasma infection, suggesting Ureaplasma spp. induced collagen fragmentation contributes to preterm rupture of membranes and neutrophil influx causing chorioamnionitis.

Phosphate adsorption from wastewater using zirconium (IV) hydroxide: Kinetics, thermodynamics and membrane filtration adsorption hybrid system studies

Excessive phosphate in wastewater should be removed to control eutrophication of water bodies. The potential of employing amorphous zirconium (Zr) hydroxide to remove phosphate from synthetic wastewater was studied in batch adsorption experiments and in a submerged membrane filtration adsorption hybrid (MFAH) reactor. The adsorption data satisfactorily fitted to Langmuir, pseudo-first order and pseudo-second order models. Langmuir adsorption maxima at 22 °C and pHs of 4.0, 7.1, and 10.0 were 30.40, 18.50, and 19.60 mg P/g, respectively. At pH 7.1 and temperatures of 40 °C and 60 °C, they were 43.80 and 54.60 mg P/g, respectively. The thermodynamic parameters, ΔG° and ΔS° were negative and ΔH° was positive. FTIR, zeta potential and competitive phosphate, sulphate and nitrate adsorption data showed that the mechanism of phosphate adsorption was inner-sphere complexation. In the submerged MFAH reactor experiment, when Zr hydroxide was added at doses of 1-5 g/L once only at the start of the experiment, the removal of phosphate from 3 L of wastewater containing 10 mg P/L declined after 5 h of operation. However, when Zr hydroxide was repeatedly added at 5 g/L dose every 24 h, satisfactory removal of phosphate was maintained for 3 days.

Adsorptive removal of heavy metals from water using sodium titanate nanofibres loaded onto GAC in fixed-bed columns

Heavy metals are serious pollutants in aquatic environments. A study was undertaken to remove Cu, Cd, Ni, Pb and Zn individually (single metal system) and together (mixed metals system) from water by adsorption onto a sodium titanate nanofibrous material. Langmuir adsorption capacities (mg/g) at 10(-3)M NaNO3 ionic strength in the single metal system were 60, 83, 115 and 149 for Ni, Zn, Cu, and Cd, respectively, at pH 6.5 and 250 for Pb at pH 4.0. In the mixed metals system they decreased at high metals concentrations. In column experiments with 4% titanate material and 96% granular activated carbon (w/w) mixture at pH 5.0, the metals breakthrough times and adsorption capacities (for both single and mixed metals systems) decreased in the order Pb>Cd, Cu>Zn>Ni within 266 bed volumes. The amounts adsorbed were up to 82 times higher depending on the metal in the granular activated carbon+titanate column than in the granular activated carbon column. The study showed that the titanate material has high potential for removing heavy metals from polluted water when used with granular activated carbon at a very low proportion in fixed-bed columns.

B-type natriuretic peptide and mortality in extremely low birth weight infants with pulmonary hypertension: a retrospective cohort analysis

Background

B-type natriuretic peptide (BNP) is a strong predictor of mortality in adult patients with various forms of pulmonary hypertension (PH) and may be a strong prognostic marker in extremely low birth weight (ELBW) infants with bronchopulmonary dysplasia (BPD) associated PH as well. We sought to assess the relationship between BNP levels and all-cause mortality in a cohort of ELBW infants with BPD and PH.

Methods

We retrospectively identified ELBW infants with BPD and PH who had serum BNP levels measured as part of routine clinical care in the neonatal intensive care unit. Peak serum BNP levels were correlated with survival to discharge or death.

Results

Thirty-six ELBW infants (mean gestational age 26.0 ± 1.9 weeks and mean birth weight 740 ± 290 grams) with BPD and PH had available survival data and had serum BNP levels measured. Peak BNP level was significantly lower among infants who survived than among those who died (128 pg/ml, [IQR 23 to 463] vs. 997 pg/ml, [IQR 278 to 1770], P < 0.004). On multivariate Cox proportional hazard analysis, BNP predicted survival independent of age, gender, and BPD severity. Area under receiver operator characteristic analysis identified a BNP value of 220 pg/ml to have 90% sensitivity and 65% specificity in predicting mortality.

Conclusion

BNP estimation may be useful as a prognostic marker of all-cause mortality in ELBW infants with BPD associated PH.

Inflammatory signals that regulate intestinal epithelial renewal, differentiation, migration and cell death: Implications for necrotizing enterocolitis

Necrotizing enterocolitis is a disease entity with multiple proposed pathways of pathogenesis. Various combinations of these risk factors, perhaps based on genetic predisposition, possibly lead to the mucosal and epithelial injury that is the hallmark of NEC. Intestinal epithelial integrity is controlled by a tightly regulated balance between proliferation and differentiation of epithelium from intestinal epithelial stem cells and cellular loss by apoptosis. various signaling pathways play a key role in creating and maintaining this balance. The aim of this review article is to outline intestinal epithelial barrier development and structure and the impact of these inflammatory signaling and regulatory pathways as they pertain to the pathogenesis of NEC.

Performance of submerged membrane bioreactor (SMBR) with and without the addition of the different particle sizes of GAC as suspended medium

In this study the effect of different particle sizes of granular activated carbon (GAC) on the performance of a submerged membrane bioreactor (SMBR) was investigated. The sizes of GAC used were 150-300, 300-600 and 600-1200 μm. The SMBR was operated at a filtration flux of 20 L/m(2)h. The removal of dissolved organic carbon (DOC) and chemical oxygen demand (COD) with the addition of GAC was 95%. The concentration of biopolymers, humic, building block and low molecular weight neutral and acids in the SMBR effluent was reduced by 20%, 66-76%, 20-50%, 30-56%, respectively. It helped to reduce the sludge volume index (SVI) and transmembrane pressure (TMP) development by 30-40% and 58%, respectively. However, the removal of NH₄(+) and PO₄(3-) was relatively low of 35-45% and 34-43%, respectively. The SMBR effluent was rich in PO₄(3-) and was removed/recovered using hydrated ferric oxide (HFO). The removal of PO₄(3-) was almost 90%.

Effect of imposed flux on fouling behavior in high rate membrane bioreactor

The influence of imposed flux and aeration rates on membrane fouling in a submerged membrane bioreactor was studied. The experiments were conducted at four imposed fluxes and three aeration rates. The effect of flux on the reduction of membrane fouling was much higher than that caused by aeration rate. A lower flux of 20 L/m(2) h produced 75 times more water than a higher flux of 40 L/m(2) h with an aeration rate of 2 L/min. Low flux showed slightly higher removal of NH(4)-N and 93-96% removal of dissolved organic matter and chemical oxygen demand. Imposed flux also had a significant effect on the composition of organics present in the soluble microbial product (SMP) and extracellular polymeric substances (EPS). At a higher flux, both SMP and EPS had organics of high molecular weight (MW) of around 48 kDa as well as lower MW organics below 200 Da.

Effect of organic loading rate on organic matter and foulant characteristics in membrane bio-reactor

In this study, the influence of organic loading rate (OLR) on the performance of a membrane bio-reactor (MBR) was investigated. The MBR was operated with 6 different OLRs between 0.5 and 3.0 kg COD/m(3)d. The hydrodynamic parameters of the MBR were kept constant. The hydraulic retention time and sludge retention time were kept at 8h and 40 d respectively. From the experimental investigation, it was found that the removal efficiency of DOC, COD and NH(4)-N decreased when OLRs were increased from 0.5 to 3.0 kg COD/m(3)d. Higher OLRs of 2.75-3.0 kg COD/m(3)d resulted in a higher transmembrane pressure development. The fractionation of organic matters showed more hydrophilic substances with higher OLRs. A detailed organic matter characterization of membrane foulant, soluble microbial product and extracellular polymeric substances showed that bio-polymers type substances together with humic acid and lower molecular neutral and acids were responsible for membrane fouling.

Biofiltration as pre-treatment to water harvesting and recycling

This paper presents the results of the long term biofilter experiments conducted with raw stormwater collected from a canal at Carlton, in Sydney. Anthracite and granular activated carbon (GAC) were used as a single filter media in biofilter columns. Media heights of 75 and 40 cm were used. The filter columns were operated at filtration velocities of 0.12 and 0.25 m/h. The removal efficiency for turbidity and DOC for the GAC filter media were found to be 75% and almost 100% respectively. The removal efficiency for the anthracite filter was much lower. Molecular weight distribution analysis showed an almost similar trend to the DOC removal. Compared with anthracite filter media, the GAC biofilter removed a much larger range of organic compounds present in the stormwater. The GAC biofilter removes organic matter earlier as compared to anthracite. Based on a limited sample of stormwater, the removal efficiency for phosphorus was upto 74% and that of nitrogen was up to 30%. In general GAC filter shows higher heavy metal removal efficiency than anthracite. The removal of zinc, iron, lead and nickel were good. However the concentration of heavy metal in the raw surface water sample was low.

Preparation of titanium dioxide nanoparticles from electrocoagulated sludge using sacrificial titanium electrodes

A comprehensive investigation of electrocoagulation using sacrificial titanium (Ti) electrodes in wastewater was carried out. The effects of specific process variables, such as initial pH, mixing, current density, initial organic loading, and ionic/electrolyte strength were first optimized to produce recyclable Ti-based sludge. The sludge was incinerated at 600 degrees C to produce functional TiO(2) photocatalyst. X-ray diffraction analysis revealed that TiO(2) produced at optimum electrocoagulation conditions was mostly anatase structure. The specific surface area of the synthesized TiO(2) photocatalyst was higher than that of the commercially available and widely used Degussa P-25 TiO(2). Furthermore, energy dispersive X-ray and X-ray photoelectron spectroscopy analyses showed that in additional to titanium and oxygen, this photocatalyst is also composed of carbon and phosphorus. These elements were mainly doped as a substitute site for the oxygen atom. Transmission electron microscopy images exhibited sharply edged nanorods, round nanoparticles, and nanotubes with nonuniform shapes showing some structural defects. Photodecomposition of gaseous acetaldehyde by this photocatalyst was also conducted under UV and visible light irradiation to study the photocatalytic properties of the doped TiO(2) photocatalyst. While no photocatalytic activity was observed under visible light irradiation, this doped TiO(2) photocatalyst exhibited high photocatalytic activity under UV light.

Hybrid filtration method for pre-treatment of stormwater

In this study the hybrid filtration process (combining fibre filter with deep bed dual media filtration) was investigated as pre-treatment to stormwater. This process was investigated in-terms of reduction in turbidity, dissolved organic carbon (DOC), colour, headloss development across the filters, suspended solids removal, organic matter removal, nutrients and heavy matter (such as iron, copper, lead, zinc) removal efficiency. A comparison was made between the hybrid filter with single media (sand) deep bed filter and fibre filter. It was found that the hybrid filtration system successfully removed turbidity (98%), colour (99%), suspended solids (99%), and DOC (55%). The removal efficiency of heavy metal was relatively low as the concentration of heavy metals present in stormwater was low. The removal efficiency of nitrate, nitrite and phosphorous (as orthophosphate) was 27, 35 and 72% respectively. Hybrid filtration processes showed a better reduction of Modified Fouling Index (MFI) value (from 15.500 s/l(2) to 9 s/l(2)) compared with single media sand, anthracite and fibre filter which were 35 s/l(2), 13 s/l(2)and 14 s/l(2) respectively when operated at FeCl(3) dose of 15 mg/l.

Membranes coupled with physico chemical treatment in water reuse

In this study, short-term experiments were conducted with different configurations of membrane hybrid systems to treat biological treated sewage effluent containing refractory organic pollutants: (i) submerged hollow fiber microfiltration (SMF) alone; (ii) spiral flocculator (SF)-SMF without settling; (iii) SF-PAC-SMF without settling and (iv) SMF with magnetic ion exchange resin MIEX pretreatment. The results indicated that the pre-flocculation of SF could improve the mitigation of membrane fouling significantly even when the system was operated at a high membrane filtration rate. The transmembrane pressure (TMP) of SF-PAC-SMF only increased marginally (0.8 kPa over 8 hours). SF-SMF without the addition of powdered activated carbon (PAC) also took a relatively long duration for the TMP to increase. The TMP only increased by 2.5 kPa over 8 hours. The SF-PAC-MF system resulted in a high dissolved organic carbon (DOC) removal of more than 96%. When used as pre-treatment to submerged membranes, the fluidized bed MIEX contactor could remove a significant amount of organic matter in wastewater. This pre-treatment helped to reduce the membrane fouling and kept the TMP low during the membrane operation.

Valuing stormwater, rainwater and wastewater in the soft path for water management: Australian case studies

A Water Sensitive City is now commonly acknowledged best practice for designing the cities of the future. In Australia, the National Water Initiative has allocated high priority towards offering insight into successful water sensitive urban development projects, to facilitate capacity building within the industry. This paper shares innovative water sensitive projects implemented at Kogarah City Council, in Sydney. Four key projects are discussed, demonstrating how stormwater, rainwater and wastewater can be incorporated into decentralised water systems to offer sustainable water management of the future. The case studies included in the paper highlight Kogarah's journey towards the Soft Path for Water Management.

Analysis of first flush to improve the water quality in rainwater tanks

Although most Australians receive their domestic supply from reticulated mains or town water, there are vast areas with very low population densities and few reticulated supplies. In many of these areas rainwater collected in tanks is the primary source of drinking water. Heavy metals have recently become a concern as their concentration in rain water tanks was found to exceed recommended levels suitable for human consumption. Rainwater storage tanks also accumulate contaminants and sediments that settle to the bottom. Although not widely acknowledged, small amounts of contaminants such as lead found in rain water (used as drinking water) may have a cumulative and poisonous effect on human health over a life time. This is true for certain factors that underlie many of the chronic illnesses that are becoming increasingly common in contemporary society. The paper reports on a study which is part of a project that aims to develop a cost effective in-line filtration system to improve water quality in rainwater tanks. To enable this, the characteristics of rainwater need to be known. One component of this characterization is to observe the effects of the first flush on a rainwater tank. Samples of the roof runoff collected from an urban residential roof located in the Sydney Metropolitan Area in the initial first few millimetres of rain were analysed. The results show that bypassing the first 2 mm of rainfall gives water with most water quality parameters compliant with the Australian Drinking Water Guidelines (ADWG) standards. The parameters that did not comply were lead and turbidity, which required bypassing approximately the first 5 mm of rainfall to meet ADWG standards. Molecular weight distribution (MWD) analysis showed that the concentration of rainwater organic matter (RWOM) decreased with increasing amount of roof runoff.

Adsorption and removal of arsenic from water by iron ore mining waste

There is a global need to develop low-cost technologies to remove arsenic from water for individual household water supply. In this study, a purified and enriched waste material (treated magnetite waste, TMW) from the Trai Cau's iron ore mine in the Thai Nguyen Province in Vietnam was examined for its capacity to remove arsenic. The treatment system was packed with TMW that consisted of 75% of ferrous-ferric oxide (Fe(3)O(4)) and had a large surface area of 89.7 m(2)/g. The experiments were conducted at a filtration rate of 0.05 m/h to treat groundwater with an arsenic concentration of 380 microg/L and iron, manganese and phosphate concentrations of 2.07 mg/L, 0.093 mg/L and 1.6 mg/L respectively. The batch experimental results show that this new material was able to absorb up to 0.74 mg arsenic/g. The results also indicated that the treatment system removed more than 90% arsenic giving an effluent with an arsenic concentration of less than 30 microg/L while achieving a removal efficiency of about 80% for Mn(2 + ) and PO(4) (3-). This could be a promising and cost-effective new material for capturing arsenic as well as other metals from groundwater.

Relief of severe retro-orbital pain and vision improvement after optic-nerve decompression in polyostotic fibrous dysplasia: case report and review of the literature

INTRODUCTION

We describe a case of a 9-year-old girl who developed progressive severe retro-orbital pain and partial visual loss in association with left optic-nerve compression due to polyostotic fibrous dysplasia of the skull.

MATERIALS AND METHODS

Intradural decompression of the optic nerve resulted in immediate and complete resolution of the pain as well as a vast visual improvement.

CONCLUSION

In cases of fibrous dysplasia of the skull with evidence of optic-nerve compression, relief of retro-orbital pain should be an additional consideration when deciding to proceed with surgical management.

Dysphagia and hoarse voice: an unusual cause

We report an unusual presentation and successful treatment of an extracranial skull base carotid aneurysm. The patient presented with a combination of multiple cranial nerve dysfunction and local mass effect. After endovascular treatment of this rare condition her symptoms resolved. The radiological images submitted demonstrate this rare condition well.

Membrane fouling propensity after adsorption as pretreatment in rainwater: a detailed organic characterisation

Organic characterisation in rainwater was investigated in terms of dissolved organic carbon (DOC) and molecular weight distribution (MWD) after powdered activated carbon (PAC) adsorption. PAC adsorption was used as pretreatment to membrane filtration to reduce membrane fouling. The MW of organic matter in rainwater used in this study was in the range of 43,000 Da to 30 Da. Each peak of organic matter consisted of biopolymers (polysaccharides and proteins), humic and fulvic acids, building blocks, low MW acids (hydrolysates of humic substances), low MW neutrals and amphiphilics. Rainwater contained the majority of hydrophilic compounds up to 72%. PAC adsorption removed 33% of total DOC. The removal efficiencies of the hydrophobic and hydrophilic fractions after PAC adsorption were 50% and 27%, respectively. PAC adsorption was found to preferentially remove the hydrophobic fraction. The majority of the smaller MW of 1,100 Da, 820 Da, 550 Da, 90 Da and 30 Da was removed after PAC adsorption. The MFI values decreased from 1,436 s/L2 to 147 s/L2 after PAC adsorption. It was concluded that PAC adsorption can be used as a pretreatment to membrane filtration with rainwater.