Greenhouse Gas Emissions from Membrane Bioreactors

Nowadays, it is widely accepted that wastewater treatment plants (WWTPs) are significant sources of greenhouse gas (GHG) emission, contributing to the anthropogenic sources. Among the GHG emitted from WWTPs, nitrous oxide (N2O) has been identified of having the major interest/concern, since its high global warming potential (GWP), is 298 times higher than that of CO2 and also to its capability to react with stratospheric ozone causing the layer depletion. Up to now, most of the experimental investigations have been carried out on conventional activated sludge (CAS) processes. The knowledge of N2O emission from advanced technologies such membrane bioreactors (MBRs) is still very limited. The present paper is aimed at providing a picture of the GHG emissions from MBR systems. In particular, data of N2O acquired from pilot plant systems monitoring are here presented. The key aim of the study was to highlight the effect of wastewater features and operational conditions on N2O production/emission from MBRs

Sulphate measurement in organic-rich solutions: Carbonate fusion pretreatment to remove organic interferences

Sulphate measurement using a barium sulphate turbidimetric method in solutions with high concentrations of organic material is shown to be problematic. The organics give background colour, which introduces a positive error to the measured absorption, and inhibit the barium sulphate precipitate, which results in a negative error. A carbonate fusion pretreatment of the sample results in the removal of the organic matter and associated interferences. With this pretreatment, excellent sulphate recoveries were obtained (100%). Rigorous testing of the method shows that reproducible and accurate results are obtainable

Pattern and Determinants of Antiretroviral Drug Adherence among Nigerian Pregnant Women

Background. The need for a high level of adherence to antiretroviral drugs has remained a major hurdle to achieving maximal benefit from its use in pregnancy. This study was designed to determine the level of adherence and identify factors that influence adherence during pregnancy. Method. This is a cross-sectional study utilizing a semistructured questionnaire. Bivariate and multiple logistic regression models were used to determine factors independently associated with good drug adherence during pregnancy. Result. 137 (80.6%) of the interviewed 170 women achieved adherence level of ≥95% using 3 day recall. The desire to protect the unborn child was the greatest motivation (51.8%) for good adherence. Fear of being identified as HIV positive (63.6%) was the most common reason for nonadherence. Marital status, disclosure of HIV status, good knowledge of ART, and having a treatment supporter were found to be significantly associated with good adherence at bivariate analysis. However, after controlling for confounders, only HIV status disclosure and having a treatment partner retained their association with good adherence. Conclusion. Disclosure of HIV status and having treatment support are associated with good adherence. Maternal desire to protect the child was the greatest motivator for adherence

Musculoskeletal symptoms and non-prescribed treatments are common in an urban African population of people living with HIV.

There are no data from West Africa reporting musculoskeletal (MSK) disease in people living with HIV (PLWH). Our primary outcome was to measure the prevalence of MSK symptoms in PLWH in urban West Africa. Our secondary outcomes were to describe the disability, impact on work and treatment use associated with the presence of MSK pain. We conducted an e-questionnaire-based point prevalence study of musculoskeletal symptoms, associated disability and treatment in 292 PLWH attending routine follow-up in Lagos, Nigeria. Seventy-three (25%) patients reported MSK pain; 28 (38%) reported chronic symptoms (> 3 months). HIV suppression rates were high in this population (n = 240, 82%) and comparable between individuals with and without chronic pain. MSK pain was associated with female gender and higher body mass index (BMI). Mechanical pain was the most common pain syndrome identified (n = 34, 47%). Lumbar spine and knee were the most common sites. Chronic pain was associated with increased disability compared with the presence of any MSK pain. High rates of treatment-seeking behaviour were seen in those individuals reporting MSK pain (n = 62, 85%). The majority of these individuals sought traditional treatments (n = 48, 66%). Chronic MSK pain and non-prescribed treatments are common in PLWH established on ART in urban West Africa. Studies are required to measure the long-term impact of these symptoms and medicines on retention in HIV care and ART adherence, besides other long-term health outcomes

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake