Comparison of filter media materials for heavy metal removal from urban stormwater runoff using biofiltration systems

The filter media in biofiltration systems play an important role in removing potentially harmful pollutants from urban stormwater runoff. This study compares the heavy metal removal potential (Cu, Zn, Cd, Pb) of five materials (potting soil, compost, coconut coir, sludge and a commercial mix) using laboratory columns. Total/dissolved organic carbon (TOC/DOC) was also analysed because some of the test materials had high carbon content which affects heavy metal uptake/release. Potting soil and the commercial mix offered the best metal uptake when dosed with low (Cu: 44.78 μg/L, Zn: 436.4 μg/L, Cd, 1.82 μg/L, Pb: 51.32 μg/L) and high concentrations of heavy metals (Cu: 241 μg/L, Zn: 1127 μg/L, Cd: 4.57 μg/L, Pb: 90.25 μg/L). Compost and sludge also had high removal efficiencies (>90%). Heavy metal leaching from these materials was negligible. A one-month dry period between dosing experiments did not affect metal removal efficiencies. TOC concentrations from all materials increased after the dry period. Heavy metal removal was not affected by filter media depth (600 mm vs. 300 mm). Heavy metals tended to accumulate at the upper 5 cm of the filter media although potting soil showed bottom-enriched concentrations. We recommend using potting soil as the principal media mixed with compost or sludge since these materials perform well and are readily available. The use of renewable materials commonly found in Singapore supports a sustainable approach to urban water management.

[Triage: prioritization of injured after a major accident or mass casualty incident]

The present work deals primarily with the triage of injured victims after a mass casualty incident by emergency physicians. Triage is central for successful execution at the scene of a major accident. It ensures that the chaos is left at the scene of the accident and does not reach the hospitals. The enormous psychological burden for triage physicians is reflected and the delegation of activities to lay persons is critically examined. The work reflects the long-term experience of the authors.

Aetiology, incidence and morphology of the C-shaped root canal system and its impact on clinical endodontics

The C-shaped root canal constitutes an unusual root morphology that can be found primarily in mandibular second permanent molars. Due to the complexity of their structure, C-shaped root canal systems may complicate endodontic interventions. A thorough understanding of root canal morphology is therefore imperative for proper diagnosis and successful treatment. This review aims to summarize current knowledge regarding C-shaped roots and root canals, from basic morphology to advanced endodontic procedures. To this end, a systematic search was conducted using the MEDLINE, BIOSIS, Cochrane Library, EMBASE, Google Scholar, Web of Science, PLoS and BioMed Central databases, and many rarely cited articles were included. Furthermore, four interactive 3D models of extracted teeth are introduced that will allow for a better understanding of the complex C-shaped root canal morphology. In addition, the present publication includes an embedded best-practice video showing an exemplary root canal procedure on a tooth with a pronounced C-shaped root canal. The survey of this unusual structure concludes with a number of suggestions concerning future research efforts.

Glucocorticoids in myasthenia gravis - if, when, how, and how much?

Glucocorticoids (GC) are the most commonly used immune-directed therapy in myasthenia gravis (MG). However, to date, GC have not proven their effectiveness in the setting of a randomized clinical trial that complies with currently accepted standards. The rationale for the use of GC in MG is the autoimmune nature of the disease, which is supported by consistent positive results from retrospective studies. Well-defined recommendations for treatment of MG with GC are lacking and further hampered by inter- and intra-individual differences in the disease course and responses to GC treatment. Uncertainties concerning GC treatment in MG encompass the indication for treatment initiation, exact dosage, dose adjustment in specific conditions (e.g., pregnancy, thymectomy), mode of tapering, and surveillance of adverse events (AE). This review illustrates the mode of action of GC in the treatment for MG, presents the currently available data on GC treatment in MG, and attempts to translate the currently available information into clinical recommendations.

Biological control of crystallographic architecture: hierarchy and co-alignment parameters

Mytilus edulis prismatic calcite and nacre layers exhibit a crystallographic structural hierarchy which differs substantially from the morphological hierarchy. This makes these biomaterials fundamentally different from classical crystalline materials. Morphological building units are defined by their surrounding organic matrix membranes, e.g. calcite fibers or nacre tablets. The crystallographic building units are defined by crystallographic co-orientation. Electron backscatter diffraction quantitatively shows how crystallographic co-orientation propagates across matrix membranes to form highly co-oriented low-mosaic composite-crystal grains, i.e. calcite fiber bundles with an internal mosaic spread of 0.5° full width at half maximum (FWHM) or nacre towergrains with an internal mosaic spread of 2° FWHM. These low-mosaic composite crystals form much larger composite-crystal supergrains, which exhibit a high mosaicity due to misorientations of their constituting calcite fiber bundles or nacre towergrains. For the aragonite layer these supergrains nucleate in one of three aragonite {110} twin orientations; as a consequence the nacre layer exhibits a twin-domain structure, i.e. the boundaries of adjacent supergrains exhibit a high probability for misorientations around the aragonite c-axis with an angle near 63.8°. Within the supergrains, the constituting towergrains exhibit a high probability for misorientations around the aragonite a-axis with a geometric mean misorientation angle of 10.6°. The calcite layer is composed of a single composite-crystal supergrain on at least the submillimeter length scale. Mutual misorientations of adjacent fiber bundles within the calcite supergrain are mainly around the calcite c-axis with a geometric mean misorientation angle of 9.4°. The c-axis is not parallel to the long axis of the fibers but rather to the (107) plane normal. The frequency distribution for the occurrence of misorientation angles within supergrains reflects the ability of the organism to maintain homoepitaxial crystallization over a certain length scale. This probability density is distributed log-normally which can be described by a geometric mean and a multiplicative standard deviation. Hence, those parameters are suggested to be a numerical measure for the biological control over crystallographic texture.

Pharmacological inhibition of NOX reduces atherosclerotic lesions, vascular ROS and immune-inflammatory responses in diabetic Apoe(-/-) mice

AIMS/HYPOTHESIS

Enhanced vascular inflammation, immune cell infiltration and elevated production of reactive oxygen species (ROS) contribute significantly to pro-atherogenic responses in diabetes. We assessed the immunomodulatory role of NADPH oxidase (NOX)-derived ROS in diabetes-accelerated atherosclerosis.

METHODS

Diabetes was induced in male Apoe(-/-) mice with five daily doses of streptozotocin (55 mg kg(-1) day(-1)). Atherosclerotic plaque size, markers of ROS and immune cell accumulation were assessed in addition to flow cytometric analyses of cells isolated from the adjacent mediastinal lymph nodes (meLNs). The role of NOX-derived ROS was investigated using the NOX inhibitor, GKT137831 (60 mg/kg per day; gavage) administered to diabetic and non-diabetic Apoe(-/-) mice for 10 weeks.

RESULTS

Diabetes increased atherosclerotic plaque development in the aortic sinus and this correlated with increased lesional accumulation of T cells and CD11c(+) cells and altered T cell activation in the adjacent meLNs. Diabetic Apoe(-/-) mice demonstrated an elevation in vascular ROS production and expression of the proinflammatory markers monocyte chemoattractant protein 1, vascular adhesion molecule 1 and IFNγ. Blockade of NOX-derived ROS using GKT137831 prevented the diabetes-mediated increase in atherosclerotic plaque area and associated vascular T cell infiltration and also significantly reduced vascular ROS as well as markers of inflammation and plaque necrotic core area.

CONCLUSIONS/INTERPRETATION

Diabetes promotes pro-inflammatory immune responses in the aortic sinus and its associated lymphoid tissue. These changes are associated with increased ROS production by NOX. Blockade of NOX-derived ROS using the NOX inhibitor GKT137831 is associated with attenuation of these changes in the immune response and reduces the diabetes-accelerated development of atherosclerotic plaques in Apoe(-/-) mice.