Oxytocin is not associated with postpartum hemorrhage in labor augmentation in a retrospective cohort study in the United States.

BACKGROUND: Previous studies reported conflicting results on the relationship between oxytocin use for labor augmentation and the risk of postpartum hemorrhage, probably because it is rather challenging to disentangle oxytocin use from labor dystocia. OBJECTIVE: This study aimed to investigate the independent association between oxytocin use for augmentation and the risk of postpartum hemorrhage by using advanced statistical modeling to control for labor patterns and other covariates. STUDY DESIGN: We used data from 20,899 term, cephalic, singleton pregnancies of patients with spontaneous onset of labor and no previous cesarean delivery from Intermountain Healthcare in Utah in the Consortium on Safe Labor. Presence of postpartum hemorrhage was identified on the basis of a clinical diagnosis. Propensity scores were calculated using a generalized linear mixed model for oxytocin use for augmentation, and covariate balancing generalized propensity score was applied to obtain propensity scores for the duration and total dosage of oxytocin augmentation. A weighted generalized additive mixed model was used to depict dose-response curves between the duration and total dosage of oxytocin augmentation and the outcomes. The average treatment effects of oxytocin use for augmentation on postpartum hemorrhage and estimated blood loss (mL) were assessed by inverse probability weighting of propensity scores. RESULTS: The odds of both postpartum hemorrhage and estimated blood loss increased modestly when the duration and/or total dosage of oxytocin used for augmentation increased. However, in comparison with women for whom oxytocin was not used, oxytocin augmentation was not clinically or statistically significantly associated with estimated blood loss (6.5 mL; 95% confidence interval, 2.5-10.3) or postpartum hemorrhage (adjusted odds ratio, 1.02; 95% confidence interval, 0.82-1.24) when rigorously controlling for labor pattern and potential confounders. The results remained consistent regardless of inclusion of women with an intrapartum cesarean delivery. CONCLUSION: The odds of postpartum hemorrhage and estimated blood loss increased modestly with increasing duration and total dosage of oxytocin augmentation. However, in comparison with women for whom oxytocin was not used and after controlling for potential confounders, there was no clinically significant association between oxytocin use for augmentation and estimated blood loss or the risk of postpartum hemorrhage.

Removal of methylene blue by acrylic polymer adsorbents loaded with magnetic iron manganese oxides: Synthesis, characterization, and adsorption mechanisms.

Dyes pose significant risks for aquatic environments and biological health in general owing to their non-biodegradable nature, carcinogenicity, and toxicity. The effective treatment of dye wastewater has become an important research topic. In this study, acrylic polymers (AP) loaded with magnetic iron manganese oxides (MIMO) (AP/MIMO) were prepared and used for the first time for the adsorption of methylene blue (MB). Carbon in AP/MIMO exists predominantly in the C-H and C-C forms, with its content reaching 50.7%. Oxygen and nitrogen in AP/MIMO exist mainly in the -CO- and -N-C forms, with contents of up to 41.5% and 73.3%, respectively. MB removal by AP/MIMO was consistent with the pseudo-second-order kinetic model (R2 = 0.99), equilibrium was achieved within 20 min, and the highest MB capacity of 2611.23 mg g-1 was predicted by the Langmuir isotherm model (R2 = 0.91-0.94). AP/MIMO exhibited excellent MB adsorption performance in the pH range of 4-10, with a removal efficiency higher than 99.0% (MB = 100 mL 1000 mg L-1; AP/MIMO = 50 mg). Thermodynamic indicators, such as positive entropy (ΔS0; 98.30 J⋅mol-1⋅K-1), negative Gibbs free energy (ΔG0; -29.40, -28.50, and -27.50 KJ⋅mol-1), and positive enthalpy (ΔH0; 2.30 KJ⋅mol-1), demonstrated that MB removal by AP/MIMO was autonomous, favorable, and endothermic. In addition, the integration of experimental results and theoretical calculations verified that electrostatic interactions were the primary mechanism for MB adsorption at carboxyl sites on AP/MIMO. The total interaction energy between AP and MB was -310.43 kJ⋅mol-1, and the electrostatic effect had a decisive contribution to the MB adsorption, with a value of up to -341.06 kJ⋅mol-1. AP and MB were most likely bound by -COO and S atoms. Overall, AP/MIMO exhibits high adsorption capacity and shows potential as a high-performance magnetic polymer for MB removal.

Potassium ferrate combined with ultrafiltration for treating secondary effluent: Efficient removal of antibiotic resistance genes and membrane fouling alleviation.

Antibiotic resistance genes (ARGs) are considered as emerging environmental contaminants, which should be controlled by wastewater treatment plants to prevent their discharge into the environment. However, conventional treatment techniques generally fail to successfully reduce ARGs, and the release of cell-free ARGs was underestimated. In this study, potassium ferrate (Fe(VI)) pretreatment combined with ultrafiltration (UF) process was developed to remove both cell-associated and cell-free ARGs in real secondary effluent, compared to ferric chloride (Fe(III)) and poly-aluminum chloride (PACl) pretreatment processes. It was found that total ARGs especially cell-free ARGs were effectively removed by Fe(VI) oxidation. However, due to the poor settleability of the negatively charged particles formed by Fe(VI) in the secondary effluent, the removal of cell-associated ARGs was less compared to Fe(III) and PACl pretreatments. The combination of Fe(VI) and UF removed the most ARGs (3.26 - 5.01 logs) due to the efficient removal of cell-free ARGs by Fe(VI) (> 2.15 logs) and co-interception of both cell-associated ARGs and Fe(VI) formed particles of the UF. High-throughput sequencing revealed that Fe(VI) decreased the viability and relative abundances of the potential ARGs hosts. Fe(VI)-UF exhibited the best performance on humic-like fluorescent organic matters removal, as well as the least phytotoxicity in the effluent. Moreover, membrane fouling was remarkably alleviated by Fe(VI) pretreatment because (1) Fe(VI) removed macromolecules such as protein-like and polysaccharide-like substances which would block the membrane pores, (2) Fe(VI) improved the hydrophilicity of foulants and reduced the hydrophobic adsorption between foulants and membrane. In short, Fe(VI)-UF is a promising technology to efficiently remove ARGs (especially cell-free ARGs) and alleviate UF membrane fouling in wastewater reclamation.

Evaluation of Fe(VI)/Fe(II) combined with sludge adsorbents in secondary effluent organic matter removal.

Wastewater reclamation and reuse are important methods that help to achieve an equilibrium within demand and offer, and also one of the important ways to reduce carbon emission. The existence of secondary effluent organic matter (EfOM) will bring potential threat to the environment in reuse process. Therefore, it is important to develop reclaimed water reuse technology that effectively remove EfOM. In this study, the removal of EfOM performance of ferrates enhanced by FeCl2 (Fe(VI)/Fe(II)) combined with sludge adsorbents (SAs) was evaluated by using the continuous-flow process (FeSDF), which was composed of Fe(VI)/Fe(II), SAs, densadeg and filtration. The results showed that when the inflow rate was 1 L/h, the optimal operating conditions of FeSDF including 5 mg/L of Fe(VI), 1 mg/L of Fe(II), 1 g/L of SA and 50% of the reflux ratio. Bulk organic indicators, including chemical oxygen demand, dissolved organic carbon, ammonia, total nitrogen, total phosphorus, turbidity, and ultraviolet absorbance at 254 nm in the effluent met the water quality standard for scenic environment use (GB/T 18921-2019 in China). The addition of Fe(II) makes the coagulation process by Fe(VI) produce more Fe(III) and produce more quality of sedimentary flocs and improve the removal efficiency of EfOM. The removal of organic micro-pollutants (OMPs) was mainly due to ferrate oxidation and SA adsorption in FeSDF, and the removal of most of the OMPs was more than 90%. The total fluorescence intensity removal efficiency in FeSDF was 63.8%. Moreover, the genotoxicity of the FeSDF effluent decreased to 0.73 µg 4-nitroquiniline-N-oxide/L, and the reduction efficiency reached 97.6%. The actual efficiency of most of the indicators is greater than the expected efficiency, indicating that there is a synergistic comprehensive effect during the whole process operation of FeSDF.

Application of potassium ferrate combined with poly-aluminum chloride for mitigating ultrafiltration (UF) membrane fouling in secondary effluent: Comparison of oxidant dosing strategies.

Coagulation has been widely applied as a pretreatment for ultrafiltration (UF) membrane in wastewater reclamation, however, it is unable to effectively ensure the removal of organic micropollutants (OMPs) and genotoxicity. To solve this problem, oxidant ferrate (VI) (FeVIO42-, FeVI) was combined with coagulant poly-aluminum chloride (PAC) as the pretreatment of UF to treat secondary effluent, and three oxidant dosing strategies (namely oxidation followed by coagulation (O-FeVI-PAC), simultaneous oxidation and coagulation (S-FeVI-PAC), and coagulation followed by oxidation (C-PAC-FeVI)) were compared at two oxidant doses. The results showed that C-PAC-FeVI pretreatment exhibited the best performance for the removal of DOC (35.9%), UV254 (33.7%), protein (71.8%), and polysaccharide (22.1%). Molecular weight and fluorescence analysis revealed that the removed organics were mainly humic substances. Both the direct UF process and PAC pretreatment showed limited removal of OMPs and genotoxicity, however, the combined pretreatments of FeVI and PAC dramatically removed them. The maximum removal efficiency of the fourteen selected OMPs and genotoxicity was obtained under S-FeVI-PAC (59.6% on average) and C-PAC-FeVI (84.1%), respectively. With respect to membrane fouling control, the normalized flux reduction showed an apparent regularity of C-PAC-FeVI > O-FeVI-PAC > S-FeVI-PAC, however, FeVI dose should be carefully determined. The addition of FeVI delayed the transition of membrane fouling mechanism from pore blockage to cake filtration, especially in C-PAC-FeVI pretreatment, which was confirmed by the fluorescence characterization of hydraulic reversible and hydraulic irreversible foulants. To sum up, C-PAC-FeVI dosing strategy seems to have more potential in membrane fouling alleviation and effluent quality improvement.

Evaluation of a hybrid process of magnetic ion-exchange resin treatment followed by ozonation in secondary effluent organic matter removal.

The presence of effluent organic matter (EfOM) and organic micro-pollutants (OMPs) in secondary effluent is receiving increasing concern due to their potential impacts on the aquatic environment and human health. In this study, the removal characteristics of EfOM by magnetic ion-exchange resin (MIEX), ozonation, and the hybrid process of MIEX followed by ozonation (M + O) were compared by measuring the bulk organic indicators (BOIs), OMPs, bio-toxicity, and fluorescence. Furthermore, the desorption characteristics of MIEX were comprehensively studied. Ozonation could reduce the OMPs, total fluorescence (TF), genotoxicity, and oestrogenic activity more effectively than MIEX, with reductions of 80.3%, 97.8%, 98.9%, and 94.6%, respectively. The M + O process was capable of removing more EfOM than the individual MIEX or ozonation processes and could reduce the genotoxicity and oestrogenic activity to the detection limit. By implementing MIEX as a pre-treatment, the generation of ammonia-nitrogen and nitrate-nitrogen was effectively reduced in the subsequent ozonation process as MIEX adsorbed organic nitrogen and nitrite-nitrogen. The different regenerants influenced the OMP desorption performance of MIEX by changing the desorption mechanisms, and NaCl + NaOH was the best regenerant due to its high total OMP desorption efficiency. Parallel factor analysis coupled with self-organising maps further explained the differences in fluorescence desorption due to the addition of NaOH to the regenerated solution. Pearson correlation analysis indicated the potential of using spectroscopic indicators, such as ultraviolet absorbance and TF, to assess the evolution of OMPs and bio-toxicity during the M + O and MIEX desorption processes.

Comparison of ozonation and UV based oxidation as pre-treatment process for ultrafiltration in wastewater reuse: Simultaneous water risks reduction and membrane fouling mitigation.

Wastewater reuse risk and membrane fouling are two concerns in ultrafiltration (UF) of secondary effluent (SE) for wastewater reuse. In this work, several wastewater reuse risk issues, such as dissolved effluent organic matters (dEfOM), organic micro-pollutants (OMPs) and bio-toxicity of SE, as well as membrane fouling were comprehensively investigated when ozonation, UV/H2O2 and UV/persulfate (UV/PS) were used as the pre-treatments for UF process. To be specific, individual UF could remove DOC and UV254 by only 7.5% and 19.8%, respectively, however, humics were largely degraded during the pre-oxidation processes revealed by molecular weight and fluorescence analysis. UF and ozonation showed limited removal of OMPs, however, UV/H2O2 and UV/PS dramatically degraded all the OMPs by more than 80%. Genotoxicity were not detected after the oxidation treatment. Membrane fouling may result from the collaborative effect of organic components, such as humic and protein like substances. Fourier transform infrared spectra of the fouled membranes showed that aromatic CC group and polysaccharides group in dEfOM were largely reduced after the oxidation pre-treatments, resulting in the improved membrane flux sustaining. Increased roughness of the membranes in the combined process supported that the less organics content after the oxidation pre-treatment contributed to improve the performance of the UF process. For the excellent organics degradation in UV/PS pre-treatment process, membrane fouling of subsequent UF process showed maximum mitigation.

Effect of pH on effluent organic matter removal in hybrid process of magnetic ion-exchange resin adsorption and ozonation.

It is essential to mitigate the risk of exposure to effluent organic matter (EfOM) in aquatic environments to ensure safe wastewater recycling. Magnetic ion-exchange (MIEX) resin adsorption combined with ozonation could provide EfOM removal. However, the poor understanding of the influences of the parameters and mechanisms in the hybrid process has restricted the applications. In this study, the response surface methodology was used to reveal the interactions of the major operation parameters. The degradation behaviour of the EfOM was investigated by using spectroscopy combined with mathematical methods. The effect of the pH on the EfOM removal was also analysed. The maximum efficiency of the removal of dissolved organic carbon (DOC) was 59.77% at the optimal MIEX resin dosage of 7.97 mL/L, ozone concentration of 8 mg/L, agitation speed of 199.84 r/min, and pH of 9.98. The ozonation was superior to resin adsorption in the removal of 1054-Da compounds, while the resin adsorption was advantageous in the removal of 4168-Da compounds. Three fluorescent components (C1, C2, and C3) were more easily subjected to external perturbation than the DOC and ultraviolet absorbance at 254 nm in the oxidation processes. The MIEX resin exhibited low efficiencies of removal of the fluorescent substances. A synchronous fluorescence analysis coupled with a two-dimensional correlation analysis revealed that the variation in EfOM followed the order of fulvic-to humic-like substances in the hybrid process of MIEX and the following ozonation. The pH was the most significant influencing factor in the hybrid process.

Enhanced organics and Cu2+ removal in electroplating wastewater by bioaugmentation.

With the improvement of electroplating process and products requirement, refractory organics, heavy metals or even heavy metal nanoparticles (NP) exist simultaneously in electroplating wastewater inevitably, makes electroplating wastewater treatment effluent difficult to meet the discharge standard. In order to improve the organics removal under the exposure of CuO NP, strains (designated as L1-L5) that have both organics degradation and Cu2+ tolerance capacities were isolated and employed in the electroplating wastewater bioaugmentation treatment using a hydrolytic/anoxic/oxic-membrane bioreactor. The Cu2+ adsorption process followed pseudo-second order kinetics and the isotherms fit well to Langmuir isotherm model. L2, L3 and L4 showed higher Cu2+ adsorption capacity than that of L1 and L5. Under the optimal condition, the maximum Cu2+ adsorption capacity of L2, L3 and L4 was 34.15, 45.68 and 26.72 mg g-1, respectively. Their average COD removal efficiency achieved 65.7 ±â€¯10.9%, 61.5 ±â€¯6.7% and 71.6 ±â€¯6.0%, respectively. The three isolates were used to construct consortia with the inoculum concentration of 400 mg L-1. One-time and repeated inoculations were evaluated to find the applicable strategy. Repeated inoculation resulted in a better COD and Cu removal performance (76.2 ±â€¯2.6% and 98.5 ±â€¯0.3%, respectively) than those of one-time inoculation (69.0 ±â€¯2.0% and 98.0 ±â€¯0.3%, respectively). The most functionally stable, balanced and resistant bacterial community was formed in the one-time inoculation system while for fungal community it was formed in the repeated inoculation system.

Investigation on the interaction of prulifloxacin with human serum albumin: a spectroscopic analysis.

The interaction between prulifloxacin (PUFX) and human serum albumin (HSA) was investigated under simulated physiologic conditions with fluorescence spectra. The fluorescence quenching process of HSA may be mainly governed by a static quenching mechanism. The apparent binding constant K(b) between PUFX and HSA at different temperatures were 2.08+/-1.04, 2.74+/-0.50, and 4.98+/-1.61x10(8) l/mol. The thermodynamic parameters, with a negative value of DeltaG(0), revealed that the binding is a spontaneous process. A binding distance R of 1.19 nm between donor and acceptor was obtained from the Forster energy transfer theory.

Investigation on interaction of prulifloxacin with pepsin: a spectroscopic analysis.

The interaction between prulifloxacin, a kind of new oral taking antibiotic and pepsin, a kind of enzyme in the stomach has been investigated in vitro under a simulated physiological condition by different spectroscopic methods. The intrinsic fluorescence of pepsin was strongly quenched by prulifloxacin. This effect was rationalized in terms of a static quenching procedure. The binding parameters have been evaluated by fluorescence quenching methods. The negative value of DeltaG(0) reveals that the binding process is a spontaneous process. The binding distance R between donor (pepsin) and acceptor (prulifloxacin) was obtained according to the Förster's resonance energy transfer theory and found to be 0.95 nm. The results obtained herein will be of biological significance in pharmacology and clinical medicine.