Phthalates in the environment: characteristics, fate and transport, and advanced wastewater treatment technologies.

Phthalates are well-known emerging contaminants that harm human health and the environment. Therefore, this review aims to discuss about the occurrence, fate, and phthalates concentration in the various environmental matrices (e.g., aquatic, sediment, soil, and sewage sludge). Hence, it is necessary to treat sources containing phthalates before discharging them to aqueous environment. Various advanced wastewater treatments including adsorption process (e.g., biochar, activated carbon), advanced oxidation processes (e.g., photo-fenton, ozonation, photocatalysis), and biological treatment (membrane bioreactor) have been successfully to address this issue with high removal efficiencies (70-95%). Also, the degradation mechanism was discussed to provide a comprehensive understanding of the phthalate removal for the reader. Additionally, key factors that influenced the phthalates removal efficiency of these technologies were identified and summarized with a view towards pilot-scale and industrial applications.

Outcome of cesarean scar pregnancy treated with local methotrexate injection.

Local injection of methotrexate (MTX) has been widely used for caesarean scar pregnancy (CSP), but the optimal candidate remains undetermined. The aim of this study is to determine the risk factors associated with treatment failure among patients who received a single dose of local MTX. This is a retrospective cohort study. Clinical information was compared between treatment success vs. failure groups. Risk factors related to treatment failure were also investigated with multivariate analysis. Of 47 patients diagnosed with CSP, 30 received local MTX injection. The initial serum ß- human chorionic gonadotropin (hCG) level in the failure group was significantly higher than in the success group (p = 0.048), and the cut-off value was 47,000 mIU/ml. The rate of type 2 position of the gestational sac in the failure group was significantly higher than in the treatment success group (p = 0.031). A high initial serum ß-hCG level (≥ 47,000 mIU/ml) was identified as the independent risk factor for treatment failure (adjusted odds ratio = 21.9; 95% confidence interval = 1.3-383.1). Type 2 gestational sac position and a higher level of ß-hCG at diagnosis appear to be associated with poor outcomes after local injection of a single dose of MTX.

Acetaminophen micropollutant: Historical and current occurrences, toxicity, removal strategies and transformation pathways in different environments.

Acetaminophen (ACT) is commonly used as a counter painkiller and nowadays, it is increasingly present in the natural water environment. Although its concentrations are usually at the ppt to ppm levels, ACT can transform into various intermediates depending on the environmental conditions. Due to the complexity of the ACT degradation products and the intermediates, it poses a major challenge for monitoring, detection and to propose adequate treatment technologies. The main objectives of this review study were to assess (i) the occurrences and toxicities, (2) the removal technologies and (3) the transformation pathways and intermediates of ACT in four environmental compartments namely wastewater, surface water, ground water, and soil/sediments. Based on the review, it was observed that the ACT concentrations in wastewater can reach up to several hundreds of ppb. Amongst the different countries, China and the USA showed the highest ACT concentration in wastewater (≤300 µg/L), with a very high detection frequency (81-100%). Concerning surface water, the ACT concentrations were found to be at the ppt level. Some regions in France, Spain, Germany, Korea, USA, and UK comply with the recommended ACT concentration for drinking water (71 ng/L). Notably, ACT can transform and degrade into various metabolites such as aromatic derivatives or organic acids. Some of them (e.g., hydroquinone and benzoquinone) are toxic to human and other life forms. Thus, in water and wastewater treatment plants, tertiary treatment systems such as advanced oxidation, membrane separation, and hybrid processes should be used to remove the toxic metabolites of ACT.

Does polycystic ovary syndrome affect morphokinetics or abnormalities in early embryonic development?

OBJECTIVES: This study aimed to investigate whether oocyte retrieval from PCOS patients affects the morphokinetics or the incidence of abnormalities in early embryonic development, using time-lapse imaging analysis. METHODS: This was a prospective study in total of 39 PCOS patients and 67 women with normal ovarian function, underwent a GnRH antagonist protocol of controlled ovarian stimulation and fertilization by ICSI. 402 zygotes from the PCOS group and 449 zygotes from the control group were observed by time-lapse monitoring for 48 h following sperm injection. RESULTS: Patients with PCOS showed a significantly higher number of retrieved oocytes, and a significantly higher number of metaphase II oocytes per cycle than that of the non-PCOS group (18.85 ± 9.41 vs. 11.48 ± 5.51 and 14.97 ± 7.43 vs. 9.51 ± 4.7, respectively). However, oocyte maturation rate and morphologically assessed embryo quality did not differ between two groups. After 48 h of the embryo culture using time-lapse video recording, most of the embryos in both groups had reached the 4-cell stage (353/449 vs. 314/402 embryos). There were no significant differences between the control and PCOS group regarding the time-points of the successive events in early embryonic development from the appearance of 2 polar bodies to the 6-cell stage. However, the percentage of t2 stages which fell in "optimal range" (>24 h and ≤28 h) was significantly lower in the PCOS group than in the control group (37.8% vs. 48.1%, P = 0.004). The proportion of embryos manifesting abnormal fertility, multinucleation, direct cleavage and reverse cleavage were not significantly different between the two groups. CONCLUSION: Our data indicated that PCOS does not affect the morphokinetics or incidence of abnormalities in early embryonic development.

Standard and optimal cut-off values of serum ca-125, HE4 and ROMA in preoperative prediction of ovarian cancer in Vietnam.

OBJECTIVES: To evaluate the validity of serum CA-125, Human Epididymis protein 4 (HE4) and Risk of Malignancy Algorithm (ROMA) at standard and optimal cut-offs, in preoperative prediction of epithelial ovarian carcinoma (EOC) in Vietnam. SUBJECTS AND METHODS: Cross-sectional, descriptive study on 277 patients with ovarian masses hospitalized at the OBGYN Departments, Hue University Hospital and Hue Central Hospital, Vietnam, from 01/2016 to 11/2017. All patients had measurements of serum CA-125 by Elecsys 2010 system and HE4 by immunoassay ARCHITECT® HE4 kits; ROMA calculated, and preoperative malignancy risk estimated. Matching these values to postoperative histopathology resulted in the preoperative prediction values. RESULTS: There were 30 (10.8%) cases of EOC. Median values of CA 125, HE4, and ROMA of EOC and benign tumors were 214.20 U/ml, 18.91 U/ml; 90.00 pmol/l, 39.80 pmol/l; and 55.20%, 4.80%, respectively. The sensitivities and specificity of CA125, HE4, and ROMA to distinguish between malignant and benign tumors at standard cut-offs were 83.3% and 78.5%; 50% and 98.38%; 80.0% and 84,6%, and those at optimal cut-offs were 83.3% and 86.6%; 80.0% and 91.5%, 86.7% and 88.7%, respectively. AUCs of CA-125, HE4, and ROMA were 0.872, 0.894, 0.912; and those for the post-menopausal group were 0.900, 0.894 and 0.924, respectively. CONCLUSION: Serum CA 125 and HE4 levels and ROMA have good validity in the diagnosis of EOC, of which ROMA gives the best result. The ROMA index should be applied in clinical practice to help in the assessment and management of patients with suspected ovarian cancer.

The value of visual inspection with acetic acid and Pap smear in cervical cancer screening program in low resource settings - A population-based study.

This study aims to determine the diagnostic values of visual inspection with acetic acid (VIA) and Pap smear in a cervical cancer screening program at a community level in Vietnam. A cross-sectional analysis was obtained, including 1034 women of reproductive age from Thua Thien Hue Province, Vietnam from 09/2012 to 09/2013. Samples were taken from cervixes for Pap smear testing, followed by visual inspection with acetic acid. Subjects with abnormal VIA and/or positive cytology results were invited for colposcopy and biopsy. Histologic confirmed cervical intraepithelial neoplasia (CIN2+) served as gold standards for diagnostic values analysis. Abnormal VIA results were recorded in 87 cases (7.7%). The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of VIA for CIN2+ were 88.8%, 43.8%, 63.4%, 51.2% and 83.3%, respectively. Diagnostic values of Pap smear were 58.0%, 85.2%, 69.9%, 83.3% and 61.3% for its sensitivity, specificity, accuracy, PPV and NPV, respectively. VIA yielded high sensitivity but its accuracy is still limited in pre-cancerous lesions during cervical cancer screening. The Pap smear has acceptable sensitivity and specificity, but its false-negative rate is still high. We recommend a combination of different tests to increase the efficiency of screening in our community.

Enhanced desalination using a three-layer OTMS based superhydrophobic membrane for a membrane distillation process.

Superhydrophobic membranes are essential for improved seawater desalination. This study presents the successful casting of a three-layered membrane composed of a top superhydrophobic coating onto a polypropylene (PP) mat through simple sol-gel processing of octadecyltrimethoxysilane (OTMS), and the bottom layer was casted with hydrophilic poly(vinyl alcohol) (PVA) by using a knife casting technique; this membrane represents a novel class of improved-performance membranes consisting of a top superhydrophobic coating onto a hydrophobic PP mat and a hydrophilic layer (PVA) at the bottom. OTMSs are well known low-surface-energy materials that enhance superhydrophobicity, and they were observed to be the ideal chemical group for increasing the hydrophobicity of the PP mat. The PVA layer acted as base layer absorbing the condensed vapor and thus enhancing the vapor flux across the membrane. The hybrid three-layered membrane exhibited superhydrophobicity, with an average contact angle of more than 160°, and demonstrated high performance in terms of rejection and water flux. This study also examined the pore size distribution, surface roughness, surface area, tensile strength, water flux, and salt rejection of the fabricated membrane. The salt rejection level was calculated to be 99.7%, and a high permeate flux of approximately 6.7 LMH was maintained for 16 h.