Interplay between physical cleaning, membrane pore size and fluid rheology during the evolution of fouling in membrane bioreactors.

Fouling is one of the most pressing limitations during operation of membrane bioreactors, as it increases operating costs and is the cause of short membrane lifespans. Conducting effective physical cleanings is thus essential for keeping membrane operation above viable performance limits. The nature of organic foulants present in the sludge and the membrane properties are among the most influential factors determining fouling development and thus, efficiency of fouling mitigation approaches. The role of other factors like sludge viscosity on fouling is still unclear, given that contradictory effects have been reported in the literature. In the present study we use a new research approach by which the complex interplay between fouling type, levels of permeate flux, membrane material and feed properties is analyzed, and the influence of these factors on critical flux and membrane permeability is evaluated. A variety of systems including activated sludge and model solutions with distinct rheological behavior has been investigated for two membranes differing in pore size distribution. We present a novel method for assessing the efficiency of fouling removal by backwash and compare it with the efficiency achieved by means of relaxation. Results obtained have proven that backwash delays development of critical fouling as compared with relaxation and reduces fouling irreversibility regardless of fluid rheology. It was shown that backwash is especially effective for membranes for which internal fouling is the main cause of loss in permeability. Nonetheless, we found out that for membranes with tight pores, both relaxation and backwash are equally effective. The critical flux decreases significantly for high-viscosity fluids, such as activated sludge. This effect is mainly caused by an intensified concentration polarization at the feed side rather than by internal fouling events. However, membrane permeability has been proven to rely more on the permeate viscosity than on the feed viscosity: poor rejection of organic fractions showcasing high viscosity causes an acute decline in membrane permeability as a consequence of increased shear stress inside the membrane pores.

[Quality in Revision Arthroplasty: A Comparison between Claims Data Analysis and External Quality Assurance]. / Ergebnisqualität in der Revisionsendoprothetik: Eine Analyse von Routinedaten mit dem Vergleich zur externen Qualitätssicherung.

BACKGROUND: External quality assurance for revisions of total knee arthroplasty (TKA) and total hip arthroplasty (THA) are carried out through the AQUA institute in Germany. Data are collected by the providers and are analyzed based on predefined quality indicators from the hospital stay in which the revision was performed. The present study explores the possibility to add routine data analysis to the existing external quality assurance (EQS). Differences between methods are displayed. The study aims to quantify the benefit of an additional analysis that allows patients to be followed up beyond the hospitalization itself. MATERIAL AND METHODS: All persons insured in an AOK sickness fund formed the population for analysis. Revisions were identified using the same algorithm as the existing external quality assurance. Adverse events were defined according to the AQUA indicators for the years 2008 to 2011.The hospital stay in which the revision took place and a follow-up of 30 days were included. For re-operation and dislocation we also defined a 365 days interval for additional follow-up. The results were compared to the external quality control reports. RESULTS: Almost all indicators showed higher events in claims data analysis than in external quality control. Major differences are seen for dislocation (EQS SD: 1.87 vs. claims data [cd] SD: 2.06 %, cd+30 d: 2.91 %, cd+365 d: 7.27 %) and reoperation (hip revision: EQS SD: 5.88 % vs. claims data SD: 8.79 % cd+30 d: 9.82 %, cd+365 d: 15.0 %/knee revision: EQS SD: 3.21 % vs. claims data SD: 4.07 %, cd+30 d: 4.6 %, cd+365 d: 15.43 %). Claims data could show additional adverse events for all indicators after the initial hospital stay, rising to 77 % of all events. CONCLUSIONS: The number of adverse events differs between the existing external quality control and our claims data analysis. Claims data give the opportunity to complement existing methods of quality control though a longer follow-up, when many complications become evident.

A membrane stirrer for product recovery and substrate feeding.

During fermentation processes, in situ product recovery (ISPR) using submerged membranes allows a continuous operation mode with effective product removal. Continuous recovery reduces product inhibition and organisms in the reactor are not exposed to changing reaction conditions. For an effective in situ product removal, submerged membrane systems should have a sufficient large membrane area and an anti-fouling concept integrated in a compact device for the limited space in a lab-scale bioreactor. We present a new membrane stirrer with integrated filtration membranes on the impeller blades as well as an integrated gassing concept in an all-in-one device. The stirrer is fabricated by rapid prototyping and is equipped with a commercial micromesh membrane. Filtration performance is tested using a yeast cell suspension with different stirring speeds and aeration fluxes. We reduce membrane fouling by backflushing through the membrane with the product stream.

Nanometer-thick lateral polyelectrolyte micropatterns induce macrosopic electro-osmotic chaotic fluid instabilities.

Electro-convective vortices in ion concentration polarization under shear flow have been of practical relevance for desalination processes using electrodialysis. The phenomenon has been scientifically disregarded for decades, but is recently embraced by a growing fluid dynamics community due its complex superposition of multi-scale gradients in electrochemical potential and space charge interacting with emerging complex fluid momentum gradients. While the visualization, quantification and fundamental understanding of the often-chaotic fluid dynamics is evolving rapidly due to sophisticated simulations and experimentation, little is known whether these instabilities can be induced and affected by chemical topological heterogeneity in surface properties. In this letter, we report that polyelectrolyte layers applied as micropatterns on ion exchange membranes induce and facilitate the electro-osmotic fluid instabilities. The findings stimulate a variety of fundamental questions comparable to the complexity of today's turbulence research.

Total ankle replacement in patients with haemophilia and virus infections--a safe alternative to ankle arthrodesis?

Despite reliable results of ankle fusion for advanced haemophilic arthropathy, total ankle replacement (TAR) may be functionally advantageous. There is only very limited literature data available on TAR in patients with haemophilia. The objective of this study is to evaluate the short- and mid-term results after TAR in patients with end-stage haemophilic ankle arthropathy and concomitant virus infections. In a retrospective study, results after eleven TAR in 10 patients with severe (n = 8) and moderate (n = 2) haemophilia (mean age: 49 ± 7 years, range, 37-59) were evaluated at a mean follow-up of 3.0 years (range, 1.2-5.4). Nine patients were positive for hepatitis C, five were HIV-positive. Range of motion (ROM), AOFAS-hindfoot-score, pain status (visual analogue scale, VAS) as well as patient satisfaction were evaluated. In two cases deep prosthesis infection occurred leading to the removal of the implant. In the remaining eight patients the mean AOFAS score improved significantly from 21.5 to 68.0 points (P < 0.0005), the VAS score decreased significantly from 7.6 to 1.9 points (P < 0.0005). ROM increased from 23.2 to 25.0 degrees (P = 0.51). At final follow-up all patients without any complications were satisfied with the postoperative results. Radiographic examination did not reveal any signs of prosthetic loosening. TAR is a viable surgical treatment option in patients with end-stage ankle osteoarthritis due to haemophilia. It provides significant pain relieve and high patient satisfaction. However, due to the increased risk of infection and lack of long-term results, TAR particularly in patients with severe haemophilia and virus infections should be indicated carefully.

Towards a carbon independent and CO2-free electrochemical membrane process for NH3 synthesis.

Ammonia is exclusively synthesized by the Haber-Bosch process starting from precious carbon resources such as coal or CH4. With H2O, H2 is produced and with N2, NH3 can be synthesized at high pressures and temperatures. Regrettably, the carbon is not incorporated into NH3 but emitted as CO2. Valuable carbon sources are consumed which could be used otherwise when carbon sources become scarce. We suggest an alternative process concept using an electrochemical membrane reactor (ecMR). A complete synthesis process with N2 production and downstream product separation is presented and evaluated in a multi-scale model to quantify its energy consumption. A new micro-scale ecMR model integrates mass, species, heat and energy balances with electrochemical conversions allowing further integration into a macro-scale process flow sheet. For the anodic oxidation reaction H2O was chosen as a ubiquitous H2 source. Nitrogen was obtained by air separation which combines with protons from H2O to give NH3 using a hypothetical catalyst recently suggested from DFT calculations. The energy demand of the whole electrochemical process is up to 20% lower than the Haber-Bosch process using coal as a H2 source. In the case of natural gas, the ecMR process is not competitive under today's energy and resource conditions. In future however, the electrochemical NH3 synthesis might be the technology-of-choice when coal is easily accessible over natural gas or limited carbon sources have to be used otherwise but for the synthesis of the carbon free product NH3.

Development of multilayer constructs for tissue engineering.

The rapidly developing field of tissue engineering produces living substitutes that restore, maintain or improve the function of tissues or organs. In contrast to standard therapies, the engineered products become integrated within the patient, affording a potentially permanent and specific cure of the disease, injury or impairment. Despite the great progress in the field, development of clinically relevantly sized tissues with complex architecture remains a great challenge. This is mostly due to limitations of nutrient and oxygen delivery to the cells and limited availability of scaffolds that can mimic the complex tissue architecture. This study presents the development of a multilayer tissue construct by rolling pre-seeded electrospun sheets [(prepared from poly (l-lactic acid) (PLLA) seeded with C2C12 pre-myoblast cells)] around a porous multibore hollow fibre (HF) membrane and its testing using a bioreactor. Important elements of this study are: 1) the medium permeating through the porous walls of multibore HF acts as an additional source of nutrients and oxygen to the cells, which exerts low shear stress (controllable by trans membrane pressure); 2) application of dynamic perfusion through the HF lumen and around the 3D construct to achieve high cell proliferation and homogenous cell distribution across the layers, and 3) cell migration occurs within the multilayer construct (shown using pre-labeled C2C12 cells), illustrating the potential of using this concept for developing thick and more complex tissues.

Pelvic reconstruction with compound osteosynthesis following hemipelvectomy: A clinical study.

To date, all surgical techniques used for reconstruction of the pelvic ring following supra-acetabular tumour resection produce high complication rates. We evaluated the clinical, oncological and functional outcomes of a cohort of 35 patients (15 men and 20 women), including 21 Ewing's sarcomas, six chondrosarcomas, three sarcomas not otherwise specified, one osteosarcoma, two osseous malignant fibrous histiocytomas, one synovial cell sarcoma and one metastasis. The mean age of the patients was 31 years (8 to 79) and the latest follow-up was carried out at a mean of 46 months (1.9 to 139.5) post-operatively. We undertook a functional reconstruction of the pelvic ring using polyaxial screws and titanium rods. In 31 patients (89%) the construct was encased in antibiotic-impregnated polymethylmethacrylate. Preservation of the extremities was possible for all patients. The survival rate at three years was 93.9% (95% confidence interval (CI) 77.9 to 98.4), at five years it was 82.4% (95% CI 57.6 to 93.4). For the 21 patients with Ewing's sarcoma it was 95.2% (95% CI 70.7 to 99.3) and 81.5% (95% CI 52.0 to 93.8), respectively. Wound healing problems were observed in eight patients, deep infection in five and clinically asymptomatic breakage of the screws in six. The five-year implant survival was 93.3% (95% CI 57.8 to 95.7). Patients were mobilised at a mean of 3.5 weeks (1 to 7) post-operatively. A post-operative neurological defect occurred in 12 patients. The mean Musculoskeletal Tumor Society score at last available follow-up was 21.2 (10 to 27). This reconstruction technique is characterised by simple and oncologically appropriate applicability, achieving high primary stability that allows early mobilisation, good functional results and relatively low complication rates.

[Basic principles of surgical treatment of bone metastases]. / Grundlagen der operativen Behandlung von Knochenmetastasen.

Due to an increased life expectancy and improved oncological treatment, the necessity for surgical treatment of bone metastases has increased as well. Ideally, therapy should concentrate on the improvement of the patient's quality of life while preferably being interdisciplinary. The type and extent of surgical therapy depend on the prognosis, tumor entity, localization of the tumor as well as on the patient's general condition. The main aims of surgical treatment is to reduce pain and preserve or restore function and mobility. After the contribution on spinal metastases in the last volume, this article focusses on metastases of the extremities and the pelvis. Pathologic fractures with an unclear oncological situation should be examined thoroughly before any surgical treatment is performed. In case of doubt, a biopsy should be performed. Depending on the individual prognosis, possible options for extremity surgery are (compound) osteosynthesis and implantation of a tumor endoprosthesis. The latter should be preferred for patients with a favorable prognosis and long life expectancy. To avoid revision surgery, the selected implant should outlast the patient's remaining life expectancy.

Corrugated round fibers to improve cell adhesion and proliferation in tissue engineering scaffolds.

Optimal cell interaction with biomaterial scaffolds is one of the important requirements for the development of successful in vitro tissue-engineered tissues. Fast, efficient and spatially uniform cell adhesion can improve the clinical potential of engineered tissue. Three-dimensional (3-D) solid free form fabrication is one widely used scaffold fabrication technique today. By means of deposition of polymer fibers, scaffolds with various porosity, 3-D architecture and mechanical properties can be prepared. These scaffolds consist mostly of solid round fibers. In this study, it was hypothesized that a corrugated fiber morphology enhances cell adhesion and proliferation and therefore leads to the development of successful in vitro tissue-engineered constructs. Corrugated round fibers were prepared and characterized by extruding poly(ethylene oxide terephthalate)-co-poly(butylene terephthalate) (300PEOT55PBT45) block co-polymer through specially designed silicon wafer inserts. Corrugated round fibers with 6 and 10 grooves on the fiber surface were compared with solid round fibers of various diameters. The culture of mouse pre-myoblast (C2C12) cells on all fibers was studied under static and dynamic conditions by means of scanning electron microscopy, cell staining and DNA quantification. After 7days of culturing under static conditions, the DNA content on the corrugated round fibers was approximately twice as high as that on the solid round fibers. Moreover, under dynamic culture conditions, the cells on the corrugated round fibers seemed to experience lower mechanical forces and therefore adhered better than on the solid round fibers. The results of this study show that the surface architecture of fibers in a tissue engineering scaffold can be used as a tool to improve the performance of the scaffold in terms of cell adhesion and proliferation.

Water hammer reduces fouling during natural water ultrafiltration.

Today's ultrafiltration processes use permeate flow reversal to remove fouling deposits on the feed side of ultrafiltration membranes. We report an as effective method: the opening and rapid closing of a valve on the permeate side of an ultrafiltration module. The sudden valve closure generates pressure fluctuations due to fluid inertia and is commonly known as "water hammer". Surface water was filtrated in hollow fiber ultrafiltration membranes with a small (5%) crossflow. Filtration experiments above sustainable flux levels (>125 l (m2h)(-1)) show that a periodic closure of a valve on the permeate side improves filtration performance as a consequence of reduced fouling. It was shown that this effect depends on flux and actuation frequency of the valve. The time period that the valve was closed proved to have no effect on filtration performance. The pressure fluctuations generated by the sudden stop in fluid motion due to the valve closure are responsible for the effect of fouling reduction. High frequency recording of the dynamic pressure evolution shows water hammer related pressure fluctuations to occur in the order of 0.1 bar. The pressure fluctuations were higher at higher fluxes (higher velocities) which is in agreement with the theory. They were also more effective at higher fluxes with respect to fouling mitigation.

Integration of hollow fiber membranes improves nutrient supply in three-dimensional tissue constructs.

Sufficient nutrient and oxygen transport is a potent modulator of cell proliferation in in vitro tissue-engineered constructs. The lack of oxygen and culture medium can create a potentially lethal environment and limit cellular metabolic activity and growth. Diffusion through scaffold and multi-cellular tissue typically limits transport in vitro, leading to potential hypoxic regions and reduction in the viable tissue thickness. For the in vitro generation of clinically relevant tissue-engineered grafts, current nutrient diffusion limitations should be addressed. Major approaches to overcoming these include culture with bioreactors, scaffolds with artificial microvasculature, oxygen carriers and pre-vascularization of the engineered tissues. This study focuses on the development and utilization of a new perfusion culture system to provide adequate nutrient delivery to cells within large three-dimensional (3D) scaffolds. Perfusion of oxygenated culture medium through porous hollow fiber (HF) integrated within 3D free form fabricated (FFF) scaffolds is proposed. Mouse pre-myoblast (C2C12) cells cultured on scaffolds of poly(ethylene-oxide-terephthalate)-poly(butylene-terephthalate) block copolymer (300PEOT55PBT45) integrated with porous HF membranes of modified poly(ether-sulfone) (mPES, Gambro GmbH) is used as a model system. Various parameters such as fiber transport properties, fiber spacing within a scaffold and medium flow conditions are optimized. The results show that four HF membranes integrated with the scaffold significantly improve the cell density and cell distribution. This study provides a basis for the development of a new HF perfusion culture methodology to overcome the limitations of nutrient diffusion in the culture of large 3D tissue constructs.

Fouling behavior of microstructured hollow fiber membranes in submerged and aerated filtrations.

The performance of microstructured hollow fiber membranes in submerged and aerated systems was investigated using colloidal silica as a model foulant. The microstructured fibers were compared to round fibers and to twisted microstructured fibers in flux-stepping experiments. The fouling resistances in the structured fibers were found to be higher than those of round fibers. This was attributed to stagnant zones in the grooves of the structured fibers. As the bubble sizes were larger than the size of the grooves of the structured fibers, it is possible that neither the bubbles nor the secondary flow caused by the bubbles can reach the bottom parts of the grooves. Twisting the structured fibers around their axes resulted in decreased fouling resistances. Large, cap-shaped bubbles and slugs were found to be the most effective in fouling removal, while small bubbles of sizes similar to the convolutions in the structured fiber did not cause an improvement in these fibers. Modules in a vertical orientation performed better than horizontal modules when coarse bubbling was used. For small bubbles, the difference between vertical and horizontal modules was not significant. When the structured and twisted fibers were compared to round fibers with respect to the permeate flowrate produced per fiber length instead of the actual flux through the convoluted membrane area, they showed lower fouling resistance than round fibers. This is because the enhancement in surface area is more than the increase in resistance caused by stagnant zones in the grooves of the structured fibers. From a practical point of view, although the microstructure does not promote further turbulence in submerged and aerated systems, it can still be possible to enhance productivity per module with the microstructured fibers due to their high surface area-to-volume ratio.

Cassie-Baxter to Wenzel state wetting transition: scaling of the front velocity.

We experimentally study the dynamics of water in the Cassie-Baxter state to Wenzel state transition on surfaces decorated with assemblies of micrometer-size square pillars arranged on a square lattice. The transition on the micro-patterned superhydrophobic polymer surfaces is followed with a high-speed camera. Detailed analysis of the movement of the liquid during this transition reveals the wetting front velocity dependence on the geometry and material properties. We show that a decrease in gap size as well as an increase in pillar height and intrinsic material hydrophobicity result in a lower front velocity. Scaling arguments based on balancing surface forces and viscous dissipation allow us to derive a relation with which we can rescale all experimentally measured front velocities, obtained for various pattern geometries and materials, on one single curve.

Direct observation of a nonequilibrium electro-osmotic instability.

We present a visualization of the predicted instability in ionic conduction from a binary electrolyte into a charge selective solid. This instability develops when a voltage greater than critical is applied to a thin layer of copper sulfate flanked by a copper anode and a cation selective membrane. The current-voltage dependence exhibits a saturation at the limiting current. With a further increase of voltage, the current increases, marking the transition to the overlimiting conductance. This transition is mediated by the appearing vortical flow that increases with the applied voltage.

Morphology and microtopology of cation-exchange polymers and the origin of the overlimiting current.

In electrodialysis desalination processes, the operating current density is limited by concentration polarization. In contrast to other membrane processes such as ultrafiltration, in electrodialysis, current transport above the limiting current is possible. In this work, the origin of the overlimiting current at cation-exchange polymers is investigated. We show that, under certain experimental conditions, electroconvection is the origin of the overlimiting conductance. The theory concerning electroconvection predicts a shortening of the plateau length of membranes with increased conductive or geometrical heterogeneity. We investigate the influence of these two parameters and show that the creation of line undulations on the membrane surface normal to the flow direction, having distances in the range of approximately 50-200% of the boundary-layer thickness, lead to an earlier onset of the overlimiting current. The plateau length of the undulated membranes is reduced by up to 60% compared to that of a flat membrane. These results verify the existence of electroconvection as a mechanism destabilizing the laminar boundary layer at the liquid-membrane interface and causing ionic transport above the limiting current density.

Outside-in trimming of humic substances during ozonation in a membrane contactor.

This paper addresses the change of molecular size distribution of humic substances (HS) during ozonation in a membrane contactor. It focuses on the characterization and identification of some small ozonation products. The membrane contactor setup allows very precise control of ozone transfer into the solution as well as precise sampling of the products in time. The molecular size distribution was followed by gel permeation chromatography (GPC). Characterization and identification of small ozonation products was performed by membrane nanofiltration and high-performance liquid chromatography (HPLC). Measurements on molecular size distribution indicate that during the ozonation process the size of the HS molecules decreases slowly and only small highly oxidated compounds are being split off the larger molecules. Pyruvic acid, formic acid, methylglyoxal, and acetaldehyde could be identified by substantial peaks. Glyoxilic acid and glyoxal were identified to a lesser extent. This suggests that HS molecules consist of a relatively stable backbone network structure and that the HS molecule degrades according to an outside-in trimming mechanism.