Conventional Versus Traction-Assisted Endoscopic Submucosal Dissection for Esophageal, Gastric, and Colorectal Neoplasms: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Endoscopic submucosal dissection (ESD) is increasingly being utilized for the resection of superficial gastrointestinal neoplasms. However, the long procedure time poses a technical challenge for conventional ESD (C-ESD). Traction-assisted ESD (T-ESD) was developed to facilitate the procedure by reducing its duration. This study compares the efficacy and safety of C-ESD versus T-ESD in the treatment of esophageal, gastric, and colorectal neoplasms. Nine randomized controlled trials (RCTs) were analyzed. Traction-assisted ESD exhibited shorter mean dissection times for the esophagus and colorectal regions and lower perforation rates in colorectal cases. No significant differences were observed in en bloc resection or bleeding rates. Traction-assisted ESD proves to be more efficient in mean procedure time for esophageal and colorectal cases and safer in perforation rates for colorectal cases, but similar rates are noted for en bloc resection or bleeding.

Electrocoagulation enhanced gravity driven membrane bioreactor for advanced treatment of rural sewage.

The daily discharge of rural sewage in China occupies 30 % of the national wastewater discharge, and developing an energy-efficient, easy to operate, and decentralized rural sewage treatment technology becomes an important task. In this work, a novel rural sewage treatment technology, Electrocoagulation enhanced Gravity-Driven Membrane Bioreactor (EC-GDMBR) was exploited for the rural sewage treatment under long-term operation (160 days). Two EC-GDMBRs with various module structures of ceramic membrane (horizontal module and side module) not only displayed the desirable effluent quality, but also sustained the stable flux (8-13 LMH). The electrocoagulation, electrooxidation, biodegradation, and separation in EC-GDMBRs were able to synergistically remove the particle matter, organic (CODCr effluent <11.6 ± 1.2 mg/L) and nutrients (NH3-N effluent <0.1 mg/L, TN effluent <8.5 mg/L, TP effluent <0.05 mg/L). Besides, the high permeability of ceramic membrane and large porosity of biofilm on its surface improved the sustainability of stable flux during the long-term operation. Moreover, by analyzing bacterial abundance, Extracellular Polymeric Substances, Adenosine Tri-Phosphate and Confocal Laser Scanning Microscopy, a large number of microorganisms grew and accumulated on the carrier, as well as formed the biofilm (23.46-659.9 µm), while Nitrobacteria (1.6-4.1 %) and Nitrate (0.01-0.06 %) exited in the carrier biofilms, promoting the nitrogen removal. Compared with EC-GDMBR with side module of ceramic membrane, EC-GDMBR with horizontal module of ceramic membrane has advantages in flux behavior, organic/nutrient removal, microbial abundance/activity, abundance of nitrogen removal functional bacteria and water permeability of biofilm, because the ceramic membrane of horizontal module can promote the uniform growth of biofilm and improve the uniformity of flow penetration distribution. In general, the findings of this work verify the reliability of EC-GDMBR for the sustainable operation of wastewater treatment and improve its application value of rural sewage treatment.

Occurrence and fate of microplastics from a water source to two different drinking water treatment plants in a megacity in eastern China.

The widespread presence of microplastics (MPs) contamination in drinking water has raised concerns regarding water safety and public health. In this study, a micro-Raman spectrometer was used to trace the occurrence of MP transport from a water source to a drinking water treatment plant (DWTP)1 with an advanced treatment process and DWTP2 with a conventional treatment process and the contributions of different processes to the risk reduction of MPs were explored. Six types of MPs were detected: polyethylene terephthalate, polyethylene, polypropylene, polystyrene, polyamide, and polyvinyl chloride. 2-5 µm (35.8-41.2%) and polyethylene terephthalate (27.1-29.9%) were the most frequently detected MP sizes and types of water source samples, respectively. The abundance of MPs in treated water decreased by 72.7-83.0% compared to raw water. Ozonation and granular activated carbon (52.7%), and sand filtration (47.5%) were the most effective processes for removing MPs from DWTP1 and DWTP2, respectively. Both DWTPs showed significant removal effects on polyethylene terephthalate, with 80.0-88.1% removal rates. The concentrations of polystyrene increase by 30.0-53.4% after chlorination. The dominant components in the treated water of DWTP1 and DWTP2 were polypropylene (24.7%) and polyethylene 27.7%, respectively, and MPs of 2-5 µm had the highest proportion (55.3-64.3%). Pollution load index and potential ecological risk index of raw water treated by DWTPs were reduced by 48.0-58.7% and 94.5-94.7%, respectively. The estimated daily intake of MPs in treated water for infants was 45.5-75.0 items/kg/d, respectively, approximately twice that of adults. This study contributes to the knowledge gap regarding MP pollution in drinking water systems.

Advanced wastewater treatment with microalgae-indigenous bacterial interactions.

Microalgal-indigenous bacterial wastewater treatment (MBWT) emerges as a promising approach for the concurrent removal of nitrogen (N) and phosphorus (P). Despite its potential, the prevalent use of MBWT in batch systems limits its broader application. Furthermore, the success of MBWT critically depends on the stable self-adaptation and synergistic interactions between microalgae and indigenous bacteria, yet the underlying biological mechanisms are not fully understood. Here we explore the viability and microbial dynamics of a continuous flow microalgae-indigenous bacteria advanced wastewater treatment system (CFMBAWTS) in processing actual secondary effluent, with a focus on varying hydraulic retention times (HRTs). The research highlights a stable, mutually beneficial relationship between indigenous bacteria and microalgae. Microalgae and indigenous bacteria can create an optimal environment for each other by providing essential cofactors (like iron, vitamins, and indole-3-acetic acid), oxygen, dissolved organic matter, and tryptophan. This collaboration leads to effective microbial growth, enhanced N and P removal, and energy generation. The study also uncovers crucial metabolic pathways, functional genes, and patterns of microbial succession. Significantly, the effluent NH4+-N and P levels complied with the Chinese national Class-II, Class-V, Class-IA, and Class-IB wastewater discharge standards when the HRT was reduced from 15 to 6 h. Optimal results, including the highest rates of CO2 fixation (1.23 g L-1), total energy yield (32.35 kJ L-1), and the maximal lipid (33.91%) and carbohydrate (41.91%) content, were observed at an HRT of 15 h. Overall, this study not only confirms the feasibility of CFMBAWTS but also lays a crucial foundation for enhancing our understanding of this technology and propelling its practical application in wastewater treatment plants.

Advanced treatment of coking wastewater: Recent advances and prospects.

Advanced treatment of refractory industrial wastewater is still a challenge. Coking wastewater is one of coal chemical wastewater, which contains various refractory organic pollutants. To meet the more and more rigorous discharge standard and increase the reuse ratio of coking wastewater, advanced treatment process must be set for treating the biologically treated coking wastewater. To date, several advanced oxidation processes (AOPs), including Fenton, ozone, persulfate-based oxidation, and iron-carbon micro-electrolysis, have been applied for the advanced treatment of coking wastewater. However, the performance of different advanced treatment processes changed greatly, depending on the components of coking wastewater and the unique characteristics of advanced treatment processes. In this review article, the state-of-the-art advanced treatment process of coking wastewater was systematically summarized and analyzed. Firstly, the major organic pollutants in the secondary effluents of coking wastewater was briefly introduced, to better understand the characteristics of the biologically treated coking wastewater. Then, the performance of various advanced treatment processes, including physiochemical methods, biological methods, advanced oxidation methods and combined methods were discussed for the advanced treatment of coking wastewater in detail. Finally, the conclusions and remarks were provided. This review will be helpful for the proper selection of advanced treatment processes and promote the development of advanced treatment processes for coking wastewater.

Assessing impacts of municipal wastewater treatment plant upgrades on bacterial hazard contributions to the receiving urban river using SourceTracker.

Upgrading municipal wastewater treatment plants (MWTPs) has been implemented in many megacities of China to reduce the discharges of nutrients and other pollutants and improve water quality of highly urbanized rivers. However, the contribution of MWTP discharge to bacterial hazards in the receiving rivers after upgrades has been largely unknown. In this study, high-throughput sequencing and shotgun metagenomics were applied to investigate the changes in the abundance, composition, potential risks, and contributions of bacteria and antibiotic resistance genes (ARGs) from effluent to receiving river after upgrading the third-largest MWTP in China with denitrification biofilters, ultrafiltration, ozonation, and disinfection processes. The annual loadings of total nitrogen and 27 types of pharmaceuticals were reduced by 42.4% ± 13.2% and 46.2% ± 15.4%, respectively. Bacterial biomass decreased from (3.58 ± 0.49) to (1.23 ± 0.27) × 107 16S rRNA gene copies/mL, and identified biomarkers in effluent and downstream shifted due to the adopted processes. Opportunistic pathogen bacteria downstream were also reduced. Although the relative abundance of total ARGs in MWTP effluent increased from 1.10 ± 0.02 to 2.19 ± 0.03 copies/16S rRNA gene after upgrades, that of total and high-risk ARGs downstream showed no significant difference. More importantly, the Bayesian-based SourceTracker method provided valuable insight by revealing that the contributions of MWTP discharge to downstream bacteria (from 44.2% ± 1.5%-31.4% ± 0.9%) and ARGs (from 61.2% ± 5.3%-47.6% ± 4.1%) were significantly reduced following the upgrades, indicating upgrading MWTP showed integrated benefits to the bacterial hazards in the receiving river. This study provides useful information for better control of bacterial hazard risks and operational strategy for the improvement of the urban aquatic ecosystem.

Autotrophic denitrification based on sulfur-iron minerals: advanced wastewater treatment technology with simultaneous nitrogen and phosphorus removal.

Autotrophic denitrification technology has many advantages, including no external carbon source addition, low sludge production, high operating cost efficiency, prevention of secondary sewage pollution, and stable treatment efficiency. At present, the main research on autotrophic denitrification electron donors mainly includes sulfur, iron, and hydrogen. In these autotrophic denitrification systems, pyrite has received attention due to its advantages of easy availability of raw materials, low cost, and pH stability. When pyrite is used as a substrate for autotropic denitrification, sulfide (S2-) and ferrous ion (Fe2+) in the substrate will provide electrons to convert nitrate (NO3-) in sewage first to nitrite (NO2-), then to nitrogen (N2), and finally to discharge the system. At the same time, sulfide (S2-) loses electrons to sulfate (SO42-) and ferrous ion (Fe2+) loses electrons to ferric iron (Fe3+). Phosphates (PO43-) in wastewater are chemically combined with ferric iron (Fe3+) to form ferric phosphate (FePO4) precipitate. This paper aims to provide a detailed and comprehensive overview of the dynamic changes of nitrogen (N), phosphorus (P), and other substances in the process of sulfur autotrophic denitrification using iron sulfide, and to summarize the factors that affect wastewater treatment in the system. This work will provide a relevant research direction and theoretical basis for the field of sulfur autotrophic denitrification, especially for the related experiments of the reaction conversion of various substances in the system.

Treatment patterns and outcomes of Medicare enrolees who developed venous leg ulcers.

OBJECTIVE: To retrospectively evaluate the comorbidities, treatment patterns and outcomes of Medicare enrolees who developed venous leg ulcers (VLUs). METHOD: Medicare Limited Data Standard Analytic Hospital Inpatient and Outpatient Department Files were used to follow patients who received medical care for a VLU between 1 October 2015 and 2 October 2019. Patients diagnosed with chronic venous insufficiency (CVI) and a VLU were propensity matched into four groups based on their treatment regimen. Episode claims were used to document demographics, comorbidities and treatments of Medicare enrolees who developed VLUs, as well as important outcomes, such as time to ulcer closure, rates of complications and hospital utilisation rates. Outcomes were compared across key propensity-matched groups. RESULTS: In total, 42% of Medicare enrolees with CVI (n=1,225,278), developed at least one VLU during the study, and 79% had their episode claim completed within one year. However, 59% of patients developed another VLU during the study period. This analysis shows that only 38.4% of VLU episodes received documented VLU conservative care treatment. Propensity-matched episodes that received an advanced treatment or high-cost skin substitutes for a wound which had not progressed by 30 days demonstrated the best outcomes when their cellular, acellular, matrix-like product (CAMP) treatment was applied weekly or biweekly (following parameters for use). Complications such as rates of infection (33%) and emergency department visits (>50%) decreased among patients who received an advanced treatment (following parameters for use). CONCLUSION: Medicare enrolees with CVI have diverse comorbidities and many do not receive sufficient management, which contributes to high rates of VLUs and subsequent complications. Medicare patients at risk of a VLU who receive early identification and advanced CAMP treatment demonstrated improved quality of life and significantly reduced healthcare resource utilisation.

A review of factors affecting the formation and roles of primary and secondary reactive species in UV254-based advanced treatment processes.

The presence of organic micropollutants (OMPs) in water has been threatening human health and aquatic ecosystems worldwide. Ultraviolet-based advanced treatment processes (UV-ATPs) are one of the most effective and promising technologies to transform OMPs in water; therefore, an increasing number of emerging UV-ATPs are proposed. However, appropriate selection of UV-ATPs for practical applications is challenging because each UV-ATP generates different types and concentrations of reactive species (RSs) that may not be sufficient to degrade specific types of OMPs. Furthermore, the concentrations and types of RSs are highly influenced by anions and dissolved organic matter (DOM) coexisting in real waters, making systematic understandings of their interfering mechanisms difficult. To identify and address the knowledge gaps, this review provides a comparison of the generations and variations of various types of RSs in different UV-ATPs. These analyses not only prove the importance of water matrices on formation and consumption of primary and secondary RSs under different conditions, but also highlight the non-negligible roles of optical properties and reactivities of DOM and anions. For example, different UV-ATPs may be applicable to different target OMPs under different conditions; and the concentrations and roles of secondary RSs may outperform those of primary RSs in OMP degradation for real applications. With continuous progress and outstanding achievements in the UV-ATPs, it is hoped that the findings and conclusions of this review could facilitate further research and application of UV-ATPs.

Removal performance of dissolved organic matter from municipal secondary effluent by different advanced treatment processes and preventing the formation of disinfection by-products.

Various advanced treatment processes including ultrafiltration (UF), ozonation, enhanced coagulation, and biological aerated filter (BAF) have been applied to reduce dissolved organic matter (DOM) from the secondary effluent of municipal wastewater treatment plants (MWTPs). In this study, DOM were characterized and the relationship between DOM characteristics and disinfection by-products (DBPs) generation was investigated systematically. Results showed that BAF and ozonation processes could significantly affect DOM characteristics in the treated effluents and the following DBP generation. UF and enhanced coagulation reduced the production of DBPs by removing large molecular hydrophobic organics. The removal of low molecule DOM by BAF resulted in a 67.6% reduction in trihalomethanes (THMs) production. Ozonation could oxidize large hydrophobic DOM into small hydrophilic molecules containing aldehyde and ketone groups, leading to 54% increase of halogenated aldehydes (HALs) and halogenated ketones (HKs). Humic acid (HA) was the main organic type in DOM and important precursor for THMs and dichloroacetonitrile (DCAN) formation. The generation of trichloromethane (TCM) showed a significant positive correlation (R2 = 0.987) with the specific ultraviolet absorbance at 254 nm (SUVA). Large molecule hydrophobic DOM devoted the most to the formation of carbonaceous disinfection by-products and [Formula: see text]-N content was an important factor affecting the generation of nitrogenous disinfection by-products. These results are important for the optimization of advanced treatment process in MWTPs, and controlling DBPs should consider the removal of low MW hydrophobic DOM and the reduction of SUVA.

Characteristics in dissolved organic matter and disinfection by-product formation during advanced treatment processes of municipal secondary effluent with Orbitrap mass spectrometry.

Dissolved organic matter (DOM) is reported to be a precursor to disinfection by-products (DBPs), which have adverse effects on human health. Therefore, it is crucial to effectively remove DOM before water disinfection. Characteristics of DOM and DBPs formation during advanced treatment processes including coagulation, adsorption, ultraviolet (UV) irradiation, and ozone (O3) oxidation in municipal secondary effluent were investigated in this research. DOM was characterized by Fourier transform infrared spectroscopy (FTIR), excitation-emission matrix fluorescence spectroscopy (EEM), and Orbitrap mass spectrometry (Orbitrap MS). Moreover, DBPs formation potential under different advanced treatment processes was also discussed. FTIR results indicated that various functional groups existing in DOM may react with the disinfectant to form toxic DBPs. EEM analysis indicated that DOM in all water samples was dominated by soluble microbial product-like (SMPs) and humic acid-like (HA) substances. The municipal secondary effluent was abundant with DOM and rich in carbon, hydrogen, oxygen, and nitrogen atoms, contained a certain dosage of phosphorus and sulfur atoms, and the highest proportion is lignin. Most of the precursors (CHO features) had positive double bond equivalent subtracted oxygen per carbon [(DBE-O)/C] and negative carbon oxidation state (Cos) in all four different advanced treatment processes. DBPs formation potential (DBPFP) of coagulation, adsorption, UV irradiation, and O3 oxidation advanced treatment processes were 487 µg L-1, 586 µg L-1, 597 µg L-1, and 308 µg L-1, respectively. And the DBPs precursors removal efficiency of coagulation, adsorption, UV irradiation, and O3 oxidation advanced treatment processes were 50.8%, 40.8%, 39.8%, and 69.0%, respectively. This study provides in-depth insights into the changes of DOM in municipal secondary effluent at the molecular level and the removal efficiency of DBPs precursors during coagulation, adsorption, UV irradiation, and O3 oxidation advanced treatment processes.

Advanced Treatment of Coking Wastewater by Polyaluminum Silicate Sulfate for Organic Compounds Removal.

Coking wastewater is a typical high-strength organic wastewater, for which it is difficult to meet discharging standards with a single biological treatment. In this study, effective advanced treatment of coking wastewater was achieved by coagulation with freshly prepared polyaluminum silicate sulfate (PASS). The performance advantage was determined through comparison with commercial coagulants including ferric chloride, polyferric sulfate, aluminum sulfate and polyaluminum chloride. Both single-factor and Taguchi experiments were conducted to determine the optimal conditions for coagulation with CODCr and UV254 as indicators. A dosage of 7 mmol/L PASS, flocculation velocity of 75 r/min, flocculation time of 30 min, pH of 7, and temperature of 20 °C could decrease the CODCr concentration from 196.67 mg/L to 59.94 mg/L. Enhanced coagulation could further help to remove the organic compounds, including pre-oxidation with ozonation, adsorption with activated carbon, assistant coagulation with polyacrylamide and secondary coagulation. UV spectrum scanning and gas chromatography-mass spectrometry revealed that the coagulation process effectively removed the majority of organic compounds, especially the high molecular weight alkanes and heterocyclic compounds. Coagulation with PASS provides an effective alternative for the advanced treatment of coking wastewater.

Patients' preference regarding inpatient versus outpatient setting - A systematic review.

OBJECTIVES: Continuously rising healthcare costs have led to financial pressure on the healthcare systems. One of the trends for the reduction of costs is the shift towards outpatient treatment. However, research has not focused on the patients' preferences regarding inpatient versus outpatient treatment settings. The purpose of this review is to examine existing studies surveying patients' preferences related to inpatient and outpatient treatment methods. The aim is to find out whether patients' wishes were queried and considered in the decision-making process. DESIGN: Therefore, the reviewers performed a systematic approach utilizing the PRISMA standards and screened 1'646 articles out of 5'606 articles from the systematic search. RESULTS AND CONCLUSION: The screening resulted in 4 studies that analyzed exclusively the patient's choice of treatment setting. The search showed an apparent paucity of current literature and highlights the need for further research. The authors' recommendation includes a better involvement of patients in the decision-making process as well as adding preferred treatment settings to advanced treatment directives and patient satisfaction questionnaires.

Surveillance, distribution, and treatment methods of antimicrobial resistance in water: A review.

The World Health Organization (WHO) recognizes antimicrobial resistance (AMR) as a serious threat to human health. Scientists warn that the world is approaching a post-antibiotic era, in which antibiotics will be ineffective, and AMR infections may become a leading cause of death worldwide. Wastewater treatment plants (WWTPs) have been identified as hotspots for the spread and reproduction of AMR. This review focuses on the fate of AMR in WWTPs and advanced water treatment processes, highlighting their removal efficiencies and limitations. Additionally, methods for monitoring AMR in WWTPs and aquatic environments are discussed. Monitoring of AMR in wastewater is crucial for tracking its presence and spread to the environment. Advanced AMR treatment processes such as membrane bioreactors (MBRs), vermifiltration (VF), advanced oxidation processes (AOPs), and membrane filtration processes (MFPs) are discussed and compared.

Application of a fluorescence EEM-PARAFAC model for direct and indirect potable water reuse monitoring: Multi-stage ozone-biofiltration without reverse osmosis at Gwinnett County, Georgia, USA.

Periods of drought coupled with increasing population growth have prompted increased interest in potable water reuse in Gwinnett County, Georgia, USA. However, such inland water recycling facilities are challenged with treatment approaches where reverse osmosis (RO) membrane concentrate disposal is a barrier to implementation of potable reuse. To evaluate alternative treatment processes, testing of two side-by-side pilot systems using multi-stage ozone and biological filtration without RO was conducted to compare indirect potable reuse (IPR) to direct potable reuse (DPR). Two water sources were investigated-influent from Lake Lanier for the IPR pilot, and a blend of 25 % reclaimed water mixed with lake water (75 %) for the DPR pilot. To assess the nature of organic matter removed during potable reuse, excitation-emission matrix (EEM) fluorescence spectroscopy/PARAllel FACtor (PARAFAC) analyses were examined as a fingerprinting tool. The objectives were to determine (a) if a DPR scenario, when preceded by advanced wastewater treatment, could achieve drinking water quality comparable to IPR and (b) if water quality monitoring using EEM/PARAFAC methods could predict results for DPR and IPR water quality, comparable to parameters obtained in a supplementary study that required more expensive, time-consuming, and complicated analytical techniques. Sample scores representing relative concentrations of fluorescing organic matter derived from the EEM-PARAFAC model decreased in the order of reclaimed water > lake water > DPR pilot > IPR pilot, demonstrating that EEM/PARAFAC could distinguish between DPR and IPR water quality. An assessment of a comprehensive list of individual organic compounds (reported separately) validated that blend ratios of 25 % reclaimed water, or higher mixed with lake water (75 %) did not meet primary and secondary drinking water standards. Likewise, in this study, EEM/PARAFAC analysis demonstrated the 25 % blend did not provide drinking water quality indicating this simple, inexpensive method could be used for potable reuse monitoring.

Treatment and utilization of swine wastewater - A review on technologies in full-scale application.

The management of swine wastewater has become the focus of attention in the farming industry. The disposal mode of swine wastewater can be classified as field application of treated waste and treatment to meet discharge standards. The status of investigation and application of unit technology in treatment and utilization such as solid-liquid separation, aerobic treatment, anaerobic treatment, digestate utilization, natural treatment, anaerobic-aerobic combined treatment, advanced treatment, are reviewed from the full-scale application perspective. The technologies of anaerobic digestion-land application is most appropriate for small and medium-sized pig farms or large pig farms with enough land around for digestate application. The process of "solid-liquid separation-anaerobic-aerobic-advanced treatment" to meet the discharge standard is most suitable for large and extra-large pig farms without enough land. Poor operation of anaerobic digestion unit in winter, hard to completely utilize liquid digestate and high treatment cost of digested effluent for meeting discharge standard are established as the main difficulties.

Advanced treatment of industrial wastewater by ozonation with iron-based monolithic catalyst packing: From mechanism to application.

An Fe-based catalyst was prepared by oxidising waste Fe shavings directly in a solution. In engineering applications, Fe shavings were compressed and modified to form Fe-based monolithic catalyst packing. Both of which exhibited excellent catalytic activity in catalytic ozonation industrial wastewater after biochemical treatment. Fe-based monolithic catalyst packing has irregular channels, large porosity, small pore diameter, and the effective specific surface area (SSA) up to 3500 m2/m3, these characteristics are conducive to mass transfer, and promote the effective utilisation of •OH in the catalyst "action zone". A tower reactor (<3000 m3/d) and reinforced concrete construction reactor (>5000 m3/d) were designed according to the wastewater flow. Regression analysis showed that hydraulic residence time (HRT) and O3/CODin are important parameters in engineering design and operation. In addition, strategies for the application of Fe-based monolithic catalyst packing to wastewater with high salinity and high inorganic carbon concentration have been proposed. Fe-based monolithic catalyst packing catalytic ozonation is a relatively cost-effective and eco-friendly process with extremely broad application prospects in the advanced treatment of industrial wastewater.

Iron-enhanced sand filters: Multi-year urban runoff (stormwater) quality performance.

Untreated urban runoff (stormwater) is a major pathway for contaminants, e.g., nutrients and metals, to receiving waters. Where eutrophication occurs, dissolved phosphorus (DP) treatment is often necessary to protect receiving waters, yet few practical methods exist. Iron-enhanced sand filters (IESFs) have successfully treated DP in laboratory and limited field studies. Yet, multi-year-IESF studies to understand reportedly variable performance are unavailable. Herein, nine IESFs were sampled from 2015 to 2018 (528 samples; 70 rainfall-runoff events). Analysis focused on influent/effluent concentrations and removal efficiencies alongside design and catchment parameters. Overall, IESFs significantly removed most total and dissolved metal analytes. Generally, phosphorus removal efficiencies correlated positively with influent concentrations and IESF:catchment area ratios, demonstrating the importance of proper sizing and siting. For all paired influent-effluent samples, respective median total phosphorus, orthophosphate, and DP removal efficiencies were 33 %, 41 %, and 13 %, and respective median effluent concentrations were 120, 25, and 75 (µg/L); with two malfunctioning sites omitted, these respective concentrations were 92, 11, and 47, which better matched relevant goals and (indirectly applicable) standards. Nonetheless, phosphorus removal efficiency and effluent concentrations varied significantly across IESFs and events. Seasonality appeared influential, yet variable influent concentrations confounded spatiotemporal removal efficiency comparisons. Thus, compared to removal efficiencies, effluent concentrations may be better indicators of receiving water risk/benefit and of equal importance for water quality crediting. Although 122 influent-effluent pairs were analyzed, a greater sample size would allow multivariate hypothesis tests with additional predictors. Overall, in this multi-site-year study, most IESFs performed at (n = 5) or near (n = 2) phosphorus effluent concentration and less-so, removal efficiency benchmarks. This research provides new quantitative knowledge on long-term IESF performance for real-world conditions and goals. Research recommendations include multivariate dimension reduction studies and comprehensive, effective information transfer to improve IESF understanding and performance and address practitioner needs, e.g., for refined design, operation, and assessment guidance.

SARS-CoV-2 genetic material is removed during municipal wastewater treatment and is undetectable after advanced treatment.

The aim of this study was to establish whether SARS-CoV-2 genetic material is detectable after municipal wastewater treatment and to verify its expected removal from purified water that is reclaimed for potable reuse. Viral loads of SARS-CoV-2 (N1 and N2 genes) were monitored in raw influent wastewater (sewage) entering a water reclamation facility and in subsequent advanced treatment. Despite the large viral RNA load in raw sewage during peak COVID-19 outbreaks, substantial amounts of SARS-CoV-2 genetic material were removed during the conventional wastewater treatment process. Further, SARS-CoV-2 genetic material was undetectable after advanced purification. This confirms that potable reuse is resilient against high viral loads which are expected results given the advanced degree of wastewater and water treatment. Findings from this study may enhance public perception of the safety of potable water reuse; however, it should also be noted that studies to date worldwide indicate no evidence of SARS-CoV-2 transmission via water, and the CDC does not consider fecal waste or wastewaters as a source of exposure.