Improved Darcian streambed measurements to quantify flux and mass discharge of volatile organic compounds from a contaminated aquifer to an urban stream.

Quantifying VOC transport from contaminated groundwater to streams is challenging and important for understanding off-site migration of VOCs, cross-media contamination (groundwater to surface water and eventually air), and potential impacts on downstream ecosystems and human populations. A streambed point sampling approach was used to quantify fluxes of water and 14 VOCs from groundwater to an urban stream in North Carolina, USA, during summer (June 2015) and winter (January 2016). The approach is unique in coupling measurements of vertical hydraulic conductivity, vertical hydraulic head gradient, and groundwater VOC concentration at each individual sampling point, reducing or eliminating some potential concerns with other Darcian methods for quantifying VOC inputs to streams. Most results were consistent with discharge of two main VOC plumes on opposite sides of the stream. Plume 1 from the west side was dominated by cis-1,2-dichloroethene (cDCE) and vinyl chloride (VC) at mean concentrations of 19 and 11 µg L-1, respectively. Plume 2 from the east side was dominated by benzene (mean concentration 56 µg L-1). Plume 2 was not previously known, and the improved sampling approach allowed VOC discharge from both plumes to be quantified simultaneously. For 13 of the 14 detected VOCs, the mean VOC flux from groundwater to the stream (fVOC) was higher in January 2016 than in June 2015, mainly because groundwater flux was higher in January. The only exception was cDCE, the most abundant VOC in Plume 1, which had mean fVOC values of 9.8 and 9.5 mg m-2 d-1 in June 2015 and January 2016, respectively. Benzene was the most abundant VOC in Plume 2 and had mean fVOC values of 11 and 37 mg m-2 d-1 in June 2015 and January 2016, respectively. High groundwater flux drove almost all the occurrences of high VOC flux. For a given VOC, the flow-weighted mean concentration (with each VOC concentration weighted by the upward groundwater flux at the VOC sampling point) was generally larger than the unweighted mean concentration. Thus, flow-weighting of concentrations gave a more accurate indication of the average VOC concentration in net groundwater discharge to the stream. An estimate of total VOC mass discharge from groundwater to the study reach of the stream, 3.6 kg of VOC per year, was based on the fVOC results and streambed area in the reach. The bulk of this discharge was due to benzene, cDCE, and VC, with individual mass discharges of 2.1, 0.83, and 0.40 kg yr-1, respectively. Estimates of maximum potential VOC degradation in the streambed suggest that the 3.6 kg yr-1 estimate of mass discharge was not sensitive to potential degradation of VOCs in the streambed sediments above the groundwater sampling depth.

Symptom burden, psychosocial distress and palliative care needs in heart failure - A cross-sectional explorative pilot study.

BACKGROUND: Beyond guideline-directed treatments aimed at improving cardiac function and prognosis in heart failure (HF), patient-reported outcomes have gained attention. PURPOSE: Using a cross-sectional approach, we assessed symptom burden, psychosocial distress, and potential palliative care (PC) needs in patients with advanced stages of HF. METHODS: At a large tertiary care center, we enrolled HF patients in an exploratory pilot study. Symptom burden and psychosocial distress were assessed using the MIDOS (Minimal Documentation System for Patients in PC) questionnaire and the Distress Thermometer (DT), respectively. The 4-item Patient Health Questionnaire (PHQ-4) was used to screen for anxiety and depression. To assess PC needs, physicians used the "Palliative Care Screening Tool for HF Patients". RESULTS: We included 259 patients, of whom 137 (53%) were enrolled at the Heart Failure Unit (HFU), and 122 (47%) at the outpatient clinic (OC). Mean age was 63 years, 72% were male. New York Heart Association class III or IV symptoms were present in 56%. With a mean 5-year survival 64% (HFU) vs. 69% (OC) calculated by the Seattle Heart Failure Model, estimated prognosis was comparatively good. Symptom burden (MIDOS score 8.0 vs. 5.4, max. 30 points, p < 0.001) and level of distress (DT score 6.0 vs. 4.8, max. 10 points, p < 0.001) were higher in hospitalised patients. Clinically relevant distress was detected in the majority of patients (HFU 76% vs. OC 57%, p = 0.001), and more than one third exhibited at least mild symptoms of depression or anxiety. Screening for PC needs revealed 82% of in- and 52% of outpatients fulfil criteria for specialized palliative support. CONCLUSION: Despite a good prognosis, we found multiple undetected and unaddressed needs in an advanced HF cohort. This study's tools and screening results may help to early explore these needs, to further improve integrated HF care.

Per- and polyfluoroalkyl substances (PFAS) in river discharge: Modeling loads upstream and downstream of a PFAS manufacturing plant in the Cape Fear watershed, North Carolina.

The Cape Fear River is an important source of drinking water in North Carolina, and many drinking water intakes in the watershed are affected by per- and polyfluoroalkyl substances (PFAS). We quantified PFAS concentrations and loads in river water upstream and downstream of a PFAS manufacturing plant that has been producing PFAS since 1980. River samples collected from September 2018 to February 2021 were analyzed for 13 PFAS at the upstream station and 43-57 PFAS downstream near Wilmington. Frequent PFAS sampling (daily to weekly) was conducted close to gauging stations (critical to load estimation), and near major drinking water intakes (relevant to human exposure). Perfluoroalkyl acids dominated upstream while fluoroethers associated with the plant made up about 47% on average of the detected PFAS downstream. Near Wilmington, Σ43PFAS concentration averaged 143 ng/L (range 40-377) and Σ43PFAS load averaged 3440 g/day (range 459-17,300), with 17-88% originating from the PFAS plant. LOADEST was a useful tool in quantifying individual and total quantified PFAS loads downstream, however, its use was limited at the upstream station where PFAS levels in the river were affected by variable inputs from a wastewater treatment plant. Long-term monitoring of PFAS concentrations is warranted, especially at the downstream station. Results suggest a slight downward trend in PFAS levels downstream, as indicated by a decrease in flow-weighted mean concentrations and the best-fitting LOADEST model. However, despite the cessation of PFAS process wastewater discharge from the plant in November 2017, and the phase-out of perfluorooctane sulfonic acid (PFOS) and perfluorooctanoic acid (PFOA) in North America, both fluoroethers and legacy PFAS continue to reach the river in significant quantities, reflecting groundwater discharge to the river and other continuing inputs. Persistence of PFAS in surface water and drinking water supplies suggests that up to 1.5 million people in the Cape Fear watershed might be exposed.

Minibactenecins ChBac7.Nα and ChBac7. Nß - Antimicrobial Peptides from Leukocytes of the Goat Capra hircus.

Antimicrobial peptides (AMPs) of neutrophils play an important role in the animal and human host defenses. We have isolated two AMPs (average molecular masses of 2895.5 and 2739.3 Da), with potent antimicrobial activity from neutrophils of the domestic goat (Capra hircus). A structural analysis of the obtained peptides revealed that they encompass N-terminal fragments (1-21 and 1-22) of the proline-rich peptide bactenecin 7.5. The primary structure of caprine bactenecin 7.5 had been previously deduced from the nucleotide sequence, but the corresponding protein had not been isolated from leukocytes until now. The obtained caprine AMPs were designated as mini-batenecins (mini-ChBac7.5Nα and mini-ChBac7.5Nß), analogously to the reported C-terminal fragment of the ovine bactenecin 7.5 named Bac7.5mini [Anderson, Yu, 2003]. Caprine mini-ChBac7.5Nα and mini-ChBac7.5Nß exhibit significant antimicrobial activity against Gram-negative bacteria, including drug-resistant strains of Pseudomonas aeruginosa, Klebsiella spp., Acinetobacter baumannii at a range of concentrations of 0.5-4 µM, as well as against some species of Gram-positive bacteria (Listeria monocytogenes EGD, Micrococcus luteus). The peptides demonstrate lipopolysaccharide-binding activity. Similarly to most proline-rich AMPs, caprine peptides inactivate bacteria without appreciable damage of their membranes. Mini-ChBac7.5Nα and mini-ChBac7.5Nß have no hemolytic effect on human red blood cells and are nontoxic to various cultured human cells. Therefore, they might be considered as promising templates for the development of novel antibiotic pharmaceuticals. Isolation of highly active fragments of the antimicrobial peptide from goat neutrophils supports the hypothesis that fragmentation of cathelicidin-related AMPs is an important process that results in the generation of potent effector molecules, which are in some cases more active than full-size AMPs. These truncated AMPs may play a crucial role in host defense reactions.

2,4-D adsorption to biochars: effect of preparation conditions on equilibrium adsorption capacity and comparison with commercial activated carbon literature data.

Batch isotherm experiments were conducted with chars to study adsorption of the herbicide 2,4-dichlorophenoxyacetic acid (2,4-D). Chars generated from corncobs, bamboo and wood chips in a laboratory pyrolyzer at 400-700 °C were compared with traditional kiln charcoals collected from villages in S/SE Asia and with activated carbons (ACs). 2,4-D uptake by laboratory chars obtained from bamboo and wood chips after 14 h of pyrolysis at 700 °C, from wood chips after 96 h of pyrolysis at 600 °C, and one of the field-collected chars (basudha) was comparable to ACs. H:C and O:C ratios declined with pyrolysis temperature and duration while surface area increased to >500 m(2)/g. Increasing pyrolysis intensity by increasing temperature and/or duration of heating was found to positively influence adsorption capacity yield (mg(2,4-D/g(feedstock))) over the range of conditions studied. Economic analysis showed that high temperature chars can be a cost-effective alternative to ACs for water treatment applications.

Epstein-Barr virus-associated diffuse large B-cell lymphoma of the hypopharynx.

PROBLEMS/OBJECTIVES: Epstein-Barr virus (EBV) is commonly associated with nasopharyngeal carcinoma and Burkitt's lymphoma, but association with hypopharyngeal and laryngeal tumours is rare. To the best of our knowledge, this is the first case report of an EBV-associated diffuse large B-cell lymphoma (DLBCL) of the hypopharynx. METHODOLOGY: A 63-year-old male patient suffering from chronic lymphocytic leukemia presented with swallowing disorders and a sore throat. Panendoscopy with laser surgical resection of tissue specimens was performed. RESULTS: Immunohistochemical and molecular genetic diagnostics, including EBV-encoded small RNA in situ hybridization, confirmed the diagnosis of an EBV-associated DLBCL of the hypopharynx. Ten weeks after the diagnosis, the patient died of disease related to multiple complications. CONCLUSIONS: We hypothesize that the EBV infection was triggered by long-term immunosuppressive therapy that led secondarily to the development of a DLBCL. Otorhinolaryngologists should keep in mind that lymphomas might develop in the entire pharynx.

NOM and MIB, who wins in the competition for activated carbon adsorption sites?

The adsorption of an odour compound common in drinking water, 2-methylisoborneol (MIB), was studied on two activated carbons in the presence of 13 well-characterised natural organic matter (NOM) solutions. It was found that, although the carbons and the NOM solutions had a wide range of characteristics, the major competitive mechanism was the same in all cases. The low molecular weight NOM compounds were the most competitive, participating in a direct competition with the MIB molecule for adsorption sites. Equivalent background concentration (EBC) calculations indicated a relatively low concentration of directly competing compounds in the NOM. Some evidence of pore restriction was also seen, with microporous carbons most affected by low molecular weight NOM, and mesoporous carbons impacted by the higher molecular weight compounds.

Factors controlling alkylbenzene sorption to municipal solid waste.

The sorption of toluene and o-xylene to individual municipal solid waste (MSW) constituents [office paper, newsprint, model food and yard waste, high density polyethylene, and poly(vinyl chloride) (PVC)] was evaluated. Effects of sorbent decomposition and solvent composition on alkylbenzene sorption were studied by evaluating biodegradable sorbents in both fresh and anaerobically decomposed form and by complementing single-solute isotherm tests with experiments conducted in acidogenic and methanogenic leachate. Alkylbenzene sorption to plastics was greaterthan to biopolymer composites, and differences in sorbate/sorbent solubility parameter compatibility explained this observation. Alkylbenzene sorption to biopolymer composites yielded linear isotherms, and sorption capacities [log(Koc/Kow)] decreased linearly with increasing sorbent polarity as expressed by the O-alkyl/alkyl ratio. Leachate composition had little effect on alkylbenzene sorption with one exception; volatile fatty acids in acidogenic leachate appeared to convert PVC from a glassy to a rubbery polymer. The results of this study showed that sorbent organic matter affinity for hydrophobic organic contaminants (HOCs) increases with increasing extent of MSW decomposition because of the recalcitrance of plastics and the preferential degradation of polar biopolymers. Furthermore, the plasticizing effect of volatile fatty acids in acidogenic leachate may enhance the bioavailability of HOCs sorbed to glassy organic matter in MSW or in soils contaminated with acidogenic leachate.

[Future outlook for dental prophylaxis from the perspective of statutory sickness insurance]. / Zukunftsperspektiven der zahnmedizinischen Prophylaxe aus Sicht der Krankenkassen.

Recent legislation in dental health care in Germany calls for a substantial expansion of prevention. The statutory sickness funds start from the assumption that group prophylaxis in core settings of children like kindergartens and schools should be the focus of combined efforts. The departments of dental health care in local public health offices could integrate the relevant services for children and adolescents. However, in the pluralistic system between providers, purchasers and underlying legislation these must come to an agreement regarding new financial solutions for this important preventive task.