The ANTENATAL multicentre study to predict postnatal renal outcome in fetuses with posterior urethral valves: objectives and design

Abstract Background Posterior urethral valves (PUV) account for 17% of paediatric end-stage renal disease. A major issue in the management of PUV is prenatal prediction of postnatal renal function. Fetal ultrasound and fetal urine biochemistry are currently employed for this prediction, but clearly lack precision. We previously developed a fetal urine peptide signature that predicted in utero with high precision postnatal renal function in fetuses with PUV. We describe here the objectives and design of the prospective international multicentre ANTENATAL (multicentre validation of a fetal urine peptidome-based classifier to predict postnatal renal function in posterior urethral valves) study, set up to validate this fetal urine peptide signature. Methods Participants will be PUV pregnancies enrolled from 2017 to 2021 and followed up until 2023 in >30 European centres endorsed and supported by European reference networks for rare urological disorders (ERN eUROGEN) and rare kidney diseases (ERN ERKNet). The endpoint will be renal/patient survival at 2 years postnatally. Assuming α = 0.05, 1–β = 0.8 and a mean prevalence of severe renal outcome in PUV individuals of 0.35, 400 patients need to be enrolled to validate the previously reported sensitivity and specificity of the peptide signature. Results In this largest multicentre study of antenatally detected PUV, we anticipate bringing a novel tool to the clinic. Based on urinary peptides and potentially amended in the future with additional omics traits, this tool will be able to precisely quantify postnatal renal survival in PUV pregnancies. The main limitation of the employed approach is the need for specialized equipment. Conclusions Accurate risk assessment in the prenatal period should strongly improve the management of fetuses with PUV

Physical and numerical modeling of overbank flow with a groyne on the floodplain

peer reviewe

Pharmaceuticals in soil leachates after raw and treated sludge spreading : impact of sludge treatments

Sewage sludge contains a huge diversity of organic contaminants including pharmaceuticals (1). These compounds may interact with the organo-mineral environment prevailing in such complex matrix through various sorption/complexation mechanisms. These interactions could be modified by the treatment applied to sludge and this reactivity modification could thus influence the contaminants fate after sludge disposal onto soil. In order to study the impact of sludge treatments on the fate of pharmaceuticals after sludge spreading on soil, we have conducted lab-scale leaching experiments with 4 types of sludge sampled on an industrial sludge treatment line including anaerobic digestion, drying and composting. Batch and column assays (based on EU standards XP CEN ISO/TS 21268-1, XP CEN ISO/TS 21268-2, XP CEN/TS 14997 et XP CEN ISO/TS 21268-3) and lysimeters experiments were conducted to assess contaminant release from 4 sludge: a thickened sludge (S), the same sludge after anaerobic digestion (DS), then after drying (DDS) and finally composted with green wastes (C-DDS). The release was also assessed from soil-sludge mixtures. Carbamazepin (CBZ), ciprofloxacin (CIP), sulfamethoxazole (SMX) and ibuprofen (IBP) were quantified in the raw and treated samples and in the leachates of the assays. CIP and IBP transfer from a non-contaminated soil was also assessed by means of laboratory column experiments. CIP was present at the highest concentration in the 4 sludge samples, the three other compounds were present at concentration around and below 100 μg/kgDM. During all the leaching experiments, only CIP, CBZ and IBP were detected. Experiments carried out on sludge showed that different sludge treatments can lead to different contaminant releases. Indeed, the dried anaerobic digested sludge and the composted sludge led to a better retention of CIP and CBZ as shown during batch and column experiments. Sludge thickening and composting led to a greater retention of IBP as shown in batch experiments. However, the sludge exhibited the same behavior in column experiments concerning IBP. In addition, CIP was neither detected in batch nor in column experiments carried out with soil-sludge mixtures whereas IBP and CBZ were either quantified or detected. In batch experiments IBP was quantified in leachates coming from soil-DS mixture and only detected in leachates of other mixtures. Under the same batch conditions, CBZ was quantified in each leachate with a lower level in the soil-C-DDS. In the column experiments, IBP was quantified in all soil-sludge mixtures as well as CBZ. In addition, column experiments with the non-contaminated soil showed that IBP can migrate in soil. But, a fraction of IBP seemed irreversibly sorbed to the soil. On the contrary, CIP showed no migration in laboratory column experiments. In lysimeter vessel under unsaturated conditions, CIP was not detected in leachates. IBP was quantified in only one leachate coming from the lysimeter filled with the soil-DS mixture and was also detected in some other leachates. CBZ was quantified in all leachates, the lowest concentration was found for the soil-compost mixture. These results confirmed what was already observed during batch and column experiments: CIP is highly retained in soils whereas IBP and CBZ can be mobilized. These results are also in accordance with results obtained on field-experiment where CBZ and IBP were detected at low frequency in the soil-leachates (2). According to the concentrations found in the raw and treated sludge, it seems that ibuprofen is preferentially released compared to carbamazepin and ciprofloxacin. Ciprofloxacin is highly retained in the soil. Ibuprofen release is nevertheless moderate. The releases of ciprofloxacin and carbamazepin are lower is the case of compost supply

Turbulent flows in straight compound open-channel with a transverse embankment on the floodplain

The present study deals with turbulent flows in an asymmetrical compound channel with an embankment set on the floodplain, perpendicularly to the longitudinal direction. The main purpose of this study was to assess how a rapidly varied flow affects interaction between the floodplain flow and the main channel flow. In addition to rapid changes in the water level and velocity across the compound channel that have a great influence on the boundary shear stress distribution, the embankment, through two recirculation zones developing upstream and downstream, is also responsible for strong lateral mass exchange between the main channel and the floodplains (channel sub-sections). The lateral velocity can indeed reach 50% of the longitudinal velocity, which modifies the characteristics of the mixing layer developing between the channel sub-sections. Depth-averaged Reynolds shear stresses five times greater than those measured for reference