Towards a plant-wide Benchmark Simulation Model with simultaneous nitrogen and phosphorus removal wastewater treatment processes.

It is more than 10 years since the publication of the Benchmark Simulation Model No 1 (BSM1) manual (Copp, 2002). The main objective of BSM1 was creating a platform for benchmarking carbon and nitrogen removal strategies in activated sludge systems. The initial platform evolved into BSM1_LT and BSM2, which allowed the evaluation of monitoring and plant-wide control strategies, respectively. The fact that the BSM platforms have resulted in 300+ publications demonstrates the interest for the tool within the scientific community. In this paper, an extension of the BSM2 is proposed. This extension aims at facilitating simultaneous carbon, nitrogen and phosphorus (P) removal process development and performance evaluation at a plant-wide level. The main motivation of the work is that numerous wastewater treatment plants (WWTPs) pursue biological phosphorus removal as an alternative to chemical P removal based on precipitation using metal salts, such as Fe or Al. This paper identifies and discusses important issues that need to be addressed to upgrade the BSM2 to BSM2-P, for example: 1) new influent wastewater characteristics; 2) new (bio) chemical processes to account for; 3) modifications of the original BSM2 physical plant layout; 4) new/upgraded generic mathematical models; 5) model integration; 6) new control handles/sensors; and 7) new extended evaluation criteria. The paper covers and analyzes all these aspects in detail, identifying the main bottlenecks that need to be addressed and finally discusses the aspects where scientific consensus is required

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Mathematical modelling of greenhouse gas emissions from membrane bioreactors: A comprehensive comparison of two mathematical models

This paper compares two mathematical models (Model I and Model II) to predict greenhouse gases emission from a University Cape Town (UCT) – membrane bioreactor (MBR) plant. Model I considers N2O production only during denitrification. Model II takes into account the ammonia-oxidizing bacteria (AOB) formation pathways for N2O. Both models were calibrated adopting real data. Model comparison was performed in terms of (i) sensitivity analysis (ii) best fit and (iii) model prediction uncertainty. On average 6% of factors of Model I and 9% of Model II resulted to be important. In terms of best fit, Model II had a better capability of reproducing the measured data. The average efficiency related to the N2O model outputs was equal to 0.33 and 0.38 for Model I and Model II, respectively. On average, 73% (Model I) and 86% (Model II) of measured data lay inside the uncertainty bands

Optimizing water and resource recovery facilities (WRRF) for energy generation without compromising effluent quality

The primary separation unit (PSU) splits the organic load on the water and resource recovery facility (WRRF) between the primary sludge (PS) anaerobic digester (AD), where energy can be generated, and the biological nutrient removal (BNR) activated sludge (AS) reactor, where energy is consumed. With a CHONP element mass-balanced plant-wide stoichiometric and kinetic steady-state model, this paper explores quantitatively the impact of four cases of increasing organics removal efficiencies in the PSU on (i) settled wastewater characteristics, (ii) balanced solids retention time (SRT) of the Modified Ludzack-Ettinger (MLE) and University of Cape Town/Johannesburg (UCT/JHB) systems for lowest economical effluent N and P concentrations, (iii) reactor volume, (iv) energy consumption for aeration, pumping and mixing, (v) energy generation by AD of PS and waste activated sludge (WAS), (vi) N&P content of the PS and WAS AD dewatering liquor (DWL) and (vii) final effluent N and P concentrations with and without enhanced biological P removal (EBPR), and looks for an optimum WRRF layout for maximum energy recovery without compromising effluent quality. For the low biogas yield from the WAS AD, decreasing as the SRT of the BNRAS system gets longer and with the added complexity of N&P removal from the digested sludge DWL, makes AD of WAS undesirable unless P recovery is required. Because the wastewater biodegradable particulate organics (BPO) have a low N&P content, it is better to divert more biodegradable particulate organics to the PSAD with enhanced primary separation than digest WAS – the PSAD DWL can be returned to the influent with relatively small impact on final effluent N and P concentration

A comprehensive integrated membrane bioreactor model for greenhouse gas emissions

A comprehensive integrated membrane bioreactor (MBR) model for wastewater treatment is here proposed. The model quantifies the main biological and physical processes. The model describes the biological removal of organic matter, nitrogen and phosphorus including greenhouse gases (carbon dioxide, CO2and nitrous oxide, N2O). The model takes into account the following main innovative aspects jointly: i. Two-step nitrification process; ii. N2O formation due to ammonia-oxidizing bacteria as a product of the hydroxylamine oxidation (NH2OH) and of the nitrite (NO2â) reduction; iii. Soluble microbial product (SMP) formation/degradation due to microbial growth and endogenous respiration; iv. Interlink between SMP and membrane fouling. The model was calibrated by employing a detailed calibration protocol and data from a University Cape Town (UCT) â MBR pilot plant. The key processes contributing to the N2O formation were properly described (total efficiency related to the calibrated model equal to 0.55). Results suggested that the incomplete hydroxylamine oxidation and the heterotrophic denitrification were the predominant processes influencing the N2O production. The model was able to describe the membrane fouling as demonstrated by the high efficiency (0.92) for the resistance state variable. This result confirms the importance in the modelling approach of considering both biological and physical processes jointly

Solids and Hydraulic Retention Time Effect on N2O Emission from Moving-Bed Membrane Bioreactors

Biological nutrient removal was operated at different solids (SRT) and hydraulic retention times (HRT) in order to assess their influence on nitrous oxide (N2O) emission from a hybrid moving-bed membrane bioreactor. The observed results show that the N2O production decreased when the SRT/HRT was decreased. The maximum N2O gaseous concentration was measured in the aerobic reactor at the end of phase I, and it decreased through phases II and III. From mass balances over the reactors of the system, the aerated (aerobic and membrane) reactors were the largest producers of N2O, showing that the greater part of N2O was produced during the nitrification process