Effects of design and operational conditions on performance of constructed wetlands for agricultural pollution control - critical review

Constructed wetlands (CWs) can be considered as an efficient nature-based solution for treatment of agricultural drainage water (ADW) and consequently for the mitigation of the non-point source pollution. Aiming to provide suggestions for the construction and implementation of CWs, this paper proposes and discusses key parameters of CW design and operation. In order to verify the effect of these features, different case studies were reviewed, focusing on the performance of CWs that are treating agricultural drainage water. The findings showed that design and operational factors (e.g., the application of simple hydraulic structures and vegetation establishment) can improve the pollutant removal efficiencies by increasing hydraulic retention time. Hydraulic efficiency of CWs can also be enhanced through certain shape characteristics (e.g., adoption of a high aspect ratio, creation a long and narrow CW shape). The careful consideration of these parameters before and during CW implementation can therefore help these systems to achieve their full potential. However, further study is recommended to assess effects of some parameters (e.g., flow direction and the application of deep zones)

Comparison of simple models for total nitrogen removal from agricultural runoff in FWS wetlands

Free water surface (FWS) wetlands can be used to treat agricultural runoff, thereby reducing diffuse pollution. However, as these are highly dynamic systems, their design is still challenging. Complex models tend to require detailed information for calibration, which can only be obtained when the wetland is constructed. Hence simplified models are widely used for FWS wetlands design. The limitations of these models in full-scale FWS wetlands is that these systems often cope with stochastic events with different input concentrations. In our study, we compared different simple transport and degradation models for total nitrogen under steady- and unsteady-state conditions using information collected from a tracer experiment and data from two precipitation events from a full-scale FWS wetland. The tanks-in-series model proved to be robust for simulating solute transport, and the first-order degradation model with non-zero background concentration performed best for total nitrogen concentrations. However, the optimal background concentration changed from event to event. Thus, to use the model as a design tool, it is advisable to include an upper and lower background concentration to determine a range of wetland performance under different events. Models under steady- and unsteady-state conditions with simulated data showed good performance, demonstrating their potential for wetland design

Removal and fate of pesticides in a farm constructed wetland for agricultural drainage water treatment under Mediterranean conditions (Italy)

A non-waterproofed surface flow constructed wetland (SFCW), treating agricultural drainage water in Northern Italy, was investigated to gain information on the potential ability for effective pesticide abatement. A mixture of insecticide imidacloprid, fungicide dimethomorph, and herbicide glyphosate was applied, by simulating a single rain event, into 470-m-long water course of the SFCW meanders. The pesticides were monitored in the wetland water and soil for about 2 months after treatment. Even though the distribution of pesticides in the wetland was not uniform, for each of them, a mean dissipation of 50% of the applied amount was already observed at ≤7 days. The dissipation trend in the water phase of the wetland fitted (r2 ≥ 0.8166) the first-order model with calculated DT50 of 20.6, 12.0, 5.8, and 36.7 days for imidacloprid, dimethomorph, glyphosate, and the glyphosate metabolite AMPA, respectively. The pesticide behavior was interpreted based on the chemical and physical characteristics of both the substances and the water-soil system. Despite the fast abatement of glyphosate, traces were detected in the water until the end of the trial. The formation of soluble 1:1 complex between glyphosate and calcium, the most representative cation in the wetland water, was highlighted by infrared analyses. Such a soluble complex was supposed to keep traces of the herbicide in solution

Performance of lagoon and constructed wetland systems for tertiary wastewater treatment and potential of reclaimed water in agricultural irrigation

Climate change poses challenges to agricultural water resources, both in terms of quantity and quality. As an adaptation measure, the new European Regulation (EU) 2020/741 establishes different water quality classes for the use of reclaimed water in agricultural irrigation. Italy is also working on the definition of a new regulation on reclaimed water reuse for agricultural irrigation (in substitution of the current one) that will also include the specific requirements imposed by the European one. Nature-based Solutions (NBS) can be a cost-effective and environmentally friendly way to facilitate water reclamation and reuse. The present study reports the outcomes of a long-term monitoring campaign of two NBS (e.g., a constructed wetland (CW) and a lagoon system (LS)) comparing influent and effluent concentrations of different contaminants (e.g., E. coli, BOD5, TSS, TN and TP) with the threshold values imposed by the new regulations. The results showed that in both the case studies, E. coli (about 100 CFU 100 mL-1) and BOD5 (lower than 25 mg L-1) mean effluent concentration need to be further reduced in reclaimed water to be suitable for unlimited reuse. As a negative aspect, in both the monitored NBS, an increase in TSS mean concentration in the effluent was observed, up to 40 mg L-1 in the case of the LS, making reclaimed water unsuitable for agricultural reuse. The CW has proven to be more effective in nitrogen removal (the effluent mean concentration was 3.4 mg L-1), whereas the LS was better at phosphorus removal (with an effluent mean concentration of 0.4 mg L-1). Based on the results, recommendations were made to further improve the performance of both systems in order to have adequate water quality, even for class A. Furthermore, the capacity of reclaimed water to meet crop water and nutrient needs was analyzed, and total nitrogen removal rate coefficients were calculated for the design of future LSs

IgG1 antibodies to acetylcholine receptors in ‘seronegative’ myasthenia gravis†

Only around 80% of patients with generalized myasthenia gravis (MG) have serum antibodies to acetylcholine receptor [AChR; acetylcholine receptor antibody positive myasthenia gravis (AChR-MG)] by the radioimmunoprecipitation assay used worldwide. Antibodies to muscle specific kinase [MuSK; MuSK antibody positive myasthenia gravis (MuSK-MG)] make up a variable proportion of the remaining 20%. The patients with neither AChR nor MuSK antibodies are often called seronegative (seronegative MG, SNMG). There is accumulating evidence that SNMG patients are similar to AChR-MG in clinical features and thymic pathology. We hypothesized that SNMG patients have low-affinity antibodies to AChR that cannot be detected in solution phase assays, but would be detected by binding to the AChRs on the cell membrane, particularly if they were clustered at the high density that is found at the neuromuscular junction. We expressed recombinant AChR subunits with the clustering protein, rapsyn, in human embryonic kidney cells and tested for binding of antibodies by immunofluorescence. To identify AChRs, we tagged either AChR or rapsyn with enhanced green fluorescence protein, and visualized human antibodies with Alexa Fluor-labelled secondary or tertiary antibodies, or by fluorescence-activated cell sorter (FACS). We correlated the results with the thymic pathology where available. We detected AChR antibodies to rapsyn-clustered AChR in 66% (25/38) of sera previously negative for binding to AChR in solution and confirmed the results with FACS. The antibodies were mainly IgG1 subclass and showed ability to activate complement. In addition, there was a correlation between serum binding to clustered AChR and complement deposition on myoid cells in patients’ thymus tissue. A similar approach was used to demonstrate that MuSK antibodies, although mainly IgG4, were partially IgG1 subclass and capable of activating complement when bound to MuSK on the cell surface. These observations throw new light on different forms of MG paving the way for improved diagnosis and management, and the approaches used have applicability to other antibody-mediated conditions

A comprehensive analysis of the epidemiology and clinical characteristics of anti-LRP4 in myasthenia gravis

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Muscle-Specific Receptor Tyrosine Kinase Antibody Positive Myasthenia Gravis Current Status

Muscle-specific tyrosine-kinase-antibody-positive myasthenia gravis (MuSK-MG) has emerged as a distinct entity since 2001. This disease has been reported worldwide, but with varying rates among patients with generalized acetylcholine-receptor-antibody-negative MG. MuSK-MG was detected in approximately 37% of generalized acetylcholine receptor antibody-negative MG. MuSK-MG patients were predominantly female with more prominent facial and bulbar involvement and more frequent crises. Disease onset tended to be earlier. Patients tended to have a relatively poor edrophonium response but showed prominent decrement in the repetitive nerve stimulation test in the facial muscles. Patients were more likely to display poor tolerance of, or a lack of improvement with, anticholinesterase agents. Somewhat better response was observed with steroids and plasma exchange. Most were managed successfully with aggressive immunomodulatory therapies, although a higher proportion of MuSK-MG patients had a refractory course when compared with other forms of generalized MG. I present here an up-to-date overview on MuSK-MG based on our experience at the University of Alabama at Birmingham and the existing literature

Treatment of Myasthenia Gravis Based on Its Immunopathogenesis

The prognosis of myasthenia gravis (MG) has improved dramatically due to advances in critical-care medicine and symptomatic treatments. Its immunopathogenesis is fundamentally a T-cell-dependent autoimmune process resulting from loss of tolerance toward self-antigens in the thymus. Thymectomy is based on this immunological background. For MG patients who are inadequately controlled with sufficient symptomatic treatment or fail to achieve remission after thymectomy, remission is usually achieved through the addition of other immunotherapies. These immunotherapies can be classified into two groups: rapid induction and long-term maintenance. Rapid induction therapy includes intravenous immunoglobulin (IVIg) and plasma exchange (PE). These produce improvement within a few days after initiation, and so are useful for acute exacerbation including myasthenic crisis or in the perioperative period. High-dose prednisone has been more universally preferred for remission induction, but it acts more slowly than IVIg and PE, commonly only after a delay of several weeks. Slow tapering of steroids after a high-dose pulse offers a method of maintaining the state of remission. However, because of significant side effects, other immunosuppressants (ISs) are frequently added as "steroid-sparing agents". The currently available ISs exert their immunosuppressive effects by three mechanisms: 1) blocking the synthesis of DNA and RNA, 2) inhibiting T-cell activation and 3) depleting the B-cell population. In addition, newer drugs including antisense molecule, tumor necrosis factor alpha receptor blocker and complement inhibitors are currently under investigation to confirm their effectiveness. Until now, the treatment of MG has been based primarily on experience rather than gold-standard evidence from randomized controlled trials. It is hoped that well-organized studies and newer experimental trials will lead to improved treatments

Autoantibodies to Agrin in Myasthenia Gravis Patients

To determine if patients with myasthenia gravis (MG) have antibodies to agrin, a proteoglycan released by motor neurons and is critical for neuromuscular junction (NMJ) formation, we collected serum samples from 93 patients with MG with known status of antibodies to acetylcholine receptor (AChR), muscle specific kinase (MuSK) and lipoprotein-related 4 (LRP4) and samples from control subjects (healthy individuals and individuals with other diseases). Sera were assayed for antibodies to agrin. We found antibodies to agrin in 7 serum samples of MG patients. None of the 25 healthy controls and none of the 55 control neurological patients had agrin antibodies. Two of the four triple negative MG patients (i.e., no detectable AChR, MuSK or LRP4 antibodies, AChR-/MuSK-/LRP4-) had antibodies against agrin. In addition, agrin antibodies were detected in 5 out of 83 AChR+/MuSK-/LRP4- patients but were not found in the 6 patients with MuSK antibodies (AChR-/MuSK+/LRP4-). Sera from MG patients with agrin antibodies were able to recognize recombinant agrin in conditioned media and in transfected HEK293 cells. These sera also inhibited the agrin-induced MuSK phosphorylation and AChR clustering in muscle cells. Together, these observations indicate that agrin is another autoantigen in patients with MG and agrin autoantibodies may be pathogenic through inhibition of agrin/LRP4/MuSK signaling at the NMJ

Autoimmune Neuromuscular Disorders in Childhood

Autoimmune neuromuscular disorders in childhood include Guillain-Barré syndrome and its variants, chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), juvenile myasthenia gravis (JMG), and juvenile dermatomyositis (JDM), along with other disorders rarely seen in childhood. In general, these diseases have not been studied as extensively as they have been in adults. Thus, treatment protocols for these diseases in pediatrics are often based on adult practice, but despite the similarities in disease processes, the most widely used treatments have different effects in children. For example, some of the side effects of chronic steroid use, including linear growth deceleration, bone demineralization, and chronic weight issues, are more consequential in children than in adults. Although steroids remain a cornerstone of therapy in JDM and are useful in many cases of CIDP and JMG, other immunomodulatory therapies with similar efficacy may be used more frequently in some children to avoid these long-term sequelae. Steroids are less expensive than most other therapies, but chronic steroid therapy in childhood may lead to significant and costly medical complications. Another example is plasma exchange. This treatment modality presents challenges in pediatrics, as younger children require central venous access for this therapy. However, in older children and adolescents, plasma exchange is often feasible via peripheral venous access, making this treatment more accessible than might be expected in this age group. Intravenous immunoglobulin also is beneficial in several of these disorders, but its high cost may present barriers to its use in the future. Newer steroid-sparing immunomodulatory agents, such as azathioprine, tacrolimus, mycophenolate mofetil, and rituximab, have not been studied extensively in children. They show promising results from case reports and retrospective cohort studies, but there is a need for comparative studies looking at their relative efficacy, tolerability, and long-term adverse effects (including secondary malignancy) in children