Batch and continuous removal of heavy metals from industrial effluents using microbial consortia

Bio-removal of heavy metals, using microbial biomass, increasingly attracting scientific attention due to their significant role in purification of different types of wastewaters making it reusable. Heavy metals were reported to have a significant hazardous effect on human health, and while the conventional methods of removal were found to be insufficient; microbial biosorption was found to be the most suitable alternative. In this work, an immobilized microbial consortium was generated using Statistical Design of Experiment (DOE) as a robust method to screen the efficiency of the microbial isolates in heavy metal removal process. This is the first report of applying Statistical DOE to screen the efficacy of microbial isolates to remove heavy metals instead of screening normal variables. A mixture of bacterial biomass and fungal spores was used both in batch and continuous modes to remove Chromium and Iron ions from industrial effluents. Bakery yeast was applied as a positive control, and all the obtained biosorbent isolates showed more significant efficiency in heavy metal removal. In batch mode, the immobilized biomass was enclosed in a hanged tea bag-like cellulose membrane to facilitate the separation of the biosorbent from the treated solutions, which is one of the main challenges in applying microbial biosorption at large scale. The continuous flow removal was performed using fixed bed mini-bioreactor, and the process was optimized in terms of pH (6) and flow rates (1 ml/min) using Response Surface Methodology. The most potential biosorbent microbes were identified and characterized. The generated microbial consortia and process succeeded in the total removal of Chromium ions and more than half of Iron ions both from standard solutions and industrial effluents

Blunt traumatic scapular fractures are associated with great vessel injuries in children.

BACKGROUND:Patients with stable blunt great vessel injury (GVI) can have poor outcomes if the injury is not identified early. With current pediatric trauma radiation reduction efforts, these injuries may be missed. As a known association between scapular fracture and GVI exists in adult blunt trauma patients, we examined whether that same association existed in pediatric blunt trauma patients. METHODS:Bluntly injured patients younger than 18 years old were identified from 2012 to 2014 in the National Trauma Data Bank. Great vessel injury included all major thoracic vessels and carotid/jugular. Demographics of patients with and without scapular fracture were compared with descriptive statistics. The χ test was used to examine this association using SAS Version 9.4 (SAS Institute, Inc, Cary, NC). RESULTS:We found a significant association between pediatric scapular fracture and GVI. Of 291,632 children identified, 1,960 had scapular fractures. Children with scapular fracture were 10 times more likely to have GVI (1.2%) compared to those without (0.12%, p \u3c 0.0001). Most common GVI seen were carotid artery, thoracic aorta, and brachiocephalic or subclavian artery or vein. Children with both scapular fracture and GVI were most commonly injured by motor vehicles (57% collision, 26% struck). CONCLUSIONS:Injured children with blunt scapular fracture have a 10-fold greater risk of having a GVI when compared to children without scapular fracture. Presence of blunt traumatic scapular fracture should have appropriate index of suspicion for a significant GVI in pediatric trauma patients. LEVEL OF EVIDENCE:Epidemiologic and prognostic study, level III; Therapeutic, level IV

Safe phlebotomy reduction in stable pediatric liver and spleen injuries

© 2019 Elsevier Inc. Purpose: Pediatric blunt solid organ injury management based on hemodynamic monitoring rather than grade may safely reduce resource expenditure and improve outcomes. Previously we have reported a retrospectively validated management algorithm for pediatric liver and spleen injuries which monitors hemodynamics without use of routine phlebotomy. We hypothesize that stable blunt pediatric isolated splenic/liver injuries can be managed safely using a protocol reliant on vital signs and not repeat hemoglobin levels. Methods: A prospective multi-institutional study was performed at three pediatric trauma centers. All pediatric patients from 07/2016–12/2017 diagnosed with liver or splenic injuries were identified. If appropriate for the protocol, only a baseline hemoglobin was obtained unless hemodynamic instability as defined in an age-appropriate fashion was determined by treating physician discretion. Descriptive statistics were conducted. Results: One hundred four patients were identified of which 38 were excluded from the protocol. There was a significant difference in abnormal shock index, pediatric age-adjusted (SIPA) values, hematocrit, and percentage of patients with hemoglobin less than 10 between the excluded and included patients. Of the 66 patients managed on the protocol, four patients had to be removed, two each on day one and day two. Of those four patients, only one required intervention. There were no mortalities. Conclusion: A phlebotomy limiting protocol may be a safe option for stable pediatric splenic and liver injuries cared for in a pediatric trauma center with the resources for rapid intervention should the need arise. The differences in groups highlight the importance of utilizing this protocol in the correct patient population. Reduced phlebotomy offers the potential for reduced resource expenditure without any evidence of increased morbidity or mortality. Level of Evidence: Level IV