Biogeochemical Evaluation of Disposal Options for Arsenic-bearing Wastes Generated During Drinking Water Treatment.

Arsenic contamination of drinking water sources threatens the health of over 50 million people around the world. Sustainable implementation of arsenic removal technologies requires disposal options for produced wastes that limit the release of arsenic. Arsenic contamination is particularly severe in Bangladesh and India, where access to landfills is limited and most wastes are disposed on the ground nearby arsenic removal units. To address concerns with arsenic release under these disposal conditions, this research characterized the stability of arsenic wastes during two alternative disposal strategies. Stabilization of wastes in concrete and mixing wastes with cow dung were tested using arsenic-bearing ferric iron wastes generated during the removal of arsenic from groundwater in West Bengal, India. Under a range of leaching tests, 4.2). Through the characterization of arsenic within the cement matrix by µXRF, arsenic was found to remain primarily associated with iron, consistent with the initial state of the waste. These results show that concrete stabilization can be a viable disposal option to limit arsenic release when low pH can be avoided. Cow dung mixing has been recommended based on the ability of microorganisms to create volatile arsine gases that can be subsequently diluted to safe levels in the atmosphere. However, little is known about the extent of volatilization or the microbial communities responsible for this transformation. Cow dung mesocosms with varying levels of methanogenic inhibition were used to study the impact of methanogenesis on arsenic volatilization under anaerobic conditions. Arsenic volatilization was primarily due to the activity of methanogens, but was not a significant transformation pathway. Less than 0.02% of the total arsenic was released to the gaseous phase. Instead, more arsenic (<4%) was leached into the aqueous phase. These results highlight that cow dung disposal may increase the potential for arsenic release into the aqueous phase and is ineffective in producing volatile arsenic gases. Taken together, these studies characterized the important microbial and geochemical determinants of arsenic fate in non-landfill disposal conditions and provide additional insight on arsenic transformations over a broader range of environmental conditions.PHDEnvironmental EngineeringUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/111432/1/tmclancy_1.pd

Informed consent for whole genome sequencing in mainstream clinics: logistical constraints and possible solutions

Introduction: Over the past several years, clinicians, patients and families in the UK have witnessed a dramatic change in the way genetic testing is performed, with the introduction of whole genome sequencing (WGS) and the NHS Genomic Test Directory in 2018 [1, 2]. In addition to WGS becoming more accessible, this has increased the chances of receiving a genetic diagnosis, established the reproductive implications of germline genetic variants and, in some patients, guided management [3]. The use of a hybrid (clinical and research) consent form may also open up opportunities to join research studies and clinical trials to more patients [4]. A new version of the consent form (Record of discussion form version 4.03) was introduced in 2021 by the NHS Genomic Medicine Service. This allows the implementation of WSG in mainstream clinical practice, whilst providing patients with the opportunity to donate data and a remainder sample to the National Genomics Research Library. The latter is managed by Genomics England Ltd (GEL), a company set up in 2013 and owned by the (English) Department of Health and Social Care. The purpose of this article is to explore ways to better support patients, relatives, and clinicians to consider the complex issues of consent in a busy general clinic, so they are better prepared when the result is available. We shall use the core ethical values that underpin consent to highlight some of the issues and, when possible, suggest practical solutions

The impact of risk-reducing gynaecological surgery in premenopausal women at high risk of endometrial and ovarian cancer due to Lynch syndrome

Women with Lynch syndrome (LS) have a significantly increased lifetime risk of endometrial cancer (40-60 %) and ovarian cancer (7-12 %). Currently there is little evidence to support the efficacy of screening for the early detection of these cancers. Another option is risk-reducing hysterectomy and/or bilateral salpingo-oophorectomy (BSO). Research on the impact of BSO in premenopausal women with a non-LS associated family history cancer has generally shown that women have a high level of satisfaction about their decision to undergo surgery. However, debilitating menopausal symptoms and sexual dysfunction are common post-surgical problems. We used a mixed methods study to explore the impact of risk-reducing gynaecological surgery in women with LS: 24 women were invited to take part; 15 (62.5 %) completed validated questionnaires and 12 (50 %) participated in semi-structured interviews. Our results suggest that risk reducing surgery does not lead to significant psychological distress and the women tend not to think or worry much about developing cancer. However, they tend to be distressed about the physical and somatic symptoms associated with menopause; their social well-being is somewhat affected, but sexual difficulties are minimal. The women reported being overwhelmingly satisfied with their decision to have surgery and with the quality of information they received prior to the operation. However, they felt underprepared for menopausal symptoms and received conflicting advice about whether or not to use HRT. Recommendations from the study include that professionals discuss the menopause, its side effects and HRT in detail prior to surgery.</p