Management of hydrogen sulphide generation at a Kraft mill effluent plant

Communities surrounding an integrated Kraft mill noticed odours from the mill’s effluent treatment plant. A project was therefore commissioned by the mill to proactively manage the odours from both the pulp-processing operations and the effluent treatment plant. This project formed part of a co-ordinated study that was implemented by the mill to limit emissions of the total reduced sulphur (TRS) components from the pulp mill operations. It was found that sulphate-reducing bacteria (SRB) converted the sulphates present in the effluent to hydrogen sulphide (H2S) by dissimilatory respiration. The combined use of a nitrate-releasing biomodifier (Bulab® 9518) and an anthraquinone sulphate-reduction inhibitor (Busperse® 2432) was effective in reducing both SRB activity and H2S levels. The average aqueous H2S levels (40 mg/ℓ) were reduced to between 92% and 99%.Keywords: biomodifiers, hydrogen sulphide, Kraft mill effluent plant, sulphate-reducing bacteria (SRB), anthraquinone, sulphate reduction inhibition, sodium nitrat

Evaluation of community-based growth monitoring in rural districts of the Eastern Cape and KwaZulu-Natal provinces of South Africa

Background: The Health Systems Trust implemented a community-based growth monitoring intervention project that fits into the Integrated Nutrition Programme focus areas and commissioned an evaluation of this project. Objective: To assess project volunteers’ knowledge on infant and young child nutrition and growth monitoring, and evaluate communitybased growth monitoring activities.Design: Five randomly selected growth monitoring sites per sub-district were evaluated. Project volunteers (n = 45) and caregivers (n = 186)attending the growth monitoring sites were interviewed by means of a questionnaire. Growth monitoring and nutrition education activities were observed at the growth monitoring sites. Setting: Two rural districts in KwaZulu-Natal (Umkhanyakude: sub-district Jozini; and Zululand: sub-district Phongola), and one rural district in the Eastern Cape (OR Tambo), South Africa. Results: Project volunteers were mostly women (87%), 38 ± 10 years old, and 27% had matric/Grade 12. There was a high turnover of project volunteers. Their nutrition knowledge varied. Forty-six per cent of the project volunteers and 39% of the caregivers could correctly identify the growth curve of a healthy growing child. Seven of the 13 sites that were visited were at a crèche. There was a referral system between the growth monitoring site and the local clinic, and links with the Department of Agriculture and, to a lesser extent, the Department of Social Welfare. Weighing methods were inconsistent and the steps of growth monitoring were not followed through. Nutrition education to the caregivers was lacking at several of the sites. Conclusion: The study highlighted both strengths and limitations of the project. Areas that need improvement include the selection, training and supervision of project volunteers performing community-based growth monitoring.

Responses of marine organisms to climate change across oceans

Climate change is driving changes in the physical and chemical properties of the ocean that have consequences for marine ecosystems. Here, we review evidence for the responses of marine life to recent climate change across ocean regions, from tropical seas to polar oceans. We consider observed changes in calcification rates, demography, abundance, distribution, and phenology of marine species. We draw on a database of observed climate change impacts on marine species, supplemented with evidence in the Fifth Assessment Report of the Intergovernmental Panel on Climate Change. We discuss factors that limit or facilitate species\u27 responses, such as fishing pressure, the availability of prey, habitat, light and other resources, and dispersal by ocean currents. We find that general trends in species\u27 responses are consistent with expectations from climate change, including shifts in distribution to higher latitudes and to deeper locations, advances in spring phenology, declines in calcification, and increases in the abundance of warm-water species. The volume and type of evidence associated with species responses to climate change is variable across ocean regions and taxonomic groups, with predominance of evidence derived from the heavily-studied north Atlantic Ocean. Most investigations of the impact of climate change being associated with the impacts of changing temperature, with few observations of effects of changing oxygen, wave climate, precipitation (coastal waters), or ocean acidification. Observations of species responses that have been linked to anthropogenic climate change are widespread, but are still lacking for some taxonomic groups (e.g., phytoplankton, benthic invertebrates, marine mammals)

Responses of Marine Organisms to Climate Change across Oceans

Climate change is driving changes in the physical and chemical properties of the ocean that have consequences for marine ecosystems. Here, we review evidence for the responses of marine life to recent climate change across ocean regions, from tropical seas to polar oceans. We consider observed changes in calcification rates, demography, abundance, distribution, and phenology of marine species. We draw on a database of observed climate change impacts on marine species, supplemented with evidence in the Fifth Assessment Report of the Intergovernmental Panel on Climate Change. We discuss factors that limit or facilitate species’ responses, such as fishing pressure, the availability of prey, habitat, light and other resources, and dispersal by ocean currents. We find that general trends in species’ responses are consistent with expectations from climate change, including shifts in distribution to higher latitudes and to deeper locations, advances in spring phenology, declines in calcification, and increases in the abundance of warm-water species. The volume and type of evidence associated with species responses to climate change is variable across ocean regions and taxonomic groups, with predominance of evidence derived from the heavily-studied north Atlantic Ocean. Most investigations of the impact of climate change being associated with the impacts of changing temperature, with few observations of effects of changing oxygen, wave climate, precipitation (coastal waters), or ocean acidification. Observations of species responses that have been linked to anthropogenic climate change are widespread, but are still lacking for some taxonomic groups (e.g., phytoplankton, benthic invertebrates, marine mammals)

Strengthening confidence in climate change impact science

Aim: To assess confidence in conclusions about climate-driven biological change through time, and identify approaches for strengthening confidence scientific conclusions about ecological impacts of climate change. Location: Global. Methods: We outlined a framework for strengthening confidence in inferences drawn from biological climate impact studies through the systematic integration of prior expectations, long-term data and quantitative statistical procedures. We then developed a numerical confidence index (Cindex) and used it to evaluate current practices in 208 studies of marine climate impacts comprising 1735 biological time series. Results: Confidence scores for inferred climate impacts varied widely from 1 to 16 (very low to high confidence). Approximately 35% of analyses were not associated with clearly stated prior expectations and 65% of analyses did not test putative non-climate drivers of biological change. Among the highest-scoring studies, 91% tested prior expectations, 86% formulated expectations for alternative drivers but only 63% statistically tested them. Higher confidence scores observed in studies that did not detect a change or tracked multiple species suggest publication bias favouring impact studies that are consistent with climate change. The number of time series showing climate impacts was a poor predictor of average confidence scores for a given group, reinforcing that vote-counting methodology is not appropriate for determining overall confidence in inferences. Main conclusions: Climate impacts research is expected to attribute biological change to climate change with measurable confidence. Studies with long-term, high-resolution data, appropriate statistics and tests of alternative drivers earn higher Cindex scores, suggesting these should be given greater weight in impact assessments. Together with our proposed framework, the results of our Cindex analysis indicate how the science of detecting and attributing biological impacts to climate change can be strengthened through the use of evidence-based prior expectations and thorough statistical analyses, even when data are limited, maximizing the impact of the diverse and growing climate change ecology literature

Management of intracranial tuberculous mass lesions: how long should we treat for? [version 3; peer review: 3 approved]

Tuberculous intracranial mass lesions are common in settings with high tuberculosis (TB) incidence and HIV prevalence. The diagnosis of such lesions, which include tuberculoma and tuberculous abscesses, is often presumptive and based on radiological features, supportive evidence of TB elsewhere and response to TB treatment. However, the treatment response is unpredictable, with lesions frequently enlarging paradoxically or persisting for many years despite appropriate TB treatment and corticosteroid therapy. Most international guidelines recommend a 9-12 month course of TB treatment for central nervous system TB when the infecting Mycobacterium tuberculosis (M.tb) strain is sensitive to first-line drugs. However, there is variation in opinion and practice with respect to the duration of TB treatment in patients with tuberculomas or tuberculous abscesses. A major reason for this is the lack of prospective clinical trial evidence. Some experts suggest continuing treatment until radiological resolution of enhancing lesions has been achieved, but this may unnecessarily expose patients to prolonged periods of potentially toxic drugs. It is currently unknown whether persistent radiological enhancement of intracranial tuberculomas after 9-12 months of treatment represents active disease, inflammatory response in a sterilized lesion or merely revascularization. The consequences of stopping TB treatment prior to resolution of lesional enhancement have rarely been explored. These important issues were discussed at the 3rd International Tuberculous Meningitis Consortium meeting. Most clinicians were of the opinion that continued enhancement does not necessarily represent treatment failure and that prolonged TB therapy was not warranted in patients presumably infected with M.tb strains susceptible to first-line drugs. In this manuscript we highlight current medical treatment practices, benefits and disadvantages of different TB treatment durations and the need for evidence-based guidelines regarding the treatment duration of patients with intracranial tuberculous mass lesions

Australian clinical practice guidelines for the diagnosis and management of Barrett's esophagus and early esophageal adenocarcinoma

Author version made available following 12 month embargo from date of publication according to publisher copyright policy.Barrett's esophagus (BE), a common condition, is the only known precursor to esophageal adenocarcinoma (EAC). There is uncertainty about the best way to manage BE as most people with BE never develop EAC and most patients diagnosed with EAC have no preceding diagnosis of BE. Moreover, there have been recent advances in knowledge and practice about the management of BE and early EAC. To aid clinical decision making in this rapidly moving field, Cancer Council Australia convened an expert working party to identify pertinent clinical questions. The questions covered a wide range of topics including endoscopic and histological definitions of BE and early EAC; prevalence, incidence, natural history, and risk factors for BE; and methods for managing BE and early EAC. The latter considered modification of lifestyle factors; screening and surveillance strategies; and medical, endoscopic, and surgical interventions. To answer each question, the working party systematically reviewed the literature and developed a set of recommendations through consensus. Evidence underpinning each recommendation was rated according to quality and applicability

Tuberculous meningitis: new tools and new approaches required [version 1; peer review: not peer reviewed]

Tuberculous meningitis is the most severe form of tuberculosis and causes widespread mortality and morbidity. Understanding of the epidemiology and pathogenesis is incomplete, and the optimal diagnosis and treatment are poorly defined. To generate research collaboration and coordination, as well as to promote sharing of ideas and advocacy efforts, the International Tuberculous Meningitis Research Consortium was formed in 2009. During the most recent meeting of this group in Lucknow, India, in March 2019, the Consortium decided to bring together key articles on tuberculous meningitis in one supplement. The supplement covers recent scientific updates, expert perspectives on specific clinical challenges, consensus statements on how to conduct research, and a set of priorities for future investigation