A Plant Efficiency Survey and Experimental Plant Results Obtained at The Sioux Falls Sewage Treatment Plant, Sioux Falls, S.D.

Sioux Falls, the largest city in South Dakota is situated on a bend in the Sioux River. The flow of this river ranges from a recorded minimum flow or 9 to a maximum flood flow of 500 cu. ft. per second. As originally designed and built the sewage system emptied into the river at three main outlets. In 1910 the City had a population of approximately 14000 people, and during the next decade its population practically doubled. During this period of growth there was added to the industries of the City a large meat packing plant which has been steadily growing and has exercised a marked influence upon the liquid wastes of the City, until at the present time when the waste from this source alone is approximately 50 percent in volume of the total amount of waste produced by the rest of the City

Transfusion-related acute lung injury: incidence and risk factors.

Transfusion-related acute lung injury (TRALI) is the leading cause of transfusion-related mortality. To determine TRALI incidence by prospective, active surveillance and to identify risk factors by a case-control study, 2 academic medical centers enrolled 89 cases and 164 transfused controls. Recipient risk factors identified by multivariate analysis were higher IL-8 levels, liver surgery, chronic alcohol abuse, shock, higher peak airway pressure while being mechanically ventilated, current smoking, and positive fluid balance. Transfusion risk factors were receipt of plasma or whole blood from female donors (odds ratio = 4.5, 95% confidence interval [CI], 1.85-11.2, P = .001), volume of HLA class II antibody with normalized background ratio more than 27.5 (OR = 1.92/100 mL, 95% CI, 1.08-3.4, P = .03), and volume of anti-human neutrophil antigen positive by granulocyte immunofluoresence test (OR = 1.71/100 mL, 95% CI, 1.18-2.5, P = .004). Little or no risk was associated with older red blood cell units, noncognate or weak cognate class II antibody, or class I antibody. Reduced transfusion of plasma from female donors was concurrent with reduced TRALI incidence: 2.57 (95% CI, 1.72-3.86) in 2006 versus 0.81 (95% CI, 0.44-1.49) in 2009 per 10 000 transfused units (P = .002). The identified risk factors provide potential targets for reducing residual TRALI