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Aquaduin started reusing wastewater effluent for infiltration, Cf.managed aquifer recharge (MAR), in its dune water catchment St-André in 2002. The treatment train at the Water Production Centre Torreele is based on multiple barrier approach with submerged ultrafiltration prior to reverse osmosis (RO). The project not only resulted in enhanced ecological values of the dunes but during the recent longer periods of drought, the combination of reuse/MAR proved to be a robust and safe way to ensure drinking-water production and thus is a potential solution to mitigate the impact of climate change [1]. Concentrate disposal is an issue when using RO. However, as Aquaduin operates in a coastal area, disposal could be managed; the concentrate was discharged in a canal that drained to the sea. To mitigate the impact of this discharge, treatment of RO concentrate using willows has been tested since 2007. This research resulted in the full-scale implementation of a willow field or marsh, that is based on the concept of a horizontally constructed wetland combined with short rotation coppice using willows (Salix). The construction started in 2021 and early 2022 the willow marsh became operational. In 2022 a total volume of 538.446 m3was treated by the willow marsh, 85% of the total volume of RO concentrate produced. This paper will present the preliminary research, construction and initial results of the treatment.

The Observable Movement Quality (OMQ) Scale measures generic movement quality. Each item of the OMQ Scale focuses on a different element; together, the 15 items assess the whole construct of movement quality.

During coronary artery bypass graft (CABG) surgery, ischaemia and reperfusion damage myocardial tissue, and increased postoperative plasma troponin concentration is associated with a worse outcome. We investigated whether metformin pretreatment limits cardiac injury, assessed by troponin concentrations, during CABG surgery in patients without diabetes.

To determine the value of fibroblast growth factor 21 (FGF21), a recently discovered biomarker for mitochondrial disease, in predicting clinical disease severity and disease progression in adult carriers of the m.3243A>G mutation.

OBJECTIVE: To compare the effectiveness of a third tumor necrosis factor-α (TNF-α)-blocking agent with rituximab after failure of 2 TNF-blocking agents in patients with rheumatoid arthritis (RA) in daily clinical practice. METHODS: Patients receiving a third TNF-blocking agent or rituximab after failure of 2 TNF-blocking agents were selected from a Dutch biologic registry. The primary outcome was the results from the Disease Activity Score of 28 joints (DAS28) over the first 12 months after start of the third biologic using mixed-model analyses. Secondary outcomes included the course of the Health Assessment Questionnaire (HAQ) and the separate components of the DAS28 over the first 12 months and the change from baseline in DAS28 and HAQ at 3 and 6 months. RESULTS: The overall course of the DAS28 over the first 12 months was significantly better for rituximab (p = 0.0044), as also observed for the HAQ, although the latter results were not statistically significant (p = 0.0537). The erythrocyte sedimentation rates, C-reactive protein, and swollen joint counts showed a better course for rituximab (p = 0.0008, p = 0.0287, p = 0.0547, respectively), but not the tender joint counts or visual analog scale for general health. DAS28 decreased significantly in both groups at 3 and 6 months (p ≤ 0.024), but the change in HAQ was significant for rituximab only at 3 months (p = 0.009). CONCLUSION: During the first 12 months of therapy, a larger improvement in disease activity and a trend toward a larger decrease in functional disability was observed in patients receiving rituximab. Switching to a biologic with another mechanism of action might be more effective after failure of 2 TNF-blocking agents in RA.

Traumatic spinal cord injury is a serious disorder in which early prediction of ambulation is important to counsel patients and to plan rehabilitation. We developed a reliable, validated prediction rule to assess a patient's chances of walking independently after such injury.

This article focuses on answering the following research question: How efficient are European rail transport companies compared with each other? When the focus in benchmarking is placed on “employee productivity performance,” Railcargo Austria and VR Cargo perform relatively well when compared with their competitors. RENFE and SNCF Fret are the worst performers. If the focus is on “sales productivity performance,” the best performers are Green Cargo, SBB, and VR Cargo. The worst performers are Trenitalia, CP, and SNCF Fret. The best in “railcar productivity performance” are Green Cargo, VR Cargo, and Railcargo Austria. The worst performers are SNCF Fret, Trenitalia, and RENFE. Analysis of effects, using a mixed model approach, showed that there are large differences among the companies. The overall trends were mostly not significant, but the distributions of the signs of the trends (+ or -) are quite plausible and significant. Two main conclusions arise: First, the inputs (employees, locomotives, and railcars) have been reduced over the years. Second, the partial productivity performances (tons/railcar, tonkms/railcar, sales/railcar, employees/railcar, sales/ton, sales/employee, sales/tonkm, and tonkms/employee) have improved over the years. Overall, less freight is transported more efficiently.

Possible chemical mechanisms for catalyzing O₂ evolution from water in natural photosynthesis are summarized, based on the atomic and electronic structures of the inorganic core as revealed by spectroscopic and X-ray diffraction experiments and insights gained from inorganic complexes that achieve O–O bond formation. The thermodynamic and kinetic requirements for this multi-step reaction are reexamined, including the coupling of the individual electron-proton steps (PCET) and the O–O bond formation step. The four oxygen atoms at the corners of the proposed hetero-cubical Mn₃CaO₄ core (3 μ₃-oxos and one μ₄-oxo) can be distinguished by the number and types of chemical bonds to Ca2+ and Mn (geometries and orbital hybridization). Two of these μ₃-oxos, postulated as substrates, are located at unique sites indicative of sp2 + pπ hybridized orbitals. Both proposed substrate oxos are strongly hydrogen-bonded to different protein carboxylate residues, which are postulated as the initial proton transfer sites. Ca2+ is weakly bonded to these substrate oxos via non-directional ionic bonds that are postulated to provide stereochemical flexibility for the homolytic formation of the O–O bond. A previously postulated heterolytic pathway involving an electrophilic oxo and nucleophilic hydroxide species is reevaluated. We extend this mechanism by postulating roles for (bi)carbonate either in proton transfer or delivering the nucleophile for O₂ formation.

Possible chemical mechanisms for catalyzing O2evolution from water in natural photosynthesis are summarized, based on the atomic and electronic structures of the inorganic core as revealed by spectroscopic and X-ray diffraction experiments and insights gained from inorganic complexes that achieve O–O bond formation. The thermodynamic and kinetic requirements for this multi-step reaction are reexamined, including the coupling of the individual electron-proton steps PCET and the O–O bond formation step. The four oxygen atoms at the corners of the proposed hetero-cubical Mn3CaO4core 3 μ3-oxos and one μ4-oxo can be distinguished by the number and types of chemical bonds to Ca2and Mn geometries and orbital hybridization. Two of these μ3-oxos, postulated as substrates, are located at unique sites indicative of sp2 pπ hybridized orbitals. Both proposed substrate oxos are strongly hydrogen-bonded to different protein carboxylate residues, which are postulated as the initial proton transfer sites. Ca2is weakly bonded to these substrate oxos vianon-directional ionic bonds that are postulated to provide stereochemical flexibility for the homolytic formation of the O–O bond. A previously postulated heterolytic pathway involving an electrophilic oxo and nucleophilic hydroxide species is reevaluated. We extend this mechanism by postulating roles for bicarbonate either in proton transfer or delivering the nucleophile for O2formation.