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In the present study, the effectiveness of two surfactants (Polysorbate 80 - Tween 80 and Sodium Dodecyl Benzensulphonate - SDBS) was investigated for the remediation of a hydrocarbon-contaminated soil. Moreover, it was elucidated the impact of surfactants on soil phosphorus (P) availability and phytotoxic effect on the growth of Vicia Faba L. An experimental laboratory-scale apparatus (bench and pilot scale) was set up for the simulation of a soil flushing intervention. Different surfactant concentrations and flushing flow rates were investigated. Hydrocarbon extraction efficiency was evaluated after treatment and phytotoxicity tests were performed by means of germination index (GI). The treated soil with the pilot scale apparatus was then used for Vicia Faba (faba beans) cultivation in pots. The growth of Vicia Faba plants was monitored and, at the end of the growth period, the plants were uprooted and subjected to biometric and chemical analyses. Results highlighted that the use of surfactants significantly increased the efficiency of hydrocarbons extraction compared to flushing test with water (19.6 %, 53.9 %, and 65.6 % for water, 0.1 % by weight of Tween 80 and SDBS, respectively, at pilot scale). Referring to Vicia Faba L., the plants grown in the blank control and in the soil treated with Tween 80 reached the same average height thus suggesting that this surfactant does not inhibit plant growth. In contrast, the lowest plant growth occurred in the soils treated with SDBS; this suggests a negative impact on plant growth. Due to the reduced plant growth, total P uptake was the lowest in plants grown in SDBS-treated soils, although such soils experienced a 20 % increase of soil available P. This increase could be ascribed to P supplied by the surfactant or high P availability as a consequence of soil pH decrease., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

This study thoroughly investigates a Membrane BioReactor - Integrated Fixed Film Activated Sludge - Intermittent Aeration (MBR-IFAS-IA) pilot plant operated from a biokinetic point of view. Specifically, respirometric techniques were applied on suspended and attached biomass to evaluate kinetic and stoichiometric parameters. The main aim was to investigate how the simultaneous presence of biofilm and activated sludge could affect the kinetic behaviour and the role of the Sludge Retention Time (SRT) variation in the kinetic behaviour of the system. The results highlighted a mutual interaction between suspended biomass and biofilm in the IFAS-MBR configuration. In Period I both the heterotrophic yield and growth rate of suspended biomass were higher compared to that of biofilm, thus highlighting higher affinity with organic matter; in contrast, the biofilm showed high affinity with nitrification, with increased nitrification rates with decreasing SRT and sustaining nitrification in the activated sludge due to "seeding" effect. Therefore, the suggestion is that it is possible to operate IFAS-MBR systems at low SRT without hampering the nitrification ability due to the growth of nitrifiers in the biofilm. Respirometry has been confirmed to be an effective tool for evaluating biomass kinetic and stoichiometric parameters. The results of this study highlighted the effect of IFAS configuration and can help apply mathematical models in the design phase and monitor biomass viability during plant operations., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: In patients with renal cell carcinoma (RCC) the role of the extent of tumor thrombus into the inferior vena cava (IVC) has never been addressed from a surgical and oncologic standpoint. This study aims to evaluate differences between level III-IV versus level I-II patients concerning peri- and postoperative morbidity, additional treatments and long-term oncological outcomes., Patients and Methods: Overall, 40 patients with RCC underwent radical nephrectomy (RN) with IVC thrombectomy at a single European institution between 2010 and 2023. Complications were reported according to the European Union (EAU) guidelines recommendations. Spider chart served as graphical depiction of surgical and oncologic outcomes., Results: Overall, 22 (55%) and 18 (45%) patients harbored level III-IV and I-II IVC thrombus. Level III-IV patients experienced significantly higher rates of intraoperative transfusions (68 vs 39%), but not significantly higher rates of intraoperative complications (32% vs 28%). Level III-IV patients had significantly higher rates of postoperative transfusions (82% vs 33%) and Clavien Dindo ≥3 complications (41% vs 15%). In level III-IV versus level I-II patients, median follow up was 482 and 1070 days, the rate of distant recurrence was 59% and 50%, the rate of systemic progression was 27% and 13%, and the rate of additional treatment/s was 64% and 61%, respectively (all p values > 0.05). Overall survival was 36% in level III-IV patients and 67% in level I-II (p = 0.001)., Conclusions: Our findings suggest that patients with level III-IV RCC who are candidates for IVC thrombectomy should be counselled about the higher likelihood of postoperative severe adverse events and worse overall survival relative to level I-II counterparts., (© 2024. Society of Surgical Oncology.)

A pilot plant with a conventional activated sludge (CAS) system with intermittent aeration (IA) was monitored. The system was configured as an Oxic Settling Anaerobic (OSA) process with the insertion of one anaerobic side-stream reactor (ASSR). The pilot plant was fed with real wastewater and an intensive experimental campaign was carried out including sludge minimization, nitrogen and carbon removal, GHG emissions and biokinetic parameters. The experimental campaign was divided into periods: Period I, II, and III. In Periods I and II, the ASSR reactor was operated with two different hydraulic retention times (HRT), 4 and 6 h, with an aeration/non-aeration ratio of 30 min/30 min. In Period III, the HRT in the anaerobic reactor was the same as in Period II. In contrast, the biological reactor's aerated/non-aerated ratio was increased to 40 min/20 min. Results demonstrated that combining IA and OSA might be effective in the reduction of excess sludge production. The yield coefficient decreased from Period I to Period II (Y obs from 0.41 to 0.25 gTSS gCOD -1 , in Period I and II, respectively). Nevertheless, the HRT increase in the ASSR compromised the system performance regarding nitrification and greenhouse gas emissions and worsened the sludge settleability. However, the increase in the aeration duration was beneficial in restoring the system's nitrification and denitrification ability and carbon footprint. The lowest carbon footprint was obtained during Period III (6.8 kgCO 2 /d)., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

The present study used bench scale columns filled with biochar for phosphorous (P) recovery from real ultrafiltered wastewater. No studies are available about the potentiality of biochar using ultrafiltered real wastewater. Therefore, this study aimed to assess phosphate (PO 4 3- ) recovery by biochar-packed columns employing real treated wastewater from an ultrafiltration process. Three flow rates were tested, specifically 0.7, 1.7 and 2.3 L h -1 , to gain insights into the optimal working conditions. Results revealed that the maximum amount of PO 4 3- recovery (namely, 3.43 mg g -1 biochar) can be achieved after 7 h by employing the highest tested flow rate. Furthermore, the phosphorus exchange capacity (PEC) was inversely correlated with the feeding flow rate (FFR), with PEC values equal to 35, 25 and 9 % for FFR of 0.67, 1.7 and 2.3 L h -1 , respectively. The pseudo-first order model best approximated the adsorption kinetics, thus suggesting that the adsorption of phosphate by biochar depends on its concentrations (i.e. physiosorption mechanism)., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 Published by Elsevier Ltd.)

This paper presents a study on reducing sewage sludge by an oxic-settling-anaerobic (OSA) pilot plant compared to the conventional activated sludge (CAS) process in view of resource recovery and moving towards plant carbon neutrality. The OSA plant was supplied with real wastewater and the anaerobic reactor was operated under two hydraulic retention times (HRT) (4 and 6 h). Greenhouse gas (GHG) emissions were monitored for the first time to determine the OSA process's production mechanism. The results highlighted that under the lowest HRT (4 h), the removal efficiencies of COD and PO 4 - P, increased from 75 to 89% and from 39 to 50% for CAS and OSA configurations, respectively. The observed yield coefficient was reduced from 0.58 gTSS gCOD -1 (CAS period) to 0.31 gTSS gCOD -1 (OSA period). A remarkable deterioration of nitrification efficiency under OSA configuration was obtained from 79% (CAS) to 27% (OSA with HRT of 6 h). The huge deterioration of nitrification significantly affected the GHG emissions, with the N 2 O-N fraction increasing from 1% (CAS) to 1.55% (OSA 4 h HRT) and 3.54% (OSA 6 h HRT) of the overall effluent nitrogen, thus suggesting a relevant environmental implication due to the high global warming potential (GWP) of N 2 O., (© 2024. The Author(s).)

The paper reports the results of an experimental study aimed at comparing two configurations of a full-scale wastewater treatment plant (WWTP): conventional activated sludge (CAS) and oxic-settling-anaerobic process (OSA) with intermittent aeration (IA). A comprehensive monitoring campaign was carried out to assess multiple parameters for comparing the two configurations: carbon and nutrient removal, greenhouse gas emissions, respirometric analysis, and sludge production. A holistic approach has been adopted in the study with the novelty of including the carbon footprint (CF) contribution (as direct, indirect and derivative emissions) in comparing the two configurations. Results showed that the OSA-IA configuration performed better in total chemical oxygen demand (TCOD) and ortho-phosphate (PO 4 -P) removal. CAS performed better for Total Suspended Solids (TSS) removal showing a worsening of settling properties for OSA-IA. The heterotrophic yield coefficient and maximum growth rate decreased, suggesting a shift to sludge reduction metabolism in the OSA-IA configuration. Autotrophic biomass showed a reduced yield coefficient and maximum growth yield due to the negative effects of the sludge holding tank in the OSA-IA configuration on nitrification. The OSA-IA configuration had higher indirect emissions (30.5 % vs 21.3 % in CAS) from additional energy consumption due to additional mixers and sludge recirculation pumps. The CF value was lower for OSA-IA than for CAS configuration (0.36 kgCO 2 /m 3 vs 0.39 kgCO 2 /m 3 in CAS)., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Objective: To evaluate transperineal laser ablation (TPLA) with Echolaser® (Echolaser® TPLA, Elesta S.p.A., Calenzano, Italy) as a treatment for benign prostatic hyperplasia (BPH) and prostate cancer (PCa) using the Delphi consensus method., Methods: Italian and international experts on BPH and PCa participated in a collaborative consensus project. During two rounds, they expressed their opinions on Echolaser® TPLA for the treatment of BPH and PCa answering online questionnaires on indications, methodology, and potential complications of this technology. Level of agreement or disagreement to reach consensus was set at 75%. If the consensus was not achieved, questions were modified after each round. A final round was performed during an online meeting, in which results were discussed and finalized., Results: Thirty-two out of forty invited experts participated and consensus was reached on all topics. Agreement was achieved on recommending Echolaser® TPLA as a treatment of BPH in patients with ample range of prostate volume, from <40 mL (80%) to >80 mL (80%), comorbidities (100%), antiplatelet or anticoagulant treatment (96%), indwelling catheter (77%), and strong will of preserving ejaculatory function (100%). Majority of respondents agreed that Echolaser® TPLA is a potential option for the treatment of localized PCa (78%) and recommended it for low-risk PCa (90%). During the final round, experts concluded that it can be used for intermediate-risk PCa and it should be proposed as an effective alternative to radical prostatectomy for patients with strong will of avoiding urinary incontinence and sexual dysfunction. Almost all participants agreed that the transperineal approach of this organ-sparing technique is safer than transrectal and transurethral approaches typical of other techniques (97% of agreement among experts). Pre-procedural assessment, technical aspects, post-procedural catheterization, pharmacological therapy, and expected outcomes were discussed, leading to statements and recommendations., Conclusion: Echolaser® TPLA is a safe and effective procedure that treats BPH and localized PCa with satisfactory functional and sexual outcomes., Competing Interests: The authors declare no conflict of interest., (© 2024 Editorial Office of Asian Journal of Urology. Production and hosting by Elsevier B.V.)

This study presents the effects on carbon and nutrient removal, membrane fouling and greenhouse gas (GHG) emissions of an Oxic-Settling-Anaerobic (OSA) - Membrane Bioreactor (MBR) pilot plant fed with real wastewater. The influence of three sludge return internal ratios (IR) was investigated by testing 45, 75 and 100%. The results showed that with the increase of IR, the biological sludge production substantially decreased by 85.8% due to the combination of cell lysis and endogenous metabolism. However, a worsening of ammonia removal efficiencies occurred (from 94.5 % to 84.7 with an IR value of 45 and 100%, respectively) mostly due to the ammonia release caused by cell lysis under anaerobic conditions. The N 2 O emission factor increased with the rise of IR (namely, from 2.17% to 2.54% of the total influent nitrogen). In addition, a variation of carbon footprint (CF) (0.78, 0.62 and 0.75 kgCO 2eq m -3 with 45, 75 and 100% IR, respectively) occurred with IR mainly due to the different energy consumption and carbon oxidation during the three periods. The study's relevance is to address the optimal operating conditions in view of reducing sludge production. In this light, the need to identify a trade-off between the advantages of reducing sludge production and the disadvantages of increasing membrane fouling and GHG emissions must be identified in the future., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The association between age at surgery and urinary continence (UC) recovery after Retzius-sparing robot-assisted radical prostatectomy (RS-RARP) is not well established. We addressed this knowledge gap, relying on a large series of 1,417 patients treated with RS-RARP at a high-volume centre between 2010 and 2021. Multivariable logistic models, as well as LOESS plot functions were performed. The probability of immediate, as well as 12-month UC-recovery progressively declined with increasing age at surgery, and per 5-years age at surgery increase reached the independent predictor status for both immediate and 12-month UC-recovery. These findings may significantly improve the quality of patient counseling regarding RS-RARP., (© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)

This study presents the excess sludge minimisation in a Membrane Bioreactor (MBR) system by an Oxic Settling Anaerobic (OSA) process. The pilot plant was fed with real wastewater and OSA was operated with two different hydraulic retention times (HRT), respectively 4 (Period II) and 6 h (Period III) and compared to an MBR (Period I). Multiple parameters/variables were monitored: sludge minimisation, nitrogen and carbon removal, membrane fouling, and biokinetic behaviour through respirometry. With respect to the current literature, greenhouse gas emissions were also here monitored, often neglected. Results demonstrated that combining MBR and OSA systems can significantly reduce excess sludge production (89.7%, in Period III and 59.7% in Period II, compared to Period I). However, Period III presented better PO 4 -P removal efficiencies but worse performances in the other parameters (COD, NH 4 and Total Nitrogen). No substantial variation in membrane fouling was obtained over the experimental periods. Finally, the HRT increase in the anaerobic reactor promoted a N 2 O-N increase inside the unaerated reactors, highlighting the need for a trade-off between sludge minimisation and GHG emission., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Biosolid management is becoming one of the most crucial issues for wastewater treatment plant (WWTP) operators. The application of the Oxic Settling Anaerobic (OSA) process allows the minimisation of excess sludge production. This study compares conventional activated sludge (CAS) and OSA layouts in a full-scale WWTP (namely, Corleone - Italy). Extensive monitoring campaigns were conducted to assess treatment performances regarding carbon and nutrient removal, greenhouse gas (GHG) emissions, excess sludge production, and biomass activity (by means of respirometric analysis). Results showed that the effluent quality consistently met the Italian discharge limits. However, with the implementation of the OSA process, there was a decrease in ammonium removal efficiency, which could be attributed to reduced nitrifier activity related to reduced biomass production and extended anaerobic conditions affecting the nitrification process. On the other hand, the OSA configuration significantly increased phosphorus removal, indicating a high phosphorus content in the resulting waste sludge. A worsening of the sludge settling properties was observed with the OSA configuration likely due to decreased EPS concentrations. The sludge production in the OSA configuration decreased by 17.3 % compared to CAS. Nitrous-oxide measurements did not show a variation between CAS and OSA configurations, confirming that the OSA process can be a suitable solution for reducing WWTP's carbon footprint., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

In the present research, insights about the mechanisms of excess sludge minimization occurring in an oxic-settling-anaerobic (OSA) were provided. The investigation involved two systems operating in parallel. In particular, a conventional activated sludge (CAS) system as control and a system implementing the OSA process both having a pre-denitrification scheme were considered. Five periods (P1-P5) were studied, during which several operating conditions and configurations were tested. Specifically, the hydraulic retention time (HRT) in the anaerobic reactor of the OSA system (P1 8 h, P2-P3 12 h, P4 8 h, P5 12 h) and the return sludge from the anaerobic to the anoxic (scheme A) (P1-P2) or aerobic (scheme B) mainstream reactors (P3-P5) were investigated. The results highlighted that the excess sludge production in the OSA was lower in all the configurations (12-41%). In more detail, the observed yield (Y obs ) was reduced from 0.50-0.89 gTSS gCOD -1 (control) to 0.22 -0.34 gTSS gCOD -1 in the OSA process. The highest excess sludge reduction (40%) was achieved when the OSA was operated according to scheme B and HRT of 12 h in the anaerobic reactor (P3). Generally, scheme A enabled the establishment of cell lysis and extracellular polymeric substances (EPS) destructuration, leading to a worsening of process performances when high anaerobic HRT (>8 h) was imposed. In contrast, scheme B enabled the establishment of maintenance metabolism in addition to the uncoupling metabolism, while cell lysis and EPS destruction were minimized. This allowed obtaining higher sludge reduction yield without compromising the effluent quality., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

In this study, real marine sediments polluted by petroleum compounds were treated by means of a bioslurry pilot scale reactor. The treatment performance was evaluated by measuring the removal of total petroleum hydrocarbon (TPH), coupled to further analyses required to understand the mechanisms involved in the biodegradation process. The maximum TPH-removal efficiency reached 86 % at the end of experiments. Moreover, high throughput 16S RNA gene sequencing was used to describe the microbiome composition in sediment prior to, and after, bioslurry treatment, in order to identify the taxa mostly entailed in the TPH removal process. The raw sediment was mostly colonized by members of Sulfurimonas genus; after bioslurry treatment, it was noticed a shift in the microbial community composition, with Proteobacteria phylum dominating the remediation environment (high increase in terms of growth for Hydrogenophaga and Sphingorhabdus genera) along with the Phaeodactylibacter genus (Bacteroidetes). Furthermore, the assessment of gaseous emissions from the system allowed to quantify the volatile hydrocarbon component and, consequently, to obtain a more accurate evaluation of TPH-removal pathway by the bioslurry system. Finally, phytotoxicity tests on sediment samples highlighted an increase of the treated sample quality status compared to the untreated one., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Objective: To evaluate the relationship between enlarged prostate, bulky median lobe (BML) or prior benign prostatic hyperplasia (BPH) surgery and perioperative functional, and oncological outcomes in high-risk (HR) prostate cancer (PCa) patients treated with Retzius-sparing robot-assisted radical prostatectomy (RS-RARP)., Methods: 320 HR-PCa patients treated with RS-RARP between 2011 and 2020 at a single high-volume center. The relationship between prostate volume, BML, prior BPH surgery and perioperative outcomes, Clavien-Dindo (CD) grade ≥ 2 90-day postoperative complications, positive surgical margins (PSMs), and urinary continence (UC) recovery was evaluated respectively in multivariable linear, logistic and Cox regression models. Complications were collected according to the standardized methodology proposed by EAU guidelines. UC recovery was defined as the use of zero or one safety pad., Results: Overall, 5.9% and 5.6% had respectively a BML or prior BPH surgery. Median PV was 45 g (range: 14-300). The rate of focal and non-focal PSMs was 8.4% and 17.8%. 53% and 10.9% patients had immediate UC recovery and CD ≥ 2. The 1- and 2-yr UC recovery was 84 and 85%. PV (p = 0.03) and prior BPH surgery (p = 0.02) was associated with longer operative time. BML was independent predictor of time to bladder catheter removal (p = 0.001). PV was independent predictor of PSMs (OR: 1.02; p = 0.009). Prior BPH surgery was associated with lower UC recovery (HR: 0.5; p = 0.03)., Conclusion: HR-PCa patients with enlarged prostate have higher risk of PSMs, while patients with prior BPH surgery have suboptimal UC recovery. These findings should help physicians for accurate preoperative counseling and to improve surgical planning in case of HR-PCa patients with challenging features., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Retzius-sparing (RS) robot-assisted radical prostatectomy represents a valid surgical treatment option for prostate cancer (PCa) patients. However, the available evidence on the role of RS in high-risk (HR) PCa setting is sparse., Objective: To describe our RS technique for HR-PCa patients and to evaluate intra-, peri-, and postoperative oncological and functional outcomes., Design Setting and Participants: A total of 340 D'Amico HR-PCa patients underwent RS at a single high-volume centre between 2011 and 2020., Surgical Procedure: Surgical procedures were performed by five experienced robotic surgeons., Measurements: Complications were collected according to the standardised methodology proposed by the European Association of Urology guidelines. Postoperative outcomes were evaluated in patients with complete follow-up data ( n  = 320). Biochemical recurrence (BCR) was defined as two consecutive prostate-specific antigen values of ≥0.2 ng/ml. Urinary continence (UC) recovery was defined as the use of zero or one safety pad. Kaplan-Meier and multivariable logistic and Cox regression models were performed., Results and Limitations: Fourteen patients (4%) experienced intraoperative complications and 52 90-d complications occurred in 44 patients (14%), of whom 24 had Clavien-Dindo 3a/b. Final pathology reported 49% International Society of Urological Pathology (ISUP) grade 4-5, 55% ≥pT3a, and 28.8% positive surgical margins (PSMs; 9.4% focal and 19.4% extended PSMs). The median follow-up was 47 mo. Overall, 35.3% and 1.3% harboured BCR and died from PCa. At 4 yr of follow-up, BCR-free survival and additional treatment-free survival were 63.6% and 56.6%, respectively. ISUP 4-5 at biopsy (odds ratio [OR]: 2.6), prostate volume (OR: 1.03), partial or full nerve sparing (OR: 1.9), and full bladder neck preservation (OR: 2.2) were independent predictors of PSMs. Pathological ISUP 4-5 (hazard ratio [HR]: 1.5) and PSMs (HR: 2.3) were independent predictors of BCR. Pathological ISUP 4-5 (HR: 1.5), PSMs (HR: 2.4), pT ≥3b (HR: 1.8), and pN ≥1 (HR: 1.8) were independent predictors of additional treatment. Immediate UC recovery was recorded in 53% patients. The 1- and 2-yr UC recovery and erectile function recovery were, respectively, 84% and 85%, and 43% and 50%., Conclusions: RS in HR-PCa patients allows optimal intra-, peri-, and postoperative outcomes. The RS approach should be considered a valid surgical treatment option for HR-PCa patients in expert hands., Patient Summary: Relying on the largest cohort of high-risk prostate cancer patients treated with Retzius sparing (RS), we observed that the RS approach is safe and allows optimal cancer control, without significantly compromising functional outcomes., (© 2022 The Author(s).)

Contaminated marine sediments represent a critical threat towards human health and ecosystems, since they constitute a potential reservoir of toxic compounds release. In the present study, a bioslurry reactor was studied for the treatment of real marine sediments contaminated by petroleum hydrocarbons. The experimental campaign was divided in two periods: in the first period, microcosm trials were carried out to achieve useful indicators for biological hydrocarbon removal from sediments. The microcosm trials highlighted that the inoculum of halotolerant allochthonous bacteria provided the highest performance followed by autochthonous biomass. Based on the achieved results, in the second experimental period a bioslurry reactor was started up, based on a semisolid stirred tank reactor (STR) operated in batch mode. The process performances have been evaluated in terms of total petroleum hydrocarbon (TPH) removal, coupled with the characterization of microbial community through a Next Generation Sequencing (NGS) and phytotoxicity tests through the Germination Index (GI) with Lepidium Sativum seeds. The achieved results showed good hydrocarbons removal, equal to 40%, with a maximum removal rate of 220 mg TPH kg -1 d -1 , but highlighting that high contaminant concentrations might affect negatively the overall removal performance. In general, the observed results were encouraging towards the feasibility of biological treatment of marine sediments contaminated by hydrocarbons. The microbiological analysis allowed the identification of taxa most involved in the degradation of TPH, highlighting after the treatment a shift in the microbial community from that of the raw sediment., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Aim:  Patient and worker satisfaction at an oncologic hub during the COVID-19 pandemic has never been reported. We addressed this topic. Methods: We conducted a survey to test the views of patients (n = 64) and healthcare professionals (n = 52) involved with our operative protocol. Results:  A moderate/severe grade of concern due to the COVID-19 emergency was recorded in 63% of patients versus 75% of hospital staff. High/very high versus low satisfaction grade about preventive strategies to reduce the risk of SARS-CoV-2 contagion was identified in the patients compared with the hospital staff group. Conclusion: Surgical treatment at a hub center of uro-oncologic patients coming from spoke centers is well accepted and should, therefore, be recommended. Preventive strategies to reduce the risk of SARS-CoV-2 contagion in hospital staff members should be implemented.

Background: Several authors claimed that the Retzius-sparing robot-assisted radical prostatectomy (RS-RARP) needs a prolonged learning curve, and outcomes during this phase could be suboptimal., Objective: To verify the safety and outcomes of RS-RARP performed by young surgeons during the learning curve., Design, Setting, and Participants: We conducted a retrospective analysis of the pre-, intra-, and postoperative features of all the patients who underwent RS-RARP from 2013 to 2017. We divided our patients into two groups: patients operated by two experienced surgeons (ESs) with >100 procedures and patients operated on by five younger surgeons in the learning curve (LCSs). LCSs had no previous experience in radical prostatectomy, and the very first RS-RARP procedures of each LCS case are included in the analysis., Outcome Measurements and Statistical Analysis: Perioperative, oncological, and functional data were analyzed. Short-term oncological results were reported as positive surgical margins (PSMs) and 1-yr disease-free survival. Complications were graded according to the Clavien-Dindo system. Potency was defined as erections sufficient for intercourse; continence was defined as no pad or one safety liner. A propensity score-matching analysis was used to adjust the difference in baseline preoperative parameters between the groups., Results and Limitations: We obtained two homogeneous groups of 256 patients each. After the matching, preoperative variables were similar in the two groups. The mean console time was longer for younger surgeons (98 vs 122 min, p < 0.001). Postoperative course, complications, and functional results were similar in the two groups; the final pathological analysis showed a worse T stage in the ES group (p = 0.017). PSMs and 1-yr disease-free survival did not differ between the groups., Conclusions: RS-RARP can be safely performed by inexperienced surgeons who have received adequate training., Patient Summary: Surgeons in the learning curve can perform Retzius-sparing robot-assisted radical prostatectomy safely, with similar early oncological results and functional outcomes., (Copyright © 2020 European Association of Urology. Published by Elsevier B.V. All rights reserved.)

The present paper investigated an Integrated Fixed Film Activated Sludge (IFAS) Membrane BioReactor (MBR) system monitored for 340 days. In particular, the short-term effects of some operational parameters variation was evaluated. Results showed a decrease of the removal rates under low C/N values. Respirometry results highlighted that activated sludge was more active in the organic carbon removal. Conversely, biofilm has a key role during nitrification. The major fouling mechanism was represented by the cake deposition (irreversible)., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

The integration of one anaerobic reactor in the mainstream (AMSR) of a pre-denitritication-MBR was evaluated with the aim to achieve simultaneous sludge minimization and phosphorous removal. The excess sludge production was reduced by 64% when the AMSR was operated under 8 h of hydraulic retention time (HRT). The highest nutrients removal performances referred to organic carbon (98%), nitrogen (90%) and phosphorous (97%) were obtained under 8 h of HRT. In contrast, prolonged anaerobic-endogenous conditions were found to be detrimental for all nutrients removal performances. Similarly, the lowest membrane fouling tendency (FR = 0.65∙10 11  m -1  d -1 ) was achieved under 8 h of HRT, whereas it significantly increased under higher HRT. The highest polyphosphate accumulating organisms kinetics were achieved under HRT of 8 h, showing very high exogenous P-release (46.67 mgPO 4 -P gVSS -1 h -1 ) and P-uptake rates (48.6 mgPO 4 -P gVSS -1 h -1 ), as well as a not negligible P-release rate under endogenous conditions at low COD/P ratio (≈1)., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

The biodegradability and treatability of a young (3 years old) municipal landfill leachate was evaluated by means of chemical oxygen demand (COD) fractionation tests, based on respirometric techniques. The tests were performed using two different biomasses: one cultivated from the raw leachate (autochthonous biomass) and the other collected from a conventional municipal wastewater treatment plant after its acclimation to leachate (allochthonous biomass). The long term performances of the two biomasses were also studied. The results demonstrated that the amount of biodegradable COD in the leachate was strictly dependent on the biomass that was used to perform the fractionation tests. Using the autochthonous biomass, the amount of biodegradable organic substrate resulted in approximately 75% of the total COD, whereas it was close to 40% in the case of the allochthonous biomass, indicating the capacity of the autochthonous biomass to degrade a higher amount of organic compounds present in the leachate. The autochthonous biomass was characterized by higher biological activity and heterotrophic active fraction (14% vs 7%), whereas the activity of the allochthonous biomass was significantly affected by inhibitory compounds in the leachate, resulting in a lower respiration rate (SOUR = 13 mg O 2 gVSS -1  h -1 vs 37 mg O 2 gVSS -1  h -1 ). The long-term performance of the autochthonous and allochthonous biomasses indicated that the former was more suitable for the treatment of raw landfill leachate, ensuring higher removal performance towards the organic pollutants., (Copyright © 2019 Elsevier B.V. All rights reserved.)

This study investigated the chance to couple the conventional Oxic Settling Anaerobic (OSA) process with a thermic treatment at moderate temperature (35 °C). The maximum excess sludge reduction rate (80%) was achieved when the plant was operated under 3 h of hydraulic retention time (HRT). Compared with the conventional OSA system, the thermic treatment enabled a further improvement in excess sludge minimization of 35%. The observed yield coefficient decreased from 0.25 gTSS gCOD -1 to 0.10 gTSS gCOD -1 when the temperature in the anaerobic reactor was increased to 35 °C, despite the lower HRT (3 h vs 6 h). Moreover, the thermic treatment enabled the decrease of filamentous bacteria, thereby improving the sludge settling properties. The thermic treatment enhanced the destruction of extracellular polymeric substances and the increase of endogenous decay rate (from 0.64 d -1 to 1.16 d -1 ) that reduced the biomass active fraction (from 22% to 4%)., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: The aim of this study is to evaluate differences in discomfort, complications and functional results after Retzius-sparing robot-assisted radical prostatectomy (RS-RARP) according to different urinary drainage: suprapubic tube (SPT) and standard urethral catheter (UC)., Methods: Prospective, comparative, consecutive, non-randomized study. In all patients with a water-tight anastomosis, no hematuria, obesity, previous suprapubic surgery or history of bladder cancer, a SPT (two-way Foley 14-Fr catheter) was positioned instead of a Foley 18-Fr UC. One week after surgery, an institutional self-compiled questionnaire was administered. The patients were divided into two groups according to the presence of UC or SPT and were compared concerning pain, perioperative results, complications, functional outcomes., Results: Fifty-six patients with UC and 135 with SPT agreed to participate to the study. Median postoperative pain score was 3 (IQR: 2-5) in UC and 3 (IQR: 1-5) in SPT group (P=0.324); urinary drain-related pain scores were 3 (IQR: 1-5) in UC and 1 (IQR: 0-3) in SPT groups (P<0.001); catheter removal related scores were 1 (IQR: 0-3) and 1 (IQR: 1-3) (P=0.317), respectively. Lastly, 17.8% (UC) and 31.1% (SPT) wore a protection (small or medium pad) while the urinary drainage was in place (P=0.061). No differences related to complications were found (P=0.085); 7.9% of patients in UC group and 4.2% in SPT group (P=0.178) used pads one year after surgery., Conclusions: We demonstrated suprapubic tube to be more comfortable than transurethral catheter after RARP, with a possible advantage concerning anastomotic postoperative problems.

The present study is aimed to assess and characterize the structure of bacterial community in advanced activated sludge systems. In particular, activated sludge samples were collected from an Integrated Fixed-film Activated Sludge - Membrane Bioreactor pilot plant under a University of Cape Town configuration with in-series anaerobic (Noair)/anoxic (Anox)/aerobic (Oxy) reactors - and further analyzed. The achieved results - based on Next Generation Sequencing (NGS) of 16S rDNA amplicons - revealed that the bacterial biofilm (bf) communities on plastic carriers of Oxy and Anox reactors had a greater diversity compared to suspended (sp) bacterial flocs of Oxy, Anox and Noair. Indeed, the Shannon diversity indices of both biofilm communities were higher than those of suspended growth samples (Oxy-bf = 4.1 and Anox-bf = 4.2 vs. Oxy-sp = 3.4, Anox-sp = 3.5 and Noair-sp = 3.4). The most striking differences have been reported in Rhodobacteraceae being more abundant in biofilm specimens than in suspended biomass samples. The vast majority of the identified bacteria differs from those obtained by culture dependent method, thus suggesting that NGS-based method is really suitable to analyze the bacterial community composition, even in advanced systems for wastewater treatment., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

A University of Cape Town Integrated Fixed-Film Activated Sludge Membrane Bioreactor (UCT-IFAS-MBR) pilot plant was operated at different values of the sludge retention time (SRT). Three SRTs were investigated at different durations: indefinitely, 30 and 15 days. The organic carbon, nitrogen and phosphorus removal, kinetic/stoichiometric parameters, membrane fouling tendency and sludge filtration properties were assessed. The findings showed that by decreasing the SRT, the pilot plant could maintain excellent carbon removal efficiencies throughout the experiments. In contrast, the biological carbon removal showed a slight nitrification and was slightly affected by the decrease of the SRT, showing high performance (approximately 91%, on average). Thus, the biofilm might have helped sustain the nitrification throughout the experiments. The average phosphorus removal performance increased slightly with a decrease in SRT, achieving the maximum efficiency (61.5%) at a SRT of 15 days. After a 30-day SRT, an increase in resistance due to pore blocking and a general worsening of the membrane filtration properties occurred.

Objective: Robot-assisted laparoscopic  radical prostatectomy (RARP) is nowadays considered  the main surgical option for localized prostate cancer (PCa). We recently developed a new approach for RARP  avoiding all the Retzius structures involved in continence  and potency preservation, the so called Retzius-sparing  technique (RSP). The objective of the paper is to report technical aspects and functional results of RSP.  METHODS: We evaluated our data and available literature  regarding RSP, functional results and advantages.  RESULTS: RSP is oncologically safe and guarantee high early continence rates., Conclusion: Long-term, prospective, comparative,  and possibly randomized studies are needed but RSP is  now spreading all over the world thanks to the different advantages that offers to patients. The most recognized benefit is surely the achievement of early continence, as well documented in multiple studies and papers, without compromising the oncological outcomes.

Background: To date, few series on robot-assisted radical prostatectomy (RARP) in kidney transplant recipients (KTRs) have been published., Purpose: To report the experience of two referral centers adopting two different RARP approaches in KTRs. Surgical, oncological and functional results were primary outcomes evaluated in the study., Material and Methods: We retrospectively analyzed data from 9 KTRs who underwent transperitoneal RARP or Retzius-sparing RARP for PCa from October 2012 to April 2016. Data were reported as median and interquartile range (IQR). Pre- and postoperative outcomes were compared by non-parametric Wilcoxon signed-rank test. Significant differences were accepted when p ≤ 0.05. Overall survival was assessed using Kaplan-Meier method., Results: Four KTRs underwent a T-RARP and 5 a RS-RARP. Patient median age was 60 (56-63) years. Charlson comorbidity index was 6 (5-6). Preoperative median PSA was 5.6 (5-15) ng / mL. Preoperative Gleason score (GS) was 6 in 5 patients, 7 (3 + 4) in 3, and 8 (4 + 4) in one. Pre- and postoperative creatinine were 1.17 (1.1; 1.4) and 1.3 (1.07; 1.57) mg / dL (p = 0.237), while eGFR was 66 (60-82) and 62 (54-81) mL / min / 1.73m2 (p = 0.553), respectively. One (11.1%) Clavien-Dindo grade II complication occurred. Two extended template lymphadenectomies were performed, both with nodal invasion. These two patients experienced a biochemical recurrence and were subjected to RT. Two patients (22.2%) had PSMs. Median follow-up was 42 months. Seven patients (77.8%) were continent, 5 (55.6%) were potent. Two (22.2%) patients died during follow-up for oncologic unrelated causes., Conclusions: Our series suggests that both RARP approaches are safe and feasible techniques in KTRs for PCa., Competing Interests: None declared, (Copyright® by the International Brazilian Journal of Urology.)

To investigate the efficacy, tolerability, and patient's preference of alprostadil cream for topical use administered within the urethral meatus versus the standard administration route, in erectile dysfunction (ED) treatment. Seventy-one patients (mean age 59.7 ± 9.0 years) affected by ED were analyzed in this multicenter, randomized, two-administration routes, cross-over trial. All patients received a single dose of alprostadil cream applying the dispenser to the tip of the penis (without contacting the urethral meatus) (Standard administration route or ST.AR) alternating with a single dose of alprostadil cream applying the dispenser within the urethral meatus (New administration route or NEW.AR) separated by a one-week washout period, according to randomization. The primary objective of the study was to evaluate the change in International Index of Erectile Function (IIEF-5) total score from baseline to the control visit by comparing the ST.AR and NEW.AR. Secondary objectives of the study were to compare the different methods of administration by evaluating the change in the Sexual Encounter Profile (SEP-2 and SEP-3) questionnaire score and the Patient Reported Outcomes (PROs) by scoring the Patient Self-Assessment of Erection (PSAE) questionnaire. The treatment safety profile was assessed by analysis of adverse events (AEs). Based on the study findings it is evident that the NEW.AR is more efficacious than the ST.AR in improving IIEF-5 and SEP scores from baseline to control visit (IIEF-5: +3.8 vs +6.3; p < 0.001; positive response to SEP-2: 10 vs 27; p = 0.002) and in terms of PSAE (a significant improvement from the baseline in 31% of patients; p < 0.001). As regards the safety profile, no difference in terms of local and systemic side effects was found.

This research elucidates the pollutants (nutrients and carbon) removal performance and nitrous oxide (N 2 O) emissions of two pilot plants. Specifically, a University of Cape Town (UCT) Membrane Bioreactor (MBR) plant and an Integrated Fixed Film Activated Sludge (IFAS)-UCT-MBR plant were investigated. The plants were fed with real wastewater augmented with acetate and glycerol in order to control the influent carbon nitrogen ratio (C/N). The short-term effect of the inlet C/N ratio variation (C/N = 5 mgCOD/mgN and C/N = 10 mgCOD/mgN) on the behaviour of both plants was investigated. The results showed that the IFAS-UCT-MBR configuration provided the best performance in terms of pollutants removal at the two investigated C/N ratios. Furthermore, the lowest N 2 O emission (with respect to the influent nitrogen) was observed in the IFAS-UCT-MBR configuration, thus suggesting a potential beneficial effect of the biofilm in the emission reduction. However, the membrane of the IFAS-UCT-MBR showed a greater fouling tendency compared to the UCT-MBR configuration. This result, likely related to the biofilm detached from carriers, could seriously affect the indirect GreenHouse Gas emissions due to the increase of the energy requirement for permeate extraction with the increase of membrane fouling., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

This study aimed at evaluating the nitrous oxide (N 2 O) emissions from membrane bioreactors (MBRs) for wastewater treatment. The study investigated the N 2 O emissions considering multiple influential factors over a two-year period: (i) different MBR based process configurations; (ii) wastewater composition (municipal or industrial); (iii) operational conditions (i.e. sludge retention time, carbon-to-nitrogen ratio, C/N, hydraulic retention time); (iv) membrane modules. Among the overall analysed configurations, the highest N 2 O emission occurred from the aerated reactors. The treatment of industrial wastewater, contaminated with salt and hydrocarbons, provided the highest N 2 O emission factor (EF): 16% of the influent nitrogen for the denitrification/nitrification-MBR plant. The lowest N 2 O emission (EF = 0.5% of the influent nitrogen) was obtained in the biological phosphorus removal-moving bed-MBR plant likely due to an improvement in biological performances exerted by the co-presence of both suspended and attached biomass. The influent C/N ratio has been identified as a key factor affecting the N 2 O production. Indeed, a decrease of the C/N ratio (from 10 to 2) promoted the increase of N 2 O emissions in both gaseous and dissolved phases, mainly related to a decreased efficiency of the denitrification processes.

Background: The objective of our study is to evaluate the effect of prostatic volume on the outcomes of Retzius-sparing robot-assisted radical prostatectomy (RSP)., Methods: All the consecutive patients undergoing RSP up to January 2015 were included. The series was divided into three groups based on prostate weight at radical prostatectomy specimen (<40 g, 40-60 g, >60 g). Perioperative, oncological and functional data were prospectively recorded. Potency was defined as erections sufficient for penetration; continence as no pad or one safety liner. Oncological results were reported as positive surgical margins (PSMs) and 1-year biochemical disease-free survival (PSA<0.2 ng/mL)., Results: We evaluated 750 patients (366 with <40 g prostates, 272 with 40-60 g prostates, 112 with >60 g prostates). Median follow-up was 22 months; PSA was higher in larger prostates (6.6 vs. 6.8 vs. 8 ng/mL). Nerve-sparing and bladder-neck sparing procedures were in similar percentages. Larger prostates required longer surgeries (90 vs. 100 vs. 100 minutes, P=0.002). Perioperative results were similar (blood loss, discharge, complications, catheter removal). Larger prostates had more frequently localized disease (pT2 in 49.5% vs. 60.7% vs. 68.5%; P=0.001); PSMs were similar both in pT2 (15.5% vs. 9.4% vs. 11.8%) and in pT3 cases (40.1% vs. 42% vs. 34%). In the three study groups, immediate continence was reached by 88%, 89.5% and 81.3% (P=0.045), while no differences were observed concerning continence (93.4%, 94.1%, 94.7%; P=0.892) or potency after follow-up., Conclusions: RSP is feasible in patients with prostates of any volume, with similar oncological and functional outcomes. Despite being inferior to the figures obtained in low volume prostates, the very high immediate continence rates observed in larger prostates encourage the use of this approach also in larger prostates.

Excess sludge minimization was studied in a MBR with pre-denitrification scheme. Sludge minimization, nitrogen removal performance and membrane fouling tendency were investigated in two configurations, characterized by a different position of the sludge retention reactor (SRR). In particular, the SRR was placed: i) in the return activated sludge line (Anaerobic Side-Stream Reactor - ASSR configuration) and ii) in the mainstream between the anoxic and aerobic reactor (Anaerobic Main-Stream Reactor - AMSR configuration). The achieved results demonstrated that the ASSR enabled a higher excess sludge reduction (74% vs 32%), while achieving lower biological nitrogen removal (BNR) (TN = 63% vs 78%) and membrane fouling tendency (FR = 2.1 · 10 12  m -1  d -1 vs 4.0 · 10 11  m -1  d -1 ) than the AMSR. It was found that metabolism uncoupling, destruction of EPS and endogenous decay simultaneously occurred in the ASSR. Conversely, selective enrichment of bacteria population with low biomass yield was found the main mechanism affecting sludge minimization in the AMSR., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Background/aim: The incidence of renal cell carcinoma (RCC) has been increasing mainly due to the increase in the incidental detection of small renal masses. The aim of this study was to verify whether the trend towards early diagnosis changed the clinical characteristics of pathologically-defined high-risk RCC patients over the last decades., Patients and Methods: A total of 741 patients with pathologically-confirmed high-risk RCC (pT1-4, and/or pN1 and/or Fuhrman grade 3-4 and/or all M1 patients) treated with radical (RN) or partial nephrectomy (PN) at a single tertiary referral center between 1987 and 2011 were included in the study. The temporal trends of pre-operative clinical and tumor characteristics were assessed relying on the lowess smoother weighted function with corresponding 95% confidence interval. Estimated annual percentage changes (EAPC) were evaluated using a log linear regression model., Results: The median age of patients increased from 57.5 to 67.3 years between 1987 and 2011 (EAPC 4.9%, p=0.002). Body mass index and gender rates remained stable during the study period. A constant trend towards patients with one or more comorbidity was observed. Moreover, the proportion of asymptomatic patients at diagnosis and of clinical T1 increased by 41.1 and 19.8%, respectively (all p≤0.007). The clinical tumor size dropped from 8.4 to 6.2 cm (EAPC -1.2%, p=0.001). This trend was accompanied by a clinically-relevant increase by 15.3% in the rate of patients without clinical metastases (p=0.07). Conversely, the rate of clinical lymphadenopathies remained stable over time. Finally, the rate of PNs performed increased by 23.3% (p<0.001)., Conclusion: Over the years, pathologically-confirmed high-risk RCC patients are older, mostly asymptomatic, with smaller cancers, with a higher rate of tumors localized to the kidney and with a decreased rate of metastatic disease at diagnosis. These trends can explain the increasing number of PNs performed despite the presence of a high-risk cancer profile., (Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Municipal solid waste (MSW) landfills now represent one of the most important issues related to the waste management cycle. Knowledge of biogas production is a key aspect for the proper exploitation of this energy source, even in the post-closure period. In the present study, a simple mathematical model was proposed for the simulation of biogas production. The model is based on first-order biodegradation kinetics and also takes into account the temperature variation in time and depth as well as landfill settlement. The model was applied to an operating landfill located in Sicily, in Italy, and the first results obtained are promising. Indeed, the results showed a good fit between measured and simulated data. Based on these promising results, the model can also be considered a useful tool for landfill operators for a reliable estimate of the duration of the post-closure period.

In the present paper, the feasibility of citrus wastewater treatment with aerobic granular sludge sequencing batch reactors (AGSBR) was investigated. Two AGSBRs (named R1 and R2, respectively) were operated for 90 days under different organic loading rates (OLR) and pH in two experimental periods. The OLR ranged approximately between 3.0 kg TCOD m -3 d -1 and 7 kg TCOD m -3 d -1 during Period I, whereas between 7 kg TCOD m -3 d -1 and 15 kg TCOD m -3 d -1 during Period II. pH was maintained at 7.0 and 5.5 in R1 and R2, respectively. The results revealed that under high OLR and unbalanced feast/famine regime (Period I), the development of fast-growing microorganisms (fungi and filamentous bacteria) was favoured in both reactors, resulting in granular sludge instability. An extended famine phase and a proper balancing between feast and famine periods (Period II) were favourable for the development of bacteria with low growth rates (0.05 d -1 ) thus enhancing the granules stability. To the benefit of granular sludge stability and effluent quality, the length of the feast period should not exceed 25% of cycle length. Moreover, under OLR lower than 7 kg TCOD m -3 d -1 the removal efficiency of total chemical oxygen demand (TCOD) was approximately 90% in R1 and R2 and no side effects on the organic carbon removal performance related to the pH were observed. In contrast, at higher OLR a significant decrease in the removal efficiency (from 90% to less than 75%) was observed in R2. Results revealed also that under low pH, hydrolysis of proteins occurred and a decrease in the biological kinetic rates proportionally to the applied OLR was observed., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

The influence of the main operational variables on N 2 O emissions from an Integrated Fixed Film Activated Sludge University of Cape Town membrane Bioreactor pilot plant was studied. Nine operational cycles (total duration: 340days) were investigated by varying the value of the mixed liquor sludge retention time (SRT) (Cycles 1-3), the feeding ratio between carbon and nitrogen (C/N) (Cycles 4-6) and simultaneously the hydraulic retention time (HRT) and the SRT (Cycles 7-9). Results show a huge variability of the N 2 O concentration in liquid and off-gas samples (ranged from 10 -1 μgN 2 O-NL -1 to 10 3 μgN 2 O-NL -1 ). The maximum N 2 O concentration (1228μgN 2 O-NL -1 ) in the off-gas samples occurred in the anoxic reactor at the lowest C/N value confirming that unbalanced C/N promotes the N 2 O emission during denitrification. The aerated reactors (aerobic and MBR) have been the major N 2 O emitters during all the three Phases., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

The aim of the present study was to investigate the nitrous oxide (N 2 O) emissions from a moving bed based Integrated Fixed Film Activated Sludge (IFAS) - membrane bioreactor (MBR) pilot plant, designed according to the University of Cape Town (UCT) layout. The experimental campaign had a duration of 110 days and was characterized by three different sludge retention time (SRT) values (∞, 30 d and 15 d). Results highlighted that N 2 O concentrations decreased when the biofilm concentrations increased within the aerobic reactor. Results have shown an increase of N 2 O with the decrease of SRT. Specifically, an increase of N 2 O-N emission factor occurred with the decrease of the SRT (0.13%, 0.21% and 0.76% of influent nitrogen for SRT = ∞, SRT = 30 d and SRT = 15 d, respectively). Moreover, the MBR tank resulted the key emission source (up to 70% of the total N 2 O emission during SRT = ∞ period) whereas the highest N 2 O production occurred in the anoxic reactor. Moreover, N 2 O concentrations measured in the permeate flow were not negligible, thus highlighting its potential detrimental contribution for the receiving water body. The role of each plant reactor as N 2 O-N producer/consumer varies with the SRT variation, indeed the aerobic reactor was a N 2 O consumer at SRT = ∞ and a producer at SRT = 30 d., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

The present study explores the interlinkages among the operational variables of a University of Cape Town (UCT) Integrated Fixed Film Activated Sludge (IFAS) membrane bioreactor (MBR) pilot plant. Specifically, dedicated experimental tests were carried out with the final aim to find-out a constitutive relationship among operational costs (OCs), effluent quality index (EQI), effluent fines (EF). Greenhouse gas (GHG) emissions were also included in the study. Results showed that the EQI increases at low flow rate likely due to the dissolved oxygen (DO) limitation in the biological processes. Direct GHGs increase with the increasing of the air flow due to the anoxic N 2 O contribution. Irreversible membrane fouling reduce from 98% to 85% at the air flow rate of 0.57m 3 h -1 and 2.56m 3 h -1 , respectively. However, the increase of the air flow rate leads to the increase of the N 2 O-N flux emitted from the MBR (from 40% to 80%)., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

The paper reports the results of an experimental campaign carried out on a University of Cape Town (UCT) integrated fixed-film activated sludge (IFAS) membrane bioreactor (MBR) pilot plant. The pilot plant was analysed in terms of chemical oxygen demand (COD) and nutrients removal, kinetic/stoichiometric parameters, membrane fouling and sludge dewaterability. Moreover, the cultivable bacterial community structure was also analysed. The pilot plant showed excellent COD removal efficiency throughout experiments, with average value higher than 98%, despite the slight variations of the influent wastewater. The achieved nitrification efficiency was close to 98% for most of the experiments, suggesting that the biofilm in the aerobic compartment might have sustained the complete nitrification of the influent ammonia, even for concentrations higher than 100 mg L -1 . The irreversible resistance due to superficial cake deposition was the mechanism that mostly affected the membrane fouling. Moreover, it was noticed an increase of the resistance due pore blocking likely due to the increase of the EPS Bound fraction that could derive by biofilm detachment. The bacterial strains isolated from aerobic tank are wastewater bacteria known for exhibiting efficient heterotrophic nitrification-aerobic denitrification and producing biofilm., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Purpose: To prospectively assess discontinuation of indwelling bladder catheterization (IBC) and relief of lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) following prostate artery embolization (PAE) in poor surgical candidates., Methods: Patients ineligible for surgical intervention were offered PAE after at least 1 month of IBC for management of urinary retention secondary to BPH; exclusion criteria for PAE included eligibility for surgery, active bladder cancer or known prostate cancer. Embolization technical and clinical success were defined as bilateral prostate embolization and removal of IBC, respectively. Patients were followed for at least 6 months and evaluated for International Prostate Symptom Score, quality of life, prostate size and uroflowmetric parameters., Results: A total of 43 patients were enrolled; bilateral embolization was performed in 33 (76.7%), unilateral embolization was performed in 8 (18.6%), and two patients could not be embolized due to tortuous and atherosclerotic pelvic vasculature (4.7%). Among the patients who were embolized, mean prostate size decreased from 75.6 ± 33.2 to 63.0 ± 23.2 g (sign rank p = 0.0001, mean reduction of 19.6 ± 17.3%), and IBC removal was achieved in 33 patients (80.5%). Clavien II complications were reported in nine patients (21.9%) and included urinary tract infection (three patients, 7.3%) and recurrent acute urinary retention (six patients, 14.6%). Nine patients (22.0%) experienced post-embolization syndrome., Conclusions: PAE is a safe and feasible for the relief of LUTS and IBC in highly comorbid patients without surgical treatment options.