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Critical Care (London, England) Jul 2023The oXiris is a novel filter for continuous renal replacement therapy (CRRT) featuring an adsorption coating to adsorb endotoxins and remove inflammatory mediators.... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The oXiris is a novel filter for continuous renal replacement therapy (CRRT) featuring an adsorption coating to adsorb endotoxins and remove inflammatory mediators. Given that no consensus has been reached on its potential benefits in treating sepsis, a meta-analysis was conducted to assess its impact on the clinical outcomes of this patient population.
METHODS
Eleven databases were retrieved to find relevant observational studies and randomized controlled trials. The Newcastle-Ottawa Scale and the Cochrane Risk of Bias Tool were used to assess the quality of the included studies. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) process was employed to assess the certainty of evidence. The 28-day mortality was the primary outcome. Secondary outcomes were 7-, 14-, and 90-day mortality, length of intensive care unit (ICU) and hospital stay, ICU and hospital mortality, norepinephrine (NE) dose, interleukin-6 (IL-6) and lactate levels, and Sequential Organ Failure Assessment (SOFA) score.
RESULTS
The meta-analysis, pooling data from 14 studies, involving 695 patients, showed significant reductions in 28-day mortality [odds ratio (OR) 0.53; 95% confidence interval (CI) 0.36-0.77, p = 0.001] and length of ICU stay [weighted mean difference (WMD) - 1.91; 95% CI - 2.56 to - 1.26, p < 0.001)] in patients with sepsis using the oXiris filter compared to other filters. Besides, the SOFA score, NE dose, IL-6 and lactate levels, and 7- and 14-day mortalities were lower in the oXiris group. However, the 90-day mortality, ICU and hospital mortality, and length of hospital stay were comparable. The quality assessment of the ten observational studies indicated intermediate to high quality (average Newcastle-Ottawa score: 7.8). However, all four randomized controlled trials (RCTs) had an unclear risk of bias. The evidence for all outcomes had a low or very low level of certainty because the original study design was mainly observational studies and the RCTs included had an unclear risk of bias and a small sample size.
CONCLUSION
The treatment with the oXiris filter during CRRT in sepsis patients may be associated with lower 28-, 7-, and 14-day mortalities, lactate levels, SOFA score, NE dose, and shorter length of ICU stay. However, due to the low or very low quality of evidence, the effectiveness of oXiris filters was still uncertain. Besides, no significant difference was observed for the 90-day mortality, ICU and hospital mortality, and length of hospital stay.
Topics: Humans; Continuous Renal Replacement Therapy; Interleukin-6; Adsorption; Sepsis; Lactates
PubMed: 37424026
DOI: 10.1186/s13054-023-04555-x -
Environmental Health Insights 2023Various review papers have been published regarding the occurrence and fate of micropollutants (MPs). MPs in the aquatic environment are still not well reviewed to... (Review)
Review
INTRODUCTION
Various review papers have been published regarding the occurrence and fate of micropollutants (MPs). MPs in the aquatic environment are still not well reviewed to generate comprehensive summaries with a special focus on their removal from wastewater using conventional and advanced treatment processes. Therefore, this review aimed to provide a synopsis of the efficiency of the advanced wastewater treatment plants in the removal of MPs.
MATERIALS AND METHODS
A systematic search of published literature was conducted on the National Library of Medicine (NLM) database, Web of Science, database, Scopus, and Google Scholar, based on studies with evidence of removal of MPs in the wastewater treatment process. Screening of the published articles was made using pre-specified inclusion and exclusion criteria.
RESULTS
Amongst the 1545 studies searched, 21 full-length articles were analyzed that showed 7 treatment options related to the removal of MPs from wastewater. MPs from wastewater effluents were successfully and effectively removed by advanced treatment techniques. Advanced Oxidation Processes (AOPs), membrane processes, and adsorption processes have all been shown to be potential solutions for the removal of MPs in advanced treatment plants (WWTPs). But, there are 2 critical issues associated with the application of the advanced treatment options which are high operational cost and the formation of dangerous by-products and concentrated residues.
CONCLUSION
This study identified that the removal of MPs using WWTPs was commonly incomplete with varying removal efficiency. Therefore, the adaptation and scale-up of the cost-effective and efficient combined wastewater treatment technology are vital to creating an absolute barrier to MPs emissions.
PubMed: 37692976
DOI: 10.1177/11786302231195158 -
Chemosphere Oct 2023This comprehensive study analysed 55 articles published between 2011 and 2022 on the use of metal organic frameworks (MOFs) for phosphate adsorption. The study found... (Meta-Analysis)
Meta-Analysis Review
This comprehensive study analysed 55 articles published between 2011 and 2022 on the use of metal organic frameworks (MOFs) for phosphate adsorption. The study found that the performance of MOFs in phosphate adsorption is influenced by various factors such as the type of MOF, synthesis method, modification/alteration, and operational conditions (initial concentration, adsorbent dose, pH, contact time, and temperature). Most of the MOFs have a wide range of theoretical maximum adsorption capacity for phosphate, but their long-term use in phosphorus recovery may be limited due to the adsorption mechanisms being dominated by inner sphere complexation. The study employed machine learning to construct artificial neural network (ANN) models for predicting phosphate adsorption capacity based on input features from operation and synthesis procedures. The initial phosphate concentration was the most important input from the operational features, while the modulator agent was consistently relevant during MOF synthesis. The models showed strong fitting for most MOF types recorded for the study, such as UIO-66, MIL-100, ZIF-8, Al-MOFs, La-MOFs, and Ce-MOFs. Overall, this study provides valuable insights for the design of MOF adsorbents for phosphate adsorption and offers guidance for future research in this area.
Topics: Phosphates; Metal-Organic Frameworks; Adsorption; Phosphorus; Neural Networks, Computer
PubMed: 37517668
DOI: 10.1016/j.chemosphere.2023.139674 -
Biomedicines Nov 2023Acute respiratory distress syndrome (ARDS) is often a consequence of a dysregulated immune response; therefore, immunomodulation by extracorporeal cytokine removal has... (Review)
Review
BACKGROUND
Acute respiratory distress syndrome (ARDS) is often a consequence of a dysregulated immune response; therefore, immunomodulation by extracorporeal cytokine removal has been increasingly used as an adjuvant therapy, but convincing data are still missing. The aim of this study was to investigate the effects of adjunctive hemoadsorption (HA) on clinical and laboratory outcomes in patients with ARDS.
METHODS
We performed a systematic literature search in PubMed, Embase, CENTRAL, Scopus, and Web of Science (PROSPERO: CRD42022292176). The population was patients receiving HA therapy for ARDS. The primary outcome was the change in PaO2/FiO2 before and after HA therapy. Secondary outcomes included the before and after values for C-reactive protein (CRP), lactate, interleukin-6 (IL-6), and norepinephrine (NE) doses.
RESULTS
We included 26 publications, with 243 patients (198 undergoing HA therapy and 45 controls). There was a significant improvement in PaO2/FiO2 ratio following HA therapy (MD = 68.93 [95%-CI: 28.79 to 109.06] mmHg, = 0.005) and a reduction in CRP levels (MD = -45.02 [95%-CI: -82.64; -7.39] mg/dL, = 0.026) and NE dose (MD = -0.24 [95%-CI: -0.44 to -0.04] μg/kg/min, = 0.028).
CONCLUSIONS
Based on our findings, HA resulted in a significant improvement in oxygenation and a reduction in NE dose and CRP levels in patients treated with ARDS. Properly designed RCTs are still needed.
PubMed: 38002070
DOI: 10.3390/biomedicines11113068 -
Journal of Hazardous Materials Apr 2024This systematic review addresses soil contamination by crude oil, a pressing global environmental issue, by exploring effective treatment strategies for sites... (Review)
Review
This systematic review addresses soil contamination by crude oil, a pressing global environmental issue, by exploring effective treatment strategies for sites co-contaminated with heavy metals and polycyclic aromatic hydrocarbons (PAHs). Our study aims to answer pivotal research questions: (1) What are the interaction mechanisms between heavy metals and PAHs in contaminated soils, and how do these affect the efficacy of different remediation methods? (2) What are the challenges and limitations of combined remediation techniques for co-contaminated soils compared to single-treatment methods in terms of efficiency, stability, and specificity? (3) How do various factors influence the effectiveness of biological, chemical, and physical remediation methods, both individually and combined, in co-contaminated soils, and what role do specific agents play in the degradation, immobilization, or removal of heavy metals and PAHs under diverse environmental conditions? (4) Do AI-powered search tools offer a superior alternative to conventional search methodologies for executing an exhaustive systematic review? Utilizing big-data analytics and AI tools such as Litmaps.co, ResearchRabbit, and MAXQDA, this study conducts a thorough analysis of remediation techniques for soils co-contaminated with heavy metals and PAHs. It emphasizes the significance of cation-π interactions and soil composition in dictating the solubility and behavior of these pollutants. The study pays particular attention to the interplay between heavy metals and PAH solubility, as well as the impact of soil properties like clay type and organic matter on heavy metal adsorption, which results in nonlinear sorption patterns. The research identifies a growing trend towards employing combined remediation techniques, especially biological strategies like biostimulation-bioaugmentation, noting their effectiveness in laboratory settings, albeit with potentially higher costs in field applications. Plants such as Medicago sativa L. and Solanum nigrum L. are highlighted for their effectiveness in phytoremediation, working synergistically with beneficial microbes to decompose contaminants. Furthermore, the study illustrates that the incorporation of biochar and surfactants, along with chelating agents like EDTA, can significantly enhance treatment efficiency. However, the research acknowledges that varying environmental conditions necessitate site-specific adaptations in remediation strategies. Life Cycle Assessment (LCA) findings indicate that while high-energy methods like Steam Enhanced Extraction and Thermal Resistivity - ERH are effective, they also entail substantial environmental and financial costs. Conversely, Natural Attenuation, despite being a low-impact and cost-effective option, may require prolonged monitoring. The study advocates for an integrative approach to soil remediation, one that harmoniously balances environmental sustainability, cost-effectiveness, and the specific requirements of contaminated sites. It underscores the necessity of a holistic strategy that combines various remediation methods, tailored to meet both regulatory compliance and the long-term sustainability of decontamination efforts.
Topics: Polycyclic Aromatic Hydrocarbons; Soil Pollutants; Metals, Heavy; Biodegradation, Environmental; Soil; Artificial Intelligence; Environmental Restoration and Remediation
PubMed: 38402679
DOI: 10.1016/j.jhazmat.2024.133813 -
The Science of the Total Environment Apr 2024Synthetic musks (SMs) have served as cost-effective substitutes for natural musk compounds in personal care and daily chemical products for decades. Their widespread use... (Review)
Review
Synthetic musks (SMs) have served as cost-effective substitutes for natural musk compounds in personal care and daily chemical products for decades. Their widespread use has led to their detection in various environmental matrices, raising concerns about potential risks. Despite numerous studies on SM levels in different natural environments, a systematic review of their contemporary presence is lacking. This review aims to address this gap by summarising recent research developments on SMs in diverse natural environments, including river water, lake water, seawater, estuarine water, groundwater, snow, meltwater, sediments, aquatic suspended matter, soils, sands, outdoor air, and atmospheric particulate matter. Covering the period from 2010 to 2023, the review focuses on four SM categories: nitro, polycyclic, macrocyclic, and alicyclic. It systematically examines their sources, occurrences, concentrations, spatial and temporal variations, and fate. The literature reveals widespread detection of SMs in the natural environment (freshwater and sediments in particular), with polycyclic musks being the most studied group. Both direct (e.g., wastewater discharges) and indirect (e.g., human recreational activities) sources contribute to SM presence. Levels of SMs vary greatly among studies with higher levels observed in certain regions, such as sediments in Southeast Asia. Spatial and temporal variations are also evident. The fate of SMs in the environment depends on their physicochemical properties and environmental processes, including bioaccumulation, biodegradation, photodegradation, adsorption, phase exchange, hydro-dilution effects. Biodegradation and photodegradation can decrease SM levels, but may produce more persistent and eco-toxic products. Modelling approaches have been employed to analyse SM fate, especially for indirect processes like photodegradation or long-distance atmospheric transport. Future studies should further investigate the complex fate if SMs and their environmental influence. This review enhances understanding of SM status in the natural environment and supports efforts to control environmental contamination.
Topics: Humans; Fresh Water; Wastewater; Biodegradation, Environmental; Seawater; Water; Water Pollutants, Chemical; Benzopyrans; Tetrahydronaphthalenes
PubMed: 38432391
DOI: 10.1016/j.scitotenv.2024.171344 -
Anais Da Academia Brasileira de Ciencias 2024Cyanotoxins pose a health threat when present in the drinking water supply since conventional water treatment processes are not effective in removing extracellular...
Cyanotoxins pose a health threat when present in the drinking water supply since conventional water treatment processes are not effective in removing extracellular metabolites hence, advanced treatment techniques are usually applied. Powdered activated carbon (PAC) is an effective adsorbent for removing toxins. However, since a high volume is necessary, alternative adsorbents have been investigated. Biochar, especially from renewable sources, is a potential adsorbent material that could replace PAC for removing toxins. This paper aimed to investigate which PAC properties play key roles in cyanotoxin adsorption by a systematic review addressing the adsorption of toxins such as microcystins-LR (MC-LR), cylindrospermopsin (CYL), and saxitoxins (STXs). As a result, the review showed that some commonly adopted indices (i.e. total surface area) are not relevant to cyanotoxin adsorption, especially if appraised alone. Along with a multi-barrier approach, PAC has to be applied taking into account the complexity of the water system, which includes a better understanding of the characteristics of the adsorbent, the target toxin, and the aqueous medium. The biochar systematic review showed that no studies have yet been designed specifically for the removal of toxins. Since biochar has not yet been applied to water treatment processes, the knowledge gap is even greater than for PAC.
Topics: Charcoal; Adsorption; Cyanobacteria Toxins; Knowledge; Powders
PubMed: 38198398
DOI: 10.1590/0001-3765202320230061 -
Journal of Nanobiotechnology Jan 2024Environmental pollution is a major issue that requires effective solutions. Nanomaterials (NMs) have emerged as promising candidates for pollution remediation due to... (Review)
Review
Advancement in nanomaterials for environmental pollutants remediation: a systematic review on bibliometrics analysis, material types, synthesis pathways, and related mechanisms.
Environmental pollution is a major issue that requires effective solutions. Nanomaterials (NMs) have emerged as promising candidates for pollution remediation due to their unique properties. This review paper provides a systematic analysis of the potential of NMs for environmental pollution remediation compared to conventional techniques. It elaborates on several aspects, including conventional and advanced techniques for removing pollutants, classification of NMs (organic, inorganic, and composite base). The efficiency of NMs in remediation of pollutants depends on their dispersion and retention, with each type of NM having different advantages and disadvantages. Various synthesis pathways for NMs, including traditional synthesis (chemical and physical) and biological synthesis pathways, mechanisms of reaction for pollutants removal using NMs, such as adsorption, filtration, disinfection, photocatalysis, and oxidation, also are evaluated. Additionally, this review presents suggestions for future investigation strategies to improve the efficacy of NMs in environmental remediation. The research so far provides strong evidence that NMs could effectively remove contaminants and may be valuable assets for various industrial purposes. However, further research and development are necessary to fully realize this potential, such as exploring new synthesis pathways and improving the dispersion and retention of NMs in the environment. Furthermore, there is a need to compare the efficacy of different types of NMs for remediating specific pollutants. Overall, this review highlights the immense potential of NMs for mitigating environmental pollutants and calls for more research in this direction.
Topics: Environmental Pollutants; Environmental Restoration and Remediation; Environmental Pollution; Nanostructures; Bibliometrics
PubMed: 38200605
DOI: 10.1186/s12951-023-02151-3 -
BMC Cardiovascular Disorders May 2024Extracorporeal blood purification has been widely used in intensive care medicine, nephrology, toxicology, and other fields. During the last decade, with the emergence...
BACKGROUND
Extracorporeal blood purification has been widely used in intensive care medicine, nephrology, toxicology, and other fields. During the last decade, with the emergence of new adsorptive blood purification devices, hemoadsorption has been increasingly applied during CPB in cardiac surgery, for patients at different inflammatory risks, or for postoperative complications. Clinical evidence so far has not provided definite answers concerning this adjunctive treatment. The current systematic review aimed to critically assess the role of perioperative hemoadsorption in cardiac surgery, by summarizing the current knowledge in this clinical setting.
METHODS
A literature search of PubMed, Cochrane library, and the database provided by CytoSorbents was conducted on June 1st, 2023. The search terms were chosen by applying neutral search keywords to perform a non-biased systematic search, including language variations of terms "cardiac surgery" and "hemoadsorption". The screening and selection process followed scientific principles (PRISMA statement). Abstracts were considered for inclusion if they were written in English and published within the last ten years. Publications were eligible for assessment if reporting on original data from any type of study (excluding case reports) in which a hemoadsorption device was investigated during or after cardiac surgery. Results were summarized according to sub-fields and presented in a tabular view.
RESULTS
The search resulted in 29 publications with a total of 1,057 patients who were treated with hemoadsorption and 988 control patients. Articles were grouped and descriptively analyzed due to the remarkable variability in study designs, however, all reported exclusively on CytoSorb therapy. A total of 62% (18/29) of the included articles reported on safety and no unanticipated adverse events have been observed. The most frequently reported clinical outcome associated with hemoadsorption was reduced vasopressor demand resulting in better hemodynamic stability.
CONCLUSIONS
The role of hemoadsorption in cardiac surgery seems to be justified in selected high-risk cases in infective endocarditis, aortic surgery, heart transplantation, and emergency surgery in patients under antithrombotic therapy, as well as in those who develop a dysregulated inflammatory response, vasoplegia, or septic shock postoperatively. Future large randomized controlled trials are needed to better define proper patient selection, dosing, and timing of the therapy.
Topics: Humans; Cardiac Surgical Procedures; Treatment Outcome; Risk Factors; Postoperative Complications; Cardiopulmonary Bypass; Male; Female; Risk Assessment; Aged; Middle Aged
PubMed: 38762715
DOI: 10.1186/s12872-024-03938-4 -
Journal of Environmental Management Feb 2024Biofiltration utilizes natural mechanisms including biodegradation and biotransformation along with other physical processes for the removal of organic micropollutants... (Review)
Review
Biofiltration utilizes natural mechanisms including biodegradation and biotransformation along with other physical processes for the removal of organic micropollutants (OMPs) such as pharmaceuticals, personal care products, pesticides and industrial compounds found in (waste)water. In this systematic review, a total of 120 biofiltration studies from 25 countries were analyzed, considering various biofilter configurations, source water types, biofilter media and scales of operation. The study also provides a bibliometric analysis to identify the emerging research trends in the field. The results show that granular activated carbon (GAC) either alone or in combination with another biofiltration media can remove a broad range of OMPs efficiently. The impact of pre-oxidation on biofilter performance was investigated, revealing that pre-oxidation significantly improved OMP removal and reduced the empty bed contact time (EBCT) needed to achieve a consistently high OMP. Biofiltration with pre-oxidation had median removals ranging between 65% and >90% for various OMPs at 10-45 min EBCT with data variability drastically reducing beyond 20 min EBCT. Biofiltration without pre-oxidation had lower median removals with greater variability. The results demonstrate that pre-oxidation greatly enhances the removal of adsorptive and poorly biodegradable OMPs, while its impact on other OMPs varies. Only 19% of studies we reviewed included toxicity testing of treated effluent, and even fewer measured transformation products. Several studies have previously reported an increase in effluent toxicity because of oxidation, although it was successfully abated by subsequent biofiltration in most cases. Therefore, the efficacy of biofiltration treatment should be assessed by integrating toxicity testing into the assessment of overall removal.
Topics: Filtration; Water Purification; Water Pollutants, Chemical; Charcoal; Water
PubMed: 38325285
DOI: 10.1016/j.jenvman.2024.120203