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However, the ESs from CEs were lower relative to Federal and State Protected Areas. Our results suggest that CEs are effective in ensuring the continuance of ESs within the UCW. V.Total nitrogen (TN) removal is the major technical challenge for wastewater treatment plants to meet the more stringent discharge standard. Bromelain research buy In this study, lab- (0.05 m3/d), pilot- (1000 m3/d) and full-scale (10,000 m3/d) combined heterotrophic and autotrophic denitrification reactors (HARs) were designed and operated to treat municipal secondary effluent. During the 110-day stable operation, the effluent TN was reduced below 2.5 mg/L without secondary pollution causing by the excessive addition of organics, close to Class IV of Environmental Quality Standards for Surface Water. The bacterial richness and diversity increased with the expansion of reactor scale. Denitrifying bacteria (DB) dominated in all reactors, however, Thiomonas (12.42%), Methylotenera (6.35%), Thiobacillus (20.62%), Methyloverstatilis (5.44%) and Thauera (8.21%) were the main genera in lab-, pilot- and full-scale reactors respectively. The denitrification efficiency temporarily deteriorated at the later stage, and redundancy analysis (RDA) indicated the obviously increased sulfate reducing bacteria (SRB) and sulfide were main contributors. Sludge supplement rapidly recovered the reactors performance in five days. This study suggests that HARs could be a promising technique for advanced denitrification of the municipal secondary effluent. The Koiliaris River basin is a semi-arid Mediterranean karstic watershed where water needs during the summer are exclusively covered by the karstic springs flow. Uncertainty assessment of the hydrologic projections for karstic watersheds may reveal possible water deficits that cannot otherwise be taken into account. The Soil Water Assessment Tool (SWAT) along with a karstic model (Karst-SWAT) is used to assess the composite spring and surface flow. The parameter uncertainty of both the surface and karstic flow models is estimated by combining the SUFI2 interface and the @RISK by PALISADE software. Eleven combinations of five Regional Climate Models (RCMs) and three Representative Concentration Pathways (RCPs) provide input to the hydrologic models. Representative rainfall time series for certain scenarios are stochastically modeled with the LARS weather generator. Monte Carlo simulations are used to investigate the effect of input internal variability on the flow output. The uncertainty of karstic flow due to the parameter uncertainty of the SWAT and Karst-SWAT models is 10.0% (Coefficient of Variation), which is comparable to the estimated uncertainty due to climate change scenarios (10.1%) until 2059. The combined uncertainty for the total flow at the basin exit due to both models' parameter uncertainty is 6.6%, comparable to the uncertainty due to the internal variability (5.6%). The total uncertainty of karstic flow, combining model parameter uncertainty and the internal variability of the climate scenarios is 11.0%. The total uncertainty estimate is used in conjunction with the lowest karstic flow projection to assess the most adverse scenario for the future mean annual karstic flow. This is the first study which estimates the combined uncertainty of surface and karstic flow prediction due to model parameter uncertainty and internal variability. Our study provides a rigorous methodology for uncertainty estimation and analysis which is transferable to other karstic regions of the world. E-waste contains valuable metals that require appropriate waste management plans. However, rudimentary e-waste processing methods are a source of heavy metals environmental pollution. This study has characterised concentrations of heavy metals in soil (n = 10), water (n = 10) and hair (n = 44) of children in areas surrounding Jakarta (Indonesia), where e-waste is being or has been conducted in the past, and in a reference unexposed site. Chronic exposure to Mn, Pb, Hg, As and Cd and its associations with attention and executive function, characterised with the Trail Making Test (TMT), along with academic performance scores was conducted using multivariate regression analysis. Models were adjusted for age, gender, parental education, environmental tobacco smoke and residential traffic. Lead (3653 ± 3355 mg/kg), cadmium (3.4 ± 0.9 mg/kg) and mercury (15.2 ± 28.5 mg/kg) concentrations from soil and manganese concentrations in water (1.43 ± 0.64 mg/L) in the exposed sites were higher than current regulations. Heavy metal concentrations in hair of children living near e-waste facilities was higher than for children living in non-exposed areas (Pb 0.155 ± 0.187 vs 0.0729 ± 0.08 mg/g; Mn 0.130 ± 0.212 vs 0.018 ± 0.045 mg/g; Hg 0.008 ± 0.0042 vs 0.002 ± 0.0011 mg/g) suggesting chronic exposure to heavy metals. Manganese exposure was associated with worse cognitive performance in the domains of attention (TMT-A score 66 s, 95% CI 0.09, 132), executive function (TMT-B score 105 s, 95% CI 11.5, 198) and social sciences (-29%, 95% CI -54, -4.7) (per unit of Mn in hair mg/g). These results suggest that informal e-waste activities contribute to local heavy metal soil contamination, and could be an important source of metal exposure to children living in the vicinity of these facilities with putative impacts on their cognitive performance. E-waste management regulation and remediation programmes should be implemented to reduce environmental pollution and associated health effects. Background/Aims Exclusive enteral nutrition (EEN) is recommended for induction of remission in pediatric Crohn's disease (CD). However, it is not currently recommended for inducing remission in adults. This report describes the use of 12-week EEN for induction of remission in anti-tumor necrosis factor (anti-TNF) refractory adult CD. Methods This is a retrospective analysis of adults with moderate to severe active (Crohn's Disease Activity Index [CDAI] >220) anti-TNF refractory CD, who received EEN for 12 weeks between April 2018 and March 2019 at Dayanand Medical College and Hospital, Ludhiana, India. Primary outcomes included achievement of clinical remission and fistula healing at 12 weeks. Improvement in inflammatory markers and nutritional status were the secondary end points. Results Out of 23 patients who received anti-TNF agents, 7 (30.4%) were refractory and were offered EEN as a salvage therapy. Six patients (66.7% females, mean age 25.6±6.5 years) consented. Four patients (66.6%) achieved clinical remission (CDAI 50%), though none achieved remission.
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