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Stable Isotopic Signatures of NO₃ in Waste Water Effluent and Los Angeles River

Journal of Water Resource and Protection 2024年第1期16卷 102-122页

作者： isaac hall Mohammad Hassan Rezaie Boroon Department of Geography Geology and Environment California State University Los Angeles California USA

A metropolitan city such as Los Angeles (LA) is an ideal study site with a very high population density, and it houses at least 3 treatment plants where sewage is treated preliminarily and then progressing to tertiary treatment before discharging into the LA River. We will gain a better understanding of the water quality in the LA River and the nitrate load in the watershed system by examining the influence of waste water treatment plants (WWTPs). The goal of this study is to pinpoint the exact source of nitrate in the LA River using the isotope signatures. We have selected sampling locations both upstream and downstream of the WWTP. This serves to monitor nitrate levels, aiding in the assessment of treatment plant effectiveness, pinpointing nitrate pollution sources, and ensuring compliance with environmental regulations. The research explores the isotopic composition of NO3 in relation to atmospheric nitrogen and Vienna Standard Mean Ocean Water, shedding light on the contributions from various sources such as manure, sewage, soil organic nitrogen, and nitrogen fertilizers. Specifically, there is a change in the δ15NAir value between the dry and wet seasons. The isotope values in the Tillman WWTP sample changed between dry and wet seasons. Notably, the presence of nitrate originating from manure and sewage is consistent across seasons, emphasizing the significant impact of anthropogenic and agricultural activities on water quality. This investigation contributes to the broader understanding of nitrogen cycling in urban water bodies, particularly in the context of wastewater effluent discharge. The findings hold implications for water quality management and highlight the need for targeted interventions to mitigate the impact of nitrogen-containing compounds on aquatic ecosystems. Overall, the study provides a valuable framework for future research and environmental stewardship efforts aimed at preserving the health and sustainability of urban water resources. This

关键词： Metropolitan City Los Angeles Treatment Plants Sewage Treatment Nitrate Source Isotope Signatures Water Quality

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Graft loss among renal-transplant recipients with early reduction of immunosuppression for BK viremia

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World Journal of Transplantation 2017年第5期7卷 269-275页

作者： Marwan M Azar Roland Assi Aziz K Valika David B Banach isaac E hall Marie-Louise Landry Maricar F Malinis Department of Pathology Section of MicrobiologyMassachusetts General HospitalBostonMA 02145United States Section of Infectious Diseases Yale School of MedicineNew HavenCT 06510United States Department of Surgery Yale University School of MedicineNew HavenCT 06510United States Adventist Health Partners ChicagoIL 60521United States Division of Infectious Diseases University of Connecticut School of MedicineFarmingtonCT 06032United States Division of Hypertension and Nephrology University of Utah School of MedicineDalt Lake CityUT 84132United States Department of Laboratory Medicine Yale University School of MedicineNew HavenCT 06510United States

AIM To review the incidence of graft loss and acute rejection among renal transplant recipients with early reduction of immunosuppression for BK *** We performed a retrospective analysis of consecutive de-novo kidney-only transplants from January 2009 to December 2012 to evaluate the incidence of Polyomavirus associated nephropathy(PyV AN). Recipient plasma was screened for BKV DNA via quantitative polymerase chain reaction(PCR) at months 1,3,6,9 and 12 post-transplant and on worsening graft *** was reduced at ≥ 3-log copies/mL. Those with viremia of ≥ 4-log copies/mL(presumptive PyV AN) underwent renal transplant biopsy. Presumptive Py VAN(PP) and definitive Py VAN(DP; biopsy-proven) were treated by immunosuppression reduction(IR) only. RESULTS Among 319 kidney transplant recipients,the median age was 53 years(range 19-83),65.8% were male,and 58.9% were white. Biopsy-proven acute rejection was found in 18.5% within 0-168 wk. Death-censored graft loss occurred in 5.3%(n = 17) and graft loss attributable to PyV AN was 0.6%(n = 2). Forty-seven patients were diagnosed with PP(14.7%) and 18(5.6%) with DP. Graft loss among participants with PyV AN(8.5%) and those without(4.8%) was not significantly different. Deceased donor kidney transplantation(OR = 2.3,95%CI = 1.1-4.6) and AR(OR = 2.3,95%CI = 1.2-4.7) were associated with Py VAN in the multivariate analysis. BK viremia between 3 and 4-log copies/mL occurred in 27 patients,all of whom underwent IR. Of these,16(59%) never developed PyV AN while 11(41%) developed PyV AN(4 DP,7 PP) within a range of 11-39 wk. CONCLUSION Instituting an early reduction of immunosuppression,in the absence of adjunctive antivirals,is effective at preventing PyV AN and may be associated with a lower incidence of graft-loss without a reciprocal increase in the incidence of acute rejection.

关键词： BK virus Renal transplant Screening PyVAN Prevention Graft loss

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Traumatic subcutaneous emphysema of the hand/forearm: A case report

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Chinese Journal of Traumatology 2022年第6期25卷 395-399页

作者： Stephen Saela Alexander Decilveo Roman isaac Deepak V.Patel Department of Orthopaedic Surgery St Josephs University Medical CenterPatersonNJ 07503USA Department of Orthopaedic Surgery Seton Hall UniversitySouth OrangeNJ 07079US

Subcutaneous emphysema is commonly associated with infection caused by gas-producing *** this case report,we describe a rare instance of traumatic subcutaneous emphysema of the hand and forearm caused by a puncture injury to the first web space of the *** objective is to increase awareness of the potential for seemingly minor trauma to cause entrapment of significant air in subcutaneous tissues,thereby decreasing the likelihood that a clinically benign-appearing patient will be started down an unnecessarily aggressive treatment pathway.A 16-year-old,otherwise healthy white female,presented to the pediatric emergency room with an impressive amount of subcutaneous emphysema that developed over a 12-h period after sustaining an accidental laceration to the first web space of her right *** appeared nontoxic and had a clinically benign presentation.A comprehensive work-up was *** was splinted by the orthopedic surgery resident on call,and was admitted to the Pediatric Intensive Care Unit for overnight *** received tetanus vaccination and broad-spectrum *** patient was discharged 2 days after admittance,with a splint applied to her right hand and *** undertook home-based physical and occupational *** had a pain-free range-of-motion in the right wrist,elbow and *** swelling in the right hand subsided *** initially alarming,traumatic subcutaneous emphysema in an otherwise healthy patient from minor wounds(as featured in this case)does not necessarily mean one ought to proceed down an aggressive treatment *** evaluation of the patient's history,clinical examination findings,and determination of the Laboratory Risk Indicator for Necrotizing Fasciitis score can help guide physicians in the management of traumatic subcutaneous emphysema and potentially avoid unnecessary and costly interventions.

关键词： Upper extremity Traumatic subcutaneous emphysema Sucking-wounds Penetrating Necrotizing fasciitis Case reports Laboratory Risk Indicator for Necrotizing Fasciitis(LRINEC)

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