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| 2. |
- Brandström, Josef, et al.
(författare)
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Individually dosed omalizumab facilitates peanut oral immunotherapy in peanut allergic adolescents
- 2019
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Ingår i: Clinical and Experimental Allergy. - : Wiley. - 0954-7894 .- 1365-2222. ; 49:10, s. 1328-1341
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Tidskriftsartikel (refereegranskat)abstract
- Background: Peanut oral immunotherapy (pOIT) has showed good short-term outcomes, but allergic reactions may prevent effective up-dosing and is a major cause of stopping OIT. In placebo-controlled trials, omalizumab has been shown to facilitate allergen immunotherapy and increase tolerance to peanut.Objective: We hypothesized that by combining omalizumab with pOIT, and monitor treatment effects with basophil allergen threshold sensitivity tests (CD-sens), peanut allergic patients could safely initiate pOIT and thereafter slowly withdraw omalizumab.Methods: This is the 2nd part of a one-armed open phase-2 study where peanut allergic adolescents (n = 23) started pOIT after an individualized omalizumab treatment. The pOIT dose was increased from 280 to 2800 mg peanut protein in 8 weeks followed by an individualized step-wise withdrawal of omalizumab, based on clinical symptoms and CD-sens levels. pOIT continued for 12 weeks followed by an open peanut challenge. Peanut CD-sens and allergen-binding activity (ABA) and IgE-ab, IgG-ab and IgG4-ab to peanut and its components were measured during the study.Results: All 23 patients successfully reached the 2800 mg maintenance dose. Moderate/systemic allergic reactions were rare while receiving full-dose omalizumab. Eleven of 23 (48%) successfully continued with pOIT after omalizumab was stopped. Compared to treatment failures, median baseline IgE-ab to peanut components Ara h 1-3 and CD-sens to peanut were significantly lower among successfully treated patients and IgG4-ab to peanut, Ara h 2 and 6 increased significantly more during treatment.Conclusions and clinical relevance: This study indicates that omalizumab is an effective adjunctive therapy for initiation and rapid up-dosing of pOIT; however, adverse events from pOIT become more frequent as omalizumab doses are decreased.
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| 3. |
- Nilsson, Mirja, et al.
(författare)
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Effect of accelerated carbonation and zero valent iron on metal leaching from bottom ash
- 2016
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Ingår i: Waste Management. - : Elsevier BV. - 0956-053X .- 1879-2456. ; 51, s. 97-104
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Tidskriftsartikel (refereegranskat)abstract
- About 85% of the ashes produced in Sweden originated from the incineration of municipal solid waste and biofuel. The rest comes from the thermal treatment of recycled wood, peat, charcoal and others. About 68% of all ashes annually produced in Sweden are used for constructions on landfills, mainly slopes, roads and embankments, and only 3% for construction of roads and working surfaces outside the landfills (SCB, 2013). Since waste bottom ash (BA) often has similar properties to crushed bedrock or gravel, it could be used for road constructions to a larger extent. However, the leaching of e.g. Cr, Cu, Mo, Pb and Zn can cause a threat to the surrounding environment if the material is used as it is. Carbonation is a commonly used pre-treatment method, yet it is not always sufficient.As leaching from aged ash is often controlled by adsorption to iron oxides, increasing the number of Fe oxide sorption sites can be a way to control the leaching of several critical elements. The importance of iron oxides as sorption sites for metals is known from both mineralogical studies of bottom ash and from the remediation of contaminated soil, where iron is used as an amendment.In this study, zero valent iron (Fe(0)) was added prior to accelerated carbonation in order to increase the number of adsorption sites for metals and thereby reduce leaching. Batch, column and pHstat leaching tests were performed and the leaching behaviour was evaluated with multivariate data analysis. It showed that leaching changed distinctly after the tested treatments, in particular after the combined treatment.Especially, the leaching of Cr and Cu clearly decreased as a result of accelerated carbonation. The combination of accelerated carbonation with Fe(0) addition reduced the leaching of Cr and Cu even further and reduced also the leaching of Mo, Zn, Pb and Cd compared to untreated BA. Compared with only accelerated carbonation, the Fe(0) addition significantly reduced the leaching of Cr, Cu and Mo. The effects of Fe(0) addition can be related to binding of the studied elements to newly formed iron oxides. The effects of Fe(0) addition were often more distinct at pH values between 7 and 9, which indicates that a single treatment with only Fe addition would be less effective and a combined treatment is recommended. The pHstat results showed that accelerated carbonation in combination with Fe(0)0 addition widens the pH range for low solubility of about one unit for several of the studied elements. This indicates that pre-treating the bottom ash with a combination of accelerated carbonation and Fe(0) addition makes the leaching properties of the ash less sensitive to pH changes that may occur during reuse. All in all, the addition of Fe0 in combination with carbonation could be an effective pre-treatment method for decreasing the mobility of potentially harmful components in bottom ash.
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| 4. |
- Nilsson, Mirja
(författare)
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Environmental assessment of bottom ash pre-treated with zero valent iron
- 2014
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Bottom ash has similar properties as crushed rocks and gravel, andcould replace some of the 40 million tonnesof virgin material used for road constructions each year.However, results presented in the literature indicate thatthe leaching of e.g. Cr, Cu, Mo, Pb and Zn can cause athreat to the sur rounding environment if the materialis used as it is. A common pre-treatment method is carbonation, whichwill reduce the pH and thereby decrease the leaching of several metals. This treatment is however not always enough, so alternative methods areneeded. One possibility could be to increase the number of sorption sites for the metals. The importance of iron oxides as sorption sits for metals isknown from both mineralogical studies of bottom ash as well as from theremediation of contaminated soil, where iron is used as an amendment.Zero valent iron (Fe 0) was therefore added prior to accelerated agingin order to increase the number of adsorption sites for metals and thereby improving the leaching quality. The performed leaching tests showed that theaddition of Fe 0 prior to accelerated aging improved the quality of the leachate compared with untreated bottom ash. There was also a significant de crease of Cu, Cr, Mo and Zn from bottom ash treated with Fe0 prior to accelerated aging com pared with bottom ash submitted to only accelerated aging. In order to make an environmental assessment of the bottom ash pretreated with Fe 0 prior to accelerated aginggeochemical modeling was performed using different pH and redox potentialsin order to simulate variations in the environment.The results in dicated that the leaching of Cr, Cr, Mo and Pb would not cause harm to the environment.Zn, however, was affected by changes in pH and leached in harmful aounts at pH values velow 6 and above 10.There are reasons to question the results from the geochemical modellingsince the results from pH-stat tests showedthat several elements leached at potentially harmful levelsat several of the tested pH. To fully evaluate the effect of addition of Fe0should the mineralogy of the pretreated bottom ash be evaluated further, in order to see what forms iron oxides are pre sent and if other metals are associated with them. However, in order to improve the quality of bottom ash,focus should be directed torwards what type of wastes that areincinerated and on the incineration process.
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| 5. |
- Nilsson, Mirja, et al.
(författare)
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Screening analysis of bottom ashes from waste incineration
- 2013
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Ingår i: Sardinia 2013. - Cagliari : CISA, Environmental Sanitary Engineering Centre.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Screening analysis of bottom ashes from waste incinerationA local waste-to-energy plant in Northern Sweden incinerates municipal solid waste (MSW). The bottom ash (BA) shall be used as construction material. To investigate the homogeneity of the BA, as a base for a more detailed characterisation, a screening was done on 0-10 mm samples taken daily during one month in an ash treatment plant for metal separation.The on-going characterisation focuses on the leaching of heavy metals from the BA as previous work (Oja 2012) showed that a number of trace metals (As, Cd, Cr, Cu, Ni, Pb and Zn) exceeds the limits set up by the Swedish EPA (Naturvårdsverket 2010) for the use of waste as construction material with regard to total content. Since Cu and Cr also exceed the leaching limits (L/S10), the bottom ash cannot be used without treatment. Ageing and the effect of immobilising amendments are studied with regard to their effect on the leaching behaviour.Material and MethodSamples of BA were taken after metal separation and sieving, daily during one month in 2012 resulting in 32 samples of two different fractions, 0-10 mm and 10-50 mm. A screening was performed on the 0-10 mm fraction analysing pH, EC both in duplicates and LOI, TS, and elemental composition using XRF on non-milled samples in triplicates. Results Based on the analyses made, no grouping of samples could be observed (figure 1), and therefore the material in each fraction was homogenized prior to further investigation. On-going studyDifferent treatment options such as accelerated ageing and stabilization with e.g. zero valent iron are investigated in an on-going study. Also, the effect of incineration parameters such as temperature, air flow and time, on the composition of the BA is studied through modelling (using Factsage). The overall goal is to improve the quality of the BA to an extent that it can be used in different ground constructions.The combined effects of weathering and iron amendment on the mineral composition and the leaching behaviour will be studied. The test program includes acid neutralization capacity (ANC), TOC, XRF, XRD analyses and a column test. Mechanical stability and freeze-thaw resistance will also be tested. Using the Factsage database the incineration process will be modelled with regard to possible changes in the composition of the BA.In addition to this work two field test areas (á 200 m2) will be installed using treated BA as base layer in a material processing and stockpile areas. The leachate will be collected using lysimeters and analysed monthly. Primary results will be available in late summer/early fall. References Naturvårdsverket (2010). Återvinning av avfall i anläggningsarbeten. Handbok 2010:1. Naturvårdsverket StockholmOja E. (2012). Botten aska som dräneringsskikt vid sluttäckning av deponier. Department of Environmental Engineering, Division of Waste Science and Technology, Luleå University of Technology
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