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  • Beral, V, et al. (author)
  • Alcohol, tobacco and breast cancer - collaborative reanalysis of individual data from 53 epidemiological studies, including 58515 women with breast cancer and 95067 women without the disease
  • 2002
  • In: British Journal of Cancer. - : Springer Science and Business Media LLC. - 1532-1827 .- 0007-0920. ; 87, s. 1234-45
  • Journal article (peer-reviewed)abstract
    • Alcohol and tobacco consumption are closely correlated and published results on their association with breast cancer have not always allowed adequately for confounding between these exposures. Over 80% of the relevant information worldwide on alcohol and tobacco consumption and breast cancer were collated, checked and analysed centrally. Analyses included 58515 women with invasive breast cancer and 95067 controls from 53 studies. Relative risks of breast cancer were estimated, after stratifying by study, age, parity and, where appropriate, women's age when their first child was born and consumption of alcohol and tobacco. The average consumption of alcohol reported by controls from developed countries was 6.0 g per day, i.e. about half a unit/drink of alcohol per day, and was greater in ever-smokers than never-smokers, (8.4 g per day and 5.0 g per day, respectively). Compared with women who reported drinking no alcohol, the relative risk of breast cancer was 1.32 (1.19 - 1.45, P < 0.00001) for an intake of 35 - 44 g per day alcohol, and 1.46 (1.33 - 1.61, P < 0.00001) for greater than or equal to 45 g per day alcohol. The relative risk of breast cancer increased by 7.1% (95% CI 5.5-8.7%; P<0.00001) for each additional 10 g per day intake of alcohol, i.e. for each extra unit or drink of alcohol consumed on a daily basis. This increase was the same in ever-smokers and never-smokers (7.1 % per 10 g per day, P < 0.00001, in each group). By contrast, the relationship between smoking and breast cancer was substantially confounded by the effect of alcohol. When analyses were restricted to 22 255 women with breast cancer and 40 832 controls who reported drinking no alcohol, smoking was not associated with breast cancer (compared to never-smokers, relative risk for ever-smokers= 1.03, 95% CI 0.98 - 1.07, and for current smokers=0.99, 0.92 - 1.05). The results for alcohol and for tobacco did not vary substantially across studies, study designs, or according to 15 personal characteristics of the women; nor were the findings materially confounded by any of these factors. If the observed relationship for alcohol is causal, these results suggest that about 4% of the breast cancers in developed countries are attributable to alcohol. In developing countries, where alcohol consumption among controls averaged only 0.4 g per day, alcohol would have a negligible effect on the incidence of breast cancer. In conclusion, smoking has little or no independent effect on the risk of developing breast cancer; the effect of alcohol on breast cancer needs to be interpreted in the context of its beneficial effects, in moderation, on cardiovascular disease and its harmful effects on cirrhosis and cancers of the mouth, larynx, oesophagus and liver. (C) 2002 Cancer Research UK.
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  • Kehoe, Laura, et al. (author)
  • Make EU trade with Brazil sustainable
  • 2019
  • In: Science. - : American Association for the Advancement of Science (AAAS). - 0036-8075 .- 1095-9203. ; 364:6438, s. 341-
  • Journal article (other academic/artistic)
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  • Persson, N, et al. (author)
  • Biologisk denitrifikation av dricksvatten - Biological denitrification of drinking water
  • 2006
  • In: Vatten: tidskrift för vattenvård /Journal of Water Management and research. - 0042-2886. ; 62:4, s. 323-333
  • Journal article (other academic/artistic)abstract
    • A pilot-plant study, made to clarify whether biological denitrification is a possible and suitable method for nitrate reduction of drinking water in Sweden is presented. The concentration of nitrate-nitrogen in un-treated water was 10–15 mg/l. The reactor was a 1.2 m aluminium tube with a inner diameter of 0.19 m. 0.75 m was filled with Filtralite®, expanded clay, through which the nitrate-contaminated water was forced to flow upwards with a velocity of 0.5 m/h. The system was run with artificial nitrate-polluted potable water from the three pumps during a week. The nitrate was then added to the water by using a solution of sodium nitrate. As carbon-source, sodium acetate was used. The Hydraulic Retention Time (HRT) of the system was 5.9 h, of which approximately 2.6 hours were within the bacterial support material. The C:N ratio was found to be below 1.5 and the system was very stable. Since the process will not work as long as oxygen is present, oxygen was degassed, but the importance of trace oxygen amounts could not be decided, since it wasn’t possible to decrease the oxygen to really low concentrations in the water prior inlet to the reactor. It was concluded that it is possible to use biological denitrification for drinking water. Post-treatment in an aerated reactor will be needed to ensure that no carbon or nitrite-nitrogen comes into the potable water.
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  • Adane, A, et al. (author)
  • Exploring data quality and use of the routine health information system in Ethiopia: a mixed-methods study
  • 2021
  • In: BMJ open. - : BMJ. - 2044-6055. ; 11:12, s. e050356-
  • Journal article (peer-reviewed)abstract
    • A routine health information system (RHIS) enables decision making in the healthcare system. We aimed to analyse data quality at the district and regional level and explore factors and perceptions affecting the quality and use of routine data.DesignThis was a mixed-methods study. We used the WHO toolkit for analysing data quality and interviewed staff at the point of data generation and along with the flow of data. Data were analysed using the Performance of Routine Information System Management framework.SettingThis study was performed in eight districts in four regions of Ethiopia. The study was nested within a 2-year programme of the Operational Research and Coaching for government Analysts.ParticipantsWe visited 45 health posts, 1 district hospital, 16 health centres and 8 district offices for analysis of routine RHIS data and interviewed 117 staff members for the qualitative assessment.Outcome measuresWe assessed availability of source documents, completeness, timeliness and accuracy of reporting of routine data, and explored data quality and use perceptions.ResultsThere was variable quality of both indicator and data element. Data on maternal health and immunisation were of higher quality than data on child nutrition. Issues ranged from simple organisational factors, such as availability of register books, to intricate technical issues, like complexity of indicators and choice of denominators based on population estimates. Respondents showed knowledge of the reporting procedures, but also demonstrated limited skills, lack of supportive supervision and reporting to please the next level. We saw limited examples of the use of data by the staff who were responsible for data reporting.ConclusionWe identified important organisational, technical, behavioural and process factors that need further attention to improve the quality and use of RHIS data in Ethiopia.
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  • Björkqvist, Maria, et al. (author)
  • Role of gastrin in the development of gastric mucosa, ECL cells and A-like cells in newborn and young rats
  • 2002
  • In: Regulatory Peptides. - 1873-1686. ; 108:2-3, s. 73-82
  • Journal article (peer-reviewed)abstract
    • Histamine-producing ECL cells and ghrelin-producing A-like cells are endocrine/paracrine cell populations in the acid-producing part of the rat stomach. While the A-like cells operate independently of gastrin, the ECL cells respond to gastrin with mobilization of histamine and chromogranin A (CGA)-derived peptides, such as pancreastatin. Gastrin is often assumed to be the driving force behind the postnatal development of the gastric mucosa in general and the ECL cells in particular. We tested this assumption by examining the oxyntic mucosa (with ECL cells and A-like cells) in developing rats under the influence of YF476, a cholecystokinin-2 (CCK2) receptor antagonist. The drug was administered by weekly subcutaneous injections starting at birth. The body weight gain was not affected. Weaning occurred at days 1522 in both YF476-treated and age-matched control rats. Circulating gastrin was low at birth and reached adult levels 2 weeks after birth. During and after weaning (but riot before), YF476 greatly raised the serum gastrin concentration (because of abolished acid feedback inhibition of gastrin release). The weight of the stomach was unaffected by YF476 during the first 2-3 weeks after birth. From 4 to 5 weeks of age, the weight and thickness of the gastric mucosa were lower in YF476-treated rats than in controls. Pancreastatin-immunoreactive cells (i.e. all endocrine cells in the stomach) and ghrelin-immunoreactive cells (A-like cells) were few at birth and increased gradually in number until 6-8 weeks of age (control rats). At first, YF476 did not affect the development of the pancreastatin-immunoreactive cells, but a few weeks after weaning, the cells were fewer in the YF476 rats. The ECL-cell parameters (oxyntic mucosal histamine and pancreastatin concentrations, the histidine decarboxylase (HDC) activity, the HDC mRNA levels and serum pancreastatin concentration) increased slowly until weaning in both YF476-treated and control rats. From then on, there was a further increase in the ECL-cell parameters in control rats but not in YF476 rats. The postnatal development of the ghrelin cells (i.e. the A-like cells) and of the A-like cell parameters (the oxyntic mucosal ghrelin concentration and the serum ghrelin concentrations) was not affected by YF476 at any point. We conclude that gastrin affects neither the oxyntic mucosa nor the endocrine cells before weaning. After weaning, CCK2 receptor blockade is associated with a somewhat impaired development of tire oxyntic mucosa and the ECL cells. While gastrin stimulation is of crucial importance for the onset of acid secretion during weaning and for the activation of ECL-cell histamine formation and secretion, the mucosal and ECL-cell growth at this stage is only partly gastrin-dependent. In contrast, the development of the A-like cells is independent of gastrin at all stages. (C) 2002 Elsevier Science B.V. All rights reserved.
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  • Bouskova, Alzbeta, et al. (author)
  • The effect of operational temperature on dewatering characteristics of digested sludge
  • 2006
  • In: Journal of Residuals Science and Technology. - 1544-8053. ; 3:1, s. 43-49
  • Journal article (peer-reviewed)abstract
    • Dewatering properties and sludge structure of anaerobically digested sludge were studied in relation to an increasing operational temperature. Sludge samples were taken from 5 pilot-scale CSTR reactors treating municipal sewage sludge with working volume of 20 L and operating at 33, 35, 37, 39 and 55 degrees C, respectively. The main parameters of interest were capillary suction time (CST), concentration of extracellular polymeric substances (EPS), charge density of the extracted EPS, filterability (dry solids content after vacuum filtration), compactibility (dry solids content after pressing) and concentration of fine particles in the liquid phase (turbidity). Sludge from the reactor working at 55 degrees C (thermophilic) contained the most fine particles in the liquid phase, which remarkably deteriorated filterability of the sample, however when subjected to an external pressure, the sludge reached the highest dry matter content of the sludge cake. Sludge originating from the reactor working at 37 degrees C reached the best filtration properties.
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  • Brunner-La Rocca, Hans-Peter, et al. (author)
  • Which heart failure patients profit from natriuretic peptide guided therapy? A meta-analysis from individual patient data of randomized trials.
  • 2015
  • In: European Journal of Heart Failure. - : Wiley. - 1388-9842 .- 1879-0844. ; 17:12, s. 1252-1261
  • Journal article (peer-reviewed)abstract
    • AIMS: Previous analyses suggest that heart failure (HF) therapy guided by (N-terminal pro-)brain natriuretic peptide (NT-proBNP) might be dependent on left ventricular ejection fraction, age and co-morbidities, but the reasons remain unclear.METHODS AND RESULTS: To determine interactions between (NT-pro)BNP-guided therapy and HF with reduced [ejection fraction (EF) ≤45%; HF with reduced EF (HFrEF), n = 1731] vs. preserved EF [EF > 45%; HF with preserved EF (HFpEF), n = 301] and co-morbidities (hypertension, renal failure, chronic obstructive pulmonary disease, diabetes, cerebrovascular insult, peripheral vascular disease) on outcome, individual patient data (n = 2137) from eight NT-proBNP guidance trials were analysed using Cox-regression with multiplicative interaction terms. Endpoints were mortality and admission because of HF. Whereas in HFrEF patients (NT-pro)BNP-guided compared with symptom-guided therapy resulted in lower mortality [hazard ratio (HR) = 0.78, 95% confidence interval (CI) 0.62-0.97, P = 0.03] and fewer HF admissions (HR = 0.80, 95% CI 0.67-0.97, P = 0.02), no such effect was seen in HFpEF (mortality: HR = 1.22, 95% CI 0.76-1.96, P = 0.41; HF admissions HR = 1.01, 95% CI 0.67-1.53, P = 0.97; interactions P < 0.02). Age (74 ± 11 years) interacted with treatment strategy allocation independently of EF regarding mortality (P = 0.02), but not HF admission (P = 0.54). The interaction of age and mortality was explained by the interaction of treatment strategy allocation with co-morbidities. In HFpEF, renal failure provided strongest interaction (P < 0.01; increased risk of (NT-pro)BNP-guided therapy if renal failure present), whereas in HFrEF patients, the presence of at least two of the following co-morbidities provided strongest interaction (P < 0.01; (NT-pro)BNP-guided therapy beneficial only if none or one of chronic obstructive pulmonary disease, diabetes, cardiovascular insult, or peripheral vascular disease present). (NT-pro)BNP-guided therapy was harmful in HFpEF patients without hypertension (P = 0.02).CONCLUSION: The benefits of therapy guided by (NT-pro)BNP were present in HFrEF only. Co-morbidities seem to influence the response to (NT-pro)BNP-guided therapy and may explain the lower efficacy of this approach in elderly patients.
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  • Carel, RH, et al. (author)
  • Exposure to asbestos and lung and pleural cancer mortality among pulp and paper industry workers
  • 2002
  • In: Journal of Occupational and Environmental Medicine. - 1076-2752 .- 1536-5948. ; 44:6, s. 579-584
  • Journal article (peer-reviewed)abstract
    • We studied the mortality from lung and pleural cancers in a cohort of 62, 937 male workers employed for at least 1 year in the pulp and paper industry in 13 countries during 1945 to 1996. Mill departments were classified according to probability and level of exposure to asbestos on the basis of available dust measurements and mill-specific information on exposure circumstances. Thirty-six percent of workers were classified as ever exposed to asbestos. Standardized mortality ratios of lung cancer were 0.99 (95 % confidence interval [CI], 0.90 to 1.08) among unexposed and 1.00 (95 % CI, 0.90 to 1.11) among ever exposed workers. The number of pleural cancer deaths among unexposed workers was 10, that among exposed workers was 14, most of which occurred among maintenance workers. In internal analyses, a trend in mortality from either neoplasm was suggested for estimated cumulative exposure to asbestos, weighted for the individual probability of exposure within the department and for duration of exposure (relative risk for lung cancer for 0.78+ f/cc-years, as compared with = 0.01 f/cc-years: 1.44, 95 % CI, 0.85 to 2.45, corresponding relative risk for pleural cancer: 2.43, 95% CI, 0.43 to 13.63). Despite a possible nondifferential misclassification of exposure and outcome, this study suggests that the carcinogenic effect of asbestos can be detected among workers employed in industries such as the pulp and paper industry, in which it is not considered to be a major hazard.
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  • Cederwall, Bo, et al. (author)
  • Evidence for a spin-aligned neutron-proton paired phase from the level structure of 92Pd
  • 2011
  • In: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 469:7328, s. 68-71
  • Journal article (peer-reviewed)abstract
    • Shell structure and magic numbers in atomic nuclei were generally explained by pioneering work(1) that introduced a strong spin-orbit interaction to the nuclear shell model potential. However, knowledge of nuclear forces and the mechanisms governing the structure of nuclei, in particular far from stability, is still incomplete. In nuclei with equal neutron and proton numbers (N = Z), enhanced correlations arise between neutrons and protons (two distinct types of fermions) that occupy orbitals with the same quantum numbers. Such correlations have been predicted to favour an unusual type of nuclear superfluidity, termed isoscalar neutron-proton pairing(2-6), in addition to normal isovector pairing. Despite many experimental efforts, these predictions have not been confirmed. Here we report the experimental observation of excited states in the N = Z = 46 nucleus Pd-92. Gamma rays emitted following the Ni-58(Ar-36,2n)Pd-92 fusion-evaporation reaction were identified using a combination of state-of-the-art high-resolution c-ray, charged-particle and neutron detector systems. Our results reveal evidence for a spin-aligned, isoscalar neutron-proton coupling scheme, different from the previous prediction(2-6). We suggest that this coupling scheme replaces normal superfluidity (characterized by seniority coupling(7,8)) in the ground and low-lying excited states of the heaviest N = Z nuclei. Such strong, isoscalar neutron-proton correlations would have a considerable impact on the nuclear level structure and possibly influence the dynamics of rapid proton capture in stellar nucleosynthesis.
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  • Chevreul, Karine, et al. (author)
  • Social/economic costs and health-related quality of life in patients with cystic fibrosis in Europe
  • 2016
  • In: European Journal of Health Economics. - : Springer Science and Business Media LLC. - 1618-7598 .- 1618-7601. ; 17, s. 7-18
  • Journal article (peer-reviewed)abstract
    • Objectives: Our goal was to provide data on the economic burden and health-related quality of life (HRQOL) of patients with cystic fibrosis (CF) and their caregivers in Europe. Methods: A cross-sectional study was carried out on adults and children with CF in eight European countries. Patients completed an anonymous questionnaire regarding their socio-demographic characteristics, use of healthcare services and presence of a caregiver. Costs were calculated with a bottom-up approach using unit costs from each participating country, and HRQOL was assessed using EQ-5D. The principal caregiver also answered a questionnaire on their characteristics, HRQOL and burden. Results: A total of 905 patients with CF was included (399 adults and 506 children). The total average annual cost per patient varied from €21,144 in Bulgaria to €53,256 in Germany. Adults had higher direct healthcare costs than children, but children had much higher informal care costs (P
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  • Costello, Eamon, et al. (author)
  • Assessment of Transversal Skills in STEM : From theory to practice in a large scale research project
  • 2022
  • In: Society for Information Technology &amp; Teacher Education International Conference. - San Diego, CA, United States : Association for the Advancement of Computing in Education (AACE), Waynesville, NC USA. ; , s. 1026-1033
  • Conference paper (peer-reviewed)abstract
    • This paper presents an overview of a large scale research project involving teachers and students across eight European countries and involving eleven partner organizations. The project was focused on helping equip students with key transversal skills and competencies. We used integrated STEM as a site to ground the development of these interdisciplinary ways of thinking, being and doing and digital tools as ways to help teachers deepen and enhance their formative assessment practice. We present here an outline of research conducted to develop a framework for conceptualising integrated STEM skills and their assessment via digital tools. This framework identified a number of core competencies and ways to both design and assess for these skills using digital tools. We also give an account of subsequent professional development with teachers and the piloting of developed teaching methods in schools. The next phase was the conduct of evaluations of our work according to a research methodology which aimed to identify best practices for scalable teaching. Some emergent findings and lessons learned along the way from two countries, Ireland and Sweden, are presented as examples here as we complete the analysis stage of the project. This paper aims to contribute to the conversations around interdisciplinary and integrated STEM skills, how they can be digitally assessed and to give an account of the workings of the associated large scale research project.
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  • Elvsashagen, T, et al. (author)
  • The genetic architecture of human brainstem structures and their involvement in common brain disorders
  • 2020
  • In: Nature communications. - : Springer Science and Business Media LLC. - 2041-1723. ; 11:1, s. 4016-
  • Journal article (peer-reviewed)abstract
    • Brainstem regions support vital bodily functions, yet their genetic architectures and involvement in common brain disorders remain understudied. Here, using imaging-genetics data from a discovery sample of 27,034 individuals, we identify 45 brainstem-associated genetic loci, including the first linked to midbrain, pons, and medulla oblongata volumes, and map them to 305 genes. In a replication sample of 7432 participants most of the loci show the same effect direction and are significant at a nominal threshold. We detect genetic overlap between brainstem volumes and eight psychiatric and neurological disorders. In additional clinical data from 5062 individuals with common brain disorders and 11,257 healthy controls, we observe differential volume alterations in schizophrenia, bipolar disorder, multiple sclerosis, mild cognitive impairment, dementia, and Parkinson’s disease, supporting the relevance of brainstem regions and their genetic architectures in common brain disorders.
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  • Grankvist, R, et al. (author)
  • Myocardial micro-biopsy procedure for molecular characterization with increased precision and reduced trauma
  • 2020
  • In: Scientific reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 10:1, s. 8029-
  • Journal article (peer-reviewed)abstract
    • Endomyocardial biopsy is a valuable tool in cardiac diagnostics but is limited by low diagnostic yield and significant complication risks. Meanwhile, recent developments in transcriptomic and proteomic technologies promise a wealth of biological data from minimal tissue samples. To take advantage of the minimal tissue amount needed for molecular analyses, we have developed a sub-millimeter endovascular biopsy device, considerably smaller than current clinical equipment, and devised a low-input RNA-sequencing protocol for analyzing small tissue samples. In in vivo evaluation in swine, 81% of biopsy attempts (n = 157) were successful. High quality RNA-sequencing data was generated from 91% of the sequenced cardiac micro-biopsy samples (n = 32). Gene expression signatures of samples taken with the novel device were comparable with a conventional device. No major complications were detected either during procedures or during 7 days’ follow-up, despite acquiring a relatively large number of biopsies (median 30) in each animal. In conclusion, the novel device coupled with RNA-sequencing provides a feasible method to obtain molecular data from the myocardium. The method is less traumatic and has a higher flexibility compared to conventional methods, enabling safer and more targeted sampling from different parts of the myocardium.
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  • Gustavsson, DJI, et al. (author)
  • Anammox i Huvudströmmen - Vad är problemet?
  • 2012
  • In: Vatten: tidskrift för vattenvård /Journal of Water Management and research. - 0042-2886. ; 68:3, s. 195-208
  • Journal article (peer-reviewed)abstract
    • When Swedish wastewater treatment plants were rebuilt to include enhanced nitrogen removal, anaerobic ammonium oxidation (anammox) was far from being a mature technology. During the 2000s, the process has been introduced into sludge liquor treatment worldwide. The step to introduce anammox in the mainstream is decreasing, but lab- and pilot-scale studies on real municipal wastewater are yet lacking. However, several pilot studies are ongoing or will be started shortly. Difficulties to introduce anammox in the mainstream are still many. Anammox is favored by a separate treatment step for COD removal, by outcompeting nitrite oxidisers with the help of low oxygen concentrations, intermittent aeration and competition with anammox bacteria for nitrite, and by having a long solid retention time. Moving Bed Biofilm Reactor (MBBR), granular reactors, and activated sludge with hydrocyclones to recirculate anammox granules in the excess sludge, are the most promising systems. Sjölunda wastewater treatment plant in Malmö, Sweden, has a separate step for COD removal and denitrification is based on an MBBR for post-denitrification with methanol. VA SYD is now starting a pilot project to study the nitritation-anammox process in the mainstream in an MBBR with the aim of achieving a robust process, and to be able to use the already existing MBBRs for anammox in the mainstream.
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  • Gustavsson, David, et al. (author)
  • Anammox in the mainstream – what is the problem?
  • 2012
  • In: Journal of Water Management and Research –Vatten. - 0042-2886. ; 68, s. 195-208
  • Journal article (other academic/artistic)abstract
    • When Swedish wastewater treatment plants were rebuilt to include enhanced nitrogen removal, anaerobic ammoniumoxidation (anammox) was far from being a mature technology. During the 2000s, the process has beenintroduced into sludge liquor treatment worldwide. The step to introduce anammox in the mainstream is decreasing,but lab- and pilot-scale studies on real municipal wastewater are yet lacking. However, several pilotstudies are ongoing or will be started shortly. Difficulties to introduce anammox in the mainstream are stillmany. Anammox is favored by a separate treatment step for COD removal, by outcompeting nitrite oxidiserswith the help of low oxygen concentrations, intermittent aeration and competition with anammox bacteria fornitrite, and by having a long solid retention time. Moving Bed Biofilm Reactor (MBBR), granular reactors, andactivated sludge with hydrocyclones to recirculate anammox granules in the excess sludge, are the most promisingsystems. Sjölunda wastewater treatment plant in Malmö, Sweden, has a separate step for COD removal anddenitrification is based on an MBBR for post-denitrification with methanol. VA SYD is now starting a pilotproject to study the nitritation-anammox process in the mainstream in an MBBR with the aim of achieving arobust process, and to be able to use the already existing MBBRs for anammox in the mainstream.
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  • Gustavsson, David, et al. (author)
  • Manammox – mainstream anammox at Sjölunda WWTP
  • 2014
  • In: Proceedings from the IWA World Water Congress and Exhibition, September 21-26, Lisbon, Portugal.
  • Conference paper (peer-reviewed)abstract
    • The next revolution in biological nutrient removal at municipal wastewater treatment plants (WWTPs) is fully autotrophic nitrogen removal. Extensive pilot tests at Sjölunda WWTP in Malmö, Sweden, are ongoing for implementing Manammox (mainstream anammox) in the existing plant, which already today separates COD and nitrogen removal. The Manammox concept is based on a combined process where nitritation-anammox is operated in moving-bed biofilm reactors for sludge liquor treatment and treatment of mainstream wastewater with exchange of biofilm carriers between the two systems. Almost complete ammonium oxidation and more than 80% nitrogen reduction was reached in the sludge liquor system and up to 60% in the main stream process. Quantitative PCR showed almost the same composition of the bacterial population with high abundance of anammox bacteria and ammonia-oxidising bacteria in all reactors and that the exchange of carriers did not effectively suppress the nitrite-oxidising bacteria in the system. Optimal choice of the oxygen supply for the process seems to be crucial for further increase of the nitrogen reduction in the mainstream.
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