Ting Zhang

BACKGROUND: Over the last few years, probiotics have been one of the most studied interventions in neonatal medicine. OBJECTIVES: The aim of this work was to analyse all studies (randomized controlled trials, RCTs, and observational studies) assessing the use of probiotics in very low birth weight (VLBW) preterm infants. SEARCH METHODS: A systematic literature search was conducted using PubMed, Embase, Cochrane Library, and Web of Science. The data from RCTs and observational studies were pooled and analysed separately. SELECTION CRITERIA: RCTs and observational studies that enrolled VLBW infants with enteral administration of probiotics were considered. Extracted study data included probiotic characteristics and at least 1 clinical outcome (necrotizing enterocolitis [NEC], late-onset sepsis or all-cause mortality). DATA COLLECTION AND ANALYSIS: Forty-four studies were eligible for our review: 30 RCTs and 14 observational studies. Severe NEC rates (stage II or more) and all-cause mortality were reduced among the probiotic groups in both the RCTs (RR 0.57, 95% CI 0.47-0.70, and RR 0.77, 95% CI 0.65-0.92, respectively) and the observational studies (RR 0.51, 95% CI 0.37-0.70, and RR 0.71, 95% CI 0.62-0.81, respectively). Furthermore, there was a 12% reduction in the risk of sepsis in RCTs and a 19% reduction in observational studies. The meta-analysis of observational studies showed a reduction in the risk of NEC in extremely low birth weight infants. However, this was not statistically significant. CONCLUSIONS: This meta-analysis of RCT and observational studies found that the use of probiotics was beneficial for the prevention of severe NEC, late-onset sepsis, and all-cause mortality in VLBW infants.

Poly- and perfluoroalkyl substances (PFAS) are increasingly investigated due to their global occurrence and potential human health risk. The ban on PFOA and PFOS has led to the use of novel substitutes such as GenX, F-53B and OBS. This paper reviews the studies on the occurrence, transformation and remediation of major PFAS i.e. PFOA, PFNA, PFBA, PFOS, PFHxS, PFBS and the three substitutes in groundwater. The data indicated that PFOA, PFBA, PFOS and PFBS were present at high concentrations up to 21,200 ng L−1 while GenX and F-53B were found up to 30,000 ng L−1 and 0.18–0.59 ng L−1, respectively. PFAS in groundwater are from direct sources e.g. surface water and soil. PFAS remediation methods based on membrane, redox, sorption, electrochemical and photocatalysis are analyzed. Overall, photocatalysis is considered to be an ideal technology with low cost and high degradation efficacy for PFAS removal. Photocatalysis could be combined with electrochemical or membrane filtration to become more advantageous. GenX, F-53B and OBS in groundwater treatment by UV/sulfite system and electrochemical oxidation proved effective. The review identified gaps such as the immobilization and recycling of materials in groundwater treatment, and recommended visible light photocatalysis for future studies.