Two-stage Treatment Research Articles

Secondary Raw Materials from Residual Carbon Fiber-Reinforced Composites by An Upgraded Pyrolysis Process.

This paper presents a process where carbon fibers and hydrogen can be recovered simultaneously through a two-stage thermal treatment of an epoxy-carbon fiber composite. For this purpose, some pieces of epoxy resin reinforced with carbon fiber fabrics have been fabricated and, after curing, have been pyrolyzed in an installation consisting of two reactors. In the first one, the thermal decomposition of the resin takes place, and in the second one, the gases and vapors coming from the first reactor are thermally treated. Once this process is completed, the solid generated is oxidized with air to eliminate the resin residues and carbonaceous products from the fibers surface. The recovered carbon fiber fabrics have been reused to make new cured parts and their electrical and mechanical properties have been measured. The results show that it is possible to obtain carbon fiber fabrics that can be processed as they leave the recycling process and that retain 80% of the tensile modulus, 70% of the flexural strength, and 50% of the interlaminar shear strength. At the same time, a gaseous stream with more than 66% by volume of hydrogen can be obtained, reaching a maximum of 81.7%.

Двухэтапное лечение глубокой перипротезной инфекции тазобедренного сустава, осложненной забрюшинным дефектом мочевого пузыря

emphasize the importance of preoperative preparation and well-coordinated work of related specialists using a specific clinical instance. Case report Reported is a successful experience of two-stage treatment of the patient with hip PJI complicated with urinary bladder defect. A 40-year old male patient diagnosed with left-sided deep hip PJI Tsukayama type 3 was treated at department of infection surgery, Rostov Regional Clinical Hospital No. 2 in January 2019. Total hip arthroplasty performed in 2008 was complicated by migration of acetabulum component. A retroperitoneal bladder defect (pressure ulcer) was detected during the first stage of resection arthroplasty and placement of an antibacterial spacer. Urological procedure was performed in a delayed manner due to technical difficulties of implant removal, prolonged and traumatic procedure, and high blood loss. With the patient's condition stabilized cystoscopy and bilateral ultrasound guided percutaneous nephroureterostomy were performed. Prolonged antibacterial aetiotropic treatment was administered. The second stage of surgical treatment included revision hip arthroplasty using a tailored acetabular component and a standard revision femoral component performed at 6 months of debridement. Results Short- and long-term results were good with sustained remission achieved. Patient could walk unassisted using a cane and had a satisfactory ROM in the left hip with HHS scored 76.255. Conclusion Multiple disciplinary teamwork is appropriate for treatment of deep PJI with much coherence, coordinated efforts and expertise from diverse professionals.

Estimating survival distributions for two-stage adaptive treatment strategies: A simulation study

Estimating survival distributions for two-stage adaptive treatment strategies: A simulation study

Current approach to bone augmentation with allogeneic cortical graft: A case report

Aim: Today, dental implant applications have become the most preferred option in the treatment of tooth deficiencies. Long-term successful results in dental implant applications depend largely on the volume and quality of the hard and soft tissues in the relevant region. Insufficient soft tissues and alveolar crest resorption complicate implant applications. Grafts and additional surgical procedures are required to compensate for resorption and to provide bone augmentation. Shell technique, one of the augmentation methods used in the treatment of alveolar bone defects, is an important procedure for guided bone regeneration. The purpose of this case report is to describe the treatment of vertical and horizontal bone loss with the Shell technique using allogeneic cortical grafts.
 Methodology: A 58-year-old female patient without any systemic disease was admitted to our clinic with the complaint of tooth loss in the right posterior mandibular region. In the intraoral and radiological examinations, it was determined that the bone volume in the relevant region was not sufficient for dental implant. Two-stage surgical treatment was planned for the patient. First, vertical and horizontal bone defects were augmented with allogeneic cortical graft application under local anesthesia. After the healing process, dental implants were placed in the sufficient volume of the alveolar bone and the patient's treatment was completed.
 Conclusion: Allogeneic grafts in the treatment of alveolar crest defects; it is a good alternative to autogenous bone grafts,there is no need for a second surgical field and the resulting reduction in morbidity.
 
 How to cite this article: Eriş Derkuş F, Yılmaz UN. Current approach to bone augmentation with allogeneic cortical graft: A case report. Int Dent Res 2021;11(Suppl.1):299-302.
 https://doi.org/10.5577/intdentres.2021.vol11.suppl1.44
 
 
 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Survival Augmented Patient Preference Incorporated Reinforcement Learning to Evaluate Tailoring Variables for Personalized Healthcare

In this paper, we consider personalized treatment decision strategies in the management of chronic diseases, such as chronic kidney disease, which typically consists of sequential and adaptive treatment decision making. We investigate a two-stage treatment setting with a survival outcome that could be right censored. This can be formulated through a dynamic treatment regime (DTR) framework, where the goal is to tailor treatment to each individual based on their own medical history in order to maximize a desirable health outcome. We develop a new method, Survival Augmented Patient Preference incorporated reinforcement Q-Learning (SAPP-Q-Learning) to decide between quality of life and survival restricted at maximal follow-up. Our method incorporates the latent patient preference into a weighted utility function that balances between quality of life and survival time, in a Q-learning model framework. We further propose a corresponding m-out-of-n Bootstrap procedure to accurately make statistical inferences and construct confidence intervals on the effects of tailoring variables, whose values can guide personalized treatment strategies.

Roles of alkali metal dopants and surface defects on polymeric carbon nitride in photocatalytic peroxymonosulfate activation towards water decontamination

Polymeric carbon nitride (PCN) has been extensively employed in peroxymonosulfate (PMS) activation for water decontamination. However, limited photocatalytic efficiency can be achieved by pristine PCN due to its intrinsic deficiencies like high electron-hole recombination rate and resistance to charge transfer. Herein, in a two-stage thermal treatment process, the nontoxic and stable Na and K were successfully anchored among the PCN skeleton with surface defects created, leading to an elevated photocatalytic activity for PMS activation. The SO4·- and 1O2 were identified as the dominant reactive oxygen species, which were generated from electron transfer processes between PMS and catalyst. Experimental and theoretical analyses suggested that the defective structures and metal dopants improved the optical properties of catalyst, endowing it a wider light absorption range and a lower energy barrier for electron transitions. The modified structures were also beneficial to electron transfer processes due to the weaker electron confinement effect, accelerating the production of SO4·- on the defective sites and 1O2 on the metal sites. The synergy of radical and non-radical species weakened the influence of side reactions between radicals from PMS and coexisting inorganic anions in practical water, hence to promote the resistance of modified catalysts in complex water matrices.

Spine stabilization in patients with the thoracic and lumbar vertebrae fractures in reduced bone mineral density

Objective To compare the clinical effectiveness of various technical and tactical options for surgical treatment of patients with thoracic and lumbar vertebrae fractures with reduced bone mineral density.Material and Methods The study included 238 patients with the thoracic and lumbar vertebrae fractures with reduced bone mineral density (BMD). The patients were aged between 48 and 85 with T-score –1.5 to –3.5. The study did not include the patients with recurrent or multiple vertebral fractures, with absence of the clear date and fact of fracture in the case history, with neurological complications or polytrauma. The patients had fractures А1.2, А1.3, В1.2, В2.3 according to the classification of Magerl (1992). All patients underwent bisegmental transpedicular fixation (TPF). Group 1 included 68 patients who underwent non-cement augmented transpedicular screw fixation. Group 2 included 170 patients who underwent cement augmented transpedicular fixation. Both groups were divided into 2 subgroups. Subgroups 1.1 and 2.1 included patients operated in two stages. The first stage was TPF and the second stage was anterior corporodesis. Subgroups 1.2 и 2.2 included patients who underwent only TPF. Outcomes and complications were studied. The observation period lasted for not less than 2 years. Correlation analysis was performed between the technique of performing operations and surgical tactics in four subgroups and treatment outcomes.Conclusion 1. In the treatment of patients with fractures in the thoracic or lumbar spine with reduced BMD, isolated TPF with cemented screw implantation is clinically equivalent to two-stage surgical treatment - TPF with cementless or cemented implantation and anterior corprodesis of injured FPS. 2. In cementless TPF in patients with decreased BMD, anterior corprodesis of the injured VMS is necessary because its failure leads to the loss of anatomical relationship correction achieved during surgery, increase in local kyphosis, and functional maladaptation of patients.

Neuropsychological development of children with biliary atresia after liver transplantation

Background. In young children, the most common liver disease leading to transplantation is biliary atresia. Liver transplantation has fundamentally improved the survival rate of children with biliary atresia. Studies on developmental outcomes in children are mostly limited to small samples; there are no such studies in the Russian Federation.Objective: to determine the cognitive outcomes in children undergoing one-stage or two-stage surgical treatment of biliary atresia.Materials and Methods. 83 children were divided into groups: 36 children underwent transplantation without previous surgical interventions (group 1), 47 children underwent the Kasai palliative portoenterostomy (group 2). Inclusion criteria: 24 months of age or younger at the moment of transplantation, no medical history of neurological pathology. All children were examined before transplantation and at 1, 3, 6 and 12 months after liver transplantation. Psychomotor development was assessed using the Griffiths Psychomotor Development Scale for children under 24 months (translated by E.S. Keshishian), the Griffiths Intellectual Development Scale for children aged 2 to 8 years, and the Modified Checklist for Autism in Toddlers, Revised, for children 16-30 months old.Results. All children had developmental delays at the time of transplantation. Up to 50% of the children had signs of cachexia, with a shoulder circumference of less than 3 percentile. Only two children showed obvious hepatic encephalopathy in the form of depressed consciousness. After liver transplantation, 94% of group 1 children recovered their preoperative psychomotor development levels, and only 68% in group 2 made these gains. At 3 and 6 months after transplantation, about 80% of group 1 children showed normal psychomotor development, whereas in group 2, only 61% did. By 12 months after liver transplantation, the difference between the groups was more evident: 83.3% of group 1 children and only 53.2% of group 2 children were developing according to age. The difference between the groups was statistically significant (p < 0.05).Conclusion. Children who received one-stage treatment of biliary atresia and underwent liver transplantation have better neuropsychological development within a year after surgery than children with two-stage surgical treatment.

Managing water sustainability in textile industry through adaptive multiple stakeholder collaboration

Textile manufacturing poses pressing challenges on water sustainability characterized by intensive chemical consumption and waterborne pollution. Industrial clustering is a hallmark of textile industry development, featuring a two-stage wastewater treatment system consisting of in-plant and centralized treatment facilities. Driven by increasingly stringent wastewater discharge limits, three pillar stakeholders in textile industrial clusters, the local government, enterprises and environmental utility operators, seek for systematic countermeasures by balancing contradictory interests. This study presents a trilateral game model to uncover the economic and environmental tradeoffs among the three stakeholders targeting the optimization of wastewater systems. The model is solidified by a representative textile industrial cluster and is then extrapolated to 242 large-scale Chinese textile clusters to quantify the benefits. The key finds are (1) the in-use wastewater systems in many clusters function with low eco-efficiency; (2) the optimal paradigm is to adaptively leave room at half- to onefold for discharge limits from in-plant to centralized treatment facilities; (3) the environmental and economic benefits thereof are 24∼x223C61% and 6%, respectively, after retrofitting to the optimal paradigm for the Chinese textile clusters.

Study on Microstructure, Mechanical Properties and Erosion Characteristics of Al-Si Alloy Manufactured by Continuous Casting Direct Rolling Process

Al-Si alloys exhibit promising wear resistance, thus being mainly employed to weld Al alloy parts and processed into components of equipment. During the new continuous casting direct rolling (CCDR) process, the raw material gradually cools and solidifies, simultaneously plastically deformed. Hence, the materials manufactured through the CCDR process presented an unparalleled microstructure. The experimental results indicated that the strength of the CCDR Al-Si alloy can be increased through cold rolling. A two-stage heat treatment (solid solution and aging treatment) was introduced to improve the ductility and satisfy the industrial application. Furthermore, the erosion wear characteristics and fracture mechanism of the CCDR Al-Si alloy dominated by the ductility were confirmed. Both cold rolling specimens (FR) and those with heat treatment (FRH) showed greater wear resistance than as-manufactured (F). The FR specimens exhibited greater wear resistance owing to a higher Al matrix strength at a lower impact angle; on the other hand, at a higher impact angle, the FRH specimens with a softer Al matrix presented better wear resistance due to the formation of a lip structure to reduce material removal. The TEM results confirmed that the nanoscale grains formation was induced in the erosion-affected region and affected the Si concentration. Conclusively, the heat-treated CCDR Al-Si alloy possessed excellent erosion resistance and workability, which can serve as a reference processed as wear-resistant mechanical parts.

Porous Biphasic Calcium Phosphate Granules from Oyster Shell Promote the Differentiation of Induced Pluripotent Stem Cells.

Oyster shells are rich in calcium, and thus, the potential use of waste shells is in the production of calcium phosphate (CaP) minerals for osteopathic biomedical applications, such as scaffolds for bone regeneration. Implanted scaffolds should stimulate the differentiation of induced pluripotent stem cells (iPSCs) into osteoblasts. In this study, oyster shells were used to produce nano-grade hydroxyapatite (HA) powder by the liquid-phase precipitation. Then, biphasic CaP (BCP) bioceramics with two different phase ratios were obtained by the foaming of HA nanopowders and sintering by two different two-stage heat treatment processes. The different sintering conditions yielded differences in structure and morphology of the BCPs, as determined by scanning electron microscopy (SEM), X-ray diffraction (XRD), and Brunauer–Emmett–Teller (BET) surface area analysis. We then set out to determine which of these materials were most biocompatible, by co-culturing with iPSCs and examining the gene expression in molecular pathways involved in self-renewal and differentiation of iPSCs. We found that sintering for a shorter time at higher temperatures gave higher expression levels of markers for proliferation and (early) differentiation of the osteoblast. The differences in biocompatibility may be related to a more hierarchical pore structure (micropores within macropores) obtained with briefer, high-temperature sintering.

Additive Manufacturing of Textured FePrCuB Permanent Magnets.

Permanent magnets based on FePrCuB were realized on a laboratory scale through additive manufacturing (laser powder bed fusion, L-PBF) and book mold casting (reference). A well-adjusted two-stage heat treatment of the as-cast/as-printed FePrCuB alloys produces hard magnetic properties without the need for subsequent powder metallurgical processing. This resulted in a coercivity of 0.67 T, remanence of 0.67 T and maximum energy density of 69.8 kJ/m3 for the printed parts. While the annealed book-mold-cast FePrCuB alloys are easy-plane permanent magnets (BMC magnet), the printed magnets are characterized by a distinct, predominantly directional microstructure that originated from the AM process and was further refined during heat treatment. Due to the higher degree of texturing, the L-PBF magnet has a 26% higher remanence compared to the identically annealed BMC magnet of the same composition.

Effect of mechano-chemical pretreatment on valorizing plant waste for 5-hydroxymethylfurfural under microwave hydrothermal treatment

Plant waste (PW) is a common and abundant renewable biomass resource whose total amount is constantly increasing and accounts for up to 50% of municipal solid waste. This study aims to develop a valorization method for PW. A two-stage treatment method combining mechanical ball milling (BM) and microwave hydrothermal treatment (MHT) was investigated. BM can effectively destroy the crystallization of cellulose and reduce the particle size to increase the specific surface area and improve the MHT efficiency. The BM-MHT process could improve the 5-hydroxymethylfurfural (HMF), which is significantly higher than physical methods like grinding, ultrasonic and liquid nitrogen treatment. The BM conditions were further optimized by using a Box-Behnken Design with response surface methodology. The model showed that the highest HMF yield could reach 1.8% at 150 °C in MHT process after BM. An economic analysis indicated that BM-MHT offers a green treatment method with great economic benefits. It provides a novel valorization strategy for organic waste like PW.

Treatment of deep periprosthetic hip infection with articulating cement-antibiotic spacers with silver plates and antibiotics

The aim of this work is to improve the results of treatment of patients with a deep periprosthetic hip joint infection by using an articulating cement-antibiotic spacer in combination with silver plates and antibiotics.Material and methods. The treatment outcomes of 52 patients operated at the Swedish-Ukrainian Angelholm Medical Center for the period from 2017 to 2020, who underwent two-stage revision arthroplasty for the deep periprosthetic infectious-inflammatory process of the hip joint, were studied. In addition, 9 patients were examined in whom, during the first stage of a two-stage treatment of an artificial hip joint infection, an articulating cement-antibiotic spacer made of bone cement with a silver content was developed.Research results. Long-term results of two-stage revision arthroplasty with the introduction of our proposed cement-antibiotic spacers were studied in 49 (94.2%) patients. Among them, 9 patients used silver plates, which showed good patient tolerance and in all cases the infection was overcome. In 49 patients in whom the long-term results of two-stage revision hip arthroplasty were studied, 44 (89.8%) achieved eradication of the infection with restoration of the function of the operated limb. We rated such results as good. The average HHS score in this group was 87.18 ± 6.44 points.Conclusions. An innovative method of treatment of deep periprosthetic infection of the hip joint has been introduced into clinical practice, which consists in increasing the effectiveness of using an articulating cement antibiotic spacer by adding silver plates to it and, in addition, an antibiotic.

Comparative analysis of pathogen structure in patients with PJI after primary total hip and knee arthroplasty.

Microbiological profile of pathogens causing periprosthetic joint infection (PJI) after primary total hip (THA) and knee (TKA) arthroplasty varies in different regions, clinics and even departments. The objective of this study was to analyze the pathogen structure in patients with PJI after primary THA and TKA and its influence on the effectiveness of the infection eradication after two-stage reimplantation. We collected the retrospective data of 364 patients-161 with PJI after primary TKA (113 treated in two stages 48 with failure after spacer implantation) and 203 patients with infected THA (127 after successful two-stage reimplantation and 76 with PJI recurrence after the first stage) within the time period from January 2012 to December 2017, treated with two-stage protocol in the single center. A comparative analysis of pathogen structure was performed between cohorts of patients with hip and knee PJI. A subanalysis was made between the subsets comprised from patients with successful two-stage treatment and the subsets with failure to treat the infection. Staphylococcus epidermidis was the most commonly identified pathogen in the full hip and knee cohorts: 30.1% and 32.5%, respectively. However, the percentage of methicillin-resistant Staphylococcus epidermidis (MRSE) among all S. epidermidis isolates was higher in the hip cohort-50% compared with 35% in the knee cohort (p = 0.073). Other coagulase-negative Staphylococci were more common to patients with PJI after primary TKA-10.3% compared with 5% (p < 0.02). Streptococcus sp. caused hip PJI in a larger percentage of cases than in knee PJI (p < 0.01)-7% and 2%, respectively (p < 0.01). Polymicrobial associations were significantly more common in hip PJI compared to knee PJI: 45.3% and 14% of cases, respectively (p < 0.001). The presence of polymicrobial infection significantly raised the risk of PJI recurrence [OR 2 (95% CI from 1.24 to 3.24)] in knee PJI patients and reduced the effectiveness of infection eradication from 73.9% to 47.8%. Comparative analysis showed significant differences in the structure of PJI pathogens in the hip and knee. These findings are useful when choosing treatment strategies and empirical antibiotics regimens, in the management of patients with PJIs after primary hip and knee arthroplasty.

Mandibular distraction of free iliac crest bone graft as treatment in a patient with a history of gunshot wound. Case Report

Introduction: The combination of non-vascularized iliac crest bone graft and distraction osteogenesis in a second surgical intervention has only been described to achieve alveolar ridge augmentation. This technique is not recommended to treat bone defects of the jaws caused by firearm projectile. Case presentation: 40-year-old woman with a segmental mandibular defect in the mandible body caused by the impact of a firearm projectile at the age of 1 year. The patient developed a severe Class II dentofacial anomaly that required a two-stage treatment; she underwent mandibular reconstruction with free iliac crest bone graft followed by a bilateral mandibular distraction at the level of the iliac crest bone graft. With these interventions, a remarkable improvement of the patient's malformation was achieved. Conclusion: Horizontal distraction of the free iliac crest bone graft is a safe and predictable procedure to treat dentolabial anomalies requiring mandibular reconstruction. This procedure was performed in the patient without complications. Further studies on the effectiveness of this technique are required.

Transformation of polyvinyl chloride (PVC) into a versatile and efficient adsorbent of Cu(II) cations and Cr(VI) anions through hydrothermal treatment and sulfonation

The reuse of waste polyvinyl chloride (PVC) has drawn much attention as it can reduce plastic waste and associated pollution, and provide valuable raw materials and products. In this study, sulfonated PVC-derived hydrochar (HS-PVC) was synthesized by two-stage hydrothermal treatment (HT) and sulfonation, and shown to be a versatile adsorbent. The removal of Cu(II) cations and Cr(VI) anions using HS-PVC reached 81.2 ± 1.6% and 60.3 ± 3.8%, respectively. The first stage of HT was crucial for the dichlorination of PVC and the formation of an aromatic structure. This stage guaranteed the introduction of -SO3H onto PVC-derived hydrochar through subsequent sulfonation. HT intensities (i.e., temperature and time) and sulfonation intensity strongly determined the adsorption capacity of HS-PVC. Competitive adsorption between Cu(II) and Cr(VI) onto HS-PVC was demonstrated by binary and preloading adsorption. The proposed Cu(II) cations adsorption mechanism was electrostatic adsorption, while Cr(VI) were possibly complexed by the phenolic -OH and reduced to Cr(III) cations by CC groups in HS-PVC. In addition, HS-PVC derived from PVC waste pipes performed better than PVC powder for Cu(II) and Cr(VI) removal (＞90%). This study provides an efficient method for recycling waste PVC and production of efficient adsorbents.

The Symmetry and Predictive Factors in Two-Stage Bilateral Hip Replacement Procedures

Background: Approximately 10–25% of total hip replacement patients undergo a bilateral procedure. The purpose of this study was to compare selected parameters associated with the first and second hip arthroplasty in patients undergoing two-stage treatment due to bilateral hip osteoarthritis and establish the predictive factors for the second procedure. Methods: This study compared the data on bilateral total hip replacement surgeries conducted in the period between 2017 and 2021 (42 patients). The following parameters from the first and second procedure were compared: the prosthetic stem, head, and insert cup size; type of cup insert; duration of anesthesia; duration of hospitalization; and the number of complications. Results: The mean duration of hospital stay at the time of the first total hip arthroplasty was 5.83 days and 5.4 days during the second stay. The mean stem sizes used during the first and second total hip replacement procedures were 7.11 and 7.09, respectively. The mean sizes of endoprosthetic cups used at the first and second total hip replacement procedures were 52.64 and 53.04, respectively. There were no significant differences between the mean prosthetic head size at the first and second surgery. The cup type used during the first and second surgery showed no difference. The mean duration of anesthesia used during the first and second total hip replacement surgery was 108.09 min and 104.52 min, respectively. We recorded a mean of 0.07 complications per patient at the first surgery and 0.02 at the second surgery. Conclusions: Our study results showed symmetry duration of anesthesia, length of hospital stay, number of complications per patient, stem size, prosthetic head size, cup insert size, and cup insert type at the first and second surgery in patients with two-stage bilateral total hip arthroplasty. We observed a strong correlation between the stem sizes of the first and second hip endoprostheses. There was also a strong correlation between the cup sizes used during the first and second surgery.

Insight into the Effect of Ice Addition on the Gel Properties of Nemipterus virgatus Surimi Gel Combined with Water Migration.

The effect of the amount of ice added (20–60%) on the gel properties and water migration of Nemipterus virgatus surimi gel obtained with two-stage heat treatment was studied. The gel strength and water-holding capability (WHC) of the surimi gel with 30% ice added were significantly higher than those of other treatment groups (p < 0.05). The addition of 30% ice was conducive to the increase of protein β-sheet proportion during heat treatment, exposing more reactive sulfhydryl groups. These promoted the combination of protein-protein through disulfide bonds and hydrophobic-hydrophobic interactions, forming an ordered three-dimensional gel network structure. Meanwhile, the increase in hydrogen bonds promoted the protein-water interaction. Low-field nuclear magnetic resonance analysis showed that more bound water was locked in the gel system, reducing the migration of immobile water to free water and finally showing better gel properties. When the amount of ice added was insufficient (20%), the gel structure lacked the support of immobile water, resulting in deterioration of gel strength. However, excessive addition of ice (>30%) was not conducive to the combination of protein-protein and protein-water, forming a large and rough gel structure, resulting in the migration of immobile water to free water and ultimately exhibited weak gel properties.

Sewage-water treatment with bio-energy production and carbon capture and storage

Typical large-scale sewage-water treatments consume energy, occupy space and are unprofitable. This work evaluates a conceivable two-staged sewage-water treatment at 40,000 m3/d of sewage-water with sewage-sludge (totaling 10kgCOD/m3) that becomes a profitable bioenergy producer exporting reusable water and electricity, while promoting carbon capture. The first stage comprises microbial anaerobic digesters reducing the chemical oxygen demand (COD) by 95% and producing 60%mol methane biogas. The effluent waters enter the subsequent aerobic stage comprising microbial air-fed digesters that extend COD reduction to 99.7%. To simulate the process, up-to-date anaerobic/aerobic digester models were implemented. A biogas-combined-cycle power plant with/without post-combustion carbon capture is designed to match the biogas production, supplying electricity to the process and to the grid. Results comprehend electricity exportation of 13.21 MW (7.92 kWh/tReusable-Water) with -9.957tCO2/h of negative carbon emission (-0.6 kgCO2-Emitted/kgCOD-Removed). The biogas-combined-cycle without carbon capture achieves 21.08 MW of power exportation, while a 37.3% energy penalty arises if carbon capture is implemented. Configurations with/without carbon capture reach feasibility at 125 USD/MWh of electricity price, with respective net present values of 6.86 and 85.07 MMUSD and respective payback-times of 39 and 12 years. These results demonstrate that large-scale sewage-water treatment coupled to biogas-fired combined-cycles and carbon capture can achieve economically feasible bioenergy production with negative carbon emissions.