Evidence-Based Design Application of Water Landscaping for Rehabilitation Gardens for Patients with Mental Disorders

The aim of the article is to explore the influence of the water landscape design of a rehabilitation garden for patients with mental disorders on the recovery effect of patients,intending to provide a better rehabilitation environment for patients with mental disorders.Based on literature research,this article reviews three aspects of evidence-based design theory,the concept of water landscape in rehabilitation gardens,and the types of water features in rehabilitation gardens.The results show that well-designed water features can significantly improve patients’psychological state and reduce anxiety and stress,and that water landscape design in rehabilitation gardens is an effective rehabilitation tool that can facilitate the recovery process of patients with mental disorders.Future designs should take into full consideration patients’needs and preferences,as well as best practices in waterscape design,to maximize its positive impact on patients’recovery.

Evidence-based optimization of integrated traditional Chinese and Western medicine therapies for prevention and treatment of coronary heart disease： design and implementation

As a chronic disease that seriously endangers public health, the number of coronary heart disease （CHD） patients in China has increased in recent years. There is great potentiality to integrate traditional Chinese and Western medicine therapies to prevent and treat CHD in clinical practice. However, most of the current integrated therapies still lack sufficient high-quality evidence, and the key links in how to apply are unclear. It is urgent to optimize them through evidence-based research to further improve the effectiveness. Therefore, we propose strategies to conduct evidence-based optimization of integrated traditional Chinese and Western medicine therapies in prevention and treatment of progressive cardiovascular diseases. These are integrated clinical trial design, attention to the key links of taking effect, combination of clinical and basic research. Based on the strategies, we started the national key research and development project ＂Evidence-based optimization research of TCM therapies in prevention and treatment of CHD （angina pectoris - myocardial infarction - heart failure）＂, which is expected to be a new paradigm in the field.

Landscape Design Elements in Rehabilitation Environment Founded on Evidence-based Design

The concept and development history of rehabilitation environment were summarized in this study,principles and techniques of applying evidence-based design in the design of rehabilitation environment were analyzed,classification and functions of landscape elements in rehabilitation environment were particularly discussed.

Irritable bowel syndrome: Pathogenesis, diagnosis, treatment, and evidence-based medicine

Irritable bowel syndrome (IBS) is a chronic and debilitating functional gastrointestinal disorder that affects 9%-23% of the population across the world. The percentage of patients seeking health care related to IBS approaches 12% in primary care practices and is by far the largest subgroup seen in gastroenterology clinics. It has been well documented that these patients exhibit a poorer quality of life and utilize the health care system to a greater degree than patients without this diagnosis. The pathophysiology of IBS is not clear. Many theories have been put forward, but the exact cause of IBS is still uncertain. According to the updated ROME III criteria, IBS is a clinical diagnosis and presents as one of the three predominant subtypes: (1) IBS with constipation (IBS-C); (2) IBS with diarrhea (IBS-D); and (3) mixed IBS (IBS-M); former ROME definitions refer to IBS-M as alternating IBS (IBS-A). Across the IBS subtypes, the presentation of symptoms may vary among patients and change over time. Patients report the most distressing symptoms to be abdominal pain, straining, myalgias, urgency, bloating and feelings of serious illness. The complexity and diversity of IBS presentation makes treatment difficult. Although there are reviews and guidelines for treating IBS, they focus on the efficacy of medications for IBS symptoms using high-priority endpoints, leaving those of lower priority largely unreported. Therefore, the aim of this review is to provide a comprehensive evidence-based review of the diagnosis, pathogenesis and treatment to guide clinicians diagnosing and treating their patients.

Evidence-based treatment for acute spinal cord injury

OBJECTIVE： To formulate an evidence-based treatment for one patient with acute spinal cord injury and summarize evidence for evaluating acute spinal cord injury treatment. METHODS： Studies related to the treatment for acute spinal cord injury were identified via a search of National Guideline Clearinghouse （NGC, 2000 11）, the Cochrane Library （Issue 1,2011）, TRIP Database （2000 11）, and PubMed （1966-2011）. Treatment strategies were formulated according to three basic principles： best evidence, doctor＇s professional experience, and wishes of the patient. RESULTS： A total of 34 articles were selected, including 1 NGC guideline, 22 systematic reviews, and 11 randomized controlled trials. Based on our review, we arrived at the following recommendations： no clinical evidence exists definitively to recommend the use of any of neuroprotective pharmaceuticals; surgery should be undertaken early; mechanical compression devices and low-molecular weight heparin should be employed to prevent thrombosis; respiratory muscle training is beneficial for pulmonary function and quality of life; and functional electrical stimulation and acupuncture can promote functional recovery. The patient accordingly underwent surgery 6 hours after trauma without receiving any neuroprotective pharmaceuticals; low-molecular weight heparin and intermittent pneumatic compression were applied to prevent thrombosis. He also underwent respiratory muscle training daily for 8 weeks and received functional electrical stimulation for 15 minutes and acupuncture for 30 minutes every day. After follow-up for 3 months, the above therapeutic regimen was confirmed efficacious for acute spinal cord injury. CONCLUSION： Evidence-based medicine provides an individualized treatment protocol for acute spinal cord injury, which can significantly improve the therapeutic effect and prognosis.

Evidence-Based Medicine Research on Prescriptions in Synopsis of the Golden Chamber in the Treatment of Pelvic Inflammatory Disease

Purpose: Based on the National Natural Science Foundation of China, we collect and sort out the literature published in approximately the last 30 years, which use prescriptions in Synopsis of the Golden Chamber to treat pelvic inflammatory disease (PID). This study provides theoretical basis for the treatment of PID;we recommend this achievement to colleagues. Method: Firstly, we searched and collected the literatures from last three decades in CNKI, Wanfang and VIP databases, which are about classical prescriptions treating endometriosis. Then, by screening all the literatures, we obtained the clinical research literatures and individual case reports. Finally, we went through the internal quality of the two categories of literatures to get the dominant prescriptions. Using a retrospective study of evidence-based medicine research, we comprehensively collect literature, standardize the disease spectrum, classify the evidence, and then evaluate the internal quality. Results: We refine 4 prescriptions which commonly are used in the treatment of PID;in other words, they are also the clinical symptoms of PID: Gui Zhi Fu Ling Wan symptom, which manifests blood stasis and cold-damp stagnancy;Dang Gui Shao Yao San symptom, which manifests disharmony of liver and spleen, qi-blood stasis and damp obstruction;Da Huang Mu Dan Tang symptom, which manifests the gathering toxic heat and qi-blood stasis;Yi Yi Fu Zi Bai Jiang San symptom, which manifests the internal toxic heat and qi-blood injury. Conclusion: This study is gospel for the patients with recurrent episodes of PID who can’t often use antibiotics. At the same time, it is also a green therapeutics which Chinese ancients dedicated to human medicine.

Management of nonalcoholic fatty liver disease:An evidence-based clinical practice review

AIM: To build a consensus among Chilean specialists on the appropriate management of patients with nonalcoholic fatty liver disease (NAFLD) in clinical practice.

Optimum municipal wastewater treatment plant design with consideration of uncertainty

A newly developed model for the optimum municipal wastewater treatment plant(MWTP) design is presented. Through introducing the interval variables, the model attempts to consider the effects of uncertainties caused by the fluctuation of the wastewater quality and quantity during the design of MWTP. The model solution procedure is illustrated in detail, and a numerical example is given to verify the feasibility and advantage of the model. Furthermore, the possibility of the model application is briefly outlined.

Treatment of backwater in bauxite flotation plant and optimization by using Box-Behnken design

Flotation indexes gradually decrease with the increase of cycle time of the backwater in bauxite floatation,and discharge of backwater brings environmental risk.In this study,methods such as Fenton-oxidation,adsorption and coagulation were used in the treatment of backwater,the flotation indexes were checked after backwater treatments,and Box-Behnken design(BBD)was used in the optimization of the main operating parameters.The results reveal that flotation indexes are effectively improved after coagulation treatment by polyaluminum ferric chloride(PAFC).The optimum parameters predicted by BBD are pH 7.55,1.09 g/L PAFC dosage and temperature of 25℃.Under these optimum conditions,a maximum recovery of Al2O3 of 82.83%and a minimum A/S of 1.30 of tailings are gained,while the deviations are less than 3%from the predicted values.These findings encourage the application of BBD for the optimization of critical parameters in backwater treatment.

Study on Ecological Landscape Design in Rural Sewage Treatment-Taking Sanmenxia Lushi Sewage Treatment Station as an Example

The problem of water pollution is one of the long-term difficulties in the process of rural environmental construction and economic development in China.In order to meet the requirements of the country’s green and sustainable development,many regions actively promote the construction of rural sewage treatment and fill in the shortcomings of the rural habitat environment to accelerate the construction of beautiful and livable villages.Through a lot of literature and case studies,this paper explores the environmental problems that are common in rural sewage treatment in the northern region of China,explores advanced domestic and foreign cases and technologies on this topic,and summarizes the landscape design strategies on this issue.From the perspective of ecological landscape design,the thesis seeks the theoretical and technical support for rural sewage treatment in river valley areas,and establishes a bridge between rural sewage treatment technology and ecological landscape.Finally,combining theory with practice,taking the project of Lushi sewage treatment in Sanmenxia as an example,team completed the landscape design of ecological sewage purification display area in Zhangjiacun.The design focuses on presenting the application of internal sewage treatment technology and external landscape aesthetics.According to the main points of ecological landscape design and the theory of ecological edge effect,the local ecological system is effectively protected,and a rural domestic sewage purification display area with economic benefits is constructed.

Treatment design of geological defects in dam foundation of Jinping I hydropower station

Jinping I hydropower station is one of the most challenging projects in China due to its highest arch dam and complex geological conditions for construction.After geological investigation into the dam foundation,a few large-scale weak discontinuities are observed.The rock masses in the left dam foundation are intensively unloaded,approximately to the depth of 150–300 m.These serious geological defects lead to a geological asymmetry on the left and right banks,and thus some major diffculties of dam construction are encountered.In this paper,the influences of geological defects on the project are analyzed,followed by the concepts and methods of treatment design.Based on the analysis,the treatment methods of the weak rock masses and discontinuities are carefully determined,including the concrete cushion,concrete replacement grids,and consolidation grouting.They work together to enhance the strength and integrity of the dam foundation.Evaluations and calibrations through geo-mechanical model tests in combination with feld monitoring results in early impoundment period show that the arch dam and its foundation are roughly stable,suggesting that the treatment designs are reasonable and effective.The proposed treatment methods and concepts in the context can be helpful for similar complex rock projects.

Computer-Aided Design and Simulation of a Membrane Bioreactor for Produced Water Treatment

Membrane Bio Reactor (MBR) has been designed and simulation for the treatment of Chemical Oxygen Demand (COD), Total Suspended Solids (TSS), Total Organic Carbon (TOC), Total Dissolved Solid (TDS) and Oil/ Grease in produced water at a capacity of 54.1778 kg/hr for removal of 95%-99% contaminants. The MBR design equations were developed using the law of conservation of mass to determine the dimensions and functional parameters. The developed performance equations were integrated numerically using fourth-order Runge-Kutta embedded in MATLAB computer program to determine the optimum range of values of the reactor functional dimensions and functional parameters. The effect of rate of energy supply per reactor volume and substrate specific rate constant on the capacity of the membrane bioreactor were investigated. Also, the effect of initial loading of substrate on Solid Retention Time (SRT) was also investigated. Results showed that kinetic parameters influenced the percentage removal of contaminants as Hydraulic Retention Time (HRT) and size of MBR decreased with increase in specific rate constant at fixed conversion of contaminants. Also, HRT and MBR size increased as the conversion of Chemical Oxygen Demand (COD) was increased, while increased in the ratio of energy supplied per volume resulted in decreased of MBR volume. The effect of initial loading of substrate on SRT showed that increased in substrate loading increased the retention time of the solid at fixed substrate conversion, while the conversion of substrate to microorganism increased as the solid retention time was increased. The increased in initial loading of substrate concentration increased the production of Mixed Liquor Suspended Solids (MLSS). Thus, the size of MBR required for the conversion of the investigated contaminants at the design percentage removal increased in the following order: oil/grease 3;0.98 and 4.68 m;and 1.38 and 6.62 at 95% and 99% respectively, while the SRT was 82.67 days.

Research in spinal surgery: Evaluation and practice of evidence-based medicine

Evidence-based medicine(EBM) is a common concept among medical practitioners, yet unique challenges arise when EBM is applied to spinal surgery. Due to the relative rarity of certain spinal disorders, and a lack of management equipoise, randomized controlled trials may be difficult to execute. Despite this, responsibility rests with spinal surgeons to design high quality studies in order to justify certain treatment modalities. The authors therefore review the tenets of implementing evidencebased research, through the lens of spinal disorders. The process of EBM begins with asking the correct question.An appropriate study is then designed based on the research question. Understanding study designs allows the spinal surgeon to assess the level of evidence provided.Validated outcome measurements allow clinicians to communicate the success of treatment strategies, and will increase the quality of a given study design. Importantly,one must recognize that the randomized controlled trial is not always the optimal study design for a given research question. Rather, prospective observational cohort studies may be more appropriate in certain circumstances, and would provide superior generalizability. Despite the challenges involved with EBM, it is the future of medicine. These issues surrounding EBM are important for spinal surgeons, as well as health policy makers and editorial boards, to have familiarity.

Treatment regimen design in clinical radiotherapy for hepatoma

Recently, the paper by Wang et at published in World Journal of Gastroenterology has given rise to great interest of many researchers. It is well known that hepatoma is one of the lethal diseases with a high incidence in the world, especially in Asia. Radiotherapy is the main treatment modality of hepatoma in clinical practice. Unfortunately, intrinsic radiosensitivity of cancer cells is not fully understood, though a large number of papers on it are now available. Yang and colleagues 21 have developed the premature chromosome condensation technique for clinical radiotherapy of hepatoma. A precise and quick measurement of cell radiosensitivity can detect the highrisk results after exposure to a large dose.

Design and Comparison of Wastewater Treatment Plant Types (Activated Sludge and Membrane Bioreactor), Using GPS-X Simulation Program: Case Study of Tikrit WWTP (Middle Iraq)

Mathematical models and simulation are considered a powerful tool in engineering practice. Those tools are becoming increasingly used for the improvement of wastewater treatment plants design because the conceptual design is complex and ill-defined. In this paper, three alternatives: 1) complete mix activated sludge without nitrogen removal (CAS);2) complete mix activated sludge with nitrogen removal (CAS-N) and;3) membrane bioreactor (MBR) processes were designed into two steps: first concept design to calculate the size of process units, then second implement modeling and simulation to improve the accuracy of the conceptual design. In brief, the treatment process design has been verified by using the activated sludge model No. 1 (ASM1) in GPS-X (v.7) simulation software. This application helps not only in sizing the treatment units but also in understanding the plant’s capacity. In the same time, it can assist in studying the future expansion works required for increased hydraulic and organic loadings. For this purpose, Tikrit WWTP was selected as a case study. The used model was validated by comparing the designed values of the plant and the modeling data. The verification of the obtained results from both hand calculations and the results of the program showed a good agreement. A significant difference in the volume of secondary treatment was obtained from design calculations, where the CAS without denitrification system was 9244 m3 (aerobic and secondary tanks), CAS with denitrification system was 11,324 m3 (anoxic, aerobic and secondary tanks) and for MBR system was 7468 m3 (anoxic, aerobic and immersed membrane tanks). From the obtained results point of view, it can be concluded that mathematical models can be considered as worthy tools to complement the established wastewater treatment plant design procedures.

Application of evidence-based medicine methods in integrative oncology research

To present the advances of evidence-based medicine and clinical research methodology in integrative oncology,we conducted a literature review of real-world studies of traditional Chinese medicine(TCM)in cancer care and summarized the available evidence.Pragmatic randomized controlled trials(pRCTs)and clinical registry studies are becoming more popular as they could compensate for the limitations of RCTs.Many RCTs of TCM for cancer treatment as well as systematic reviews have been published.The most investigated therapies are based on acupuncture,Chinese herbal compounds,and Chinese patent medicines.Acupuncture has a significant advantage in relieving cancer-related symptoms.Published studies focus more on improving clinical symptoms and laboratory indicators.However,the patient's quality of life deserves more attention.

An Evidence-Based Management Approach to HIV/AIDS in Nigeria

Objectives: This paper seeks to examine the history of HIV/AIDS in Nigeria while presenting a clear picture of some of the issues that exist in service delivery. Lastly, this paper explores how an evidence-based management approach offers an effective set of tools to HIV/AIDS organizations. Methods: Content analysis and a qualitative desk review of the literature. Results: Findings from this paper reveal that through the use of evidence-based management, preconceived notions can be challenged so as to yield a diversity of thought and a more people-centered approach to public health delivery. This paper also shows that in the Nigerian setting, an evidence-based management framework can be a transformative tool in ensuring that key populations can receive critical care and treatment in the long run despite the uncertainty that might exist when it comes to funding and resources. Conclusions: Evidence-based management is a rigorous framework that can be used for understanding how a multitude of factors can position an organization to achieve its theory of change, which in turn can lead to sustainable impact in the long run. Incorporating the use of evidence in everyday organizational behavior involves not only looking at the manner in which data is aggregated, but also how it is disseminated. In order to ensure that the evidence is not manipulated, nonprofit organizations are often viewed as being best suited for collecting evidence since they are not heavily plagued by systemic corruption and political tides, compared to their government counterparts.

Evidence-Based Therapy May Improve Outcome in Glomerulonephritis—A Prospective Field Survey

Introduction and aims: Although glomerulonephritis is rare in the general population it is the second most important cause for end-stage renal failure. The therapy of glomerulonephritis is guided by a limited number of individual clinical trials and treatment recommendations are based on meta-analysis and Cochrane Systematic Reviews. The impact of such therapy standards on the prognosis of glomerulonephritis is not known. Methods: Between October 2002 and December 2008 patients with abnormal urine findings and/or decreasing renal function of unknown cause were referred for renal biopsy. In a collaboration of out-patient nephrologists with a major teaching hospital, all patients received treatment recommendations according to evidence-based therapy guidelines based on Cochrane Systematic Reviews. Patient charts were systematically reviewed and patients were re-examined for follow-up until November 2009. Cox Regression analysis was performed to identify independent prognostic factors. Results: Two hundred patients with primary or secondary glomerulonephritis were identified. Complete follow-up data were available from 196 patients with 324 therapeutic interventions. The mean follow-up was 2.8 ± 2.0 years. Among all patients, 37% remained unchanged ill, 13% died, 17% had progressing renal disease, while 19% had a complete and 14% a partial remission. Proteinuria declined in primary glomerulonephritis (5.0 ± 5.4 g/d to 2.1 ± 3.4 g/d, p Conclusions: In a multivariate model of standardised glomerulonephritis therapy the presence of tubulointerstitial fibrosis was associated with death or progresssive renal disease, while prednisolone-based therapy regimens and intensified nephrological follow-up resulted in a significant delay of endstage-renal failure. This result should direct future health care policies because glomerulonephritis accounts for nearly 20% of the dialysis population.

Causal Analysis on the Lining Exfoliation and Treatment Design of an Operational Tunnel

According to the actual situation of the secondary lining of a expressway tunnel in Chongqing,this paper analyzed the specific reasons for lining exfoliation with corresponding test reports.According to this,a quick treatment scheme for lining exfoliation is proposed,which can make the treatment timely and effective,and suggestions for treating similar diseases in tunnels are put forward,which can provide reference for similar projects.

Challenges and Motivating Factors of Orthodontic Treatment among Patients Attending Komfo Anokye Teaching Hospital

Background: Orthodontic treatment poses challenges such as discomfort, aesthetic concerns, dietary restrictions, time commitment, and financial considerations for patients. These challenges can deter individuals from pursuing treatment or cause anxiety during the process. However, patients are motivated by the desire to improve their appearance, boost self-confidence, and enhance oral health. They also value the long-term benefits of treatment, including improved dental function and overall well-being. Professional recommendations from dentists and orthodontists, along with social support from family and friends, further encourage patients to undergo treatment. Understanding these challenges and motivating factors is crucial for orthodontic professionals to tailor treatment plans and ensure positive experiences and successful outcomes for their patients. Objective: To determine the challenges and motivating factors of orthodontic treatment among patients attending Komfo Anokye Teaching Hospital. Method: The study was conducted at Komfo Anokye Teaching Hospital in Kumasi, Ghana, with a sample size of 60 orthodontic patients. Data was collected using self-administered questionnaires and analyzed using SPSS software. Ethical approval was obtained, and the findings were shared with stakeholders. Results: Findings showed a higher representation of females (63.3%) seeking orthodontic treatment. Common motivations for seeking orthodontic treatment included aesthetic Concerns (38.2%), misaligned teeth (28.1%) and recommendation from dentist (19.2%). Challenges reported included pain and discomfort (36.7%), difficulty chewing (15%), expensive treatment (14.4%) and missed appointments (11.7%). Factors motivating treatment continuation were visible improvements (30%), achieving optimal results (23%), reducing pain and discomfort (17%). External influences, such as family pressure, also played a role. Patients appreciated the support of healthcare providers during treatment but suggested better pain management and education. Conclusion: The study provided valuable insights into patient motivations, challenges and factors influencing satisfaction and adherence to orthodontic treatment at KATH.