Performance Evaluation of Two Series Vertical Flow Filters for Wastewater Treatment: A Case Study of the Prototype Installed at Gaston Berger University, Saint-Louis, Senegal

This paper evaluates the efficacy of two sequential vertical flow filters (VFF), FV1 and FV2, implanted with Typha, in a pilot-scale wastewater treatment system. FV1 comprises three cells (FV1a, FV1b, and FV1c), while FV2 consists of two cells (FV2a and FV2b), each designed to reduce various physicochemical and microbiological pollutants from wastewater. Quantitative analyses show significant reductions in electrical conductivity (from 1331 to 1061 μS/cm), biochemical oxygen demand (BOD5 from 655.6 to 2.3 mg/L), chemical oxygen demand (COD from 1240 to 82.2 mg/L), total nitrogen (from 188 to 37.3 mg/L), and phosphates (from 70.9 to 14.6 mg/L). Notably, FV2 outperforms FV1, particularly in decreasing dissolved salts and BOD5 to remarkably low levels. Microbiological assessments reveal a substantial reduction in fecal coliforms, from an initial concentration of 7.5 log CFU/100mL to 3.7 log CFU/100mL, and a complete elimination of helminth eggs, achieving a 100% reduction rate in FV2. The study highlights the impact of design parameters, such as filter material, media depth, and plant species selection, on treatment outcomes. The findings suggest that the judicious choice of these components is critical for optimizing pollutant removal. For instance, different filtration materials show varying efficacies, with silex plus river gravel in FV1c achieving superior pollutant reduction rates. In conclusion, VFFs emerge as a promising solution for wastewater treatment, underscoring the importance of design optimization to enhance system efficiency. Continuous monitoring and adaptation of treatment practices are imperative to ensure water quality, allowing for safe environmental discharge or water reuse. The research advocates for ongoing improvements in wastewater treatment technologies, considering the environmental challenges of the current era. The study concludes with a call for further research to maximize the effectiveness of VFFs in water management.

Clinical characteristics and treatment of inflammatory bowel disease: A comparison of Eastern and Western perspectives

Inflammatory bowel disease(IBD) is a chronic, relapsing intestinal inflammatory disorder with unidentified causes. Both environmental factors and genetic aspects are believed to be crucial to the pathogenesis of IBD. The incidence and prevalence of IBD have recently been increasing throughout Asia, presumably secondary to environmental changes. This increasing trend in IBD epidemiology necessitates specific health care planning and education in Asia. To this end, we must gain a precise understanding of the distinctive clinical and therapeutic characteristics of Asian patients with IBD. The phenotypes of IBD reportedly differ considerably between Asians and Caucasians. Thus, use of the same management strategies for these different populations may not be appropriate. Moreover, investigation of the Asian-specific clinical aspects of IBD offers the possibility of identifying causative factors in the pathogenesis of IBD in this geographical area. Accordingly, this review summarizes current knowledge of the phenotypic manifestations and management practices of patients with IBD, with a special focus on a comparisonof Eastern and Western perspectives.

Recto-sigmoid endoscopic-ultrasonography in the staging of deep infiltrating endometriosis

Recto-sigmoid endoscopic ultrasonography(RS-EUS) has first been used in the staging of pelvic deep infil-trating endometriosis in the early 1990's. Since then, although publications have been sparse, RS-EUS is routinely used for this indication in few centers. In this paper, we focus on technical aspects and operating method of rectal and sigmoid endo-sonography, and describe the most characteristic echographic presen-tations of endometriosis of the lower digestive tract. Through a literature review, results obtained with dif-ferent types of endo-rectal probes, either flexible en-doscopic, or blind rigid, are presented and compared with those of other close imaging techniques: magnetic resonance imaging and the more recent trans-vaginal sonography. As well as these two latter techniques, RS-EUS appears as an interesting method in the staging of pelvic deep infiltrating endometriosis particularly to evaluate rectal and sigmoid infiltrations. However, more prospective studies are required, to correctly define respective indications for each exam, in the light of re-cent advancements in treating this frequent disease.

Medical Treatment Process Modeling Based on Process Mining and Treatment Patterns

activities.Ex-periments on a synthetic log of the non-secondary hy-pertension MTP and empirical findings demonstrate the effectiveness of our approach.The results show that the process mining in our approach framework can automatically generate more accurate MTP mod-els,and the subprocess models based on treatment pat-terns make the models easy to understand.

Dosimetric Effects Due to Inter-Observer Variability of Organ Contouring When Utilizing a Knowledge-Based Planning System for Prostate Cancer

Purpose: Radiotherapy is a widely accepted standard of care for early-stage prostate cancer, and it is believed that the plan quality and treatment outcome are associated with contour accuracy of both the target and organs-at-risk (OAR). The purposes of this study are to 1) assess geometric and dosimetric uncertainties due to inter-observer contour variabilities and 2) evaluate the effectiveness of geometric indicators to predict target dosimetry in prostate radiotherapy. Methods: Twenty prostate patients were selected for this retrospective study. Five experienced clinicians created unique structure sets containing prostate, seminal vesicles, bladder, and rectum for each patient. A fully automated script and knowledge-based planning routine were utilized to create standardized and unbiased plans that could be used to evaluate changes in isodose distributions due to inter-observer variability in structure segmentation. Plans were created on a “gold-standard” structure set, as well as on each of the user-defined structure sets. Results: Inter-observer variability of contours during structure segmentation was very low for clearly defined organs such as the bladder but increased for organs without well-defined borders (prostate, seminal vesicles, and rectum). For plans generated with the user-defined structure sets, strong/moderate correlations were observed between the geometric indicators for target structure agreement and target coverage for both low-risk and intermediate-risk patient groups, while OAR indicators showed no correlation to final dosimetry. Conclusions: Target delineation is crucial in order to maintain adequate dosimetric coverage regardless of the associated inter-observer uncertainties in OAR contours that had a limited impact upon final dosimetry.

Autoimmune hepatitis in a patient infected by HIV-1 and under highly active antiretroviral treatment:Case report and literature review

Liver disease has recently been described as an im-portant cause of morbidity and mortality in patientsinfected with human immunodeficiency virus （HIV）.Liver test changes are useful surrogates of the burdenof liver disease. Previous studies have shown that trans-aminase elevations are frequent among these patients.The cause of those changes is harder to establish inHIV-patients. We present a 61-year-old caucasian male,diagnosed with HIV type 1 infection since 1998, underhighly active antiretroviral treatment （HAART）, withvirological suppression and immunological recovery.He presented in a follow-up laboratory workup highvalues of transaminases, arthralgia at the hip joints and hepatomegaly. Liver function tests were normal. Theantibodies to hepatitis viruses were negative. However,autoimmune study and liver biopsy were compatible with autoimmune hepatitis （AIH）. The AIH is a rare di-agnosis in HIV-infected patients perhaps because the elevation of transaminases and changes in liver function tests are often associated to HAART or to other possible liver diseases, namely viral hepatitis and non-alcoholic steatohepatitis. The diagnosis may be underestimated. There are no specifc recommendations available for the treatment of HIV-associated AIH although the immuno-supression with slower tapering seems the most reason-able approach.

A Prospective Study of Inpatient Ketamine Subanaesthetic Dose Infusion in Chronic Refractory Pain

Background: Inpatient subanaesthetic ketamine infusion for 5 days may improve pain and reduce oral opioid usage in patients with chronic pain. Objective: This study aims to investigate pain and psychological outcomes of ketamine parenteral infusion (0.1 - 0.35 mg/kg/h or maximum 24 mg/hour) for 5 days in patients with chronic refractory pain. The secondary objective is to explore any prognostic pain and psychological factors associated with the successful response to the ketamine treatment. Methodology: A prospective longitudinal study of a small cohort (N = 35) of patients with heterogenous chronic refractory pain conditions was conducted from one week to two months follow-up. Results: Pain Severity was significantly improved from mean 6.5 to 5.1 (t = 3.77, p < 0.001, d = 0.6) at 1-week and 5.9 (t = 2.14, p = 0.042, d = 0.4) at 2-month;Pain Interference from mean 7.0 to 5.1 (t = 4.99, p < 0.001, d = 0.9) at 1-week and 6.1 (t = 2.16, p = 0.041, d = 0.4) at 2-month;Pain Self-Efficacy Questionnaire (PSEQ) from mean 17 to 24 (t = −3.37, p = 0.002, d = −0.6) at 1-week and 23 (t =−2.60, p = 0.016, d =−0.5) at 2-month;Pain Catastrophizing (PCS) from 28 to 23 (t = 3.4, p = 0.002;d = 0.6) at 1-week and 21 (t = 2.45, p = 0.022, d = 0.5) at 2-month;Depression from mean 21 to 16 (t = 2.16, p = 0.038, d = 0.4) at 1-week and 16 (t = 3.53, p = 0.002, d = 0.7) at 2-month;and oral Morphine Equivalent Daily Dose (oMEDD) reduced from mean 191 mg/day on admission to 122 mg/day at 1-week (t = 2.38, p = 0.023;d = 0.4) and 93 mg/day at 2-month (t = 2.59, p = 0.016;d = 0.5). There was no significant difference between responders and non-responders on baseline psychological measures (t33 < 1.19, p > 0.244) and pain classifications ( = 0.610, p = 0.894). Conclusion: Ketamine subanaesthetic dose infusion for 5 days was found to be effective in managing chronic refractory pain with significant opioid reduction and small improvements in all chronic pain outcomes, except anxiety, at 1-week and 2-month follow-up and with minimal severe adverse effects.

Meta-analysis on integrative medicine for the treatment of malignant ascites: a comparative study

OBJECTIVE: To compare the efficacy of integrated Chinese and Western Medicine with that of only Western Medicine for the treatment of malignant ascites.METHODS: All randomized controlled trials(January 2004 to March 2013) from the China National Knowledge Infrastructure Database, Chinese Biomedical Literature Database, and Wanfang Database were searched with keywords. Meta-analysis was conducted by combining the odds ratios of the individual studies. Review Manager 5.0 was used for the analysis.RESULTS: One thousand one hundred and fifty-six patients from 19 randomized controlled trails were included. Of them, 630 patients were treated with integrated Chinese and Western Medicine(the integrative group), and 526 patients were treated with Western Medicine alone(the control group). The Meta-analysis showed that the total effective rate was 78.73% in the integrated group, and 59.13% in the control group. The effective percentage was sig-nificantly higher in the integrative group than that of the control group [OR = 2.85, 95% CI(2.16,3.74),P < 0.01].CONCLUSION: The short-term curative effect in the integrative group was better than that in the control group. Integrative medicine may be beneficial for malignant ascites.

Reduning injection for fever, rash, and ulcers in children with mild hand, foot, and mouth disease: a randomized controlled clinical study

OBJECTIVE： To assess the efficacy and safety of Re- duning injection for fever, rash, and ulcers in chil- dren with mild hand, foot, and mouth disease （HFMD）. METHODS： A stratified-block randomized, dou- ble-blind, parallel-controlled, and multicenter clini- cal trial was conducted with 360 patients in five hospitals across China： Quanzhou Children＇s Hospi- tal, Shijiazhuang No. 5 Hospital, Shanghai Public Health Centre, Hunan Provincial Children＇s Hospi- tal, and Kaifeng Children＇s Hospital. Patients were randomized into three groups with 120 in each. Group A was treated with Western Medicine, group B with Reduning injection, a Chinese herbal medi- cine, and group C with both Reduning injection and Western Medicine. Results were compared for treatment efficacy and safety on HFMD. The clinical outcomes were observed as follows： fever and on- set time of antifebrile effect （time to bring the body temperature down 〉0.5~C after medication）; cumu- lative time for fever recovery （body temperature re- covering to normal and lasting more than 24 h without medication）; cumulative time for rash dis- appearance （without new rashes or ulcers appear- ing and the original ones fading away）; and cumula- tive time for mouth ulcer disappearance. RESULTS： For the onset time of the antifebrile ef- fect, there was no statistical difference between groups A and B （P〉O.05） and groups B and C （P〉 0.05）. However, there was a statistical difference be- tween groups A and C （P〈0.05）, and the effect ingroup C was the best. For the cumulative time for rash disappearance, there was no statistical differ- ence between groups A and B （P〉0.05）. There were statistical differences between groups A and C, and groups B and C （P〈0.05）, and the effect in group C was the best. For the cumulative time for mouth ul- cers disappearance, there were no statistical differ- ences among the three groups （P〉0.05）. CONCLUSION： Reduning injection with Western Medicine for symptomatic treatment is most effec- tive for mild HFMD. No adverse reactions were ob- served.