Case Report of a Pseudoaneurysm of Ascending Aorta Treated by Stent

Pseudoaneurysms of the ascending aorta are a rare complication of aortic and cardiac surgery. In this article, we present a clinical case of a 56-year-old patient with a fortuitous diagnosis of a pseudoaneurysm of ascending aorta that was treated by an endovascular stent-graft. We discuss in this article the diagnostic and therapeutic aspect of the case and the place of endovascular treatment for the ascending aorta.

Potential risk of soil irrigation with treated wastewater over 40 years:a field experiment under semi-arid conditions in northeastern Tunisia

In Tunisia,water scarcity is only adding pressure on water demand in agriculture.In the context of sustainable development goals,Tunisia has been reusing treated wastewater(TWW)as a renewable and inexpensive source for soil fertigation and groundwater(GW)recharge.However,major risks can be expected when the irrigation water is of poor quality.This study aims for evaluating the potential risk of TWW and GW irrigation on soil parameters.Accordingly,we evaluated the suitability of water quality through the analysis of major and minor cations and anions,metallic trace elements(MTEs),and the sodium hazard by using the sodium adsorption ratio(SAR)and the soluble sodium percentage(SSP).The risk of soil sodicity was further assessed by SAR and the exchangeable sodium percentage(ESP).The degree of soil pollution caused by MTEs accumulation was evaluated using geoaccumulation index(Igeo)and pollution load index(PLI).Soil maps were generated using inverse spline interpolation in ArcGIS software.The results show that both water samples(i.e.,TWW and GW)are suitable for soil irrigation in terms of salinity(electrical conductivity<7000μS/cm)and sodicity(SAR<10.00;SSP<60.00%).However,the contents of PO_(4)^(3-),Cu^(2+),and Cd^(2+)exceed the maximum threshold values set by the national and other standards.Concerning the soil samples,the average levels of SAR and ESP are within the standards(SAR<13.00;ESP<15.00%).On the other hand,PLI results reveal moderate pollution in the plot irrigated with TWW and no to moderate pollution in the plot irrigated with GW.Igeo results indicate that Cu^(2+)is the metallic trace element(MTE)with the highest risk of soil pollution in both plots(Igeo>5.00),followed by Ni^(2+)and Pb^(2+).Nevertheless,Cd^(2+)presents the lowest risk of soil pollution(Igeo<0.00).Statistical data indicates that Ca^(2+),Na+,Ni^(2+),and Pb^(2+)are highly distributed in both plots(coefficient of variation>50.0%).This study shows that the use of imagery tools,such as ArcGIS,can provide important information for evaluating the current status of soil fertility or pollution and for better managing soil irrigation with TWW.

Treat to target in Crohn’s disease:A practical guide for clinicians

A treat-to-target(T2T)approach applies the principles of early intervention and tight disease control to optimise long-term outcomes in Crohn's disease.The Selecting Therapeutic Targets in Inflammatory Bowel Disease(STRIDE)-II guidelines specify short,intermediate,and long-term treatment goals,documenting specific treatment targets to be achieved at each of these timepoints.Scheduled appraisal of Crohn’s disease activity against pre-defined treatment targets at these timepoints remains central to determining whether current therapy should be continued or modified.Consensus treatment targets in Crohn’s disease comprise combination clinical and patient-reported outcome remission,in conjunction with biomarker normalisation and endoscopic healing.Although the STRIDE-II guidelines endorse the pursuit of endoscopic healing,clinicians must consider that this may not always be appropriate,acceptable,or achievable in all patients.This underscores the need to engage patients at the outset in an effort to personalise care and individualise treatment targets.The use of non-invasive biomarkers such as faecal calprotectin in conjunction with cross-sectional imaging techniques,particularly intestinal ultrasound,holds great promise;as do emerging treatment targets such as transmural healing.Two randomised clinical trials,namely,CALM and STARDUST,have evaluated the efficacy of a T2T approach in achieving endoscopic endpoints in patients with Crohn’s disease.Findings from these studies reflect that patient subgroups and Crohn’s disease characteristics likely to benefit most from a T2T approach,remain to be clarified.Moreover,outside of clinical trials,data pertaining to the real-world effectiveness of a T2T approach remains scare,highlighting the need for pragmatic real-world studies.Despite the obvious promise of a T2T approach,a lack of guidance to support its integration into real-world clinical practice has the potential to limit its uptake.This highlights the need to describe strategies,processes,and models of care capable of supporting the integration and execution of a T2T approach in real-world clinical practice.Hence,this review seeks to examine the current and emerging literature to provide clinicians with practical guidance on how to incorporate the principles of T2T into routine clinical practice for the management of Crohn’s disease.

Situational Analysis of Malaria Control Following the 2021 Distribution of Long Lasting Insecticide-Treated Bed Nets in the Tiko Health District, South West Region, Cameroon

Malaria is still a major public health concern in Cameroon as more than 20 million people are at risk of the disease. Despite the government’s effort to scale up the distribution of long lasting insecticide-treated bed nets (LLINs), full ownership and optimal use is still limited. In 2021, over a million LLINs were made available for distribution in the South West Region. However, the current situation of malaria has not yet been ascertained following the 2021 mass distribution campaign (MDC). Therefore, the aim of this study was to determine LLIN ownership, coverage, usage and the prevalence of malaria following the 2021 MDC in the Tiko Health District (THD), South West Region of Cameroon. A cross-sectional study was carried from May 1 to 27, 2022 in which a multi-stage sampling technique was used to enroll eligible participants. Data were collected from household heads using questionnaires and capillary blood samples collected from consented household members were used to test for malaria. Data were analyzed using SPSS version 25 at 0.05 significance level. From the 150 households surveyed, 96 (64.0%) owned a mosquito net before the recent MDC. There was an overall significant increase (p p = 0.644) in LLINs ownership between areas where door-to-door (79.5%) and fixed “Hit and Run” (75.8%) strategies were used in the distribution of LLINs in THD. The prevalence of malaria was 10.2%. The regular use of LLINs was significantly associated (p = 0.007) with low malaria prevalence. The 2021 MDC had an impact on malaria prevalence in those who properly used them.

Clinical Study on the Effectiveness of Xian Fang Huo Ming Yin for Treating Cutaneous Infections and Promoting Wound Healing in Patients with Perianal Abscess

Objective:To explore the effect of the Xian Fang Huo Ming Yin(XFHM)for treating cutaneous infections and promoting wound healing in patients with perianal abscesses.Methods:Sixty-one patients with perianal abscesses who were admitted to our hospital(Xinghua City People’s Hospital)from May 2022 to May 2023 were selected and randomly divided into two groups,a control group(30 cases)and a study group(31 cases).Both groups received surgical treatment.The control group received conventional treatment and warm water fumigation,sitz bath,and surgical dressing change after surgery,while the research group received XFHM based on the control group.XFHM was taken orally and replaced with warm water for fumigation and sitz bathing.Both groups received treatment for 4 weeks but discontinued sitz bathing after 2 weeks.Various clinical indicators between the two groups were compared.Results:The total clinical effective rate and wound recovery rate of the study group were higher than that of the control group.There were differences in the wound pain scores,surrounding tissue edema,and wound secretions at different time points.Both groups experienced wound pain.The scores of wound pain,surrounding tissue edema,and wound secretions of the study group were lower than those of the control group,7 and 14 days after surgery.The serum interleukin 6(IL-6),tumor necrosis factor-alpha(TNF-α)levels,and pH values of the study group were lower than those of the control group 10 days after surgery(P<0.05).Conclusion:The application of XFHM for treating cutaneous infections and promoting wound healing in patients with perianal abscesses improved the treatment outcome,alleviated clinical symptoms,and promoted healing.

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.

Treated wastewater irrigation effect on soil,crop and environment:Wastewater recycling in the loess area of China

A study was carded out at the Loess Plateau in Dongzhi, China, to test the feasibility of using secondary treatment sewage effluent and to determine whether the water quality would then meet the recommended irrigation norm. Seven crops, including celery, wheat, maize, millet, apples, rapeseed and yellow beans, were tested in the study. Physical and chemical properties of the soil, crop yield and quality and leachate at different soil depths were measured. In most cases, the quality of the crops that made use of treated sewage was not distinctively different from those that did not use treated sewage. However, yields for the former were much higher than they were for the latter. Leachates at different soil depths were analyzed and the results did not show alarming levels of constituents. For a period of approximately 14 months, the treated sewage irrigation had no significant effect on the loess soil and no cases of illness resulting from contact with the treated sewage were reported. With treated sewage irrigation, a slight increase in the organic content of the soil was observed.

Biosorption of copper ions from dilute aqueous solutions on base treated rubber (Hevea brasiliensis) leaves powder: kinetics, isotherm, and biosorption mechanisms

The effciency of sodium hydroxide treated rubber (Hevea brasiliensis) leaves powder (NHBL) for removing copper ions from aqueous solutions has been investigated. The e?ects of physicochemical parameters on biosorption capacities such as stirring speed, pH, biosorbent dose, initial concentrations of copper, and ionic strength were studied. The biosorption capacities of NHBL increased with increase in pH, stirring speed and copper concentration but decreased with increase in biosorbent dose and ionic strength. The isotherm study indicated that NHBL fitted well with Langmuir model compared to Freundlich and Dubinin-Radushkevich models. The maximum biosorption capacity determined from Langmuir isotherm was 14.97 mg/g at 27°C. The kinetic study revealed that pseudo- second order model fitted well the kinetic data, while Boyd kinetic model indicated that film diffusion was the main rate determining step in biosorption process. Based on surface area analysis, NHBL has low surface area and categorized as macroporous. Fourier transform infrared (FT-IR) analyses revealed that hydroxyl, carboxyl, and amino are the main functional groups involved in the binding of copper ions. Complexation was one of the main mechanisms for the removal of copper ions as indicated by FT-IR spectra. Ion exchange was another possible mechanism since the ratio of adsorbed cations (Cu2+ and H+) to the released cations (Na+, Ca2+, and Mg2+) from NHBL was almost unity. Copper ions bound on NHBL were able to be desorbed at > 99% using 0.05 mol/L HCl, 0.01 mol/L HNO3, and 0.01 mol/L EDTA solutions.

Effect of restoration technique on resistance to fracture of endodontically treated anterior teeth with flared root canals

This study was designed to compare the impact of post and core systems on resistance to fracture of endodontically treated anterior teeth with flared root canals and to assess their fracture pattern. Sixty central incisors were cut horizontally 2 mm coronal to the cementoenamel junction(CEJ). After root canal therapy, teeth were assigned into 6 groups(n = 10 each) based on a post system and used as follows: Group C, non-flared root received size #1 glass fiber posts(Control); Group AP, flared root restored with anatomical post; Group RC, flared root restored with size #1 fiber post and cemented with thick layer of resin cement; Group CR, flared root restored with size #1 and reinforced with composite resin; Group CM, cast post-core; Group CP, CAD/CAM polymer-infiltrated ceramic post and core.Following post cementation, core build-up and crown insertion, the specimens were thermo-cycled up to 10,000 cycles(5 C/55 C; 30 seconds dwell time, 6 seconds transition time) and then statically loaded at 1 mm/minute crosshead speed using a universal testing machine. One-way ANOVA and Tukey HSD post hoc test(α= 0.05) were used for data analysis. Group C recorded significantly higher resistance to fracture values [(826.9±39.1) N] followed by group CP [(793.8±55.6) N] while group RC yielded the lowest fracture resistance values [(586.7±51.4) N]. The resistance to fracture of wide root canals can be enhanced by using one-piece CAM/CAM post and core as an alternative to the use of either glass fiber post, relined with composite resin increasing the thickness of luting cement or the use of cast post and core system. However, this was an in vitro investigation and further in vivo studies are necessary.

Acute effects of chlorpyryphos-ethyl and secondary treated effluents on acetylcholinesterase and butyrylcholinesterase activities in Carcinus maenas

The acute effects of commercial formulation of chlorpyrifos-ethyl （Dursban ） and the secondary treated industrial/urban effluent （STIUE） exposure on acetylcholinesterase （ACHE） and butyrylcholinesterase （BuChE） activities in hepatopancreas and gills of Mediterranean crab Carcinus maenas were investigated. After 2 d of exposure to chlorpyriphos-ethyl, the AChE activity was inhibited in both organs at concentrations of 3.12 and 7.82 μg/L, whereas the BuCHE was inhibited only at higher concentration 7.82 μg/L of commercial preparation Dursban~. The exposure of crabs to Dursban （3.12 μg/L） showed a significant decrement of ACHE activity at 24 and 48 h, whereas the BuChE was inhibited only after 24 h and no inhibition for both enzymes was observed after 72 h. Moreover, a significant repression of AChE activity was observed in both organs of C. maenas exposed to 5% of STIUE. Our experiments indicated that the measurement of AChE activity in gills and hepatopancreas of C. maenas would be useful biomarker of organophosphorous （OP） and of neurotoxic effects of STIUE in Tunisia.

Characteristics and Driven Factors of Nitrous Oxide and Carbon Dioxide Emissions in Soil Irrigated with Treated Wastewater

The reuse of treated wastewater in agricultural systems could partially help alleviate water resource shortages in developing countries. Treated wastewater differs from fresh water in that it has higher concentrations of salts, Escherichia coli and presence of dissolved organic matter, and inorganic N after secondary treatment, among others. Its application could thus cause environmental consequences such as soil salinization, ammonia volatilization, and greenhouse gas emissions. In an incubation experiment, we evaluated the characteristics and effects of water-filled pore space （WFPS） and N input on the emissions of nitrous oxide （N2O） and carbon dioxide （CO2） from silt loam soil receiving treated wastewater. Irrigation with treated wastewater （vs. distilled water） significantly increased cumulative N2O emission in soil （117.97 μg N kg-1）. Cumulative N2O emissions showed an exponentially increase with the increasing WFPS in unamended soil, but the maximum occurred in the added urea soil incubated at 60% WFPS. N2O emissions caused by irrigation with treated wastewater combined with urea-N fertilization did not simply add linearly, but significant interaction （P〈0.05） caused lower emissions than the production of N2O from the cumulative effects of treated wastewater and fertilizer N. Moreover, a significant impact on cumulative CO2 emission was measured in soil irrigated with treated wastewater. When treated wastewater was applied, there was significant interaction between WFPS and N input on N2O emission. Hence, our results indicated that irrigation with treated wastewater should cause great concern for increasing global warming potential due to enhanced emission of N2O and CO2.

Water quality of reclaimed water from treated urban wastewater in Chaobai River Basin,North China

The utilization of reclaimed water could be an efficient tool to alleviate water scarcity,especially for dry river augmentation.However,it is crucial to monitor water quality to ensure safety to human health and to avoid negative effects on the environment.Reclaimed water samples were collected bimonthly from May to November in 2010 in Chaobai River,and the physiochemical parameters were determined.The main results are as follows:The parameters exceeding the threshold value of the water guidelines are mainly nutrition related to nitrogen and phosphorus,which are known to increase the risk of eutrophication in surface waters.Additionally,nitrite and nitrate can be detrimental to human health.The majority of the parameters have a peaking concentration in May,whereas others either show significant temporal variation over the entire period or remain relatively constant in all four months.Correlation analysis shows that some parameters(pH,T and B) have no significant correlation with others,whereas significant positive correlation was found for Sr with EC and TDS,for CI with TDS,for Si02 with TP and for NO3-N with TN and a significant negative correlation between SO4 and Ba.According to principal component analysis,60.108%of the total data is represented by dominant solutes,and the second principal component with a percentage of 31.876 comprises parameters related to nitrogen.Subsequent cluster analysis of parameters identified four groups,which represent different compositions,and samples in May differ from others.

Clinical Observation on 57 Cases with Medical Amenorrhea Treated by Acupuncture

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PROBING A STOCHASTIC EPIDEMIC HEPATITIS C VIRUS MODEL WITH A CHRONICALLY INFECTED TREATED POPULATION

The hepatitis C virus is hitherto a tremendous threat to human beings,but many researchers have analyzed mathematical models for hepatitis C virus transmission dynamics only in the deterministic case.Stochasticity plays an immense role in pathology and epidemiology.Hence,the main theme of this article is to investigate a stochastic epidemic hepatitis C virus model with five states of epidemiological classification:susceptible,acutely infected,chronically infected,recovered or removed and chronically infected,and treated.The stochastic hepatitis C virus model in epidemiology is established based on the environmental influence on individuals,is manifested by stochastic perturbations,and is proportional to each state.We assert that the stochastic HCV model has a unique global positive solution and attains sufficient conditions for the extinction of the hepatotropic RNA virus.Furthermore,by constructing a suitable Lyapunov function,we obtain sufficient conditions for the existence of an ergodic stationary distribution of the solutions to the stochastic HCV model.Moreover,this article confirms that using numerical simulations,the six parameters of the stochastic HCV model can have a high impact over the disease transmission dynamics,specifically the disease transmission rate,the rate of chronically infected population,the rate of progression to chronic infection,the treatment failure rate of chronically infected population,the recovery rate from chronic infection and the treatment rate of the chronically infected population.Eventually,numerical simulations validate the effectiveness of our theoretical conclusions.

206 CASES OF SPINOGENIC DIZZINESS TREATED BY CONTRALATERAL ACUPUNCTURE

Spinogenic dizziness is one of the dis-orders related to the vertebral column.Pathological changes in tissues surroundingthe vertebral column will lead to dynamicalimbalance of the vertebra,resulting in dis-eases in the related parts of the body.In re-cent years,the author has treated 206 pa-tients with this disease by contralateralacupuncture with satisfactory results.

Life Cycle Assessment of CCA-Treated Wood Highway Guard Rail Posts in the US with Comparisons to Galvanized Steel Guard Rail Posts

A cradle-to-grave life cycle assessment is done to identify the environmental impacts of chromated copper arsenate (CCA)-treated timber used for highway guard rail posts, to understand the processes that contribute to the total impacts, and to determine how the impacts compare to the primary alternative product, galvanized steel posts. Guard rail posts are the supporting structures for highway guard rails. Transportation engineers, as well as public and regulatory interests, have increasing need to understand the environmental implications of guard rail post selection, in addition to factors such as costs and service performance. This study uses a life cycle inventory (LCI) to catalogue the input and output data from guard rail post manufacture, service life, and disposition, and a life cycle impact assessment (LCIA) to assess anthropogenic and net greenhouse gas (GHG), acidification, smog, ecotoxicity, and eutrophication potentially resulting from life cycle air emissions. Other indicators of interest also are tracked, such as fossil fuel and water use. Comparisons of guard rail post products are made at a functional unit of one post per year of service. This life cycle assessment (LCA) finds that the manufacture, use, and disposition of CCA-treated wood guard rails offers lower fossil fuel use and lower anthropogenic and net GHG emissions, acidification, smog potential, and ecotoxicity environmental impacts than impact indicator values for galvanized steel posts. Water use and eutrophication impact indicator values for CCA-treated guard rail posts are greater than impact indicator values for galvanized steel guard rail posts.

Compressive and Flexural Strengths of Cement Stabilized Earth Bricks Reinforced with Treated and Untreated Pineapple Leaves Fibres

This study compares the effect of treated pineapple leaves fibres (T-PALF) with sodium hydroxide solution and untreated fibres (N-PALF) on the compressive and flexural strength of earth bricks stabilized with 3% and 5% cement. The fibre content ranged from 0% to 5% in steps of 1% by weight. The compressive strength tests were made at 7, 14, 21 and 28 days of curing;the flexural strength test were conducted at 28th day only. The results show that the T-PALF had a higher compressive strength when comparing to the N-PALF. The highest compressive strength of the bricks was obtained at 28 days of curing. The compressive strength at 28 days of stabilized brick at 3% and 5% of cement reinforced with T-PALF were 4.01 and 4.81 MPa, respectively, while the one reinforced with N-PALF was 3.19 and 4.63 MPa, respectively. The results further show that the highest flexural strength of both stabilized bricks at 3% and 5% of cement reinforced with T-PALF and N-PALF was obtained with the bricks stabilized with 5% of cement reinforced with T-PALF. This results show that bricks stabilized with 5% cement and reinforced with 3% of treated fibres content are good for construction of load bearing walls. It was observed;a significant improvement of the reinforced blocks under flexure than under compression.

Bilateral choroidal osteoma with unilateral polypoidal choroidal vasculopathy treated with conbercept

Dear Editor,Chorodial osteoma(CO) is a rare choroidal tumor characterized by the presence of mature bone tissue predominantly in the juxtapapillary or macularregion.CO mostly affects young healthy females in the second or third decades of life.It is unilateral in approximately 80%of cases[1],as patients have no obvious visual symptoms during the early stage of CO,and the growth of CO is slow.CO patients usually visit the eye clinic during the later stages of CO and have poor vision.Gradual decline in vision in CO patients is related to changes in retinal pigment epithelium(RPE)and photoreceptor atrophy.Choroidal neovascularization(CNV)and the resultant subretinal fluid and hemorrhage are the most frequent causes of sudden vision loss in CO[2].We report a rare case of bilateral CO with unilateral polypoidal choroidal vasculopathy(PCV)in a middle-aged male.

Influence of Various Materials on Biomechanical Behavior of Endocrown-Restored, Endodontically-Treated Mandibular First Molar: A 3D-Finite Element Analysis

To evaluate the effect of restorative materials on stress distribution of endodontically treated teeth, the 3D models of an endodontically treated mand^ular first molar, restoration, and cement layer were created. Three different materials （composite resin, ceramage and ceramic） were studied and two loading conditions （vertical and oblique load） were simulated. Mohr-Coulomb failure criterion of enamel, dentine, endocrown and cement were evaluated separately. It is indicated that under both loading conditions, the highest values of Mohr-Coulomb failure criterion were observed in Ceramage-restored group for remaining tooth structure while in ceramic-restored group for the restoration. Compared to composite resin and Ceramage, ceramic endocrown transferred less stress, namely was more protective to the tooth structure.

Primary gastrointestinal stromal tumor of the liver treated with sequential therapy

A 67-year-old female presented with a primary hepatic gastrointestinal stromal tumor that was detected by computed tomography and diagnosed based on histopathological and genetic analyses.The tumor was microscopically composed of spindle cells and epithelioid cells,and immunohistochemistry results showed positive staining for CD117 and CD34expression.A genetic analysis revealed a heterozygous point mutation and deletion in exon 11 of c-KIT.After an R0 resection,imatinib mesylate was administered for 1 year until its use was discontinued due to severe side effects.Two years after the original operation,the tumor recurred in the residual liver and was completely resected again.Imatinib mesylate was administered for 2 years until it was replaced by sunitinib malate because of disease progression.The patient has survived for 53 mo after undergoing a sequential therapy consisting of surgical excision,imatinib and sunitinib.