Tailing propensity in the ultraviolet disinfection of trickling filter and activated sludge wastewater treatment processes.

In this paper, the effect of suspended flocs on the tailing of ultraviolet (UV) disinfection kinetics of secondary effluents was examined. To achieve this goal, final effluents produced in two processes for treating wastewater; namely, a trickling filter system and an activated sludge system, were collected and their UV disinfection were compared. Tailing of the UV dose response curve was controlled by the fraction of flocs that are both culturable and UV-resistant, referred to as the 'tailing propensity'. Using this parameter, the contribution of various floc size fractions in reducing the UV disinfection efficiency of wastewater samples was quantified. Activated sludge flocs larger than 125 µm exhibited as much as 35 times greater tailing propensity than smaller flocs in the range of 20-25 µm. Within a fixed size range, the tailing propensity of flocs generated in the trickling filter system was 3 to 8 times higher than that of activated sludge flocs, and this difference increased with the floc size. A mathematical model was developed to predict the UV disinfection of secondary effluents from suspended particle size distribution data. The model showed good agreement with experimental results.

Asian venous thromboembolism guidelines: updated recommendations for the prevention of venous thromboembolism.

The Asian venous thromboembolism (VTE) prophylaxis guidelines were first published in 2012. Since its first edition, the Asian Venous Thrombosis Forum (AVTF) working group have updated the Asian VTE epidemiology and reviewed issues that were not addressed in the previous guidelines. The authors noted that the rising incidence of VTE across Asia may be attributable to aging population, dietary changes, and increasing incidence of obesity and diabetes. The new additions in the guideline include role of thrombophilia in VTE, bleeding risk in Asians, individual risk assessment, updates in the prevention of VTE in medically ill, bariatric surgery, cancer, orthopedic and trauma patients. The influence of primary thrombophilia in perioperative VTE is still unclear. The secondary risk factors, however, are similar between Asians and Caucasians. The group found no evidence of increased risk of bleeding while using pharmacological agents, including the use of novel anti-coagulants. At present, Caprini risk assessment model is widely used for individual risk assessment. Further validation of this model is needed in Asia. In medically ill patients, pharmacological agents are preferred if there is no bleeding risk. Intermittent pneumatic compression device (IPC) is recommended in patients with bleeding risk but we do not recommend using graduated compressive stockings. In bariatric patients, data on VTE is lacking in Asia. We recommend following current international guidelines. A high index of suspicion should be maintained during postbariatric surgery to detect and promptly treat portomesenteric venous thrombosis. Different cancer types have different thrombotic risks and the types of surgery influence to a large extent the overall VTE risk. Cancer patients should receive further risk assessment. In patients with higher thrombotic risk, either due to predisposing risk or concomitant surgery, low molecular weight heparin is indicated. Different countries appear to have different incidence of VTE following trauma and major orthopedic surgery. We recommend mechanical prophylaxis using IPC as the main method and additional pharmacological prophylaxis if the thrombotic risk is high. As for obstetric practice, we propose adherence to the UK Greentop guideline that is widely accepted and utilized across Asia. To improve VTE thromboprophylaxis implementation in the region, we propose that there should be better health education, establishment of hospital-based guidelines and multidisciplinary collaboration.