Regeneration of As(V)-loaded granular activated carbon through electrocoagulation.

As(V)-loaded granular activated carbon was regenerated through electrocoagulation assisted by elution with NaCl. Adsorption of As(V) by activated carbon was highest at pH 6, and subsequent desorption in water was highest at pH 11, followed by pH 3. Lower initial pH improved arsenic removal during electrocoagulation, NaCl concentration was insignificant, but removal increased with current density. Adding Fe(II) before electrocoagulation led to an improved removal efficiency up to a concentration of 30 mg/L. Regeneration of As(V)-loaded activated carbon increased with current density and time up to a maximum of 85%. An increase in NaCl concentration to 6000 mg/L further improved regeneration to 92%. Regeneration at a lower current density only dropped slightly from 54% to 51% when doubling activated carbon concentration, demonstrating excellent scalability. Repeated adsorption-desorption tests were performed, where 81% and 69% regeneration were obtained after four regenerations with NaCl concentrations of 6000 and 750 mg/L, respectively. NaCl concentration in the tested range did not influence electrocoagulation but improved regeneration through elution. The combination of electrocoagulation and elution facilitated a higher regeneration efficiency, meanwhile removing As(V) from the solution through adsorption on iron hydroxide. PRACTITIONER POINTS: As(V)-loaded activated carbon was regenerated by electrocoagulation with elution. Regeneration increased with regeneration time and current density up to 85%. Addition of 6000 mg/L NaCl further increased regeneration to 93%. Regeneration of 82% was achieved after four regenerations. NaCl did not affect electrocoagulation but improved regeneration through elution.

The Additional Effect of Interfascial Hydrodissection with Dextrose on Shoulder and Neck Function in Patients with Myofascial Pain Syndrome: A Randomized Control Trial.

OBJECTIVES: To evaluate whether the application of an interfascial injection with dextrose water could result in reduced pain, improved shoulder function and range of motion. DESIGN: This is a double-blind randomized controlled trial. Thirty-five patients with chronic shoulder pain were randomly assigned to receive either an interfascial injection of 10 mL of 10% dextrose water guided by ultrasound, or a sham injection of 0.5 mL of 10% dextrose water into the subcutaneous layer. All patients received education on a home program of self-massage and self-stretching. Shoulder pain, shoulder range of motion (ROM), and neck and shoulder function were measured before injection, and at 4 and 12 weeks after injection. RESULTS: Both groups showed significant improvements in visual analog scale (VAS) scores at 12 weeks follow-up. The interfascial injection group exhibited a significant pain reduction compared with the sham group at the 12 weeks follow up. No between group differences were observed in shoulder ROM, pain threshold and neck and shoulder function. CONCLUSION: Interfascial injection is effective in decreasing pain in patients with myofascial pain syndrome.

Hemoglobin and Its Z Score Reference Intervals in Febrile Children: A Cohort Study of 98,572 Febrile Children.

OBJECTIVES: Febrile disease and age of children were associated with a variation in hemoglobin (Hb) level. Both CRP and Hb serve as laboratory markers that offer valuable insights into a patient's health, particularly in relation to inflammation and specific medical conditions. Although a direct correlation between CRP and Hb levels is not established, the relationship between these markers has garnered academic attention and investigation. This study aimed to determine updated reference ranges for Hb levels for age and investigated its correlation with CRP in febrile children under the age of 18. METHODS: This is a cohort study of in Chang Gung Memorial Hospitals conducted from January 2010 to December 2019. Blood samples were collected from 98,572 febrile children who were or had been admitted in the pediatric emergency department. The parameters of individuals were presented as the mean ± standard deviation or 2.5th and 97.5th percentiles. We also determined the variation of Hb and Z score of Hb between CRP levels in febrile children. RESULT: We observed that the Hb levels were the highest immediately after birth and subsequently underwent a rapid decline, reaching their lowest point at around 1-2 months of age, and followed by a steady increment in Hb levels throughout childhood and adolescence. In addition, there was a significant and wide variation in Hb levels during the infant period. It revealed a significant association between higher CRP levels and lower Hb levels or a more negative Z score of Hb across all age subgroups. Moreover, in patients with bacteremia, CRP levels were higher, Hb concentrations were lower, and Z scores of Hb were also lower compared to the non-bacteremia group. Furthermore, the bacteremia group exhibited a more substantial negative correlation between CRP levels and a Z score of Hb (r = -0.41, p < 0.001) compared to the non-bacteremia group (r = -0.115, p < 0.049). CONCLUSION: The study findings revealed that the Hb references varied depending on the age of the children and their CRP levels. In addition, we established new reference values for Hb and its Z scores and explore their relationship with CRP. It provides valuable insights into the Hb status and its potential association with inflammation in febrile pediatric patients.

Effect of wearable exoskeleton on post-stroke gait: A systematic review and meta-analysis.

BACKGROUND: Wearable exoskeletons are a recently developed technology. OBJECTIVES: The present systematic review aimed to investigate the effect of a wearable exoskeleton on post-stroke walking by considering its use in a gait training system and simply as an orthosis assisting walking. METHODS: We systematically searched for randomised and quasi-randomised controlled trials in PubMed, Scopus, CINAHL and Embase databases from their earliest publication record to July 2021. We chose reports of trials investigating the effects of exoskeleton-assisted training or the effects of wearing an exoskeleton to assist walking. A meta-analysis was conducted to explore the benefits of the wearable exoskeleton on mobility capacity, walking speed, motor function, balance, endurance and activities of daily living. RESULTS: We included 13 studies (492 participants) comparing exoskeleton-assisted training with dose-matched conventional gait training. Studies addressing the effect of wearing a wearable exoskeleton were unavailable. As compared with conventional gait training at the end of the intervention, exoskeleton-assisted training was superior for walking speed (mean difference [MD] 0.13 m/s, 95% CI 0.05; 0.21) and balance (standardized MD [SMD] 0.3, 95% CI 0.07; 0.54). The subgroup with chronic stroke (i.e., > 6 months) presented the outcome favouring exoskeleton-assisted training regarding overall mobility capacity (SMD 0.37, 95% CI 0.04; 0.69). At the end of follow-up, exoskeleton-assisted training was superior to conventional gait training in overall mobility (SMD 0.45, 95% CI 0.07; 0.84) and endurance (MD 46.23 m, 95% CI 9.90; 82.56). CONCLUSIONS: Exoskeleton-assisted training was superior to dose-matched conventional gait training in several gait-related outcomes at the end of the intervention and follow-up in this systematic review and meta-analysis, which may support the use of exoskeleton-assisted training in the rehabilitation setting. Whether wearing versus not wearing a wearable exoskeleton is beneficial during walking remains unknown.