Treatment of tomato paste wastewater by electrochemical and membrane processes: process optimization and cost calculation.

This study investigated the treatment of wastewater from tomato paste (TP) production using electrocoagulation (EC) and electrooxidation (EO). The effectiveness of water recovery from the pretreated water was then investigated using the membrane process. For this purpose, the effects of independent control variables, including electrode type (aluminum, iron, graphite, and stainless steel), current density (25-75 A/m2), and electrolysis time (15-120 min) on chemical oxygen demand (COD) and color removal were investigated. The results showed that 81.0% of COD and 100% of the color removal were achieved by EC at a current density of 75 A/m2, a pH of 6.84 and a reaction time of 120 min aluminum electrodes. In comparison, EO with graphite electrodes achieved 55.6% of COD and 100% of the color removal under similar conditions. The operating cost was calculated to be in the range of $0.56-30.62/m3. Overall, the results indicate that EO with graphite electrodes is a promising pretreatment process for the removal of various organics. In the membrane process, NP030, NP010, and NF90 membranes were used at a volume of 250 mL and 5 bar. A significant COD removal rate of 94% was achieved with the membrane. The combination of EC and the membrane process demonstrated the feasibility of water recovery from TP wastewater.

Monopolar stereoelectroencephalography-guided radiofrequency thermocoagulation.

OBJECTIVE: Stereoelectroencephalography (SEEG)-guided radiofrequency thermocoagulation (RFTC) has the advantage of producing a lesion in the epileptogenic zone (EZ) at the end of SEEG. The majority of published SEEG-guided RFTCs have been bipolar and usually performed between contiguous contacts of the same electrode. In the present study, the authors evaluate the safety, efficacy, and benefits of monopolar RFTC at the end of SEEG. METHODS: This study included a series of 31 consecutive patients who had undergone RFTC at the end of SEEG for drug-resistant focal epilepsy in the period of January 2013-December 2019. Post-RFTC seizure control was assessed after 2 months and at the last follow-up visit. Twenty-one patients underwent resective epilepsy surgery after the SEEG-guided RFTC, and the postoperative seizure outcome among these patients was compared with the post-RFTC seizure outcome. RESULTS: Four hundred forty-six monopolar RFTCs were done in the 31 patients. Monopolar RFTCs were performed in all cortical areas, including the insular cortex in 11 patients (56 insular RFTCs). There were 31 noncontiguous lesions (7.0%) because of vascular constraints. The volume of one monopolar RFTC, as measured on T2-weighted MRI immediately after the procedure, was between 44 and 56 mm3 (mean 50 mm3). The 2-month post-RFTC seizure outcomes were as follows: seizure freedom in 13 patients (41.9%), ≥ 50% reduced seizure frequency in 11 (35.5%), and no significant change in 7 (22.6%). Seizure outcome at the last follow-up visit (mean 18 months, range 2-54 months) showed seizure freedom in 2 patients (6.5%) and ≥ 50% reduced seizure frequency in 20 patients (64.5%). Seizure freedom after monopolar RFTC was not significantly associated with the number or location of coagulated contacts. Seizure response after monopolar RFTC had a high positive predictive value (93.8%) but a low negative predictive value (40%) for seizure outcome after subsequent resective surgery. In this series, the only complication (3.2%) was a limited intraventricular hematoma following RFTC performed in the hippocampal head, with spontaneous resolution and no sequelae. CONCLUSIONS: The use of monopolar SEEG-guided RFTC provides more freedom in terms of choosing the SEEG contacts for thermocoagulation and a larger thermolesion volume. Monopolar thermocoagulation seems particularly beneficial in cases with an insular EZ, in which vascular constraints could be partially avoided by making noncontiguous lesions within the EZ.

Electrocoagulation in treatment of municipal wastewater- life cycle impact assessment.

The purpose of this study is investigation of electrocoagulation (EC) as a treatment of municipal wastewater, integrating life cycle impact assessment (LCIA) for assessing its environmental performance of investigated treatment. The study evaluated the effectiveness of EC in removing physico-chemical and microbial parameters using aluminum (Al) and iron (Fe) electrodes in monopolar and bipolar modes. Bipolar arrangement of Al(-)/Al/Al/Al(+) electrodes achieved the highest removals: 70% COD, 72% BOD5 followed by complete elimination of total phosphorous, turbidity and microbial parameters. This treatment was subject to investigation of the influence of reaction time (t = 10-60 min) on removals at higher current density (CD = 3.33 mA/cm2). In order to reduce energy consumption, the same reaction time range was used with a reduced CD = 2.33 mA/cm2. Following removal efficiencies obtained: 47-72% COD (higher CD) and 53-78% (lower CD); 69-75% BOD5 (higher CD) and 55-74% CD (lower CD); 12-21% NH4- (higher CD) and 7-22% NH4- (lower CD). Total P, NO3- and NO2- compounds showed the same removals regardless the CD. Decrease in current density did not influence removals of total suspended matter, turbidity, salinity as well as microbial parameters. The bipolar arrangement of Al(-)/Al/Al/Al(+) electrodes, assuming a lower CD = 2.33 mA/cm2 and t = 30 min, was assessed with the Recipe 2016Midpoint (H) and USEtox v.2 LCIA methods to explore the environmental justification of using EC for wastewater treatment. The LCIA results revealed that the EC process significantly reduces water eutrophication and toxicity for freshwater and marine ecosystems, but has higher impacts in global warming, fossil fuel consumption, human toxicity, acidification, and terrestrial ecotoxicity due to high energy consumption. This can be mainly explained by the assumption in the study that the EC precipitate is dispersed to agricultural soil without any pre-treatment and material recovery, along with relatively high energy consumption during the process.

Will Endoscopic-Ultrasound-Guided Choledocoduodenostomy with Electrocautery-Enhanced Lumen-Apposing Metal Stent Placement Replace Endoscopic Retrograde Cholangiopancreatography When Treating Distal Malignant Biliary Obstructions?

Malignant distal biliary obstructions are becoming increasingly common, especially in patients with cancers of the pancreatic head, despite progress in medical oncology research. ERCP is the current gold standard for management of such strictures, but the emergence of EC-LAMS has rendered EUS-CDS both safe and efficient. It is a "game changer"; originally intended for ERCP failure, two randomised clinical trials recently proposed EUS-CDS as a first-intent procedure in palliative settings. For resectable diseases, the absence of iatrogenic pancreatitis associated with a lower rate of postsurgical adverse events (compared with ERCP) leads us to believe that EUS-CDS might be used in first-intent as a pre-operative endoscopic biliary drainage.

A mechanistic mathematical model for the treatment of synthetic oil-field wastewater (produced water) by electrocoagulation process using aluminium electrodes.

Produced water (PW) is the largest by-product that comes out of the oil wells during oil and gas (O&G) field exploration. PW contains high-salt concentration along with other organic and inorganic components; therefore, PW must be treated before disposal. Electrocoagulation (EC) is an effective treatment method to remove pollutants from PW which has been the focus of many experimental studies; however, a mathematical model specifically for PW treatment by EC has not been developed yet. In this work, a comprehensive mathematical model has been developed to elucidate the role of EC operating parameters on the PW treatment performance and determine the mechanism for COD (Chemical Oxygen Demand) removal. The present model considers and identifies the dominant Al-hydroxy complex species and their contribution to the COD removal from synthetic PW samples by estimating their rate constants and comparing their magnitudes and investigates multi-scale modelling of the EC reactor. The influence of working parameters such as current density, initial pH, interelectrode distance, mixing speed and solution volume of PW on Al coagulant production and COD removal was investigated and modelled. The study estimates the rate constants of the reactions taking place for COD removal by EC process and by comparing their magnitudes identifies the dominant reactions and coagulant species involved in the process. The mathematical model prediction of COD removal fits well with the experimental data at 10 mA cm-2, 15 mA cm-2 and 20 mA cm-2 current density with R2 value of 0.96, 0.97 and 0.92, respectively and for dissolved Al concentration R2 value of 0.96, 0.99, and 0.97, respectively. The simulated results reproduced a good fit at initial pH of 6.1, 7.3 and 8.6 with R2 value of 0.92, 0.96 and 0.98, respectively for COD removal. The mathematical model and the experimental results showed the role of dominant Al-hydroxy complex species such as Al OH 2 + , Al OH 2 + , Al OH 3 , Al 2 OH 2 + 4 and Al OH 4 - in controlling the COD removal process. Under different operating conditions considered in the study, the model also predicted the COD removal performance of the EC reactors at different reactor volumes with R2 value of 0.96 for higher solution volume and larger reactor. The model presented and rate constants determined in the study will provide a theoretical basis for designing, scaling up and operating the EC reactor for oil-field PW treatment.

Radiofrequency thermocoagulation under neuromonitoring guidance and general anesthesia for treatment of refractory trigeminal neuralgia.

OBJECTIVE: Radiofrequency thermocoagulation (RFT) for refractory trigeminal neuralgia is usually performed in awake patients to localize the involved trigeminal branches. It is often a painful experience. Here, we present RFT under neuromonitoring guidance and general anesthesia. METHOD: Stimulation of trigeminal branches at the foramen ovale with the tip of the RFT cannula is performed under short general anesthesia. Antidromic sensory-evoked potentials (aSEP) are recorded from the 3 trigeminal branches. The cannula is repositioned until the desired branch can be stimulated and lesioned. CONCLUSION: aSEP enable accurate localization of involved trigeminal branches during RFT and allow performing the procedure under general anesthesia.

A comparative study of BiZact™ tonsillectomy versus cold steel dissection technique in adults: Analysis of operating time, intraoperative blood loss, postoperative bleeding rate and pain.

OBJECTIVES: To analyse operating time, intraoperative blood loss, postoperative bleeding rate and pain when using the relatively new BiZact™ tonsillectomy device compared to the commonly used cold steel dissection technique with bipolar cautery in adults. DESIGN: Retrospective case control study. Parameters analysed for significant association with technique were operating time, intraoperative blood loss, wound pain on postoperative days 1-4 and rate of post-tonsillectomy bleeding (PTB). SETTING: Monocentric study at a department of otolaryngology and head and neck surgery at a tertiary centre in Germany. PARTICIPANTS: A total of 183 patients who underwent a bilateral tonsillectomy with either the BiZact™ tonsillectomy device or the cold dissection technique with bipolar cautery for haemostasis. MAIN OUTCOME MEASURES: Operating time, intraoperative blood loss, postoperative pain on the first to fourth postoperative day (numeric rating scale: 0-10) (PTB, primary bleeding ≤24 h, secondary bleeding >24 h postoperative; Stammberger scale). RESULTS AND CONCLUSION: The BiZact™ tonsillectomy device leads to a significant shorter operating time with less intraoperative blood loss compared to cold steel dissection with bipolar haemostasis. No benefits with regards to PTB or postoperative pain could be observed. The use of the BiZact™ device provides major benefits in clinical routine and stands up to conventional tonsillectomy techniques.

Comparison of the efficacy of continuous radiofrequency thermocoagulation, pulsed radiofrequency denervation applications, and TENS therapies for lumbar facet syndrome: A single-blind randomized controlled trial.

OBJECTIVES: We aimed to compare the effectiveness of TENS, used in physical therapy departments, and continuous radiofrequency thermocoagulation (CRF) and pulsed radiofrequency denervation (PRF), used in algology departments, in patients with lumbar facet syndrome (LFS). METHODS: Subjects were selected from patients with LFS visiting outpatient clinics of physical therapy and algology departments at Ege University School of Medicine, whose pain was refractory to medical treatment for at least 3 months. Subjects were randomized into 3 groups. A total of 60 patients, with 20 in each group, were enrolled. The first group received CRF, the second group received TENS for 30 minutes a day for 15 days, and the third group received PRF. Patients were assessed at baseline, at the end of the first and sixth months, for a total of three times. RESULTS: Improvements at month 1 and month 6 were found to be statistically significant in all three treatment groups with respect to their pain scores, Oswestry Disability Indexes, hand-floor distance measurements, 20-meter walking times, 6-min walking distances, Beck Depression Inventory, and most of the SF-36 domain scores (p<0.05). A comparison of the treatment groups showed no superiority of any group over the others in any assessment parameters (p>0.05). CONCLUSION: We suggest that it might be more appropriate to use TENS, a non-invasive treatment, before trying more invasive procedures like CRF and PRF in these patients. However, it has been stated that further studies involving a larger patient sample are needed.

Removal of microplastics in food packaging industry wastewaters with electrocoagulation process: Optimization by Box-Behnken design.

Currently, the vast majority of studies on microplastics (MPs) focus on determining the quantity and presence of these particles in various receiving environments and their treatment in domestic wastewater treatment plants. However, little research has been conducted on the treatment of microplastics in industrial effluent. Therefore, in this study, effluent samples from the cooling water tank of a local food packaging manufacturing company were analyzed to determine the presence and quantity of MPs for the first time. MPs removal from industrial wastewater using the electrocoagulation (EC) method was optimized using the Box Behnken Design (BBD). A second-order model was developed to estimate the microplastic removal efficiency, and the R2, adjusted R2, and predicted R2 of the model were 0.9994, 0.9985, and 0.9962, respectively. The optimal reaction parameters resulting in the maximum removal rate of microplastics (99 %) were determined to be pH 6.74, current density of 3.16 mA cm-2, and duration of 13.58 min. The cost of microplastic treatment per m3 of wastewater in the EC system, operated under optimal conditions, was calculated as 0.125 $. In this study, it was concluded that the EC process is a highly efficient technique for the removal of MPs from industrial wastewater at a low cost. Determining the most favorable conditions with BBD for the EC process at the feasibility stage of treatment plants will provide economic benefits and increase treatment efficiency during the installation of large-scale plants.

Extensive Hydrocelectomy Using the Harmonic Scalpel Supersedes Classic Techniques.

OBJECTIVE: To present our technique using the harmonic scalpel for scrotal, extensive hydrocelectomy in adolescents and its advantages, compared with the historical techniques. Scrotal hydrocelectomy is an old-timer procedure in-which the Lord plication, the Jaboulay and the bottleneck techniques are the standard of care, up to date. A cumbersome, unpleasant scrotal dressing is commonly used to try to mitigate postoperative edema and hematoma.1 The harmonic scalpel denaturates proteins by ultrasonic vibrations, and provides advantages over conventional electrocautery with respect to bleeding, drain volume, postoperative pain, and the return to normal activity.2-5 MATERIALS: Adolescents with a large hydrocele, and no inguinal hernia were selected for this operation. All tissue layers except the skin were divided by harmonic scalpel Focus (Eticon). RESULTS: Between 2017 and 2023, 43 adolescents at a median age of 14.3years (range 12-18years), were operated with this technique, using the harmonic scalpel, by a single surgeon. Median operative time was 23 minutes (range 18-35 minutes). No scrotal dressing was used. One patient had a postoperative seroma that was drained spontaneously. CONCLUSION: The described technique is simple and time-saving, with no postoperative major edema nor hematoma in this series. The only disadvantage is the higher cost of the harmonic scalpel, that may be offset by a short time of recovery. Following our experience, we no longer use other techniques for this surgery.

Study on the treatment of oily wastewater by evaluating the growth process of aggregates in an electrocoagulation reactor.

Electrocoagulation has been widely studied in oily wastewater treatment because of its high demulsification efficiency and no secondary reagent is required. Oil removal largely depends on the properties of the aggregates. This study aimed to explore the growth process of aggregates and oil removal near the anode by electrocoagulation. Four factors, current density, solution temperature, initial pH value, and electrode structure, were investigated. According to the findings, the current density and temperature have the most significant influence on the growth process of aggregates. The oil removal rate depends more on the average particle size than the fractal dimension. The results showed that the current density and solution temperature have the most significant influence on the parameters of the electrocoagulation process. With increasing current density, the aggregate growth rate and average particle size entering the stable period were accelerated, and the oil removal efficiency was promoted. The growth of aggregates was retarded at high temperatures. The change in the scope of the fractal dimension was minor, ranging from 1.65 to 1.84, during the growth process of the aggregates. Foamed aluminium electrodes were beneficial for accelerating aggregate growth instead of aluminium plates, but the energy consumption was obviously increased. The relationship between the mean particle size and mean fractal dimension of aggregates is consistent with the power function. From the point of view of aggregate growth, this study forms the basis for an in-depth understanding of the demulsification mechanism.

A pilot-scale electrocoagulation-treatment wetland system for the treatment of landfill leachate.

In the present study, the technical feasibility of an electrocoagulation-treatment wetland continuous flow system, for the removal of organic matter from landfill leachate (LL), was evaluated. The response surface methodology (MSR) was used to assess the individual and combined effects of the applied potential and distance between electrodes, on the removal efficiency and optimization of the electrocoagulation process. The hybrid treatment wetland system consisted of a vertical flow system coupled to a horizontal subsurface flow system, both planted with Canna indica. For a chemical oxygen demand (COD) concentration - without pretreatment of 5142.8 ± 2.5 mg L-1, the removal percentage for the electrocoagulation system was 79.4 ± 0.16%, under the optimal working conditions (Potential: 20 V; Distance: 2.0 cm). The COD removal efficiency in the treatment wetland with Canna indica showed a dependence with the hydraulic retention time, reaching 59.2 ± 0.2 % over 15 days. The overall efficiency of the system was about 91.5 ± 0.02 % removal of COD. In addition, a decrease in the biochemical oxygen demand (94.8 ± 0.14%) and total suspended solids (88.2 ± 0.22%), also related to the contamination levels of the LL, were obtained. This study, for the first time, shows that the coupling of electrocoagulation together with a treatment wetland system is a good alternative for the removal of organic contaminants present in LL.

Diffusion spectrum imaging based semi-automatic optic radiation tractography for vision preservation in SEEG-guided radiofrequency thermocoagulation.

OBJECTIVE: To assess the efficacy and safety of stereoelectroencephalography (SEEG)-guided radiofrequency thermocoagulation (RFTC), using diffusion spectrum imaging (DSI) tractography to preoperatively delineate the optic radiation (OR) and reduce the risk of visual field defects (VFDs) where the epileptogenic zones (EZs) are located in or close to the eloquent visual areas. METHODS: We prospectively followed up twenty-four consecutive patients (12 males and 12 females) who underwent SEEG-guided RFTC in or near the OR pathway. A distance of ≥ 3.5 mm away from the OR on the targeted electrodes contacts that exhibited relevant ictal onset patterns, IEDs and EES during SEEG recordings, was required as our selection criterion prior to performing RFTC, enough to theoretically prevent VFDs. Using default tracking parameters, the optic radiation was tracked semi-automatically in DSI-studio. RESULTS: There were 12 male and 12 female patients ranging in age from 6 to 57 years, with follow-up period ranging from 6 to 37 months. Nineteen patients responded to RFTC (R+, 79.16 %), and 5 patients did not benefit from RFTC (R-, 20.83 %). The preoperative application of DSI semi-automatic based OR tractography was successful in the protection of the OR in all 24 patients. Three patients experienced a neurologic deficit following RFTC, and five patients had a partial quadrant visual field deficit prior to surgery that did not worsen, and none of the remaining nineteen patients had a quadrant visual field deficit. CONCLUSION: Our study validates the safety and efficacy of SEEG-RFTC as a viable therapeutic approach for epileptic foci situated in or adjacent to the visual eloquent regions. We demonstrate that DSI-based tractography offers superior precision in delineating the OR compared to DTI. We establish that implementing a criterion of a minimum distance of ≥ 3.5 mm in radius from the OR on the targeted electrode contacts prior to conducting RFTC can effectively mitigate the risk of VFDs.

Geometry of cold snare polypectomy and risk of incomplete resection.

BACKGROUND: Cold snare polypectomy (CSP) is safer than and equally efficacious as hot snare polypectomy (HSP) for the removal of small (<10mm) colorectal polyps. The maximum polyp size that can be effectively managed by piecemeal CSP (p-CSP) without an excessive burden of recurrence is unknown. METHODS: Resection error risks (RERs), defined as the estimated likelihood of incomplete removal of adenomatous tissue for a single snare resection pass, for CSP and HSP were calculated, based on an incomplete resection rate. Polyp area, snare size, estimated number of resections, and optimal resection defect area were modeled. Overall risk of incomplete resection (RIR) was defined as RIR=1 - (1 - p)n, where p is the RER and n the number of resections. RESULTS: A 40-mm polyp has a four times greater area than a 20-mm polyp (314.16mm2 vs. 1256.64mm2), and requires three times more resections (11 vs. 33, respectively, assuming 8-mm piecemeal resection pieces for p-CSP). RIRs for a 40-mm polyp by HSP and p-CSP were 15.1%-23% and 40.74%-60.60% respectively. CONCLUSION: RER is more important with p-CSP than with HSP. The number of resections, n, and consequently RIR increases with increasing polyp size. Given the overwhelming safety of CSP, specific techniques to minimize the RER should be studied and developed.

Evaluating the performance of electrocoagulation system in the removal of polystyrene microplastics from water.

Emerging pollutants, particularly microplastics, present a significant threat to both the environment and human health. Traditional treatment methods lack targeted strategies for their removal. This study thoroughly investigated the efficacy of electrocoagulation as a method for efficiently extracting microplastics from water. Various critical operational parameters, including electrode combinations, pH levels, electrolyte concentrations, electrode geometries, configurations, current intensities, and reaction times, were systematically examined. The study systematically examined the impact of different combinations of aluminium (Al) and stainless steel (SS) electrodes, including Al-Al, SS-SS, Al-SS, and SS-Al. Among these combinations, it was found that the Al-Al pairing exhibited outstanding efficiency in microplastic removal, while simultaneously minimizing energy consumption. Initial pH emerged as a critical parameter, with a neutral pH of 7 demonstrating the highest removal efficiency. In the pursuit of optimizing parameters like electrolyte concentrations, electrode geometry, and configuration, it's noteworthy that consistently achieving removal efficiencies exceeding 90% has been a significant achievement. However, to ascertain economic efficiency, additional factors such as energy consumption, electrode usage, and post-treatment conductivity must be taken into account. To tackle the complexity posed by various parameters and criteria, using multi-criteria decision-making tools like TOPSIS is essential, as it has a track record of effectiveness in practical applications. The electrolyte concentration of 0.5 g L-1 is identified as optimal by TOPSIS analysis Additionally, the TOPSIS highlighted the superiority of cylindrical hollow wire mesh electrodes and established the monopolar parallel configuration as the most effective electrode connection method. The investigation carefully evaluated the effect of reaction time, determining that a 50-min window provides optimal microplastic removal efficiency. This refined system exhibited remarkable proficiency in eliminating microplastics of varying size ranges (0-75 µm, 75-150 µm, and 150-300 µm), achieving removal efficiencies of 90.67%, 93.6%, and 94.6%, respectively, at input concentration of 0.2 g L-1. The present study offers a comprehensive framework for optimizing electrocoagulation parameters, presenting a practical and highly effective strategy to address the critical issue of microplastic contamination in aquatic environments.

Effect of ozonation and UV-LED combination on simultaneous removal of toxic elements during electrocoagulation.

Cyanide and heavy metals pose significant risks as contaminants in certain industrial effluents. This study aims to concurrently eliminate cyanide and specific heavy metals from synthetic wastewater resembling gold processing effluent, employing an improved electrocoagulation method incorporating ozone and UV-LED. The investigation delves into the effects of pH, electrode type, current density, reaction time, and ozonation. The findings revealed notable removal efficiencies: 98% for cyanide, 76% for nickel, 85% for copper, and 84% for zinc when utilizing a stainless steel electrode as the cathode. Optimal removal rates were achieved at 94% for cyanide, 93% for copper, 92% for zinc, and 83% for nickel, employing the UV-LED-ozone technique with an ozonation flow rate of 4 mg/s at pH = 10. Notably, when Al-Gr-SS-Fe electrodes and a current of 15 mA/cm2 were applied, these removal efficiencies were observed. Therefore, the most favorable conditions for the concurrent removal of pollutants from synthetic wastewater involved maintaining a pH of 10, utilizing SS-Fe as anode and Al-Gr as cathode electrodes, and employing a current density of 15 mA/cm2. The addition of ozonation with a flow rate of 4 mg/s, along with UV-LED, further enhanced the removal process. In summary, it can be inferred that the enhanced electrocoagulation method outperformed conventional electrocoagulation, leading to increased elimination of cyanide and selected heavy metals.

Comprehensive Comparison of Therapeutic Efficacy of Radiofrequency Thermocoagulation and Pulsed Radiofrequency in Treatment of Elderly Patients with Thoracic Postherpetic Neuralgia.

BACKGROUND We comprehensively compared the therapeutic efficacy of radiofrequency thermocoagulation (RFT) and pulsed radiofrequency (PRF) in the treatment of elderly patients with thoracic postherpetic neuralgia (PHN). MATERIAL AND METHODS We divided 149 elderly patients with thoracic PHN into 2 groups - the RFT group (n=79) and the PRF group (n=70) - based on the radiofrequency mode administered. The Visual Analog Scale (VAS), Athens Insomnia Scale (AIS), Generalized Anxiety Disorder 7 items (GAD-7), and Patient Health Questionnaire 9 items (PHQ-9) were used to analyze the degree of pain, sleep quality, and psychological state of patients before and 1 week, 1 month, 3 months, 6 months, and 12 months after treatment. RESULTS VAS, AIS, GAD-7, and PHQ-9 scores were significantly decreased after RFT and PRF treatment (P<0.001). There was no significant difference in VAS scores between the 2 groups at 1 week and 1 month after treatment (P>0.05). Then, VAS scores in the RFT group were significantly lower than those in the PRF group at 3, 6, and 12 months after treatment (P<0.001). At 1 week after treatment, there were no significant differences in AIS, GAD-7, and PHQ-9 scores between the 2 groups (P>0.05). However, the RFT group had significantly lower AIS, GAD-7, and PHQ-9 scores than the PRF group at 1, 3, 6, and 12 months after treatment (P<0.05). CONCLUSIONS RFT and PRF both effectively reduced pain in the distribution area of thoracic spinal neuropathy and improved the sleep quality and psychological state of elderly patients with thoracic PHN, but RFT had a better long-term effect.

Needle-tip electrocautery versus steel scalpel incision in neurosurgery: study protocol for a prospective single-centre randomised controlled double-blind trial.

INTRODUCTION: Electrocautery is used widely in surgical procedures, but making skin incision has routinely been performed with scalpel rather than electrocautery, for fear that electrocautery may cause poor incision healing, excessive scarring and increased wound complication rates. More and more studies on general surgery support the use of electrocautery for skin incision, but research comparing the two modalities for scalp incision in neurosurgery remains inadequate. This trial aims to evaluate the safety and efficacy of needle-tip monopolar for scalp incision in supratentorial neurosurgery compared with steel scalpel. METHODS AND ANALYSIS: In this prospective, randomised, double-blind trial, 120 eligible patients who are planned to undergo supratentorial neurosurgery will be enrolled. Patients will be randomly assigned to two groups. In controlled group scalp incision will be made with a scalpel from the epidermis to the galea aponeurotica, while in intervention group scalp will be first incised with a steel scalpel from the epidermis to the dermis, and then the subcutaneous tissue and galea aponeurotica will be incised with needle-tip monopolar on cutting mode. The primary outcomes are scar score (at 90 days). The secondary outcomes include incision pain (at 1 day, on discharge, at 90 days) and alopecia around the incision (at 90 days), incision blood loss and incision-related operation time (during operation), incision infection and incision healing (on discharge, at 2 weeks, 90 days). ETHICS AND DISSEMINATION: This trial will be performed according to the principles of Declaration of Helsinki and good clinical practice guidelines. This study has been validated by the ethics committee of West China Hospital. Informed consent will be obtained from each included patient and/or their designated representative. Final results from this trial will be promulgated through publications. TRIAL REGISTRATION NUMBER: ChiCTR2200063243.

Alternative treatment of olive mill wastewater by combined sulfate radical-based advanced electrocoagulation processes.

The aim of this study is to investigate the performance of advanced electrocoagulation (EC) process for the treatment of olive mill wastewater. In EC process, iron plates were used as electrodes, and peroxydisulfate (PS) and peroxymonosulfate (PMS) were added as oxidants. The effects of the initial pH value, current density, oxidant dose, and electrolysis time were optimized for pollutant removal from olive mill wastewater by EC-PS and EC-PMS processes. Control experiments showed that addition of oxidants to the conventional EC process increased the pollutant removal efficiency. Classical optimization method was used to determine optimum conditions, which were initial pH 4, current density 40 mA/cm2 , oxidant dose 5 g/L, and electrolysis time 30 min for both processes. Under these conditions, EC-PS and EC-PMS processes achieved 50.5% and 48.9% chemical oxygen demand (COD), 93.8% and 89.3% total phenol, 87.7% and 83% UV254 , and 74.5% and 64.1% total suspended solid removal efficiencies. Quenching experiments were performed to determine the dominant radical species participating in the processes. It was observed that hydroxyl and sulfate radicals were involved in both processes but hydroxyl radicals were more active. Specific energy consumption was calculated as 5.90 kWh/kg COD for EC process, 4.95 kWh/kg COD for EC-PS process, and 5.20 kWh/kg COD for EC-PMS process. The organic removal/sludge ratio of EC-PS process was found to be higher with 17.5 g/L value. Although the application of EC-PS and EC-PMS processes alone is insufficient to meet the discharge limits, they have been found to be effective in olive mill wastewater treatment. PRACTITIONER POINTS: Peroxydisulfate (PS) and peroxymonosulfate (PMS)-based advanced electrocoagulation (EC) was used in olive mill wastewater treatment. 50.5% chemical oxygen demand (COD), 93.8% TP, 87.7% UV254 , and 74.5% TSS removals were achieved by EC-PS. 48.9% COD, 89.3% TP, 83% UV254 , and 64.1% TSS removals were obtained by EC-PMS. Hydroxyl and sulfate radicals were involved in both processes.

Clinical application and follow-up of electrocautery-enhanced lumen-apposing metal stents for endoscopic ultrasonography-guided interventions.

Aim: The lumen-apposing metal stent (LAMS) is a new device that expands the scope of gastrointestinal intervention under endoscopy. LAMS was initially used for the treatment of pancreatic fluid collections (PFCs), but is increasingly being used off-label. The electrocautery system simplifies the deployment of LAMS, making it more suitable for off-label situations. The short-term results of electrocautery-enhanced lumen-apposing metal stents (ECE-LAMS) are satisfactory; however, the long-term follow-up results must be evaluated. The aim of this article is to review the expanded clinical application of ECE-LAMS, the clinical value of on-label and off-label use, and follow-up results.Methods: After searching in PubMed and Web of Science databases using 'electrocautery-enhanced lumen-apposing metal stents' and 'endoscopic ultrasonography (EUS) -guided interventions' as keywords, studies related were compiled and examined.Results: ECE-LAMS are widely used for on-label and off-label situations. The short-term and long-term results of ECE-LAMS are satisfactory, but there are still some studies that do not agree with this viewpoint.Conclusion: The clinical application of ECE-LAMS is relatively safe and reliable but more well-designed randomized trials and prospective studies are needed to evaluate the impact of this technology on therapeutic EUS, to improve the safety and success rate of EUS-guided LAMS implantation, and to expand its application in other indications.