Low-cost Treatment Research Articles

Preparation of low-cost sludge-based highly porous biochar for efficient removal of refractory pollutants from agrochemical and pharmaceutical wastewater

Producing a high-performance sludge biochar through a feasible method is a great challenge and is crucial for practicability. Herein, we reported a highly porous sludge biochar synthesized from agrochemical-pharmaceutical and municipal sludge blends through a novel pyrolysis-acid treatment-post pyrolysis method. The optimized biochar named ASMS91 obtained interconnected pores with a total pore volume of 0.894 cm3/g and a surface area of 691.4 m2/g through extended acid wash and subsequent post-pyrolysis, which is superior to non-activated sludge biochar. ASMS91 removed 45.3 % of wastewater COD (156 mg/L) in 24 h, which was rapid and higher performance than commercial activated carbon (1000 iodine number). This outstanding performance is due to its high adsorption ability of long-chain aliphatic compounds (e.g., 2,4-Di-tert-butylphenol, neophytadiene and eicosane) into mesopores, which accounts for 71.8 % of pore filling. ASMS91 was highly recyclable, and adsorption was reduced by only 5.3 % after the 4th cycle. It also outperformed other sludge biochar in literature in removing perfluorooctanoic acid (PFOA), 6:2 fluorotelomer sulfonate (6:2 FTS), sulfamethoxazole, methylene blue, and methylene orange. Finally, the feasibility of our proposed method was validated by a brief techno-economic analysis. This feasible approach may support future research regarding sludge valorization and low-cost chemical wastewater treatment.

Yoga as a Potential Tool for Filling Implementation Gap in Promoting Better Mental Health in Geriatric Age Group at Global Level: A Scoping Review

This scoping review aims to review the effectiveness of yoga as a complementary intervention for improving mental health outcomes in the geriatric population globally. Yoga is practiced by millions worldwide. Since practitioners of yoga claim to have calmer minds and better psychological and physical health, this topic needs to be reviewed at length. There is a considerable treatment gap worldwide in treating mental disorders, especially in old age, and there is a shortage of low-cost, feasible, and acceptable preventive or treatment options available to tackle mental ailments for the senior population at large. Yoga can potentially act as a low-cost intervention for promoting better mental health. The article reviews yoga as an implementation strategy for meeting this global challenge. Information related to “Yoga and Mental Health” and “Yoga and old age” was searched in two databases, i.e., PubMed and Google Scholar, using a standard search strategy and search strings. Only the articles published in the English language were selected. A standard data extraction form was used to extract and tabulate the data. A comprehensive search strategy (annexed) yielded only two papers as the work on implementation research on mental health is dismal. Both were excluded as the papers did not belong to implementation research. However, for the sake of narrative review, a common search strategy in PubMed included key terms such as “yoga and aging and mental health” and yielded 54 results out of which 7 were included for this scoping review. Comprehensive advanced search from Google Scholar revealed 4850 articles. Screening found 1 implementation research abstract only and two clinical trials. None was included as they did not belong to implementation research. Considering the potential that yoga has as a preventive and therapeutic option, scientific work on implementation research involving mental health and yoga is required. Considering the bludgeoning amount of work done on the subject, there is a possibility of including the same in mainstream medicine as a low-cost preventive or therapeutic option to address the implementation gap in mental health, especially for the senior age group.

Pretreatment for potable reuse: Enhancing the biological removal of 1,4-dioxane from landfill leachate through cometabolism with tetrahydrofuran.

1,4-Dioxane is a probable human carcinogen and a persistent aquatic contaminant. Cometabolic biodegradation of 1,4-dioxane is a promising low-cost and effective treatment technology; however, further demonstration is needed for treating landfill leachate. This technology was tested in two full-scale moving bed biofilm reactors (MBBRs) treating raw landfill leachate with tetrahydrofuran selected as the cometabolite. The raw leachate contained on average 82 μg/L of 1,4-dioxane and before testing the MBBRs removed an average of 38% and 42% of 1,4-dioxane, respectively. First, tetrahydrofuran was added to MBBR 1, and 1,4-dioxane removal was improved to an average of 73%, with the control MBBR removing an average of 37% of 1,4-dioxane. During this period, an optimal dose of 2mg/L of tetrahydrofuran was identified. Tetrahydrofuran was then fed to both MBBRs, where the 1,4-dioxane removal was on average 73% and 80%. Cometabolic treatment at the landfill significantly reduced the concentration of 1,4-dioxane received from the landfill at a downstream wastewater treatment and indirect potable reuse facility, reducing the load of 1,4-dioxane from 44% to 24% after the study. PRACTITIONER POINTS: Cometabolic degradation of leachate 1,4-dioxane with THF in MBBRs is a feasible treatment technology and a low-cost technique when retrofitting existing biological treatment facilities. The MBBRs can be operated at a range of temperatures, require no operational changes beyond THF addition, and operate best at a mass ratio of THF to 1,4-dioxane of 24. Source control of 1,4-dioxane significantly reduces the concentration of 1,4-dioxane in downstream wastewater treatment plants and potable reuse facilities.

Effect of Using Photobiomodulation (660 Nanometers) for the Treatment of Diabetic Ulcers: Protocol for a Randomized Controlled Trial.

Diabetic foot ulcers (DFUs) result in tissue damage or impairment of deeper structures that affect quality of life. The impacts are numerous, and even after a long treatment period, 65% of patients experience recurrence. Among the interventions used to accelerate the healing process of DFUs, photobiomodulation therapy (PBMT) is a painless, noninvasive, and low-cost treatment. To achieve effective therapeutic results optimal PBMT parameters are necessary. The positive effect of PBMT on diabetic cells may be dependent on fluence (J/cm2) and wavelength (nm). This double-blind, randomized clinical trial will be conducted at the University Clinic of Physical Therapy. One hundred patients will be randomly placed in 4 groups. A Laserpulse Ibramed (Helium-Neon, HeNe, 660 nm) with 20 W power will be used (continuous mode), with doses stipulated for each treatment group (GL1, 4 J/cm2; GL2, 8 J/cm2; GL3, 12 J/cm2) and Endophoton KLD GaAs 904 nm (ST, 10 J/cm2) for 2 nonconsecutive days per week for 10 weeks, for a total of 20 sessions. The primary outcomes will be ulcer healing rate and University of Texas classification scores. Patients' DFUs will be assessed on the 1st day, 5 weeks, and 10 weeks of treatment then 1 month after the end of treatment. This study may aid effective clinical decision-making for the management of DFUs.

Cost of early progression: patients with epidermal growth factor receptor mutated metastatic non-small-cell lung cancer.

Aim: Compare healthcare costs for patients with epidermal growth factor receptor mutated (EGFRm) metastatic non-small-cell lung cancer (mNSCLC) with and without progression and estimate costs of progression.Materials & methods: Retrospective claims analysis (2015-2020) from adults with EGFRm mNSCLC initiating EGFR tyrosine kinase inhibitors. Adjusted costs for 12months were compared (with vswithout progression) and cumulative costs for early versus late progression were predicted over 36months.Results: A total of228 patients with EGFRm mNSCLC were included. Patients with progression within 12months incurred significantly higher total costs despite lower treatment costs (vswithout progression). Medical costs were significantly higher among early versus late progressors.Conclusion: These data may aid providers aiming to administer quality care in a cost-efficient way.

Fabrication of a hyphenated S-scheme and Schottky-junction photocatalyst based on a ternary TiNbCTx@α-Bi2O3/ZnSe heterostructure with enhanced optical and photoelectrochemical properties

Environmental pollution by pharmaceuticals poses a serious threat to humans and animals. Hence there is a need for a low-cost, environmentally friendly, and sustainable treatment technology for environmental remediation. Herein, we report the synthesis of a novel TiNbCTx@α-Bi2O3/ZnSe ternary photocatalytic nanocomposite, characterised using spectroscopic and microscopic techniques. Moreover, the optical and photoelectrochemical properties of the photocatalysts were assessed using spectroscopic tools such as UV–Vis DRS, EIS and PL. The synthesised pristine, cubic ZnSe, monoclinic Bi2O3, α-Bi2O3/ZnSe and the ternary composites’ crystallinity were all confirmed by the co-existence of their crystal planes and bands in XRD, SAED, and Raman spectroscopy, correspondingly. SEM and TEM analysis confirmed the anticipated characteristic morphologies and the interfaces. Improved optical properties deduced from UV–Vis DRS measurements revealed α-Bi2O3 and ZnSe to have band gaps of 2.7 eV and 2.41 eV, respectively. Upon creating an α-Bi2O3/ZnSe heterostructure and TiNbCTx@α-Bi2O3/ZnSe ternary system, a red shift was observed in their band gaps, indicating improved optical properties. The electrochemical properties of the materials were determined using EIS. These were used to deduce the charge transfer kinetics of the heterostructure and ternary system, which showed TiNbCTx@α-Bi2O3/ZnSe to be an outstanding photocatalyst over the synthesised pristine materials and α-Bi2O3/ZnSe heterostructure. The photocurrent response of the TBZ-7 % exhibited enhanced generation and separation of photoexcited charge carriers 4 folds higher than those of pristine materials. The PL spectra of the TBZ-7 % showed low intensity due to the suppression of charge recombination rates. Moreover, the Nyquist and LSV plots of TBZ-7 % presented improved charge transfer ability and a prolonged lifetime of photoinduced charge carriers (280 ms), respectively. With these enhanced properties, TiNbCTx@α-Bi2O3/ZnSe ternary photocatalytic nanocomposite demonstrates the extraordinary potential for environmental remediation in degrading ARVs from water.

Overview of the low-cost technologies for household water treatment in developing countries

ABSTRACT This study explored various low-cost water treatment technologies that are used to minimize levels of pathogens and contaminants in raw water. The paper focused on techniques such as cloth filtration, boiling, chlorination, and solar water disinfection. In the communities, cloth filtration is applied as the initial step of treating raw water with the proper choice of cloth fabrics followed by either boiling, chlorination or solar water disinfection. In low-income communities with unclean burning fuel sources, boiling was found to be the preferred method. Chlorination was also a popular technique associated with the challenges of low or high levels of free chlorine at the point of use and disinfection by-products. Solar water disinfection required optimal residence time and detection sensors for microorganism inactivation. Overall, the paper provided valuable insights into the different low-cost water treatment techniques that are commonly used for household applications, particularly in developing countries.

The impact of exercise on depression: how moving makes your brain and body feel better.

This study aimed to comprehensively explore and elucidate the intricate relationship between exercise and depression, and focused on the physiological mechanisms by which exercise influences the brain and body to alleviate depression symptoms. By accumulating the current research findings and neurobiological insights, this study aimed to provide a deeper understanding of the therapeutic potential of exercise in the management and treatment of depression. We conducted a systematic review of the scientific literature by selecting relevant studies published up to October 2023. The search included randomized controlled trials, observational studies, and review articles. Keywords such as "exercise," "depression," "neurobiology," "endocrinology," and "physiological mechanisms" were used to identify pertinent sources. Inflammation has been linked to depression and exercise has been shown to modulate the immune system. Regular exercise can (1) reduce the levels of pro-inflammatory cytokines, potentially alleviating depressive symptoms associated with inflammation; (2) help in regulating circadian rhythms that are often disrupted in individuals with depression; and (3) improve sleep patterns, thus regulating mood and energy levels. The mechanisms by which exercise reduces depression levels are multifaceted and include both physiological and psychological factors. Exercise can increase the production of endorphins, which are neurotransmitters associated with a positive mood and feelings of well-being. Exercise improves sleep, reduces stress and anxiety, and enhances self-esteem and social support. The implications of exercise as a treatment for depression are significant because depression is a common and debilitating mental health condition. Exercise is a low-cost, accessible, and effective treatment option that can be implemented in various settings such as primary care, mental health clinics, and community-based programs. Exercise can also be used as an adjunctive treatment along with medication and psychotherapy, which can enhance treatment outcomes.

Aprotinin (II): Inhalational Administration for the Treatment of COVID-19 and Other Viral Conditions.

Aprotinin is a broad-spectrum inhibitor of human proteases that has been approved for the treatment of bleeding in single coronary artery bypass surgery because of its potent antifibrinolytic actions. Following the outbreak of the COVID-19 pandemic, there was an urgent need to find new antiviral drugs. Aprotinin is a good candidate for therapeutic repositioning as a broad-spectrum antiviral drug and for treating the symptomatic processes that characterise viral respiratory diseases, including COVID-19. This is due to its strong pharmacological ability to inhibit a plethora of host proteases used by respiratory viruses in their infective mechanisms. The proteases allow the cleavage and conformational change of proteins that make up their viral capsid, and thus enable them to anchor themselves by recognition of their target in the epithelial cell. In addition, the activation of these proteases initiates the inflammatory process that triggers the infection. The attraction of the drug is not only its pharmacodynamic characteristics but also the possibility of administration by the inhalation route, avoiding unwanted systemic effects. This, together with the low cost of treatment (≈2 Euro/dose), makes it a good candidate to reach countries with lower economic means. In this article, we will discuss the pharmacodynamic, pharmacokinetic, and toxicological characteristics of aprotinin administered by the inhalation route; analyse the main advances in our knowledge of this medication; and the future directions that should be taken in research in order to reposition this medication in therapeutics.

Operation room nursing based on humanized nursing mode combined with nitric oxide on rehabilitation effect after lung surgery

BACKGROUND With advancements in the diagnosis and treatment of lung diseases, lung segment surgery has become increasingly common. Postoperative rehabilitation is critical for patient recovery, yet challenges such as complications and adverse outcomes persist. Incorporating humanized nursing modes and novel treatments like nitric oxide inhalation may enhance recovery and reduce postoperative complications. AIM To evaluate the effects of a humanized nursing mode combined with nitric oxide inhalation on the rehabilitation outcomes of patients undergoing lung surgery, focusing on pulmonary function, recovery speed, and overall treatment costs. METHODS A total of 79 patients who underwent lung surgery at a tertiary hospital from March 2021 to December 2021 were divided into a control group (n = 39) receiving a routine nursing program and an experimental group (n = 40) receiving additional humanized nursing interventions and atomized inhalation of nitric oxide. Key indicators were compared between the two groups alongside an analysis of treatment costs. RESULTS The experimental group demonstrated significant improvements in pulmonary function, reduced average recovery time, and lower total treatment costs compared to the control group. Moreover, the quality of life in the experimental group was significantly better in the 3 months post-surgery, indicating a more effective rehabilitation process. CONCLUSION The combination of humanized nursing mode and nitric oxide inhalation in postoperative care for lung surgery patients significantly enhances pulmonary rehabilitation outcomes, accelerates recovery, and reduces economic burden. This approach offers a promising reference for improving patient care and rehabilitation efficiency following lung surgery.

Landmarks in Quail Coccidiosis Research with Special Scrutiny to the Available Egyptian Literature: A Review

Quails are an important alternative to chicken production for protein sources, offering many advantages over other poultry species. However, raising quail faces certain challenges, such as a shortage of specified hatcheries and the lack of local markets for quail eggs and meat, particularly in Egypt. In addition, there is less interest in quail’s medication and vaccine production. A significant disease affecting the health and productivity of quails is coccidiosis, which is associated with poor feed conversion ratio, lower growth performance, heightened mortality, and high cost of vaccination and treatment. Attention to quail coccidiosis and its clinical forms, diagnosis, morphological characterization, control, and prevention is very critical for improving quail meat and egg production. This review compiles scientific data on quail coccidiosis, with a focus on literature from Egypt, for classification, data analysis, and processing.

Coral sands as potential low cost treatment for removing fluoride from drinking water

Fluoride (F-) toxicity from contaminated drinking water affects over 200 million people worldwide. While defluoridation with adsorbents such as calcium carbonate, is commonly used, most technologies are unsuitable for resource-constrained areas. Coral sand is readily available in tropical regions but is yet to be investigated as a potential F- adsorbent. The effectiveness of coral sand at removing F- from drinking water was assessed using acid-enhanced lime defluoridation with two beach (Kiribati and Vanuatu) and one commercially available coral sands. Citric acid was selected as it is readily accessible, palatable and safe for human consumption. Mini columns with a 5:1 sand-to-fluid ratio, 0.025 M citric acid and a 4-hour residence time, could be used seven times to reduce F- from 10 mg/L to below the World Health Organization (WHO) guideline value of 1.5 mg/L. Mini columns packed with coarser grained (1.3 mm) Vanuatu sand could be used at least 10 times. Increasing citric acid to 0.050 M reduced removal efficiency. Prototype treatment devices, developed using 1 L polyethylene jerrycans and 1 kg of commercial sand, could only be used a maximum of three times with 0.025 M citric acid. All coral sands contained F- as well as other trace elements of human health concern, including As, B, Cr, Mn, and Ni that were released into the treated water, resulting in exceedances of drinking water standards. Total Cr concentrations in treated water always exceeded the 0.05 mg/L WHO health guideline whereas As exceeded the 0.01 mg/L value in the majority of treated water samples. In addition, B, Na, and Ni concentrations exceeded the WHO guidelines in many water samples treated with Kiribati and Vanuatu sands. Treated water samples were also unpalatable as potable water based on hardness, total dissolved solids and elevated concentrations of Al, Fe, and Mn. It is recommended that drinking water treated with coral sand be analysed for the presence of contaminants of health concern.

Selective Heterogeneous Fenton Degradation of Formaldehyde Using the Fe-ZSM-5 Catalyst.

As a toxic Volatile Organic Pollutant (TVOC), formaldehyde has a toxic effect on microorganisms, consequently inhibiting the biochemical process of formaldehyde wastewater treatment. Therefore, the selective degradation of formaldehyde is of great significance in achieving high-efficiency and low-cost formaldehyde wastewater treatment. This study constructed a heterogeneous Fe-ZSM-5/H2O2 Fenton system f or the selective degradation of target compounds. By immobilizing Fe3+ onto the surface of a ZSM-5 molecular sieve, Fe-ZSM-5 was prepared successfully. XRD, BET and FT-IR spectral studies showed that Fe-ZSM-5 was mainly composed of micropores. The influences of different variables on formaldehyde-selective heterogeneous Fenton degradation performance were studied. The 93.7% formaldehyde degradation and 98.2% selectivity of formaldehyde compared with glucose were demonstrated in the optimized Fenton system after 360 min. Notably, the resultant selective Fenton oxidation system had a wide range of pH suitability, from 3.0 to 10.0. Also, the Fe-ZSM-5 was used in five consecutive cycles without a significant drop in formaldehyde degradation efficiency. The use of reactive oxygen species scavengers indicated that the hydroxyl radical was the primary active species responsible for degrading formaldehyde. Furthermore, great degradation performance was acquired with high concentrations of formaldehyde for this system, and the degradation efficiency was more than 95.0%.

Initiating immunoglobulin replacement therapy helps reduce severe infections and shifts healthcare resource utilization to outpatient services among US patients with inborn errors of immunity

Aims Patients with inborn errors of immunity (IEI) are predisposed to severe recurrent/chronic infections, and often require hospitalization, resulting in substantial burden to patients/healthcare systems. While immunoglobulin replacement therapies (IgRTs) are the standard first-line treatment for most forms of IEI, limited real-world data exist regarding clinical characteristics and treatment costs for patients with IEI initiating such treatment. This retrospective analysis examined infection and treatment characteristics in US patients with IEI initiating IgRT with immune globulin infusion (human), 10% (IG10%). Healthcare resource utilization (HCRU) and associated costs before and after treatment initiation were compared. Additionally, the impact of COVID-19 on infection diagnoses was evaluated. Methods Patients with IEI initiating IG10% between July 2012 and August 2019 were selected from Merative MarketScan Databases using diagnosis/prescription codes. Patients were followed 6 months before and after first IG10% claim date. Demographic and clinical characteristics were described. Treatment characteristics and HCRU before and after IG10% initiation were compared. Infection diagnoses during 2020 and 2019 (March–December) were compared. Results The study included 1,497 patients with IEI diagnoses (mean age = 43.4 years) initiating IG10%, with frequently reported comorbidities like asthma (32.1%). Following IG10% initiation, fewer severe infection diagnoses (11.6% vs 19.9%), fewer infection-related inpatient (10.8% vs 19.5%) and outpatient services (71.6% vs 79.9%), and lower infection-related total healthcare costs ($7,849 vs $13,995; p < 0.001)—driven by lower inpatient costs ($2,746 vs $9,900)—were observed than before. Fewer patients had infection diagnoses during COVID-19 (22.8%) than the prior year (31.2%). Conclusion Patients with IEI are susceptible to severe infections leading to high disease burden and treatment costs. Following IG10% initiation, we observed fewer infections, lower infection-related treatment costs, and shift in care (inpatient to outpatient) leading to significant cost savings. Among patients with IEI, 27% fewer infection diagnoses were observed during the early COVID-19 lockdown period than the prior year.

Budget impact analysis of natalizumab biosimilar on pharmaceutical expenditure for the treatment of relapsing-remitting multiple sclerosis in Italy

Background: The availability of high-efficacy disease-modifying therapy (DMT), including natalizumab, improved treatment efficacy in adults with highly-active relapsing-remitting multiple sclerosis (RRMS). Natalizumab patent protection has expired, and the natalizumab biosimilar (Tyruko®) has been recently reimbursed by AIFA. As the price of natalizumab biosimilar is expected to be lower as compared with natalizumab originator’s price, a budget impact analysis was conducted to assess the economic impact associated to the introduction of natalizumab biosimilar for patients with highly-active RRMS. Methods: A budget impact model was developed, considering the INHS perspective and a 5-years time horizon. The number of patients treated with natalizumab was estimated based on historical natalizumab consumption data, disease prevalence rates and natalizumab market share. The budget impact population was divided into prevalent and incident patients. The model assumes that some patients in treatment with natalizumab originator will switch to natalizumab biosimilar and that some naïve patients will directly start treatment with natalizumab biosimilar. The ex-factory price of natalizumab originator (intravenous and subcutaneous) and biosimilar (intravenous) and the corresponding administration costs were included. All assumptions were validated by expert opinion. Results: Eligible population was estimated at 7,552, 7,779, 8,090, 8,494 and 8,834 in years 1, 2, 3, 4 and 5 respectively. The introduction of natalizumab biosimilar, considering a progressive increase in market share from 9.6% (year 1) to 40.5% (year 5), would provide an overall savings (5-years time horizon) over € 47 million to the INHS. The scenario analysis highlights that the lower treatment cost of biosimilar natalizumab compared to originator natalizumab would offset the higher cost associated with intravenous versus subcutaneous administration. Conclusion: Considering the results of this budget impact analysis, it is realistic to expect that the presence of biosimilar natalizumab will contribute to the sustainability of public pharmaceutical expenditure.

Mandibular Overdentures When Treating Failing Dentition With Immediate Prosthetic Loading.

Patients may present with failing mandibular dentition either involving the entire arch, partial arch that currently has a partial denture to replace the prior missing teeth or wearing a full denture. Finances may limit restoration of the arch with an All-on-X concept and the patient's goals are a stable prosthesis that does not move whenconcept and the patient's goals are a stable prosthesis that does not move when eating or speaking is the patient's expressed goal. Overdentures can fulfil that goal and provide a stable restored arch at a lower treatment cost than treatment with a fixed hybrid prosthesis. Traditionally, when these type cases have been treated, the remaining dentition has been extracted, depending on availability of bone, implants are placed. Those typically were left to osseointegrate and loaded several months later with a delayed loading approach. This requires relining the denture and the patient having a loose, non-stable prosthesis during that healing phase. An alternative approach utilizes immediate activation of the implants with overdenture attachments thus, providing an immediate stable retentive full arch mandibular removable prosthesis (overdenture) by immediate activation of overdenture attachments (ie.Locators) aids the patient in their goals without delays in treatment. This article will present two case examples of mandibular arches with failing dentition related to caries and periodontal issues and their treatment with immediate implant placement and loading with Locator attachments. Long-term follow-up of 1-year 8-months in one case and 33-months in the other case demonstrate crestal bone stability with this immediate overdenture loading protocol.

Cost-effectiveness analysis of later-line treatments for refractory metastatic colorectal cancer.

3525 Background: Recent clinical trials support regorafenib dose optimization (ReDO), a combination therapy with trifluridine/tipiracil and bevacizumab (TAS-BEV), and fruquintinib (FRUQ) for the treatment of refractory metastatic colorectal cancer (mCRC). This study evaluated relative cost-effectiveness of ReDO, TAS-BEV, and FRUQ for mCRC from a payer perspective in the United States. Methods: A Markov model was constructed to estimate total costs and quality-adjusted life years (QALY) for each treatment. In the base case, clinical parameters were obtained from the ReDOS study for ReDO, the SUNLIGHT study for TAS-BEV, and the FRESCO study for FRUQ. Economic parameters were obtained from IBM Micromedex RED BOOK for treatment costs and from the Centers for Medicare &amp; Medicaid Services and the Agency for Healthcare Research and Quality for health care resource use. Incremental cost-effectiveness ratio (ICER) was used to evaluate relative cost-effectiveness of treatments. Model robustness was checked with deterministic (DSA) and probabilistic sensitivity analysis (PSA). A subgroup analysis was performed in patients with and without previous use of anti-VEGF therapy, but using the FRESCO-2 study for FRUQ because OS and PFS for this subgroup was unavailable in the FRESCO study. Results: In the base case, ReDO provided a higher QALY at a lower cost than TAS-BEV and FRUQ. During the first two months following treatment initiation, TAS-BEV had a higher total cost ($67,862) than ReDO ($44,695) and FRUQ ($48,688), partly due to the cost of managing neutropenia and using concomitant granulocyte colony stimulating factors (GCSF). The base case results were robust in DSA and PSA. Most influential parameters determining relative cost-effectiveness were related to treatment cost and effectiveness. In patients with previous anti-VEGF therapy, ReDO provided a higher QALY at a lower cost (0.571 QALY; $86,694) than TAS-BEV (0.490 QALY; $148,784) and FRUQ (0.411 QALY; $101,236). In patients without previous anti-VEGF therapy, TAS-BEV had a higher QALY (0.755 vs 0.571) and a higher cost ($232,701 vs $86,694) than ReDO, resulting in an ICER of $790,988 per QALY. Conclusions: ReDO was cost-effective compared with TAS-BEV and FRUQ, regardless of previous use of anti-VEGF therapy. In the base case, ReDO had a lower treatment cost than TAS-BEV and FRUQ, especially during the first month of dose optimization. TAS-BEV had the highest total cost, partly due to the cost of managing neutropenia and GCSF use. [Table: see text]

Factors Associated with Defecation Satisfaction among Japanese Adults with Chronic Constipation.

Background: Constipation causes substantial morbidity worldwide. Methods: This survey assessed constipation-related factors in Japan using the Japanese version of the Irritable Bowel Syndrome Quality of Life (IBS-QOL-J) instrument. We also examined the relationship among laxative type, Bristol Stool Form Scale (BSFS) scores, and treatment cost. Finally, we examined differences in satisfaction scores according to laxative type, treatment type, treatment cost, and BSFS score. Results: IBS-QOL-J was higher among those taking salt and/or irritation laxatives. Those paying >JPY 5000 (USD 50.00) had the lowest IBS-QOL-J. IBS-QOL-J was significantly lower among those with a BSFS score of 1 or 2 (severe constipation). Conclusions: This study's findings suggest that a variety of factors, including treatment type and cost, are associated with defecation satisfaction. Those who had hard stools, used multiple laxatives, or spent more on treatment were less satisfied. Future strategies should target therapies that do not require multiple laxatives with lower treatment costs. Adequate defecation with a small number of appropriate laxatives at minimal cost appears to improve defecation satisfaction. It is desirable to identify appropriate laxatives and improve dietary habits and exercise routines. It is also necessary to stop blindly increasing laxative usage and properly diagnose constipation disorders such as anatomical abnormalities other than functional constipation.

Effect of sandblasting and acid surface pretreatment on the specific capacitance of CuO nanostructures grown by hot water treatment for supercapacitor electrode applications

Crystalline copper oxide (CuO) nanostructures with micro, nano, and micro-nano surface roughness were grown on Cu sheet substrates by a facile, scalable, low-cost, and low-temperature hot water treatment (HWT) method that simply involved immersing Cu sheet in DI water at 75 °C for 24 h without any chemical additives. Various morphological features and sizes of CuO nanostructures were tuned by using different surface pretreatment techniques including acid treatment, sandblasting, or a combination of those two. The surface morphology of the prepared samples was analyzed by scanning electron microscopy. The crystal structure of the CuO nanostructures was investigated by x-ray diffraction XRD and Raman spectroscopy. To study the pseudocapacitive behavior, their potential supercapacitor performance, and equivalent series resistance, electrochemical analysis was done by cyclic voltammetry and electrochemical impedance spectroscopy for all the CuO/Cu samples in 1 M of Na2SO4 electrolyte. Among all, the best supercapacitive performance was achieved for CuO/Cu samples pretreated with Sandblasting followed by Acid treatment resulting in a specific capacitance of about 104 F g−1. The electrode with the sandblasted + acid pretreated sample showed a maximum of ∼69% capacitive retention after 2000 consecutive cycles. Our results indicate that CuO nanostructures on Cu substrates prepared with different surface pretreatment conditions and grown by HWT can be promising electrodes for supercapacitor device applications.

Low Cost Water Purification: Harnessing Adsorbents for Sustainable Treatment Solutions

Water is essential for life, yet millions lack access to clean drinking water. Low-cost treatment methods are crucial to ensure equitable access to safe water and prevent waterborne diseases in underserved communities. The study devised a 12-liter water filter utilizing pebbles, sand, and adsorbents biochar of Julifora, cashew nut shell and rice husk. Results demonstrated the filter's effectiveness in sustaining pH levels while reducing chloride, fluoride, hardness and alkalinity. Particularly noteworthy was the capacity of cashew nut biochar to efficiently adsorb chloride, fluoride, hardness and alkalinity as 27%, 37%, 38% and 43% respectively. This indicates its promising role as an adsorbent for water purification. The findings underscore the potential of the designed filter in improving drinking water quality by mitigating contaminants. Further refinement and optimization of the filter could enhance its efficacy in meeting stringent water quality standards, addressing the pressing need for accessible and safe drinking water globally.