Differentiating fouling from ageing for a condition-based diffuser maintenance.

Diffuser maintenance such as cleaning and membrane replacement are key to energy-efficient aeration at water resource recovery facilities (WRRFs). In previous research, fouling and ageing effects on diffuser performance have been lumped together by only comparing new and used membranes. But meaningful diffuser maintenance requires that fouling (mitigated by cleaning) can be separately assessed from ageing (calling for membrane replacement).

Comparison of guideline- and model-based WWTP design for uncertain influent conditions.

In this study, two methods for wastewater treatment plant (WWTP) dimensioning were compared: (1) a traditional guideline-based approach, and (2) a mechanistic model-based approach. The design outputs depended on uncertainties in correlated influent concentrations, which emphasises the importance of uncertainty analysis. The results showed that model-based design could simplify and reduce the time required for uncertainty and sensitivity analysis compared to a conventional design approach, in which the equations are solved manually and iteratively.

To calibrate or not to calibrate, that is the question.

Sensors used for control have become widespread in water resources recovery facilities during the strive for resource efficient operations. However, their accuracy is reliant on uncertain laboratory measurements, which are used for calibration and, in turn, to correct for sensor drift. At the same time, current sensor calibration practices are lacking clear theoretical understanding of how measurement uncertainties impact the final control action.

Model-based monitoring of diffuser fouling using standard sensors.

Fouling of fine-pore diffusers can cause substantial aeration energy wastage. It remains challenging to monitor their condition and decide the optimal time for labour-intensive and costly cleaning actions. In this study, we show that data from standard sensors (airflow rate, dissolved oxygen concentration, pressure and airflow valve position), which are fed to simple models, can track the diffuser's condition.

Sensor bias impact on efficient aeration control during diurnal load variations.

This study highlights the need to increase our understanding of the interplay between sensor drift and the performance of the automatic control system. The impact from biased sensors on the automatic control systems is rarely considered when different control strategies are assessed in water resource recovery facilities. Still, the harsh measurement environment with negative effects on sensor data quality is widely acknowledged.

Repetitive transcranial magnetic stimulation of the primary motor cortex in management of chronic neuropathic pain: a systematic review.

Objectives: Repetitive transcranial magnetic stimulation (rTMS) of the primary motor cortex (M1) with frequencies 5-20 Hz is an expanding non-invasive treatment for chronic neuropathic pain (NP). Outcome data, however, show considerable inhomogeneity with concern to the levels of effect due to the great diversity of treated conditions. The aim of this review was to survey the literature regarding the efficacy and safety of M1 rTMS, and the accuracy to predict a positive response to epidural motor cortex stimulation (MCS) which is supposed to give a more longstanding pain relief.

COVID-19 highlights the need for universal adoption of standards of medical care for physicians in nursing homes in Europe.

The nursing home sector has seen a disproportionately high number of deaths as part of the COVID-19 pandemic. This reflects, in part, the frailty and vulnerability of older people living in care homes but has also, in part, been a consequence of the failure to include care homes in the systematic planning of a response to COVID, as well as a measure of neglect of standards and quality improvement in the sector. In response, the EUGMS published a set of medical standards of care developed in consultation with experts across its member national societies in 2015.

Prevention of adverse drug reactions in hospitalized older patients with multi-morbidity and polypharmacy: the SENATOR* randomized controlled clinical trial.

Background: Multi-morbidity and polypharmacy increase the risk of non-trivial adverse drug reactions (ADRs) in older people during hospitalization. Despite this, there are no established interventions for hospital-acquired ADR prevention.

Methods: We undertook a pragmatic, multi-national, parallel arm prospective randomized open-label, blinded endpoint (PROBE) controlled trial enrolling patients at six European medical centres.

Automated active fault detection in fouled dissolved oxygen sensors.

Biofilm formation causes bias in dissolved oxygen (DO) sensors, which hamper their usage for automatic control and thereby balancing energy- and treatment efficiency. We analysed if a dataset that was generated with deliberate perturbations, can automatically be interpreted to detect bias caused by biofilm formation. We used a challenging set-up with realistic conditions that are required for a full-scale application.

[Severe COPD can benefit from endobronchial valves].

Lung volume reduction using endobronchial one-way valves (EBV) have been introduced as a new treatment for end-stage COPD and emphysema. They cause the lung parenchyma distal to the valve to collapse by causing an atelectasis. Nine randomized controlled trials (RCTs) studying the effects of insertion of EBVs in patients with severe emphysema were identified.

The effect of SENATOR (Software ENgine for the Assessment and optimisation of drug and non-drug Therapy in Older peRsons) on incident adverse drug reactions (ADRs) in an older hospital cohort - Trial Protocol.

Background: The aim of this trial is to evaluate the effect of SENATOR software on incident, adverse drug reactions (ADRs) in older, multimorbid, hospitalized patients. The SENATOR software produces a report designed to optimize older patients' current prescriptions by applying the published STOPP and START criteria, highlighting drug-drug and drug-disease interactions and providing non-pharmacological recommendations aimed at reducing the risk of incident delirium.

Methods: We will conduct a multinational, pragmatic, parallel arm Prospective Randomized Open-label, Blinded Endpoint (PROBE) controlled trial.

Who are the main medical care providers of European nursing home residents? An EuGMS survey.

Introduction: Nursing home residents are complex, vulnerable and have been historically neglected. The EuGMS is committed to improving their care, and is currently developing a curriculum of core competencies. Integral to these efforts is identifying the physicians, for whom, education in these competencies needs to be directed.

Implementation of geriatric care models in Europe (imAGE.eu): a cross-sectional survey in eight countries.

Purpose: Despite the beneficial impact of comprehensive geriatric assessment (CGA) for older patients in the hospital, it is not clear to what extent these models have been implemented in European hospitals. This study aims to map the implementation status of CGA-based models of care in general hospitals in Europe.

Methods: A cross-sectional survey study was conducted in autumn 2017 to map the implementation status of CGA-based care models in general hospitals (n = 178) in Belgium, Denmark, Estonia, Greece, Iceland, Ireland, Malta, and Slovenia.

Fault signatures and bias progression in dissolved oxygen sensors.

Biofilm fouling is known to impact the data quality of sensors, but little is known about the exact effects. We studied the effects of artificial and real biofilm fouling on dissolved oxygen (DO) sensors in full-scale water resource recovery facilities, and how this can automatically be detected. Biofilm fouling resulted in different drift direction and bias magnitudes for optical (OPT) and electrochemical (MEC) DO sensors.

Positron emission tomography and computed tomographic (PET/CT) imaging for radiation therapy planning in anal cancer: A systematic review and meta-analysis.

To improve the accuracy of chemoradiation therapy in anal cancer patients PET/CT is frequently used in the planning of radiation therapy. A systematic review was performed to assess impact on survival, quality of life, symptom score, change in target definition and treatment intention. Systematic literature searches were conducted in Medline, EMBASE, the Cochrane Library, and Centre for Reviews and Dissemination.

Renal function and outcome after heart transplantation.

Objectives: To investigate whether measured glomerular filtration rate (mGFR) is a risk factor for death and/or end-stage renal disease (ESRD) after heart transplantation (HTx).

Methods: All adult patients (n = 416) who underwent HTx between 1988 and 2010 were included. mGFR was performed both preoperatively and postoperatively as annual follow-up.

Benefits and risks with acellular dermal matrix (ADM) and mesh support in immediate breast reconstruction: a systematic review and meta-analysis.

In modern implant-based immediate breast reconstruction, it has become common to use biological acellular dermal and synthetic matrices in combination with a tissue expander or an implant. The aim of this systematic review was to examine differences in recurrence of cancer, impact on oncological treatment, health related quality of life, complications and aesthetic outcome between matrix and no matrix in immediate breast reconstruction. Systematic searches, data extraction and assessment of methodological quality were performed according to predetermined criteria.

Incident adverse drug reactions in geriatric inpatients: a multicentred observational study.

Background: Adverse drug reactions (ADRs) are common in older adults and frequently have serious clinical and economic consequences. This study was conducted as a feasibility study for a randomized control trial (RCT) that will investigate the efficacy of a software engine to optimize medications and reduce incident (in-hospital) ADRs. This study's objectives were to (i) establish current incident ADR rates across the six sites participating in the forthcoming RCT and (ii) assess whether incident ADRs are predictable.

Gaussian process regression for monitoring and fault detection of wastewater treatment processes.

Monitoring and fault detection methods are increasingly important to achieve a robust and resource efficient operation of wastewater treatment plants (WWTPs). The purpose of this paper was to evaluate a promising machine learning method, Gaussian process regression (GPR), for WWTP monitoring applications. We evaluated GPR at two WWTP monitoring problems: estimate missing data in a flow rate signal (simulated data), and detect a drift in an ammonium sensor (real data).