The genitourinary syndrome of menopause (GSM) and stress urinary incontinence (SUI) are common clinical challenges for women's health and quality of life. The laser treatment and particularly the vaginal erbium laser (VEL) may provide a new non-invasive treatment for both GSM and SUI. However, the estimation of the ultimate results of different laser treatments may be altered by different issues, such as patient selection, concomitant treatments, and long-term effect of vaginal laser thermotherapy. In the present paper, we present the protocol for a large multicenter study on the evaluation of the efficacy and safety of VEL for the treatment of GSM and SUI, the Vaginal Erbium Laser Academy Study (VELAS). This study will evaluate the effects of three laser applications in 1500 postmenopausal women. Subjective and objective symptoms will be evaluated prior to the first laser treatment with follow-up visits after 4 weeks from the last laser application, and subsequently after every 3 months for 1 year. Findings from the VELAS have the potential to affect clinical care practice and health decisions for millions of women world-wide for a non-hormonal treatment for GSM and a non-invasive treatment of SUI.
The ever-increasing occurrence and persistence of pharmaceutically active compounds (PhACs) in soils, sediments, drinking water supplies and wastewater effluents are a matter of serious environmental concern for governments and researchers worldwide. Nanofiltration as tertiary treatment method can be a viable and practical tool to remove these pollutants from aquatic environments. However, organic matter present in water sources can foul the membrane surface during operation, thus being potentially able to affect the membrane performance. Therefore, fouling mechanisms could heavily influence on the removal efficiencies. The purpose of this study was to investigate the implementation of three nanofiltration membranes (TFC-SR2, NF-270 and MPS-34) and to study both the rejection of trace PhACs and the fouling mechanisms for each membrane as a function of feed solution pH. Fouling mechanisms were predicted by Hermia's model adapted to cross-flow configurations. Results demonstrated that higher removals were obtained at slightly alkaline pH, especially for anionic trace PhACs. At the same conditions, more severe fouling was observed, which resulted in strong flux declines and an increase in hydrophobicity. This indicates that the attached organic matter on the membrane surface acts as a secondary selective barrier for separation.
Background: The quality of water for human consumption is an objective of fundamental importance for the defense of public health. Since the management of networks involves many problems of control and efficiency of distribution, the Water Safety Plan (WSP) was introduced to address these growing problems. Methods: WSP was applied to three companies in which the water resource assumes central importance: five water kiosks, a third-range vegetable processing company, and a residence and care institution. In drafting the plan, the terms and procedures designed and tested for the management of urban distribution systems were applied to safeguard the resource over time. Results: The case studies demonstrated the reliability of the application of the model even to small drinking-water systems, even though it involved a greater effort in analyzing the incoming water, the local intended use, and the possibilities for managing the containment of the dangers to which it is exposed. This approach demonstrates concrete effectiveness in identifying and mitigating the dangers of altering the quality of water. Conclusions: Thanks to the WSP applied to small drinking-water systems, we can move from management that is focused mainly on verifying the conformity of the finished product to the creation of a global risk assessment and management system that covers the entire water supply chain.
Alzheimer’s disease and vascular dementia are estimated to be the most common causes of dementia, although mixed dementia could represent the most prevalent form of dementia in older adults aged more than 80 years. Behavioral disturbances are common in the natural history of dementia. However, so far, there is a paucity of studies that investigated the causal association between behavioral psychological symptoms of dementia and dementia sub-types, due to the high heterogeneity of methodology, study design and type of clinical assessment. To understand the scant evidence on such a relevant clinical issue, it could be hypothesized that a new shifting paradigm could result in a better identification of the relationship between behavioral disturbances and dementia. This narrative review provides an update of evidence on the behavioral patterns associated with different dementia sub-types and offers a potential future perspective as common ground for the development of new translational studies in the field of behavioral disturbances in dementia and the appropriateness of psychoactive treatments.
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