Application of Steel Slag as an Aggregate in Concrete Production: A Review

Steel slag is a solid waste produced in crude steel smelting, and a typical management option is stockpiling in slag disposal yards. Over the years, the massive production of steel slags and the continuous use of residue yards have led to vast occupation of land resources and caused severe environmental concerns. Steel slag particles can potentially be used as aggregates in concrete production. However, the volume stability of steel slag is poor, and the direct use of untreated steel slag aggregate (SSA) may cause cracking and spalling of concrete. The present research summarizes, analyzes, and compares the chemical, physical, and mechanical properties of steel slags. The mechanism and treatment methods of volume expansion are introduced, and the advantages, disadvantages, and applicable targets of these methods are discussed. Then, the latest research progress of steel slag aggregate concrete (SSAC) is reviewed. Using SSA leads to an increase in the density of concrete and a decrease in workability, but the mechanical properties and durability of SSAC are superior to natural aggregate concrete (NAC). Finally, future research in this field is proposed to motivate further studies and guide decision-making.

[Status and treatment of knee extension device disruption after total knee arthroplasty]

Objective

To summarize the principle, classification, and treatment methods of knee extension device disruption after total knee arthroplasty (TKA).

Methods

By extensively consulted the relevant domestic and abroad literature, the principle, classification, and treatment methods of injury according to different parts of the knee extension device after TKA were summarized and analyzed.

Results

The knee extension device disruption after TKA mainly occurs in the quadriceps tendon, patella tendon, and patella. Once the knee extension device is injured, it will seriously affect the functional recovery of the patient after surgery, resulting in delayed knee extension, limited range of motion, difficulty walking, and joint pain, etc. The current treatment methods are diverse, including conservative treatment and surgical treatment. Surgical treatment includes direct suture repair (traditional perosseous fixation and suture anchoring techniques), reconstruction and reinforcement repair (reconstruction using synthetic patches, autografts, and allografts). For the treatment of different parts, it is necessary to comprehensively consider the patient's knee joint tissue condition, the presence or absence of underlying diseases, and the presence or absence of donors.

Conclusion

There is no uniform conclusion on the treatment of knee extension device disruption after TKA. Different injury situations need to be considered comprehensively to choose the appropriate treatment method.

A new classification of descending necrotizing mediastinitis and surgical strategies

Background

Descending necrotizing mediastinitis (DNM) is an inflammation occurring in the oropharynx and descending to the deep cervical space and mediastinum, which is a serious infectious disease. The investigation of a new classification system and treatment methods for DNM is still necessary.

Methods

A total of 139 patients with DNM caused by odontogenic or pharyngeal infection were retrospectively analyzed in last 20 years in the Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine. The patients were divided into the traditional treatment Group T (Group T: 43 patients) and the new classification Group N (Group N: 96 patients). A new DNM classification was developed based on the progression of mediastinal infection as follows: type Ia: infection in the anterosuperior mediastinum; type I: infection in the anterior mediastinum; type II: infection in the posterior mediastinum; and type III: infection of the whole mediastinum.

Results

There were 49, 8, 10, and 29 patients classified as type Ia, I, II, and III, respectively in the Group N. The type Ia DNM patients were managed with transcervical mediastinal drainage, and the patients with types I and II DNM underwent open (thoracoscopic) surgery, 1 patient within types I died. The 29 patients with type III were managed with unilateral or bilateral open (thoracoscopic) surgery, among them, 8 patients died. The mortality rate for patients with type III DNM was 27.6%. The overall mortality rate in Group N was 9.4%. The mortality rate for patients in the Group T was 25.6%. The mortality rate of Group N was significantly lower than that of Group T (P<0.05).

Conclusions

We have carried out a new clinical classification of DNM, and selected the appropriate treatment method according to the classification, and achieved a better effect than the traditional treatment method.

A new concept of advanced management of hazardous waste in the Republic of Korea

In order to activate the recycling of hazardous wastes, the hazardous characteristics of wastes should be removed or stabilized. However, most recyclers in recycling companies do not understand how to remove the hazardous characteristics in wastes with the proper technology. The aim of a new form of advanced management of hazardous waste is to inform recyclers and operators in industries about hazardous characteristics and the treatment methods required for all management processes, from waste generation to final treatment. In a new method of advanced management of hazardous wastes, chemicals in the waste should be initially examined at the generation source in each industry to create a chemical catalogue. Since hazardous characteristics can be determined by a chemical catalogue obtained from the waste, the hazardous characteristics of wastes can be established and considered when choosing the proper treatment method. Then, the categories of waste treatment methods for each hazardous characteristic can be introduced for generators to treat hazardous wastes properly. Therefore, it is possible to create a link between the source and the final treatment of hazardous wastes using a new concept of industry (In), waste (W), hazardous chemicals and their hazardous characteristics (Ha) and treatment methods (T). This new concept of the "InWhat" system, which includes all management processes in Korea, from waste generation to final treatment, will be proposed as a tool in the advanced management of hazardous wastes.

In vitro efficacy of three different implant surface decontamination methods in three different defect configurations

OBJECTIVES

Evaluation of in vitro efficacy of three different implant surface decontamination methods in a peri-implant bone defect model.

MATERIAL AND METHODS

A total of 180 implants were stained with indelible red color and distributed to standardized peri-implant bone defect resin models with a circumferential defect angulation of 30°, 60°, or 90° (supraosseous defect). Sixty implants were assigned to each type of defect. All implants were cleaned by the same examiner. For each type of defect, 20 implants were cleaned for 2 min with one of 3 devices: curette (CUR), sonicscaler (SOSC), or air abrasion with glycine powder (APA). Thereafter, photographs were taken from both sides of each implant and the cumulative uncleaned implant surface area was measured by color recognition technique. Scanning electron micrographs (SEM) were examined to assess morphologic surface damages.

RESULTS

The cleaning efficacy as percent (%) of residual color was significantly different for each of the 3 defect angulations (p < 0.001) for each treatment device: 30° CUR: 53.44% > SOSC: 19.69% > APA: 8.03%; 60° CUR: 57.13% > SOSC: 11.4% > APA: 0.13%; and 90° CUR: 48.1% > SOSC: 13.07% > APA: 0.58%. The differences between the three different cleaning modalities within each defect type were also significant (p < 0.005). SEM micrographs showed no surface damages after the use of APA.

CONCLUSION

Air powder abrasion is the most efficient (APA > SOSC > CUR) and less surface damaging treatment modality for each defect angulation in this in vitro model.

[Oral treatment for obstructive sleep apnea syndrome]

Obstructive sleep apnea syndrome (OSAS) is a common clinical disease with high incidence and low treating proportion, difficult evaluation, and complicated nosogenesis. OSAS can cause systematic impairments. Various treatment methods were applied in clinical setting with the tendency of cross-disciplinary promotion. Oral treatment plays an exceedingly important role in OSAS research and therapy. This study reports the oral treatment involving OSAS therapy.

Analysis of alternatives for insulinizing patients to achieve glycemic control and avoid accompanying risks of hypoglycemia

The aims of the present study were to explore the efficacy of glycemic control and the risks of hypoglycemia with different methods of insulin therapy, and to provide reference data for the clinical treatment of diabetes. In this retrospective study, hospitalized patients diagnosed with type 2 diabetes between March and December 2014, in the Department of Endocrinology in the First Affiliated Hospital of Wannan Medical College, were divided into three groups, including an intensive insulin analogue therapy group, a premixed insulin analogue treatment group and a premixed human insulin therapy group. The efficacy of glycemic control and the incidence of hypoglycemia were determined in each of the insulin treatment groups. Compared with the other treatment groups, the intensive insulin analogue therapy group was associated with superior blood glucose control, shorter time to reach standard insulin regimen, shorter hospitalization time, fewer fluctuations in blood glucose levels and lower insulin dosage on discharge from hospital. However, this treatment was also associated with a high risk of hypoglycemia. In conclusion, when combined with the effective prevention of hypoglycemia and appropriate nursing care (especially in hospital care), intensive insulin analogue therapy may provide the greatest benefit to patients.

Diagnosis and treatment of pancreatic pseudocysts and cystic tumors based on own material and quoted literature

Pseudocysts constitute the most basic cystic lesions of the pancreas. Symptomatic cysts may be treated by means of both minimally invasive methods and surgery. Currently, it is believed that approximately 5% of cystic lesions in the pancreas may in fact, be neoplastic cystic tumors. Their presence is manifested by generally irregular multilocular structures, solid nodules inside the cyst or in the pancreatic duct, frequently vascularized, as well as fragmentary thickening of the cystic wall or septation.

Alternative methods for the treatment of post-menopausal troubles

Background

Menopause is described as the transition from the reproductive phase of a women to the non reproductive. Changes in hormone levels might lead to complaints and health consequences especially during peri- and postmenopause. Hormone therapy has a potential damaging health risk profile and is recommended for temporal limited therapy for acute vasomotor symptoms only.

Objective

The present HTA-report aims to assess the effectiveness and the cost-effectiveness of alternative treatment methods for women with postmenopausal symptoms in Germany regarding patient relevant endpoints (reduction of symptoms and frequency of adverse events and improvement of quality of life).

Methods

A systematic literature search was carried out in 33 relevant databases in September 2010. Citations were selected according to pre-defined criteria and were extracted and evaluated.

Results

In the systematic research 22 studies are identified for the effectiveness evaluation, 22 primary studies and one review.

High doses of isolated genistein reduce the frequency/intensity of hot flashes while low doses of genistein show no significant effect. Intake of isoflavone extract such as genistein, daidzein, glycitein in various combinations does not have an effect on improvement of cognitive function or vaginal dryness. The effect of black cohosh and hop extract for menopausal complaints cannot be determined since results are heterogenous. The combination of isoflavone, black cohosh, monk’s pepper, valerian and vitamin E has a positive effect on menopause symptoms. Ginkgo biloba shows no significant effect on menopause symptoms and cognitive improvement beside mental flexibility. Acupuncture has a significant influence on hot flashes especially in severe cases.

Discussion/Conclusion

No final statement can be drawn regarding the effectiveness of alternative treatment methods due to qualitative shortcomings of included studies and a general limited availability of studies in this field. Furthermore, the generalization of the present HTA is limited due to the inclusion of only postmenopausal women.

Anxiety and alcohol use disorders: comorbidity and treatment considerations

The co-occurrence of anxiety disorders and alcohol use disorders (AUDs) is relatively common and is associated with a complex clinical presentation. Sound diagnosis and treatment planning requires that clinicians have an integrated understanding of the developmental pathways and course of this comorbidity. Moreover, standard interventions for anxiety disorders or AUDs may need to be modified and combined in targeted ways to accommodate the unique needs of people who have both disorders. Optimal combination of evidence-based treatments should be based on a comparative balance that considers the advantages and disadvantages of sequential, parallel, and integrated approaches.

Four cases of traumatic hypotony maculopathy treated by various methods

Several reports have been published on methods for treating hypotony maculopathy. Currently, the preferred choice of treatment depends on the severity of the illness. We experienced four cases of traumatic hypotony maculopathy and treated them by various methods. Cases 1-3 were treated by various surgical treatments. Case 1 was treated by combined cataract surgery and pars plana vitrectomy. The vitreous cavity was replaced with 20% sulfur hexafluoride (SF6). Case 2 did not improve with laser trabeculoplasty, so further encircling was performed. Case 3 did not improve with photocoagulation of the ciliary body and injection of 20% SF6 into the vitreous cavity. Consequently, this case required suturing of the ciliary body to the sclera, cryopexy for the ciliary body, and injection of 100% SF6. Case 4 was treated only with eye drops. Intraocular pressure (IOP) increased in all cases as a result of treatment. Treatment improved hypotony maculopathy in all cases. Pre-treatment visual acuities ranged from 0.03 to 0.4, with IOP ranging from 2 to 10 mmHg. Post-treatment visual acuity ranged from 0.09 to 1.2, with IOP ranging from 14 to 16 mmHg. Only case 2 resulted in poor visual prognosis because of choroidal rupture near the foveola. The difficulty in choosing treatment methods lies in the need for multiple surgical treatments for some cases. Effective and noninvasive treatment methods are expected to be established in the future.

An e-health solution for people with alcohol problems

Self-management of chronic diseases has been a research focus for years. Information and communication technologies (ICTs) have played a significant role in aiding patients and their families with that management task. The recent dramatic increase in smartphone capabilities has expanded the potential of these technologies by facilitating the integration of features specific to cell phones with advanced capabilities that extend the reach of what type of information can be assessed and which services can be provided. A recent review of the literature covering the use of ICTs in managing chronic diseases, including addiction, has examined the effectiveness of ICTs, with an emphasis on technologies tested in randomized controlled trials. One example of an addiction-relapse prevention system currently being tested is the Alcohol Comprehensive Health Enhancement Support System (A-CHESS) Program.

Interventions targeting HIV-infected risky drinkers: drops in the bottle

Alcohol use is common among people infected with HIV and may contribute to adverse consequences such as reduced adherence to treatment regimens and increased likelihood of risky sexual behaviors. Therefore, researchers and clinicians are looking for treatment approaches to reduce harmful alcohol consumption in this population. However, clinical trials of existing treatment models are scarce. A literature review identified only 11 studies that included HIV-infected patients with past or current risky alcohol use and which targeted alcohol use and other health behaviors. Four studies focusing on HIV-infected participants with alcohol problems found mixed effects on adherence and on alcohol use. Five clinical trials included at least 10 percent of HIV-infected subjects who use alcohol; of these, only one reported significant evidence of a favorable impact on alcohol consumption. Finally, two trials targeting alcohol users at high risk for HIV infection identified treatment effects that were not sustained. Taken together, these findings provide limited evidence of the benefit of behavioral interventions in this population. Nevertheless, these studies give some guidance for future interventions in HIV-infected patients with alcohol problems.

The past and future of research on treatment of alcohol dependence

Research on the treatment of alcoholism has gained significant ground over the past 40 years. Studies such as the National Institute on Alcohol Abuse and Alcoholism's Project MATCH, which examined the prospect of tailoring treatments for particular people to better suit their needs, and Project COMBINE, which examined in-depth, cognitive-behavioral therapy and medical management, helped pave the way for a new way of approaching alcoholism treatment. New findings garnered through the National Epidemiologic Survey on Alcohol and Related Conditions further defined the problem. At the heart of this research has been the development of procedures to characterize, measure, and monitor the fidelity to a particular conceptual psychotherapeutic approach so that clear comparisons can be made between conceptually and technically distinct approaches. Advances in scientific methodology and statistics have provided tools to analyze complex datasets. The resulting findings mark an improvement over the first models of treatment developed decades ago, which tended to focus on anecdotal findings and assumptions. This hard-earned progress has enabled scientists today to move ahead and address the next set of challenges. Future research, coupled with a restructured treatment system capable of making new scientific findings rapidly available to the community, hold the key to significantly improving treatment outcomes and reducing suffering from alcohol-related disorders.

HIV/AIDS, comorbidity, and alcohol: can we make a difference?

Alcohol use is common among people infected with HIV and plays an important role in their health outcomes. Because alcohol use complicates HIV infection and contributes to comorbid diseases, it is important for researchers and practitioners to understand these interactions and to integrate alcohol treatment with medical management of long-term HIV infection and associated comorbidity. The Veterans Aging Cohort Study (VACS) is a large, multisite study of the effects of alcohol use on HIV outcomes in the broader context of aging. A multilevel strategy intervention trial is needed to address the many modifiable implications of alcohol consumption among those receiving treatment for HIV.

Current state of treatment for alcohol and other drug use disorders in adolescents

Over the past decade, treatment programs have been developed specifically for adolescents with alcohol and other drug (AOD) use disorders. The vast majority of these programs use psychosocial approaches, which can be further classified into family-based interventions and multisystemic therapy, motivational enhancement therapy, behavioral therapy, and cognitive-behavioral therapy. Outcome studies have evaluated the effectiveness of the different approaches. The results indicate that all of these strategies can improve an adolescent's outcome on a variety of measures. Pharmacotherapy rarely is used in the treatment of adolescents with AOD use disorders, and existing studies only have assessed the effectiveness of agents aimed at treating coexisting psychiatric conditions. Future studies should use more consistent, state-of-the-art assessment instruments developed specifically for adolescents and also pay greater attention to an adolescent's developmental status and its impact on treatment outcome.

Improving treatment through research: directing attention to the role of development in adolescent treatment success

Treatment of adolescents with alcohol use problems can be as successful as in adults, but the success often is short-lived, with most treated adolescents relapsing within a few months. Developmental differences among adolescents may contribute to this high rate of relapse, and treatment approaches that pay direct attention to the patients' developmental status may improve outcomes. To date, studies assessing adolescent alcohol treatment rarely have investigated the association between developmental stage and outcome. In addition, even experts do not fully agree on the developmentally appropriate outcomes that should be evaluated in adolescent treatment studies. Research methods and variables used to assess the outcome of adolescent alcohol treatment often rely on those used in treatment studies of adults. Developmental factors that may directly influence adolescents' amenability to treatment, such as pubertal status, psychological development (e.g., executive mental functions), social relationships, and developmental transitions, have not been adequately investigated. Studies using concepts from developmental science are needed to determine how individual characteristics, various contextual influences (e.g., from peers, family, or the social environment), and the interactions of these factors influence alcohol use behavior, amenability to treatment, and treatment outcomes. Knowledge gained in studies directly examining developmental factors should help in the design of more effective treatment programs with lower relapse rates.

Charting a path between research and practice in alcoholism treatment

The journey between research and practice in alcoholism treatment is worthwhile but can be difficult because of the inherent differences between the treatment and research disciplines. This article describes how the path between research and practice can be navigated successfully, discusses the factors that influence the journey, and offers specific pharmaceutical and behavioral interventions as examples of research-based treatment approaches that can be implemented more widely.

Endotoxin and Kupffer cell activation in alcoholic liver disease

One central component in the complex network of processes leading to the development of alcoholic liver disease is the activation of immune cells residing in the liver (i.e., Kupffer cells) by a substance called endotoxin, which is released by bacteria living in the intestine. Alcohol consumption can lead to increased endotoxin levels in the blood and liver. When activated, Kupffer cells produce signaling molecules (i.e., cytokines) that promote inflammatory reactions as well as molecules called reactive oxygen species (ROS), which can damage liver cells. Endotoxin activates Kupffer cells by interacting with a complex of protein molecules that are located on the outside of the Kupffer cell or which extend into the cell. Binding of endotoxin alters the activities of the proteins in this complex so that they trigger a cascade of biochemical signals in the Kupffer cell, resulting in cytokine and ROS production and, ultimately, liver damage. Because alcohol can enhance endotoxin release and, therefore, Kupffer cell activation, novel approaches to inhibit these processes might help prevent or ameliorate alcoholic liver disease.

Diagnosis and treatment of alcoholic liver disease and its complications

Alcoholic liver disease (ALD) is a serious and potentially fatal consequence of alcohol use. The diagnosis of ALD is based on drinking history, physical signs and symptoms, and laboratory tests. Treatment strategies for ALD include lifestyle changes to reduce alcohol consumption, cigarette smoking, and obesity; nutrition therapy; and pharmacological therapy. The diagnosis and management of the complications of ALD are important for alleviating the symptoms of the disease, improving quality of life, and decreasing mortality.

Use and misuse of alcohol among older women

Older women may be especially at risk for alcohol problems because they are more likely than men to outlive their spouses and face other losses that may lead to loneliness and depression. Physiologically, women are also at greater risk for alcohol-related health problems as they age. Because of these risks, alcohol use recommendations for older women generally are lower than those set for both older men and younger women. Screening and brief intervention may be especially useful in minimizing alcohol problems in older women. Although brief intervention research with this population is limited, the findings are promising.

Contingency management. Incentives for sobriety

Contingency management (CM), the systematic reinforcement of desired behaviors and the withholding of reinforcement or punishment of undesired behaviors, is an effective strategy in the treatment of alcohol and other drug (AOD) use disorders. Animal research provides the conceptual basis for using CM in AOD abuse treatment, and human studies have demonstrated the effectiveness of CM interventions in reducing AOD use; improving treatment attendance; and reinforcing other treatment goals, such as complying with a medication regimen or obtaining employment.

Psychopathology in adolescent alcohol abuse and dependence

Adolescents who abuse or are dependent on alcohol often have coexisting mental disorders. These disorders may both precipitate alcohol use disorders and result from them. In addition, both types of disorders may arise independently in adolescents at high risk. Mental disorders that commonly co-occur with alcohol use disorders in adolescents include antisocial disorders, mood disorders, and anxiety disorders. Treatment programs for adolescents with alcohol use disorders should seek not only to eliminate alcohol and other drug use but also to improve the symptoms of other mental disorders.

Treatment of alcohol withdrawal

Appropriate treatment of alcohol withdrawal (AW) can relieve the patient's discomfort, prevent the development of more serious symptoms, and forestall cumulative effects that might worsen future withdrawals. Hospital admission provides the safest setting for the treatment of AW, although many patients with mild to moderate symptoms can be treated successfully on an outpatient basis. Severe AW requires pharmacological intervention. Although a wide variety of medications have been used for this purpose, clinicians disagree on the optimum medications and prescribing schedules. The treatment of specific withdrawal complications such as delirium tremens and seizures presents special problems and requires further research.

Introduction to alcohol withdrawal

Heavy drinkers who suddenly decrease their alcohol consumption or abstain completely may experience alcohol withdrawal (AW). Signs and symptoms of AW can include, among others, mild to moderate tremors, irritability, anxiety, or agitation. The most severe manifestations of withdrawal include delirium tremens, hallucinations, and seizures. These manifestations result from alcohol-induced imbalances in the brain chemistry that cause excessive neuronal activity if the alcohol is withheld. Management of AW includes thorough assessment of the severity of the patient's symptoms and of any complicating conditions as well as treatment of the withdrawal symptoms with pharmacological and nonpharmacological approaches. Treatment can occur in both inpatient and outpatient settings. Recognition and treatment of withdrawal can represent a first step in the patient's recovery process.

Scarring in alcoholic liver disease: new insights and emerging therapies

Like other organs, the liver responds to injury (e.g., from chronic alcohol ingestion) with scar formation (i.e., fibrosis). Specialized cells known as stellate cells play a major role in the development of liver fibrosis. Normally these cells serve as important storage depots for vitamin A, but during alcoholic injury, a collection of cellular and molecular mediators cause stellate cells to undergo a process of activation that results in dramatic changes in their structure and function. Activated stellate cells then become primary producers of scar tissue. In turn, accumulated scar provokes a series of events that contributes to deteriorated liver function. An improved understanding of the factors that trigger stellate cell activation has led to new therapeutic approaches for reversing or preventing liver fibrosis more effectively.

Interventions for Alcoholics Who Smoke

More than 85 percent of adults with a history of alcohol abuse also smoke, and they may be more addicted to nicotine than are smokers without a history of drinking. Alcoholics who smoke also have higher risks of cancer and cardiovascular disease. Indeed, it has been reported that more alcoholics die from tobacco-related diseases than from disorders related to their alcoholism. The complex interaction that exists between alcoholism recovery and tobacco is discussed. In addition, methods are presented for helping alcoholics to stop smoking, including motivating patients, using innovative interventions, and matching effective interventions to the motivational level of the alcoholic. By better understanding the interaction between alcohol and tobacco, scientists can improve treatment outcome and cost-effectiveness for alcoholics who smoke.

Treating Alcohol Problems in the Context of Other Drug Abuse

People seeking treatment for alcohol problems frequently abuse other drugs as well, such as tobacco, cocaine, marijuana, methamphetamine, and opiates. The problem of polydrug use raises important issues for treatment providers. A person who abuses multiple drugs may have a more difficult time stopping drinking and a higher risk for relapse to alcohol use after treatment. Conversely, a person who successfully stops drinking may offset this achievement by substituting another drug for alcohol. Successful treatment must take into account both alcohol- and drug-related issues, with particular emphasis on assessment, motivation, treatment design, and outcome evaluation.

Recovery of Cognitive Functioning in Alcoholics: The Relationship to Treatment

Alcoholics' successful recovery depends on their regaining cognitive functioning. Although their cognitive deficits often are subtle and improve with a period of abstinence from alcohol, they can hamper the effectiveness of treatment programs. If patients cannot comprehend the information imparted during therapy, they may not be able to use treatment strategies successfully in "real world" challenges. Cognitive recovery can be enhanced using strategies such as repeated mental exercises. Adding such practice to treatment regimens could improve some alcoholics' chances of recovering successfully.