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•Evaluation of the recurrence of disease activity after OCR discontinuation in a multicenter retrospective cohort.•Recurrence of focal inflammation after OCR discontinuation is scarce but not absent.•Further larger studies to determine the immune reconstitution therapy potential of OCR are important.

Acute bacterial meningitis (ABM) is a rare but disabling infectious condition that requires a performant multidisciplinary management approach. Between 70 and 90 adult patients are diagnosed with community-acquired ABM in Belgium annually, and reported case fatality rates range from 17 to 40%. The currently available guidelines provide evidence-based guidance on how to manage this disease. However, these guidelines do not translate the evidence to the daily practice at the emergency department in a Belgian healthcare context. We created a taskforce in University Hospitals Leuven consisting of experts with complementary expertise in managing this disease: neurology, neurosurgery, intensive care medicine, microbiology and infectious diseases. The taskforce agreed upon a flowchart containing seven management steps encompassing all relevant phases in emergency ABM management. In addition to the focus on timely and adequate initiation of antimicrobial treatment, the flowchart and protocol also provide guidance on practical hurdles such as how to assess the safety of performing a lumbar puncture and when to refer patients to the intensive care department. This protocol was implemented in University Hospitals Leuven and fosters inter-disciplinary coordination of ABM care.

Multiple sclerosis (MS) is an autoimmune, inflammatory demyelinating disease of the central nervous system characterized in the majority of the patients by a relapsing-remitting disease course. For decades high-dosage corticosteroids (CS) are considered the cornerstone in the management of acute MS relapses. However, many unanswered questions remain when it comes to the exact modalities of CS administration. In this review on behalf of the Belgian Study Group for MS we define the efficacy of CS in reducing MS-related morbidity and examine whether the effect is different according to type of CS, route of administration, cumulative dosage, timing of initiation and disease course. We also review the use of CS in combination with other MS treatments and during pregnancy and lactation. Furthermore, we delineate the relevant adverse events due to a pulse CS regimen and present a decision tree that can be used when treating MS relapses in clinical practice.

AbstractThis paper presents an integrated mathematical model that is capable of predicting and assessing the impact of ultrasonic (US) treatment on the excess activated sludge production in an activated sludge wastewater treatment system. Biological processes in the reactor are simulated in Matlab®/Simulink by the ASM1 model into which two algebraic equations, which capture the US treatment, are integrated. Calibration and validation data series come from a pilot plant installed at two locations, i.e. at a communal wastewater treatment plant (Mechelen-Noord) and at an industrial food flavor production site Haasrode, both located in the Flanders region of Belgium. The results show that the built-up model is capable of correctly predicting excess sludge reduction in the treatment system (which is a sequencing batch reactor in both cases). A reduction of approximately 42% for the communal case study can be reported, while the result obtained for the industrial case study, characterized by a very high organic loading, is quite comparable, i.e. about 38%. The latter represents a huge amount of excess sludge avoided given the nominally very high sludge production rate. The model can now be exploited to maximize the excess sludge reduction while minimizing the US operational costs.

This paper presents an integrated mathematical model that is capable of predicting and assessing the impact of ultrasonic (US) treatment on the excess activated sludge production in an activated sludge wastewater treatment system. Biological processes in the reactor are simulated in Matlab®/Simulink by the ASM1 model into which two algebraic equations, which capture the US treatment, are integrated. Calibration and validation data series come from a pilot plant installed at two locations, i.e. at a communal wastewater treatment plant (Mechelen-Noord) and at an industrial food flavor production site Haasrode, both located in the Flanders region of Belgium. The results show that the built-up model is capable of correctly predicting excess sludge reduction in the treatment system (which is a sequencing batch reactor in both cases). A reduction of approximately 42% for the communal case study can be reported, while the result obtained for the industrial case study, characterized by a very high organic loading, is quite comparable, i.e. about 38%. The latter represents a huge amount of excess sludge avoided given the nominally very high sludge production rate. The model can now be exploited to maximize the excess sludge reduction while minimizing the US operational costs.

Sedimentation and filtration are the most common techniques for activated sludge separation in wastewater treatment plants. Using partial least squares (PLS), the influence of bioflocculation related variables on removal effiency was assessed. Small particles and dissolved polysaccharides are deemed detrimental for filtration, while hydrophobic large flocs improve the filtration performance. Settling worsens when filaments are present and improves with the presence of large flocs. The potential of using PLS is demonstrated, although more measurements and samples of a wide diversity would improve the modeling performance. Such models can then pinpoint crucial measurements for bioflocculation monitoring in relation to separation performance in wastewater treatment plants.

Current guidelines recommend vaccination against SARS-CoV2 for people with multiple sclerosis (pwMS). The long-term review of the safety and effectiveness of COVID-19 vaccines in pwMS is limited.

Ultrasonic treatment of waste activated sludge is one of the possibilities to reduce excess sludge production through the mechanism of sludge disintegration and cell lysis. In the past, several attempts have been made to model the process of solubilisation of the particulate volatile suspended solid part of the activated sludge (VSS) into soluble COD (sCOD). However, the focus of these models was predominantly on predicting an efficiency factor for the release of sCOD (Disintegration Degree, DDCOD) and provided no information on the release of nutrients and the instantaneous reduction of VSS. Moreover, often insufficient influential variables were included in the model equations, making the models only applicable on the training dataset of their own experimental research. This paper, therefore, seeks to build a simple model, which contains all influential input variables, that can predict not only the sCOD release but also the nutrients release (ortho-PO4-P and soluble Kjeldahl nitrogen) and VSS reduction simultaneously. Therefore, in first instance, a Principal Component Analysis (PCA) is carried out on the input and output data matrix of obtained experimental observations that will be used as training data. In this way, certain correlated input variables and independent output variables can be removed from the model, in order to increase its simplicity and predictive nature. Then, the model is built on the basis of Partial Least Squares Regression (PLS-R) and a part of the observations is used to validate the predictive strength of the model.

The performance of the activated sludge process is limited by the ability of the sedimentation tank (1) to separate the activated sludge from the treated effluent and (2) to concentrate it. Apart from bad operating strategies or poorly designed clarifiers, settling failures can mainly be attributed to filamentous bulking. Image analysis is a promising technique that can be used for early detection of filamentous bulking. The aim of this paper is therefore twofold. Foremost, correlations are sought between image analysis information (i.e., the total filament length per image, the mean form factor, the mean equivalent floc diameter, the mean floc roundness and the mean floc reduced radius of gyration) and classical measurements (i.e., the Sludge Volume Index (SVI)). Secondly, this information is both explored and exploited in order to identify dynamic ARX and state space-type models. Their performance is compared based on two criteria.

Abstract:  In high-resistance, salt-absorbing epithelia the apical amiloride-sensitive Na+ channel is the key site for regulation of salt and water balance. The saturation of macroscopic Na+ transport through these channels was investigated using A6 epithelial monolayers. The relation between transepithelial Na+ transport (I Na) and apical Na+ concentration ([Na+]ap) under short-circuit conditions was studied. Michaelis-Menten analysis of the saturable short-circuit current (I sc) yielded an apparent Michaelis-Menten constant (K m I ) of 5 mmol/l and a maximal current (I max) of 8 μA/cm2. The microscopic parameters underlying I Na, namely the single-channel current (i) and the open channel density (N o), were investigated by the analysis of current fluctuations induced by the electroneutral amiloride analogue CDPC (6-chloro-3,5-diaminopyrazine-2-carboxamide). A two-state model analysis yielded the absolute values of i (0.18  0.01 pA) and N o (65.38  9.57 million channels/cm2 of epithelium) at [Na+]ap = 110 mmol/l containing 50 μmol/l CDPC. Our data indicate that in A6 cells both i and N o depend on [Na+]ap. Between 3 and ≈ 20 mmol/l the density of conducting pores, N o, decreases sharply and behaves again as an almost [Na+]ap-independent parameter at higher [Na+]ap. The single-channel current clearly saturates with an apparent Michaelis-Menten constant, K m i , of ≈ 17 mmol/l. Thus, the [Na+]ap dependence of N o as well as the limited transport capacity of the amiloride-sensitive Na+ channel are both responsible for the saturation of I Na.

Some people with multiple sclerosis (pwMS) are at increased risk of severe Coronavirus disease 19 (COVID-19) and should be rapidly vaccinated. However, vaccine supplies are limited, and there are concerns about side-effects, particularly with the ChAdOx1nCoV-19 (AstraZeneca) vaccine.