International Consensus Statement on Rhinology and Allergy: Rhinosinusitis

Background: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods: ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results: ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion: This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS

Fouling in reverse osmosis (RO) membrane in water recovery from secondary effluent : a review

Reverse osmosis (RO) is the most preferable process for water recovery from secondary effluent (SE) because of its higher rejection of impurities with lower associated cost and higher quality of product. Fouling still is a major challenge during the water recovery due to higher contaminant loadings in SE and high rejection capability of this membrane. The presence of suspended solids, colloidal and organic matters, and high level of biological activities in SE further elevate fouling potentiality. This review was performed to identify major foulants causing hindrance in sustainable application of reverse osmosis and to present available pre-treatment options for these foulants. There are four fouling types present in RO namely; bio-fouling, inorganic/scaling, organic, and particulate fouling. Among them; bio-fouling is less understood but dominant since the pre-treatment options are not well developed. Other fouling mechanisms have been overcome by well developed pre-treatments. The major foulants for RO are dissolved and macromolecular organic substances, sparingly soluble inorganic compounds, colloidal and suspended particles, and micro-organisms. Some of these potential fouling water quality parameters (PFWQPs) are interrelated with each others such as electrical conductivity is a surrogate measure of total dissolved solids with established stable relationship. Most of these PFWQPs such as total suspended solids, turbidity, chemical oxygen demand can be removed by conventional pre-treatment; some such as colloidal particles and micro-organisms by modern options and even others such as endocrine disrupting compounds, pharmaceutical and personal care products are still challenging for current pre-treatments. These foulants need to be identified properly to integrate appropriate pre-treatments for minimizing fouling potentiality to increase water recovery at minimal costs. <br /