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Four organic solid wastes (coffee grounds, ground nut shell, paper money sewage sludge and cork powder) have been investigated as bloating inducing agents in lightweight aggregate (LWA) manufacturing when mixed in small proportions (2.5 wt.%) with three types of clays. The pellets obtained were fired in a rotary kiln at the maximum feasible temperature for 4 min. A similar impact was observed both in the working conditions and in the properties of the LWAs, showing that the differences between said residues are not as decisive as those of the clays to which they are added. The organic wastes have played a crucial role in achieving reducing conditions inside the aggregate. Thus, their addition has led to substantial improvements both from an operational point of view, lowering the working temperature, and from a technological perspective, favoring bloating and the development of a highly porous and lightweight structure. Leachate studies have shown that the LWAs meet the regulatory limits. The outcomes of this investigation show that, in line with the precepts of the Circular Economy, the recovery of organic wastes of different nature can have a place in the production of environmentally friendly LWAs

This work was developed within the scope of project i3N (LA/P/0037/2020. I.P. N. F. Santos thanks i3N for the BPD Grant BPD/UI96/5177/2020. S. O. Pereira thanks i3N for the BPD Grant BPD/UI96/5808/2017. The authors also thank Jonas Deuermeier for the XPS measurements. Publisher Copyright: © 2022 Elsevier Ltd Laser-induced graphene from paper (paper-LIG) was applied in non-enzymatic electrochemical sensing of uric acid (UA) in human urine. Paper-LIG was formed by CO2 laser modification of paper into a 3D graphene arrangement. Kinetic analysis of paper-LIG electrodes returned effective heterogeneous electron transfer standard rate constants of 1.4 × 10−3 cm s−1 and 7.8 × 10−4 cm s−1 for [Ru(NH3)6]2+/3+ and [Fe(CN)6]4−/3− redox probes, respectively. These electrodes were able to detect and quantify uric acid in PBS within the 10–300 μM range at pH between 5.6 and 7.4. At pH 7.4, a linear response (R2 = 0.999) from 10 to 250 μM was achieved, with a limit of detection of 3.97 μM and a sensitivity of 0.363 μA cm−2 μM−1. Paper-LIG electrodes denoted adequate selectivity in synthetic urine as well as in ascorbic acid (AA) and dopamine (DA)-containing electrolytes. Determination of urinary UA content in human samples returned a concentration of c.a. 1.8–1.9 mM, within the range for healthy individuals. Recoveries of samples spiked with 50 and 100 μM UA were 100.6% and 95.4%, respectively, with satisfactory reproducibility and stability. These cheap, lightweight, flexible, and eco-friendly paper-LIG biosensors for non-enzymatic quantification of UA in human urine pave the way to widespread application in the detection of other important biomarkers. publishersversion published

The current data on climate change and environmental degradation are dramatic. The consequences of these changes are already having a significant impact on people's health. Physicians - as advocates of the patients, but also as citizens - have an ethical obligation to be involved in efforts to stop these changes. The European Federation of Internal Medicine (EFIM) strongly encourages the Internal Medicine societies and internists across Europe to play an active role in matters related to climate change and environmental degradation. At a national level, this includes advocating the adoption of measures that reduce greenhouse gas (GHG) emissions and environmental degradation and contributing to policy decisions related to these issues. At a hospital level and in clinical practice, supporting actions by the health sector to reduce its ecological footprint is vital. At the level of EFIM and its associated internal societies, promoting educational activities and developing a toolkit to prepare internists to better care for citizens who suffer from the consequences of climate change. In addition to advocating and implementing effective actions to reduce the ecological footprint of the health industry, recommending the introduction of these themes in scientific programs of Internal Medicine meetings and congresses and the pre- and postgraduate medical training. At a personal level, internists must be active agents in advocating sustainable practices for the environment, increasing the awareness of the community about the health risks of climate change and environmental degradation, and being role models in the adoption of environmentally friendly behaviour.

This article is part of a series on methods for living guidelines, consolidating practical experiences from developing living guidelines. It focuses on methods for identification, selection, and prioritisation of clinical questions for a living approach to guideline development.Members of the Australian Living Evidence Consortium (ALEC), the National Institute of Health and Care Excellence (NICE) and the US Grading of Recommendations, Assessment, Development and Evaluations (GRADE) Network, convened a working group. All members have expertise and practical experience in the development of living guidelines. We collated methods documents on prioritisation from each organisation's living guidelines, conducted interviews and held working group discussions. We consolidated these to form best-practice principles, which were then edited and agreed on by the working group members.We developed best-practice principles for 1) identification, 2) selection, and 3) prioritisation, of questions for a living approach to guideline development. Several different strategies for undertaking prioritising questions are explored.The paper provides guidance for prioritising questions in living guidelines. Subsequent papers in this series explore consumer involvement, search decisions, and methods decisions, that are appropriate for questions with different priority levels.

Flexible inkjet-printed antenna is presented. The proposed antenna is designed on a synthetic paper substrate with an area of 35 × 40 mm2 to provide frequency bands for many popular wireless applications. Simulation and measurement are used to study the performances, including the frequency bands, radiation patterns, peak gains and efficiency, of the antenna in two severely bending conditions with a curvature radius of 20 mm in the forward and backward directions. The antenna printed in photo papers material could not be fully flexible due to cracks introduced to the coating material on the surface of the photo paper. Hence, the resin coated material was only suitable for curved devices. The synthetic paper material used in this paper does not have a resin coating, therefore, the antenna does not lose its flexibility and can be bent in both the forward and backward directions without any cracks. Results show that bending in these two conditions has insignificant effects on the performances of the antenna. With a curvature radius of 20 mm in the forward direction, the measured peak gain and efficiency of the antenna are in the ranges from −3 to +2 dBi and 40% to 60%, respectively. The results together with the low cost make the antenna most suitable for many flexible 5G communications devices.

In recent years, many projects have been developed to reduce the energy consumption of buildings, both from the point of view of energy efficiency and the integration of renewable energies. However, few projects are related to the problem of integrating DER in environments dominated by high-tech equipment, the so-called ”critical loads”: data centers, railroad stations, airports, and hospitals. The European Interreg Sudoe IMPROVEMENT project aim is to renovate existing public buildings where critical loads predominate, converting them into nearly zero-energy buildings (NZEB), and for this purpose, it integrates combined cooling, heat, and power (CCHP) microgrid with renewable and other distributed energy resources (DER) like hybrid energy storage systems (ESS). With still one year to go before the end of the project, the consortium partners present in this position paper the latest progress of their respective work packages to date. info:eu-repo/semantics/publishedVersion

Producing living guidelines requires making important decisions about methods for evidence identification, appraisal and integration to allow the living mode to function. Clarifying what these decisions are and the trade-offs between options is necessary. This paper provides Living Guideline developers with a framework to enable them to choose the most suitable model for their living guideline topic, question or context.We developed this guidance through an iterative process informed by interviews, feedback and a consensus process with an international group of Living Guideline developers.Several key decisions need to be made both before commencing and throughout the continual process of Living Guideline development and maintenance. These include deciding what approach is taken to the systematic review process; decisions about methods to be applied for the evidence appraisal process, including the use of unpublished data; and selection of "triggers" to incorporate new studies into Living Guideline recommendations. In each case, there are multiple options and trade-offs.We identify trade-offs and important decisions to be considered throughout the Living Guideline development process. The most appropriate, and most sustainable, mode of development and updating will be dependent on the choices made in each of these areas.

To describe and reflect on the consumer engagement approaches used in five living guidelines from the perspectives of consumers (i.e., patients, carers, the public and their representatives) and guideline developers.In a descriptive report, we used a template to capture engagement approaches and the experiences of consumers and guideline developers in living guidelines in Australia and the UK. Responses were summarised using descriptive synthesis.One guideline used a Consumer Panel, three included two to three consumers in the guideline development group and one did both. Much of our experience was common to all guidelines (e.g., consumers felt welcome but that their role initially lacked clarity). We identified six challenges and opportunities specific to living guidelines: managing the flow of work; managing engagement in online environments; managing membership of the panel; facilitating more flexibility, variety and depth in engagement; recruiting for specific skills - although these can be built over time; developing living processes to improve and adapt consumer engagement together.Consumer engagement in living guidelines should follow established principles of consumer engagement in guidelines. Conceiving the engagement as living, underpinned by a living process evaluation, allows the approach to be developed with consumers over time.

Background: Along with demographic changes, a larger number of older adults may encounter health risks related to overweight and obesity. According to the obesity paradox, it is still uncertain whether nutritional interventions aiming at weight loss in older adults has favorable or adverse effects on health.Aims: We aim to propose an approach that can be applied in community health care settings for identifying overnutrition among older adults with overweight or obesity in order to find those who may benefit from a nutritional intervention aimed at controlling body weight and maintaining or increasing physical function and quality of life. A second aim is to substantiate the proposed approach with results from the scientific literature on nutritional interventions.Methods: The approach was developed in a stepwise, followed by a narrative literature review.Results: The approach proposed for risk screening of older adults includes BMI ≥ 25 kg/m2, minimum one physical function criterion (muscle strength or physical performance) or one metabolic criterion (presence of non-communicable disease (NCDs)). Appropriate criteria, assessment tools and cut-off values adapted to older adults in community care settings are proposed for both. A total of 10 intervention studies (13 papers) identified in the narrative literature search supports that nutritional interventions including exercise are effective for older adults with overnutrition (BMI ≥ 25) and concurrently low physical function and/or NCDs.Conclusion: An approach was proposed including screening for BMI ≥ 25, functional and NCD criterion. The approach confirmed by a narrative literature review, revealed a high heterogeneity of nutritional intervention studies in overweight and obese adults in community health care settings.

Chronic pancreatitis is associated with impaired quality of life, high incidence of comorbidities, serious complications and mortality. Healthcare costs are exorbitant. Some medical societies have developed guidelines for treatment based on scientific evidence, but the gathered level of evidence for any individual topic is usually low and, therefore, recommendations tend to be vague or weak. In the present position papers on chronic pancreatitis from the Societat Catalana de Digestologia and the Societat Catalana de Pàncrees we aimed at providing defined position statements for the clinician based on updated review of published literature and on multidisciplinary expert agreement. The final goal is to propose the use of common terminology and rational diagnostic/therapeutic circuits based on current knowledge. To this end 51 sections related to chronic pancreatitis were reviewed by 21 specialists from 6 different fields to generate 88 statements altogether. Statements were designed to harmonize concepts or delineate recommendations. Part 2 of these paper series discuss topics on treatment and follow-up. The therapeutic approach should include assessment of etiological factors, clinical manifestations and complications. The complexity of these patients advocates for detailed evaluation in multidisciplinary committees where conservative, endoscopic, interventional radiology or surgical options are weighed. Specialized multidisciplinary units of Pancreatology should be constituted. Indications for surgery are refractory pain, local complications, and suspicion of malignancy. Enzyme replacement therapy is indicated if evidence of exocrine insufficiency or after pancreatic surgery. Response should be evaluated by nutritional parameters and assessment of symptoms. A follow-up program should be planned for every patient with chronic pancreatitis. © 2021 Elsevier España, S.L.U.

Objective The purpose of this study was to develop a natural language processing (NLP) pipeline to identify incidental thyroid nodules (ITNs) meeting criteria for sonographic follow-up and to assess both adherence rates to white paper recommendations and downstream outcomes related to these incidental findings. Methods 21583 non-contrast chest CT reports from 2017 and 2018 were retrospectively evaluated to identify reports which included either an explicit recommendation for thyroid ultrasound, a description of a nodule ≥ 1.5 cm, or description of a nodule with suspicious features. Reports from 2018 were used to train an NLP algorithm called fastText for automated identification of such reports. Algorithm performance was then evaluated on the 2017 reports. Next, any patient from 2017 with a report meeting criteria for ultrasound follow-up was further evaluated with manual chart review to determine follow-up adherence rates and nodule-related outcomes. Results NLP identified reports with ITNs meeting criteria for sonographic follow-up with an accuracy of 96.5% (95% CI 96.2-96.7) and sensitivity of 92.1% (95% CI 89.8-94.3). In 10006 chest CTs from 2017, ITN follow-up ultrasound was indicated according to white paper criteria in 81 patients (0.8%), explicitly recommended in 46.9% (38/81) of patients, and obtained in less than half of patients in which it was appropriately recommended (17/35, 48.6%). Discussion NLP accurately identified chest CT reports meeting criteria for ITN ultrasound follow-up. Radiologist adherence to white paper guidelines and subsequent referrer adherence to radiologist recommendations showed room for improvement.

Lithium metal is deemed a promising anode material for the next-generation batteries with high specific energy. Unfortunately, the growth of Li dendrites and infinite volume change during cycling, caused by the "hostless" feature of metallic Li, have posed a great challenge to the commercialization of Li metal anode. The introduction of appropriate host materials for Li metal is highly desirable. In this work, a N, P dual-doped 3D carbon derived from low-cost quantitative filter paper (NPCQP) is designed and fabricated for direct using as a host for Li metal anode. The resulting NPCQP host achieves a high deposition/stripping Coulombic efficiency of above 97.5 % with a low nucleation overpotential. Moreover, the NPCQP@Li symmetric cells enable an excellent long-term cycling performance (1000 h) with an ultralow voltage hysteresis (12 mV) and stable interface behavior. When paired with the commercial LiFePO

Pseudoestrogene bisphenol A (BPA) can be important ingredient of thermochromic inks, increasingly used materials in thermal printing paper, security printing, advertising, design and as temperature indicators in medicine and food industry. BPA mass fraction in thermochromic inks can be up to several percent. Hence, disposal of items with thermochromic prints pose a risk of environmental pollution. In this work BPA mass fraction was monitored during anaerobic degradation of papers with thermochromic prints in soil in both matrices: papers and soil. The degradation conditions simulated deeper layers of waste at a landfill site. Six types of papers with prints of thermochromic ink containing 2% of BPA were subjected to anaerobic degradation over up to 150 days.

Introduction The assessment of the risk of virus transmission through papers, such as postcards, is important. However, the stability of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and influenza A virus (IAV) on different types of papers is currently unknown. Investigation of the survival time of these viruses on different types of papers will provide insights into their risk of long-distance transport by postal items. Methods We evaluated the stability of SARS-CoV-2 and IAV, mixed with a culture medium, on the surface of postcards with various coatings, including plain paper (PP), inkjet paper (IP), and inkjet photo paper (IPP). The surface structure of each paper was microscopically assessed. Results The surface structures of PP, IP, and IPP varied greatly depending on the presence or absence, and type, of coat layer, regardless of the base material. IP and IPP surfaces were less conducive to virus survival than PP surfaces, because of the difference in surface shapes. The survival times of SARS-CoV-2 on each paper were approximately 59.8 (PP), 6.5 (IP), and 9.8 h (IPP), and significantly longer than those of IAV (10.3, 1.8, and 3.3 h, respectively). Conclusions The risk of SARS-CoV-2 transmission via paper, such as postcards, is significantly higher than that of IAV transmission. While PP, IP, and IPP have the same base material, their surface structures differ, which affects viral stability. The IP and IPP surfaces are less suitable for virus survival. This study provides novel insights into the risks of viral transmission via paper.

The COVID-19 pandemic crisis, among so many social, economic and health problems, also brought new opportunities. The potential of telemedicine to improve health outcomes had already been recognised in the last decades, but the pandemic crisis has accelerated the digital revolution. In 2020, a rapid increase in the use of remote consultations occurred due to the need to reduce attendance and overcrowding in outpatient clinics. However, the benefit of their use extends beyond the pandemic crisis, as an important tool to improve both the efficiency and capacity of future healthcare systems. This article reviews the literature regarding telemedicine and teleconsultation standards and recommendations, collects opinions of Portuguese experts in respiratory medicine and provides guidance in teleconsultation practices for Pulmonologists. info:eu-repo/semantics/publishedVersion

This manuscript aimed to enhance the mechanical, thermal, and ignition properties of bagasse paper when coated with different coatings synthesized from hydroxyethyl cellulose, 1,3-di-p-toluidine-2,2,2,4,4,4-hexachlorocyclodiphosph(V)azane, Talc powder, NaHCO3, cellulose nanocrystal. The effect of these coatings on the mechanical properties was studied by measuring elongation, tensile strength, and burst strength. The stages of degradation and ash residue of the measuring specimens were determined using thermal gravimetric analysis (TGA), behind that, the ignition properties as the flame chamber (UL/94), and limiting oxygen index (LOI) was measured according to standards. These tests proved that 1,3-di-p-toluidine-2,2,2,4,4,4-hexachlorocyclodiphosph(V)azane has a direct effect on improving the mechanical characteristics and enhancing the ignition properties of the coated specimens compared to uncoated. In this study the physical, mechanical, thermal, and ignition properties of the bagasse paper sheets were enhanced by easy and low-cost method via synthesis of new coatings based on commercially available chemicals in a reasonable cost.

Laser-induced graphene (LIG) technology featuring low-cost, high-efficiency and scalability has presented great advantages in micro-supercapacitors (MSCs) fabrication. However, the limited capacitance of LIG based MSCs is still hindering their further development. Herein, we introduce joule heating as a critical in-situ treatment merged with the assembly of laser-induced graphene paper based MSCs (LIGP-MSCs) toward capacitive enhancement. By increasing heating-treatment temperature from ∼20 to 500 °C, the number of nanopores in LIGP continuously increases, attributed to the gradual decomposition of amorphous carbon components. The resulting joule-heated LIGP (J-LIGP) with improved specific surface area (160.97–533.49 m2/g) and pore volume (0.179–0.553 cm3/g) as well as superhydrophilic surface is highly suitable to be employed as J-LIGP-MSCs microelectrodes. By investigating process dependent performance, the J-LIGP-MSCs heated at 500 °C for 60 min delivers a significantly improved specific areal capacitance (CA) of 13.71 mF/cm2 at 10 mV/s, which is approximately six-fold higher than that of unheated LIGP-MSCs. By further exploring and optimizing the process efficiency, J-LIGP-MSCs with a CA of 12.61 mF/cm2 has been achieved by 550 °C heating for only 5 min. Along with superior mechanical flexibility, cyclability and structural modularity, the proposed in-situ joule heating treatment is finally proved to be a universal approach for consistently enhancing the CA of LIG based MSCs processed under various chemical modifications.

Antimicrobial stewardship programs (ASPs) have made immense strides in optimizing antibiotic, antifungal, and antiviral use in clinical settings. However, although ASPs are required institutionally by regulatory agencies in the United States and Canada, they are not mandated for transplant centers or programs specifically. Despite the fact that solid organ transplant recipients in particular are at increased risk of infections from multidrug-resistant organisms, due to host and donor factors and immunosuppressive therapy, there currently are little rigorous data regarding stewardship practices in solid organ transplant populations, and thus, no transplant-specific requirements currently exist. Further complicating matters, transplant patients have a wide range of variability regarding their susceptibility to infection, as factors such as surgery of transplant, intensity of immunosuppression, and presence of drains or catheters in situ may modify the risk of infection. As such, it is not feasible to have a “one-size-fits-all” style of stewardship for this patient population. The objective of this white paper is to identify opportunities, risk factors, and ASP strategies that should be assessed with solid organ transplant recipients to optimize antimicrobial use, while producing an overall improvement in patient outcomes. We hope it may serve as a springboard for development of future guidance and identification of research opportunities.

Mitigation of global warming, energy security and industrial competitiveness urge the energy-intensive pulp and paper industry (PPI) to transform energy use practices. This study investigates how the PPI has responded to the need for the energy transition in the 2000s. Finland and Sweden as forerunners of energy-efficient operation and decarbonization of the PPI are used as target countries. Understanding of changes in energy consumption is complemented using decomposition analysis (Logarithmic Mean Divisia Index Method) and the energy efficiency index approach. Analysis of companies’ investments in energy technologies is used for explaining changes in energy production. Evidence of significant development towards the more sustainable operation of the PPI was found. Energy consumption per produced unit has decreased, i.e., energy efficiency has improved. Fossil fuels have been partially replaced with bio-based alternatives. Thus, the CO2 intensity has decreased substantially. The generation of renewable electricity has increased in both countries. Examples of Finland and Sweden indicate that the PPI has great potential to contribute to CO2 emission reduction worldwide in the future as energy efficiency can be further improved, and the share of fossil fuels can be decreased increasing the use of biofuels and self-generated green electricity at least in kraft pulp mills.

Palliative radiation therapy (pRT) is an effective tool for people with incurable cancer, in the treatment of many cancer-related symptoms such as pain, bleeding and dyspnea. As utilization rates for palliative radiation therapy increase, the demands on the healthcare system continue to grow. Radiation Therapists with advanced knowledge, skills and judgements began demonstrating their ability to practice autonomously in 2004, with the development of the Clinical Specialist Radiation Therapist (CSRT) role. Since this time, CSRTs with a specific focus in pRT (pCSRT) have been increasing in both numbers as well as their positive effects on the cancer care system. Integrating a pCSRT into the existing pRT system has resulted in increased access to and quality of pRT being delivered to palliative cancer patients. The benefits of the addition of pCSRTs to the cancer care system include increasing system capacity and increasing quality of care. This white paper provides information related to the improvements that can be realized in a RT program related to the care and treatment of its palliative patients by adding a pCSRT to the interprofessional healthcare team and suggest it as one of many strategies that can be undertaken to make improvements to access and quality of care.

Neonatal and infantile cholestasis (NIC) can represent the onset of a surgically correctable disease and of a genetic or metabolic disorder worthy of medical treatment. Timely recognition of NIC and identification of the underlying etiology are paramount to improve outcomes. Upon invitation by the Italian National Institute of Health (ISS), an expert working grouped was formed to formulate evidence-based positions on current knowledge about the diagnosis of NIC. A systematic literature search was conducted to collect evidence about epidemiology, etiology, clinical aspects and accuracy of available diagnostic tests in NIC. Evidence was scored using the GRADE system. All recommendations were approved by a panel of experts upon agreement of at least 75% of the members. The final document was approved by all the panel components. This position document summarizes the collected statements and defines the best-evidence diagnostic approach to cholestasis in the first year of life.

A novel paper-based analytical device (PAD) was prepared and applied to determine the xanthine oxidase (XOD) inhibitory activity of Salvia miltiorrhiza extracts. First, polycaprolactone was 3D printed on filter paper and heated to form hydrophobic barriers. Then the modified paper was cut according to the specific design. Necessary reagents including XOD for the colorimetric assay were immobilized on two separate pieces of paper. By simply adding phosphate buffer, the reaction was performed on the double-layer PADs. Quantitative results were obtained by analyzing the color intensity with the specialized device system (including a smartphone, a detection box and sandwich plates). The 3D-printed detection box was small, with a size of 9.0 cm × 7.0 cm × 11.5 cm. Color component G performs well in terms of linearity and detection limits and thus was identified as the index. The reaction conditions were optimized using a definitive screening design. Moreover, a 10 % glycerol solution was found to be a suitable stabilizer. When the stabilizer was added, the activity of XOD could be maintained for at least 15 days under 4 °C or -20 °C storage conditions. The inhibitory activity of Salvia miltiorrhiza extracts was investigated and compared to that of allopurinol. The results obtained with the PADs showed agreement with those obtained with the microplate method. In conclusion, the proposed PAD method is simple, accurate and has potential for point-of-care testing. It also holds promise for use in rapid quality testing of medicinal herbs, intermediate products, and preparations of traditional Chinese medicines.

Made available in DSpace on 2022-04-29T08:31:12Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-10-01 Organization and planning of reverse logistics networks make sustainable processes more efficient. Thus, an important sector for connecting the collection and waste paper recycling echelons is the intermediate center. In this study, a Mixed Integer Linear Programming model, which is multi-objective, multi-product, multi-level and multi-period, was developed to optimize the waste paper logistics processes of intermediate centers. The formulation includes the following echelons: collection, considering vehicle routing with different capacities; inventory of non-baling materials; baling sorted waste and inventory of bales; selling bales; disposal of non-recyclable waste. The aims of the model include: maximizing the collected waste; minimizing distances; maximizing both the production and sale of bales, and minimizing costs. According to research carried out in the literature, the developed model is a new proposal and to implement it, the Weighted Goal Programming and Revised Multi-Choice Goal Programming approaches were used to deal with multiple objectives and incorporate uncertainty into the quantity of waste available for collection. To analyze the proposed model, computational tests were executed with instances based on real data from a Brazilian company in the sector. For all performed tests, General Algebraic Modeling System 23.6.5 modeling language and CPLEX 12.2.0.2 solver were used for modeling and optimization. The results show that this study presents formulation and technological approaches that represent real situations and provide competitive solutions to the problem. Sáo Paulo State University “Júlio de Mesquita Filho” [Universidade Estadual Paulista Júlio de Mesquita Filho] School of Engineering of Guaratinguetá [Faculdade de Engenharia de Guaratinguetá] Production Department, Av. Ariberto Pereira da Cunha, 333, Portal das Colinas Agulhas Negras Military Academy [Academia Militar das Agulhas Negras] Rodovia Presidente Dutra, km 306, s/n Escola Preparatória de Cadetes do Exército Avenida Papa Pio XII 350 Jardim Chapadão Campinas - SP Brazil, Avenida Papa Pio XII, 350, Jardim Chapadão, Campinas - SP Sáo Paulo State University “Júlio de Mesquita Filho” [Universidade Estadual Paulista Júlio de Mesquita Filho] School of Engineering of Guaratinguetá [Faculdade de Engenharia de Guaratinguetá] Production Department, Av. Ariberto Pereira da Cunha, 333, Portal das Colinas

This white paper was developed to provide leukapheresis guidance for the collection of mononuclear cells from adult and pediatric patients who are destined for immune effector cell (IEC) therapies for commercial and research applications. Currently, there is considerable variability in leukapheresis processes and limited published information regarding best practices relevant to new cellular therapies, especially IECs. Herein the authors address critical leukapheresis questions in five domains to help guide consistent collection processes and ensure high-quality products. The first four domains are onboarding, pre-collection, collection and post-collection, with protocol feasibility, preparation, care and follow-up of the patient/donor at each step, respectively, and technical considerations during collection. The fifth domain of quality assurance focuses on ensuring product potency, purity, safety and auditing.The American Society for Apheresis (ASFA) Clinical Applications Committee (IEC Therapy Subcommittee) was charged by the society's board of directors with working collaboratively with other ASFA committees and organizations, including the Foundation for the Accreditation of Cellular Therapy, Association for the Advancement of Blood and Biotherapies, American Society for Transplantation and Cellular Therapy, National Marrow Donor Program and International Society for CellGene Therapy, to develop guidelines regarding leukapheresis collection of cells destined for the manufacture of IEC therapies. After a review of the literature and discussion with members of the involved committees and various institutions, a draft guidance was created and circulated for comment and revision.Critical aspects of apheresis that could affect the quality and quantity of the leukapheresis product were identified. These areas were then discussed and reviewed. After consensus, the best practice guidelines were proposed and accepted.In the current era of rapid growth of IEC therapies, it is important to address critical leukapheresis steps to provide high-quality products and more consistent practices and to eliminate redundant efforts.

Preoperative planning constitutes a fundamental tool in the management of fractures; however, its practical application is far from the desired, perhaps due to the absence of a basic and simple method, adapted to the current times. We describe a digital planning method, halfway the traditional and the technological, which preserves its educational essence, allows for the understanding of the fracture and the individualisation of the osteosynthesis.After the initial analysis of the fracture and the patient's characteristics, different measurements are made on X-ray and CT images with a digital medical imaging software. These images are then copied into a presentation programme (Microsoft® PowerPoint or Keynote ©Apple Inc.), in which the main fragments and fracture lines are traced with the computer pointer. These are subsequently moved into a reduced position and the implants for internal fixation are graphically represented together with a guide of the surgical strategy.We show 4 cases of different types of fractures operated through reduction and osteosynthesis after preoperative planning according to the described method. The basic points for the surgical planning, logistics, tactics and postoperative radiological results of each case are detailed.Despite the rise of advanced planning software, traditional paper and pencil methods are still fundamental, even more so for the trauma surgeon in training. The digital planning method described is very appropriate for this purpose, as it combines the advantages of both methods: simplicity, accessibility, quickness, low cost, reproducibility, educational character, efficiency and possibility of simulation, corrections and reuse of cases.

In those cases where construction-generated soils with high water contents are used as filling or embankment materials, it is sometimes difficult to satisfy the specified compaction degrees. Recently, soil stabilization using a paper sludge ash-based stabilizer (PSAS) has been developed. Paper sludge (PS) ash is waste generated by the incineration of PS discharged from paper mills. It has been found that PS ash can absorb and retain excess water; and therefore, PS ash can simultaneously improve the stability of muds when it is mixed with them. However, the current mixture design approach for PSAS-treated soils is only applicable to muds with water contents exceeding the liquid limits and cannot be applied to construction-generated soils in which the coarse fraction is dominant. Therefore, this study evaluated the effects of a PSAS on the compaction and mechanical characteristics of coarse-grained soils to use them as materials for irrigation earth dams. A series of compaction tests were conducted on two types of soil samples treated with a PSAS to investigate its effects on the compaction characteristics. The compaction characteristics obtained from the tests were assessed considering the water absorption and retention performance of the PSAS. It was found that the modified optimum water content w*opt of the treated samples, which was evaluated using the amount of water unabsorbed and unretained by the PSAS, was almost equal to the wopt of the untreated samples. Consequently, a new mixture design approach was proposed based on the compaction characteristics. The calculated results successfully demonstrated that, if the compaction curve of an untreated sample and the water absorption and retention ratio, Wab, of the PSAS corresponding to a certain curing period are obtained, the range in the PSAS addition amount, APS1m3, required to attain the targeted compaction degree, (Dc)target, for the curing period can be estimated without conducting compaction tests on the treated samples. Finally, the strength characteristics of the treated samples prescribed by the proposed mixture design method were investigated by conducting CBR tests and CU ¯ TC tests. Based on the test results, discussions were made on the contribution of the proposed mixture design to the strength development of the treated samples and on the development mechanism.

SARS-CoV-2 pandemic has changed across the last 2 years. The development and approval of SARS-CoV-2 vaccines and the emergence of new variants has opened up a new scenario. On this regard, Spanish Society of Nephrology (S.E.N.) Council considers that an update of the previous recommendations should be performed. In the present statement, and taking into account the current epidemiological situation, are included updated recommendations of protection and isolation for patients on dialysis programs.