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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 updated report on image guided radiation therapy (IGRT) is part of a series of consensus-based white papers previously published by the American Society for Radiation Oncology addressing patient safety. Since the first white papers were published, IGRT technology and procedures have progressed significantly such that these procedures are now more commonly used. The use of IGRT has now extended beyond high-precision treatments, such as stereotactic radiosurgery and stereotactic body radiation therapy, and into routine clinical practice for many treatment techniques and anatomic sites. Therefore, quality and patient safety considerations for these techniques remain an important area of focus.The American Society for Radiation Oncology convened an interdisciplinary task force to assess the original IGRT white paper and update content where appropriate. Recommendations were created using a consensus-building methodology, and task force members indicated their level of agreement based on a 5-point Likert scale from "strongly agree" to "strongly disagree." A prespecified threshold of ≥75% of raters who selected "strongly agree" or "agree" indicated consensus.This IGRT white paper builds on the previous version and uses other guidance documents to primarily focus on processes related to quality and safety. IGRT requires an interdisciplinary team-based approach, staffed by appropriately trained specialists, as well as significant personnel resources, specialized technology, and implementation time. A thorough feasibility analysis of resources is required to achieve the clinical and technical goals and should be discussed with all personnel before undertaking new imaging techniques. A comprehensive quality-assurance program must be developed, using established guidance, to ensure IGRT is performed in a safe and effective manner. As IGRT technologies continue to improve or emerge, existing practice guidelines should be reviewed or updated regularly according to the latest American Association of Physicists in Medicine Task Group reports or guidelines. Patient safety in the application of IGRT is everyone's responsibility, and professional organizations, regulators, vendors, and end-users must demonstrate a clear commitment to working together to ensure the highest levels of safety.

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.

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

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

The use of administrative databases and clinical registries in lower extremity arthroplasty research is growing. Such observational studies are unable to fully control for confounders and cannot establish causality. However, many authors use causal language when describing their aims or findings, potentially misleading readers. We examined the prevalence of causal language and inferences in the lower extremity arthroplasty literature.We systematically identified administrative database and registry studies on hip and knee arthroplasty that were published in 4 orthopaedic journals in 2020. Papers were graded independently by two reviewers for the presence of causal language in both the title and abstract as well as the full text. Chi-squared analyses were conducted to determine the relationship between the causality grading and article characteristics including the journal of publication.Of 116 eligible articles, we classified 79.3% of titles and abstracts as either consistently causal or inconsistently causal, with only 20.7% as consistently non-causal. A total of 40.5% of full texts were consistently causal, 49.1% were inconsistent, and 10.3% were consistently non-causal. Chi-squared analyses revealed no statistically significant association between the title and abstract's grading and the journal (p = .720), nor with the use of a database or registry (p = .716).Causal language and inferences were present in 79.3% of titles and abstracts of lower extremity arthroplasty observational database studies published in 2020. The high prevalence of causal language and inferences in the arthroplasty literature may mislead readers.

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.

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.

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.