Search

Drug hypersensitivity reactions (DHRs) in childhood are mainly caused by betalactam or non-betalactam antibiotics, and non-steroidal anti-inflammatory drugs (NSAIDs). Laboratory tests for identifying children who are allergic to drugs have low diagnostic accuracy and predictive value. The gold standard to diagnose DHR is represented by the drug provocation test (DPT), that aims of ascertaining the causative role of an allergen and evaluating the tolerance to the suspected drug. Different protocols through the administration of divided increasing doses have been postulated according to the type of drug and the onset of the reaction (immediate or non immediate reactions). DPT protocols differ in doses and time interval between doses. In this position paper, the Italian Pediatric Society for Allergy and Immunology provides a practical guide for provocation test to antibiotics and NSAIDs in children and adolescents.

The pulp and paper (P&P) sector is a dynamic manufacturing industry and plays an essential role in the Austrian economy. However, the sector, which consumes about 20 TWh of final energy, is responsible for 7% of Austria’s industrial CO2 emissions. This study, intending to assess the potential for improving energy efficiency and reducing emissions in the Austrian context in the P&P sector, uses a bottom-up approach model. The model is applied to analyze the energy consumption (heat and electricity) and CO2 emissions in the main processes, related to the P&P production from virgin or recycled fibers. Afterward, technological options to reduce energy consumption and fossil CO2 emissions for P&P production are investigated, and various low-carbon technologies are applied to the model. For each of the selected technologies, the potential of emission reduction and energy savings up to 2050 is estimated. Finally, a series of low-carbon technology-based scenarios are developed and evaluated. These scenarios’ content is based on the improvement potential associated with the various processes of different paper grades. The results reveal that the investigated technologies applied in the production process (chemical pulping and paper drying) have a minor impact on CO2 emission reduction (maximum 10% due to applying an impulse dryer). In contrast, steam supply electrification, by replacing fossil fuel boilers with direct heat supply (such as commercial electric boilers or heat pumps), enables reducing emissions by up to 75%. This means that the goal of 100% CO2 emission reduction by 2050 cannot be reached with one method alone. Consequently, a combination of technologies, particularly with the electrification of the steam supply, along with the use of carbon-free electricity generated by renewable energy, appears to be essential.

An origami three-dimensional design of a paper-based potentiometric sensor is described. In its simplest form, this electrochemical paper-based analytical device (ePAD) is made from three small parts of the paper. Paper layers are folded on each other for the integration of a solid contact ion selective electrode (here a carbon-paste composite electrode) and a solid-state pseudo-reference electrode (here writing pencil 6B on the paper), which are in contact with a hydrophilic channel fabricated on the middle part (third part) of the paper. In this case, the pseudo-reference and working electrodes are connected to the two sides of the hydrophilic channel and hence the distance between them is as low as the width of paper. The unmodified carbon paste electrode (UCPE) and modification with the crown ether benzo15-crown-5 (B15C5) represented a very high sensitivity to Cu (II) and Cd2+ ions, respectively. The sensor responded to H2O2 using MnO2-doped carbon paste electrode (CPE). Furthermore, a biosensor was achieved by the addition of glucose oxidase to the MnO2-doped CPE and hence made it selective to glucose with ultra-sensitivity. In addition to very high sensitivity, our device benefits from consuming a very low volume of sample (10.0 µL) and automatic sampling without need for sampling devices.

Objective Communication in healthcare has influenced and been influenced by the COVID-19 pandemic. In this position paper, we share observations based on the latest available evidence and experiential knowledge that have emerged during the pandemic, with a specific focus on policy and practice. Methods This is a position paper that presents observations relating to policy and practice in communication in healthcare related to COVID-19. Results Through our critical observations as experts in the field of healthcare communication, we share our stance how healthcare communication has occured during the pandemic and suggest possible ways of improving policy and professional practice. We make recommendations for policy makers, healthcare providers, and communication experts while also highlighting areas that merit further investigation regarding healthcare communication in times of healthcare crises. Conclusion We have witnessed an upheaval of healthcare practice and the development of policy on-the-run. To ensure that policy and practice are evidence-based, person-centred, more inclusive and equitable, we advocate for critical reflection on this symbiotic relationship between COVID-19 and the central role of communication in healthcare. Practice implications This paper provides a summary of the key areas for development in communication in healthcare during COVID-19. It offers recommendations for improvement and a call to review policies and practice to build resilience and inclusive and equitable responsiveness in communication in healthcare.

Endothelial cells (ECs) are sentinels of cardiovascular health. Their function is reduced by the presence of cardiovascular risk factors, and is regained once pathological stimuli are removed. In this European Society for Cardiology Position Paper, we describe endothelial dysfunction as a spectrum of phenotypic states and advocate further studies to determine the role of EC subtypes in cardiovascular disease. We conclude that there is no single ideal method for measurement of endothelial function. Techniques to measure coronary epicardial and micro-vascular function are well established but they are invasive, time-consuming, and expensive. Flow-mediated dilatation (FMD) of the brachial arteries provides a non-invasive alternative but is technically challenging and requires extensive training and standardization. We, therefore, propose that a consensus methodology for FMD is universally adopted to minimize technical variation between studies, and that reference FMD values are established for different populations of healthy individuals and patient groups. Newer techniques to measure endothelial function that are relatively easy to perform, such as finger plethysmography and the retinal flicker test, have the potential for increased clinical use provided a consensus is achieved on the measurement protocol used. We recommend further clinical studies to establish reference values for these techniques and to assess their ability to improve cardiovascular risk stratification. We advocate future studies to determine whether integration of endothelial function measurements with patient-specific epigenetic data and other biomarkers can enhance the stratification of patients for differential diagnosis, disease progression, and responses to therapy.

Commercially available health technologies such as smartphones and smartwatches, activity trackers and eHealth applications, commonly referred to as wearables, are increasingly available and used both in the leisure and healthcare sector for pulse and fitness/activity tracking. The aim of the Position Paper is to identify specific barriers and knowledge gaps for the use of wearables, in particular for heart rate (HR) and activity tracking, in clinical cardiovascular healthcare to support their implementation into clinical care. The widespread use of HR and fitness tracking technologies provides unparalleled opportunities for capturing physiological information from large populations in the community, which has previously only been available in patient populations in the setting of healthcare provision. The availability of low-cost and high-volume physiological data from the community also provides unique challenges. While the number of patients meeting healthcare providers with data from wearables is rapidly growing, there are at present no clinical guidelines on how and when to use data from wearables in primary and secondary prevention. Technical aspects of HR tracking especially during activity need to be further validated. How to analyse, translate, and interpret large datasets of information into clinically applicable recommendations needs further consideration. While the current users of wearable technologies tend to be young, healthy and in the higher sociodemographic strata, wearables could potentially have a greater utility in the elderly and higher-risk population. Wearables may also provide a benefit through increased health awareness, democratization of health data and patient engagement. Use of continuous monitoring may provide opportunities for detection of risk factors and disease development earlier in the causal pathway, which may provide novel applications in both prevention and clinical research. However, wearables may also have potential adverse consequences due to unintended modification of behaviour, uncertain use and interpretation of large physiological data, a possible increase in social inequality due to differential access and technological literacy, challenges with regulatory bodies and privacy issues. In the present position paper, current applications as well as specific barriers and gaps in knowledge are identified and discussed in order to support the implementation of wearable technologies from gadget-ology into clinical cardiology.

The symposium "New criteria of resectability for pancreatic cancer" was held during the 33nd meeting of the Japanese Society of Hepato-Biliary-Pancreatic Surgery (JSHBPS) in 2021 to discuss the potential modifications that could be made in the current resectability classification. The meeting focused on setting the foundation for developing a new prognosis-based resectability classification that is based on the tumor biology and the response to neoadjuvant treatment (NAT). The symposium included selected experts from Western and Eastern high-volume centers who have discussed their concept of resectability status through published literature. During the symposium, presenters reported new resectability classifications from their respective institutions based on tumor biology, conditional status, pathology, and genetics, in addition to anatomical tumor involvement. Interestingly, experts from all the centers reached the agreement that anatomy alone is insufficient to define resectability in the current era of effective NAT. On behalf of the JSHBPS, we would like to summarize the content of the conference in this position paper. We also invite global experts as internal reviewers of this paper for intercontinental cooperation in creating an up-to-date, prognosis-based resectability classification that reflects the trends of contemporary clinical practice.

This White Paper provides a step-by-step approach on how to procure e-mobility solutions. Chapter 1 covers the implementation of a so-called innovation procurement. Chapter 2 covers all relevant aspects that are related to the Government Procurement Agreement (GPA) of the World Trade Organization with a link to the most relevant aspects of EU Trade Agreements that enhance the competitiveness of European companies. The chapter also presents an overview of the most recent and relevant EU initiatives to maintain a level playing field in public procurement within and across the boundaries of the EU Internal Market. Chapter 3 covers the possibilities to include social and environmental criteria within government procurements. Chapter 4 concludes on the findings of the e-Mobility paper and provides the reader with useful practices and tools to follow up on the procurement of e-mobility solutions. For the context of this White Paper, e-mobility solutions are transport solutions which are based on heavy duty vehicles with a zero-emission tailpipe pollution, which are a category under article 4 (5) of the Directive 2009/33/EC of 23 April 2009 on the promotion of clean road transport vehicles in support of low-emission mobility amended by Directive (EU) 2019/1161 of the European Parliament and of the Council of 20 June 2019

A new process for the production of bioethanol from paper mill sludge (PMS) is described in this work. PMS biomass feedstock was processed via the simultaneous saccharification and fermentation (SSF) with and without accelerants. The enzymatic hydrolysis and fermentation were first evaluated, and the energy demand was 2.2 MJ/L of produced ethanol. When the enzymatic hydrolysis and fermentation were combined, the energy demand was reduced to 1.0 MJ/L ethanol, the sugars production increased, and the overall capital cost of the process decreased. The sugar yield was improved by adding accelerant and selecting the optimal fiber recovery method. The accelerant improved the enzymatic hydrolysis via a pathing/bridging mechanism. The SSF with the chemical fiber recovery method coupled with accelerant addition would be the best process configuration. Upon this combination, the glucose profile was enhanced from 9.8 g/L to 17.0 g/L. The sludge fiber conversion by SSF was improved by selecting an efficient fiber recovery method combined with the accelerant addition. SSF in chemical fiber recovery with accelerant addition was the best process by a 10% improvement of ethanol yield. The proposed process configuration offers a lower cost and sustainable process and contributes to the circular economy of zero waste discharges.

The main aim of the study was to assess the environmental performance, through the application of the life cycle assessment, of a recycled paper production process focusing on the energy aspect. The production process occurred in a paper mill that produces packaging paper using paper and cardboard from source separation of municipal solid waste as raw materials. Two scenarios (S1 and S2) were defined by their energy supply sources. A cogeneration (CHP) system using natural gas for the combined production of thermal and electric energy was the source in S1. The Italian electricity grid (using the Italian country mix) and a natural gas boiler were the separate sources for electric and thermal energy, respectively, in S2. Finally, in order to evaluate the environmental effects on the results of the study about the variation in the natural gas supply source, four alternative Italian import mixes (M1, M2, M3, and M4) were defined by varying the contribution of the supplier countries. The environmental impacts were evaluated with ReCiPe 2016 (H) using both midpoint and endpoint approaches. The results showed that for both the scenarios, the energy consumption was the main cause of impacts mainly because of the natural gas contribution. The presence of the cogeneration (CHP) system generated significant environmental benefits compared with the use of energy provided by more conventional sources. The production and use of chemicals as well as the disposal of waste produced during the paper production were other environmental hotspots. The variation in the composition of the Italian import mix of natural gas, in terms of the supplier country’s contribution, had a significant influence on the results. The import of natural gas from Russia was the most impactful option. Since Russia is the country that contributes to the Italian import mix the most, in the next years, the use of natural gas in Italy could become increasingly impactful. Therefore, the replacement of natural gas with renewable sources is an urgent priority.

A novel miniaturized and sustainable platform exploiting two merged paper-based substrates has been applied for the programmable pre-concentration of analytes of interest and electrochemical detection of mercury traces in drinking water using printable sensor strips. This strategy represents a novel versatile possibility in merging humble materials maximizing their impacts on analytical and remediation challenges.

This work was supported by the research group "Ciencia y Cultura del Patrimonio"(HUM-1057) and the Ministerio de Economia y Competitividad in the framework of the I + D research project "Nuevas alternativas al conocimiento de los materiales y los procesos de conservacion y restauracion de obra grafica y patrimonio documental"(REF.MAT2014-58659-P). Funding for open access charge: Universidad de Granada/CBUA., This study offers a new tool to restorers to bleach paper documents: artificial light radiation (ALR). It is a controlled method that is an alternative to other highly aggressive procedures that have been applied to cellulose based media. Its main novelty is its intrinsic lighting characteristics which guarantee uniformity and avoid heating the paper. The results of testing this new tool were compared to those of bleaching with hydrogen peroxide (H2O2). Each of the two methods was applied to five different types of widely used paper: Arches and Somerset (brands serving for engraving and digital printing), Ingres (drawing), press-type (magazines and newspapers) and Bible-type (historical documents). Once characterised by physico-mechanical, chemical and optical parameters (grammage, thickness, specular gloss, optical properties, air permeance, tensile properties, determining the pH of both surface and aqueous extracts), the different papers were bleached by the two methods according to pre-established criteria. Finally, to determine the evolution and effects of the two treatments, the papers were subjected to accelerated ageing., Research group "Ciencia y Cultura del Patrimonio" HUM-1057, Spanish Government MAT2014-58659-P, Universidad de Granada/CBUA

PurposeThis position paper urges a drive towards clarity in the key definitions, terminologies and habits of speech associated with digital engineering and building information modelling (BIM). The ultimate goal of the paper is to facilitate the move towards arriving at an ideal definition for both concepts.Design/methodology/approachThis paper takes the “explanation building” review approach in providing prescriptive guidelines to researchers and industry practitioners. The aim of the review is to draw upon existing studies to identify, describe and find application of principles in a real-world context.FindingsThe paper highlights the definitional challenges surrounding digital engineering and BIM in Australia, to evoke a debate on BIM and digital engineering boundaries, how and why these two concepts may be linked, and how they relate to emerging concepts.Originality/valueThis is the first scholarly attempt to clarify the definition of digital engineering and address the confusion between the concepts of BIM and digital engineering.

Patients with heart failure (HF) who contract SARS-CoV-2 infection are at a higher risk of cardiovascular and non-cardiovascular morbidity and mortality. Regardless of therapeutic attempts in COVID-19, vaccination remains the most promising global approach at present for controlling this disease. There are several concerns and misconceptions regarding the clinical indications, optimal mode of delivery, safety and efficacy of COVID-19 vaccines for patients with HF. This document provides guidance to all healthcare professionals regarding the implementation of a COVID-19 vaccination scheme in patients with HF. COVID-19 vaccination is indicated in all patients with HF, including those who are immunocompromised (e.g. after heart transplantation receiving immunosuppressive therapy) and with frailty syndrome. It is preferable to vaccinate against COVID-19 patients with HF in an optimal clinical state, which would include clinical stability, adequate hydration and nutrition, optimized treatment of HF and other comorbidities (including iron deficiency), but corrective measures should not be allowed to delay vaccination. Patients with HF who have been vaccinated against COVID-19 need to continue precautionary measures, including the use of facemasks, hand hygiene and social distancing. Knowledge on strategies preventing SARS-CoV-2 infection (including the COVID-19 vaccination) should be included in the comprehensive educational programmes delivered to patients with HF. This article is protected by copyright. All rights reserved. [Abstract copyright: This article is protected by copyright. All rights reserved.]

Patent foramen ovale (PFO) is implicated in the pathogenesis of a number of medical conditions but to date only one official position paper related to left circulation thromboembolism has been published. This interdisciplinary paper, prepared with the involvement of eight European scientific societies, reviews the available evidence and proposes a rationale for decision making for other PFO-related clinical conditions. In order to guarantee a strict evidence-based process, we used a modified grading of recommendations, assessment, development, and evaluation (GRADE) methodology. A critical qualitative and quantitative evaluation of diagnostic and therapeutic procedures was performed, including assessment of the risk/benefit ratio. The level of evidence and the strength of the position statements were weighed and graded according to predefined scales. Despite being based on limited and observational or low-certainty randomised data, a number of position statements were made to frame PFO management in different clinical settings, along with suggestions for new research avenues. This interdisciplinary position paper, recognising the low or very low certainty of existing evidence, provides the first approach to several PFO-related clinical scenarios beyond left circulation thromboembolism and strongly stresses the need for fresh high-quality evidence on these topics.

The handling of cultural heritage objects has become a highly debated topic in the last decade. The work and outcomes described in this paper are aimed to provide objective data to assist in making appropriate decisions as to whether or not wearing gloves is appropriate in a given situation. The forensic fingermark development techniques of 1,2-indandione and single metal deposition II were used to investigate the efficacy of handwashing and glove use to improve the information available when deciding whether to use gloves when handling paper objects. It was found that fingermarks did not permeate through polymer glove types but could through cotton gloves. It was also shown that the amounts of observable fingermark residues were greater 5 min after handwashing than if handwashing had not occurred, undermining previous arguments for not wearing gloves if hands could be washed before object handling., Graphical abstract Image 1, Highlights • Fingermarks can be transferred onto paper even after washing hand. • Developed fingermark residues initially increase after handwashing. • Handwashing is not sufficient to prevent fingermark contamination of artifacts. • Fingermark residues can be transferred from surfaces to gloves to paper. • Some antibacterial gels can increase the amount of fingermark residue deposited.

Microbial dehydrogenase activity can help to determine the oxidizing capacity of activated sludge. Here we propose an innovative and automated express-method based on rapid determination of dehydrogenase activity. The measurement is based on the rate of methylene blue reduction by living microbial cells in suspension. A single analysis takes 10 min. The method was adapted for biofilms immobilized on the floating carriers of industrial bioreactors and the kinetics of biological oxidation by activated sludge and biofilms was compared. New parameters were proposed to characterize the biological oxidation under low oxygen levels. The obtained make it possible to quickly determine the dehydrogenase activity of activated sludge and biofilms and promptly monitor the effectiveness of industrial biological wastewater treatment.

In daily clinical practice, clinicians integrate available data to ascertain the diagnostic and prognostic probability of a disease or clinical outcome for their patients. For patients with suspected or known cardiovascular disease, several anatomical and functional imaging techniques are commonly performed to aid this endeavor, including coronary computed tomography angiography (CCTA) and nuclear cardiology imaging. Continuous improvement in positron emission tomography (PET), single-photon emission computed tomography (SPECT), and CT hardware and software has resulted in improved diagnostic performance and wide implementation of these imaging techniques in daily clinical practice. However, the human ability to interpret, quantify, and integrate these data sets is limited. The identification of novel markers and application of machine learning (ML) algorithms, including deep learning (DL) to cardiovascular imaging techniques will further improve diagnosis and prognostication for patients with cardiovascular diseases. The goal of this position paper of the European Association of Nuclear Medicine (EANM) and the European Association of Cardiovascular Imaging (EACVI) is to provide an overview of the general concepts behind modern machine learning-based artificial intelligence, highlights currently prefered methods, practices, and computational models, and proposes new strategies to support the clinical application of ML in the field of cardiovascular imaging using nuclear cardiology (hybrid) and CT techniques.

International audience; This paper is intended to update the former consensus between the French Societies of Radiology and Cardiology about the use of stress cardiac magnetic resonance imaging in chronic coronary syndrome, published in 2009. The Delphi method was used to build the present consensus. This expert panel consensus includes recommendations for indications, the procedure (with patient preparation), stress-inducing drugs, the acquisition protocol, interpretation and risk stratification by stress magnetic resonance imaging.

The fabrication of underwater devices is necessary for the exploration of water environments and interactions in the Human–Computer Interaction (HCI) field. However, there are fewer approaches to support prototyping used in water environments. The existing prototype methods lack systematic waterproof treatments and provide insufficient software for balance and buoyancy analysis. To address these limitations, we present ElectroPaper, a new approach for the design and fabrication of prototypes used in water environments (surface or beneath) with paper-based electronic interfaces with a crease layer, hardware distribution layer, and hollow-out layer to support physical properties, such as waterproofing, foldability, and conformability. The approach includes a computational design tool for assisting in balance analysis, three-dimensional (3D) model unfolding, and circuit drawing. We describe the design and fabrication process and provide several example applications to illustrate the feasibility and utility of our approach. ElectroPaper provides an inexpensive and effective medium for the fabrication of customized digital prototypes for water environment use.

International audience; This position paper was intended to update the former consensus between the French Societies of Radiology and Cardiology about the use of stress cardiac magnetic resonance imaging (MRI) in chronic coronary syndrome published in 2009. The Delphi method was used to build the present consensus. This expert panel consensus includes recommendations for indications, procedure with patient preparation, stress inducing drugs, acquisition protocol, interpretation and risk stratification by stress MRI.

Publisher Copyright: © 2020, The Author(s). Severe blood disorders and cancer are the leading cause of death and disability from noncommunicable diseases in the global pediatric population and a major financial burden. The most frequent of these conditions, namely sickle cell disease and severe thalassemia, are highly curable by blood or bone marrow transplantation (BMT) which can restore a normal health-related quality of life and be cost-effective. This position paper summarizes critical issues in extending global access to BMT based on ground experience in the start-up of several BMT units in middle-income countries (MICs) across South-East Asia and the Middle East where close to 700 allogeneic BMTs have been performed over a 10-year period. Basic requirements in terms of support systems, equipment, and consumables are summarized keeping in mind WHO’s model essential lists and recommendations. BMT unit setup and maintenance costs are summarized as well as those per transplant. Low-risk BMT is feasible and safe in MICs with outcomes comparable to high-income countries but at a fraction of the cost. This report might be of assistance to health care institutions in MICs interested in developing hematopoietic stem cell transplantation services and strengthening context appropriate tertiary care and higher medical education.

At the beginning of October, the member organisations of the European Association of Hospital Pharmacists (EAHP) adopted a new position paper on pharmacy preparations and compounding. The position aims at providing information about the practice of pharmacy preparations and compounding in hospitals and asks for a stronger embedment of compounding and reconstitution practices in European hospital pharmacies, linked to increasing capacity and training. The different sections of EAHP’s position paper touch on the importance of compounding for addressing patient needs, the involvement of hospital pharmacies in reconstitution practices and the role of hospital pharmacists in the preparation and use of advanced therapy medicinal products (ATMPs). Linked to personalised medication, it shares information on the engagement of hospital pharmacists and the adjustments …

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is emerging as a global pandemic outbreak. To date, approximately one million deaths and over 32 million cases have been reported. This ongoing pandemic urgently requires an accurate testing device that can be used in the field in a fast manner. Serological assays to detect antibodies have been proven to be a great complement to the standard method of reverse transcription-polymerase chain reaction (RT-PCR), particularly after the second week of infection. We have developed a specific and sensitive immunosensor for immunoglobulin detection produced against SARS-CoV-2. Unlike other lateral flow-based assays (LFAs) involving the utilization of multiple antibodies, we have reported a label-free paper-based electrochemical platform targeting SARS-CoV-2 antibodies without the specific requirement of an antibody. The presence of SARS-CoV-2 antibodies will interrupt the redox conversion of the redox indicator, resulting in a decreased current response. This electrochemical sensor was proven effective in real clinical sera from patients with satisfactory results. In addition, the proposed format was also extended to antigen detection (the spike protein of SARS-CoV-2), which presents new possibilities for diagnosing COVID-19., Highlights • Electrochemical sensor for COVID-19 diagnostic. • Serological assay for SARS-CoV-2 antibodies was demonstrated. • Sensitivity enhancement compared to the traditional LFA devices. • Applicable to real clinical sera with satisfactory results.

This study develops a framework of internal and external factors that influence the adoption of eco-innovation. We studied 80 adoption processes in the Dutch brewing industry and the Dutch paper industry and analysed the relative importance of different factors. We find that internal factors were more important than external factors. The analysis also shows differences between the industries. The financial advantage was important for both industries, but especially for the paper industry. For the brewing industry, ethical responsibility and stakeholders played a more important role in the adoption. The analysis also revealed differences for small and large firms. Ethical responsibility and stakeholders are relatively more often mentioned by small firms, whereas clear objectives and regulations were mentioned more by large firms. Our study highlights that the adoption of eco-innovation is a complex process and the position in the supply chain as well as the size of a firm influence what is important in the adoption of eco-innovation.

Tissue paper is defined by its physical and mechanical properties, namely: high softness, low grammage, high bulk and high liquid absorption capacity. It is expected that the production of tissue paper will continue to grow, which increases the importance of better understanding the processes involved in its production as well as its optimization [1] . The experimental data presented in this article, are the physical-mechanical characterization of a group of 13 industrial base tissue papers, which were collected at the end of the tissue paper machine on Portuguese factories. These samples vary in grammage, composition and creping [2] , enabling a later evaluation of the crepe type [3] and its relationship with the final properties of the tissue paper.

Paper-based microfluidic devices are an attractive platform for developing low-cost, point-of-care diagnostic tools. As paper-based devices&rsquo, detection chemistries become more complex, more complicated devices are required, often entailing the sequential delivery of different liquids or reagents to reaction zones. Most research into flow control has been focused on introducing delays. However, delaying the flow can be problematic due to increased evaporation leading to sample loss. We report the use of a CO2 laser to uniformly etch the surface of the paper to modify wicking speeds in paper-based microfluidic devices. This technique can produce both wicking speed increases of up to 1.1&times, faster and decreases of up to 0.9&times, slower. Wicking speeds can be further enhanced by etching both sides of the paper, resulting in wicking 1.3&times, faster than unetched channels. Channels with lengthwise laser-etched grooves were also compared to uniformly etched channels, with the most heavily grooved channels wicking 1.9&times, faster than the fastest double-sided etched channels. Furthermore, sealing both sides of the channel in packing tape results in the most heavily etched channels, single-sided, double-sided, and grooved, wicking over 13&times, faster than unetched channels. By selectively etching individual channels, different combinations of sequential fluid delivery can be obtained without altering any channel geometry. Laser etching is a simple process that can be integrated into the patterning of the device and requires no additional materials or chemicals, enabling greater flow control for paper-based microfluidic devices.

Background Mobile health (mHealth) tools may be useful platforms for dietary monitoring and assessment. Objective This study aims to evaluate the effectiveness of a mobile dietary self-monitoring app for weight loss versus a paper-based diary among adults with a BMI of 23 kg/m2 or above. Methods A total of 33 men and 17 women aged 18-39 years participated in a 6-week randomized controlled trial. We randomly assigned participants to one of two groups: (1) a smartphone app group (n=25) or (2) a paper-based diary group (n=25). The smartphone app group recorded foods and dietary supplements that they consumed and received immediate dietary feedback using Well-D, a dietary self-monitoring app developed by our team. The paper-based diary group was instructed to record foods or supplements that they consumed using a self-recorded diary. The primary outcomes were weight, BMI, waist circumference, body fat mass, and skeletal muscle mass. We also examined changes in nutrient intake, including energy, carbohydrate, protein, fat, dietary fiber, vitamins, and minerals, using 3-day 24-hour recalls. Differences in changes between the two groups were analyzed using independent t tests or Wilcoxon Mann-Whitney tests. All of the data were analyzed using intent-to-treat analysis. Results The mean number of days recorded was 18.5 (SD 14.1) for the app group and 15.5 (SD 10.1) for the paper-based diary group. The differences in changes in weight, BMI, and waist circumference were not significantly different between the app group and paper-based diary group (P=.33, .34, and .70, respectively). Similarly, changes in body fat mass or skeletal muscle mass did not differ between the two groups (P=.71 and .054, respectively). Although energy intake was reduced in both groups, there was no significant difference in changes in energy intake between the two groups (P=.98). Conclusions There were no differences in changes in anthropometric measures and nutrient intake between the app group and the paper-based diary group. Both mobile dietary self-monitoring app and paper-based diary may be useful for improving anthropometric measures. Trial Registration Clinical Research Information Service KCT0003170; https://cris.nih.go.kr/cris/search/search_result_st01_en.jsp?seq=11642&ltype=&rtype=

Natural materials are increasingly limited, encouraging the use of materials such as waste materials that have not been widely used for building materials or manufacturing products. Waste paper has been used as a material for the book-YRR.18 book cover through management and design approaches. The waste paper materials used are better than those used to produce this book cover: cellulose = 45.80% = pentosan 25.90% and lignin = 22.60%. Therefore, this research aims to provide product design from environmentally friendly materials and analysis of the value of its products in terms of loss-profit, so that it can be a profitable business potential for book producers in Indonesia as well as encourage book producers in Indonesia to being involved in efforts to save the environment. Keywords: Waste Paper Material; Product Value; Design Book Cover Model-YRR. 18. ABSTRAK Bahan-bahan alami yang semakin terbatas, mendorong penggunaan bahan-bahan seperti bahan limbah yang belum banyak dimanfaatkan untuk bahan bangunan atau pembuatan produk. Kertas bekas selama ini digunakan sebagai bahan pembuatan sampul buku Model -YRR.18 melalui pendekatan manajemen dan desain. Bahan limbah kertas yang digunakan lebih baik daripada yang digunakan untuk memproduksi sampul buku ini adalah: selulosa = 45,80% = pentosan 25,90% dan lignin = 22,60%. Oleh karena itu, penelitian ini bertujuan untuk memberikan desain produk dari bahan ramah lingkungan dan analisa nilai produknya dari sisi loss-profit, sehingga dapat menjadi potensi bisnis yang menguntungkan bagi produsen buku di Indonesia sekaligus terlibat dalam upaya penyelamatan lingkungan. Kata kunci : Bahan Limbah Kertas; Nilai Produk; Desain Sampul Buku Model-YRR.18.

Background Clinical free-text data (eg, outpatient letters or nursing notes) represent a vast, untapped source of rich information that, if more accessible for research, would clarify and supplement information coded in structured data fields. Data usually need to be deidentified or anonymized before they can be reused for research, but there is a lack of established guidelines to govern effective deidentification and use of free-text information and avoid damaging data utility as a by-product. Objective This study aimed to develop recommendations for the creation of data governance standards to integrate with existing frameworks for personal data use, to enable free-text data to be used safely for research for patient and public benefit. Methods We outlined data protection legislation and regulations relating to the United Kingdom for context and conducted a rapid literature review and UK-based case studies to explore data governance models used in working with free-text data. We also engaged with stakeholders, including text-mining researchers and the general public, to explore perceived barriers and solutions in working with clinical free-text. Results We proposed a set of recommendations, including the need for authoritative guidance on data governance for the reuse of free-text data, to ensure public transparency in data flows and uses, to treat deidentified free-text data as potentially identifiable with use limited to accredited data safe havens, and to commit to a culture of continuous improvement to understand the relationships between the efficacy of deidentification and reidentification risks, so this can be communicated to all stakeholders. Conclusions By drawing together the findings of a combination of activities, we present a position paper to contribute to the development of data governance standards for the reuse of clinical free-text data for secondary purposes. While working in accordance with existing data governance frameworks, there is a need for further work to take forward the recommendations we have proposed, with commitment and investment, to assure and expand the safe reuse of clinical free-text data for public benefit.

Microbial enzymes are the safe alternatives to chemical based bleaching of pulp in paper mills. For effective biobleaching, both hemicellulolytic and lignolytic enzymes are required. This study reports laccase (L) + xylanase (X) and laccase (L) + mannanase (M) enzyme concoctions for pulp biobleaching derived from Bacillus sp. LX and Bacillus sp. LM isolated from the decaying organic matter. All enzymes were thermo-alkali-stable, hence were suitable for their application in pulp biobleaching. When a mixture of L + X/L + M was used for mixedwood pulp biobleaching, 46.32/40.25% reduction in kappa number; 13.21/10.01% and 3.36/2.76% improvement in brightness and whiteness was achieved respectively. Moreover, no laccase mediator system was required in the current process. Significant changes in the structure of enzymatically treated pulp were also observed. All these properties make these concoctions of enzymes suitable for their application in pulp and paper mill.

The graphene paper microsieves can be applied in the filtration of biological fluids or separation of solid particles from exploitation fluids. To produce graphene paper microsieves for specific applications, good control over fabrication should be achieved. In this study, a laser ablation method using a picosecond laser was applied to fabricate graphene paper microsieves. Holes in the microsieves were drilled using pulsed laser radiation with a pulse energy from 5 to 100 &micro, J, a duration of 60 ps, a wavelength of 355 nm, and a repetition rate of 1 kHz. The impact method was applied using 10 to 100 pulses to drill one hole. To produce holes of a proper diameter which could separate biological particles of a certain size (&ge, 10 &micro, m), optimum parameters of graphene paper laser ablation were defined using the MATLAB software taking into account laser pulse energy, repetition rate, and a desired hole diameter. A series of structural tests were carried out to determine the quality of an edge and a hole shape. Experimental results and Laguerre&ndash, Gauss calculations in MATLAB were then compared to perform the analysis of the distribution of diffraction fringes. Optimum experimental parameters were determined for which good susceptibility of the graphene paper to laser processing was observed.

Highlights • UASB was proposed for RPMW anaerobic treatement under mesophilic conditions. • Start-up up of the UASB reactor was completed in the 24 days. • 80,76 % COD and 90 % TS were removed at an OLR of 7,27 g COD/L d. • At optimal OLR of 8.31 g COD/L d was required to produce 62.51 L/d biogas. • For HRT 15.14 h, after reactor start-up 80.63 % of COD was removed. • The average biogas composition was 72.98 % CH4, 19.76 % CO2, 0.9 % O2., The anaerobic digestion (AD) has become an alternative source and an attractive treatment method. Up-flow Anaerobic Sludge Blanket (UASB) digester has been designed to treat the Recycled paper mill wastewater (RPMW) in Morocco. This paper provides a research on anaerobic digestion of RPMW using UASB technology. The UASB digester was designed following the characterization of wastewater and the feed rate, with the volume of 70 liters. The UASB reactor treating the RPMW was operated for 130 days with minimal overload problems. The experiments were carried out in the mesophilic temperature (37 °C) at different organic loading rates (OLR). A daily analysis was performed to ensure the efficiency of the digester. In this study, the AD experiment was performed in continuous mode with an effluent inlet flow rate equal to 1 L/h. Using the optimal OLR value 5.18 g COD/Ld and with an effluent 5,7 g COD/L, a biogas yield of 92 N mL/g COD removed (at normal temperature and pressure) was obtained during the RPMW anaerobic treatment. The reactor was operated at an optimal hydraulic retention time (HRT) of 15.14 h with a biogas production volume of the optimal value 62.5 L/d. These results indicate that RPMW can be effectively treated in a UASB reactor with the advantage of producing biogas. We tested our system with RPMW, to see the production capacity of the UASB system, which the objective is to develop the system for the industrial scale.

Asthma prevalence in Italy is on the rise and is estimated to be over 6% of the general population. The diagnosis of asthma can be challenging and elusive, especially in children and the last two decades has brought evidences that asthma is not a single disease but consists of various phenotypes. Symptoms can be underestimated by the patient or underreported to the clinician and physical signs can be scanty. Usual objective measures, like spirometry, are necessary but sometimes not significant. Despite proper treatment asthma can be a very severe condition (even leading to death) however new drugs have recently become available which can be very effective in its control. Since asthma is currently thought to be caused by inflammation, a direct measure of the latter can be of paramount importance. For this purpose, the measurement of Fractional Exhaled Nitric Oxide (FENO) has been used since the early years of the current century as a non-invasive, easy-to-assess tool useful for diagnosing and managing asthma. This SIP-IRS/SIAAIC Position Paper is a narrative review which summarizes the evidence behind the usefulness of FENO in the diagnosis, management and phenotypization of asthma.

The European Position Paper on Rhinosinusitis and Nasal Polyps 2020 is the update of similar evidence based position papers published in 2005 and 2007 and 2012. The core objective of the EPOS2020 guideline is to provide revised, up-to-date and clear evidence-based recommendations and integrated care pathways in ARS and CRS. EPOS2020 provides an update on the literature published and studies undertaken in the eight years since the EPOS2012 position paper was published and addresses areas not extensively covered in EPOS2012 such as paediatric CRS and sinus surgery. EPOS2020 also involves new stakeholders, including pharmacists and patients, and addresses new target users who have become more involved in the management and treatment of rhinosinusitis since the publication of the last EPOS document, including pharmacists, nurses, specialised care givers and indeed patients themselves, who employ increasing self-management of their condition using over the counter treatments. The document provides suggestions for future research in this area and offers updated guidance for definitions and outcome measurements in research in different settings. EPOS2020 contains chapters on definitions and classification where we have defined a large number of terms and indicated preferred terms. A new classification of CRS into primary and secondary CRS and further division into localized and diffuse disease, based on anatomic distribution is proposed. There are extensive chapters on epidemiology and predisposing factors, inflammatory mechanisms, (differential) diagnosis of facial pain, allergic rhinitis, genetics, cystic fibrosis, aspirin exacerbated respiratory disease, immunodeficiencies, allergic fungal rhinosinusitis and the relationship between upper and lower airways. The chapters on paediatric acute and chronic rhinosinusitis are totally rewritten. All available evidence for the management of acute rhinosinusitis and chronic rhinosinusitis with or without nasal polyps in adults and children is systematically reviewed and integrated care pathways based on the evidence are proposed. Despite considerable increases in the amount of quality publications in recent years, a large number of practical clinical questions remain. It was agreed that the best way to address these was to conduct a Delphi exercise . The results have been integrated into the respective sections. Last but not least, advice for patients and pharmacists and a new list of research needs are included. The full document can be downloaded for free on the website of this journal: http://www.rhinologyjournal.com. ispartof: RHINOLOGY vol:58 issue:Suppl S29 pages:I-+ ispartof: location:Netherlands status: published

Madagascar undergoes, like all countries in the world, the effects of climate change. in fact, since the last 5 years, in the coastal regions and the basins, the temperature has raised from 2 to 2.5 ° and varies between 34 to 36 ° in the shadow during the rainy season and on the high hills, the temperature diminishes from 2 to 2.5 ° during the dry period and varies from 4 ° to 8 °. However, the structure of lodging of 60% of the people are not adapted to this temperature change. Particularly, in the coastal regions, the walls of the houses are made of sheet iron. The inside of these houses is very hot when the weather is hot and very cold when it is cold. The inhabitants can’t afford the houses made in bricks or breeze block and the natural sources of aggregates are in the process of exhaustion. In the other part, we have seen that tons of paper are ready to be burned at the administrative services (public treasury, public financing, universities, ...) and the newspaper publishers. So, it becomes a must to find another way to the construction materials, justifying in that case our research axis. This study aims at the developing of construction material based on recycled paper, binder and aggregate. It deals of picking up or gathering all waste of papers and outdates newspapers and transforming them into brick for building constructions. What’s more, papers have prominent thermal insulating properties. Our work is focused on the study of variants on the different manufacturing processes, the choice of binder, the preparation of the specimens with different binders and different dosages, the mechanical compression tests for different binders, the evaluation of thermal conductivity for different binders and the numerical simulation of the thermo mechanical behavior of samples. The result is a lightweight brick with good thermal insulation. Tests have also made it possible to declare that the material has acceptable mechanical properties : the compressive strength is 1.56 [N/mm2], higher than the value prescribed by the standard for lightweight concrete blocks for construction of 1.1 [N/mm2], the value of thermal conductivity is 0.114 [W/mK], ten times less conductive heat than concrete and it can replace glass wool for a double its thickness. The specific weight is 57.5 [kg/m2].The practical results were confirmed by finite element simulations.

The Heart Failure Association of the European Society of Cardiology has published a previous position paper and various guidelines over the past decade recognizing the value of palliative care for those affected by this burdensome condition. Integrating palliative care into evidence-based heart failure management remains challenging for many professionals, as it includes the identification of palliative care needs, symptom control, adjustment of drug and device therapy, advance care planning, family and informal caregiver support, and trying to ensure a good death. This new position paper aims to provide day-to-day practical clinical guidance on these topics, supporting the coordinated provision of palliation strategies as goals of care fluctuate along the heart failure disease trajectory. The specific components of palliative care for symptom alleviation, spiritual and psychosocial support, and the appropriate modification of guideline-directed treatment protocols, including drug deprescription and device deactivation, are described for the chronic, crisis and terminal phases of heart failure. Funding Agencies|Patient Forum of the European Society of Cardiology

At the end of the 20th century, the future of the paper was not very optimistic due to the development of numerical technologies. Even if some paper grades have suffered, others like packaging boards, tissue papers and speciality papers have good economic trends. Furthermore, the environmental policies contribute to the development of natural fibre based materials and also to reuse a maximum of materials. Another important point to take into account is the climate warming, the fossil resources depletion and the trade globalization. All of that leads to new potential resources in order to produce greener paper and board. This chapter highlights the origin of natural fibres which could be used in the pulp and paper business, describes briefly the pulping and papermaking processes including some aspects about the specificity of the use of annual plants and to presents some new challenges for papermakers.

Because some of the critical events during the removal of water before the dryer section on a paper machine happen very rapidly within enclosed spaces – such as wet-press nips – there have been persistent challenges in understanding the governing mechanisms. In principle, a fuller understanding of the controlling mechanisms, based on evidence, should permit progress in achieving both higher rates of production of paper and more reliable control of paper attributes. In addition, energy can be saved, reducing environmental impacts. The goal of this article is to review published work dealing both with the concepts involved in water removal and evidence upon which existing and new theories can be based. The scope of this review includes all of the papermaking unit operations between the jet coming from the headbox and the final wet-press nip of an industrial-scale paper machine. Published findings support a hypothesis that dewatering rates can be decreased by densification of surface layers, plugging of drainage channels by fines, sealing effects, flocculation, and rewetting. Ways to overcome such effects are also reviewed.

We present a rapid (

Smallpox was declared eradicated in 1980, with known seed stock retained in two high security Biosafety Level 4 laboratories in the United States and Russia. Experts agree the likelihood of theft from these laboratories is low, and that synthetic creation of smallpox is a theoretical possibility. Until 2017 it was believed that synthetic smallpox was technically too complex a task to be a serious threat. However, in 2017, Canadian scientists synthesised a closely related orthopoxvirus, horsepox, using mail order DNA and $100,000. Simultaneously, terrorist groups have declared intent to conduct biological attacks. In this context an exercise was held on August 16th 2018, with international and cross-sectoral stakeholders to review preparedness for a bioterrorism attack in the Asia-Pacific region and globally. The exercise was conducted by The National Health and Medical Research Council (NHMRC) Centre for Research Excellence, Integrated Systems for Epidemic Response, with contextual input from the Ministry of Health and Medical Services Fiji. The scenario involved a deliberate release in Fiji, followed by a larger release in a more populous Asian country. Mathematical modelling was used to underpin epidemic projections under different conditions. The exercise alternated between clinical, public health, emergency and societal responses, with participants making real-time decisions on cross-sectoral response across the region and the world. Key weak points which are influential in determining the final size and impact of the epidemic were identified (based on mathematical modelling of transmission in Fiji and globally). We identified potential gaps in preparedness for smallpox and factors which influence the severity of a smallpox epidemic. This included identifying which determinants of epidemic size are potentially within our control, and which are not. Influential factors within our control include: preventing an attack through intelligence, law enforcement and legislation; speed of diagnosis; speed and completeness of case finding and case isolation; speed and security of vaccination response, including stockpiling; speed and completeness of contact tracing; protecting critical infrastructure and business continuity; non-pharmaceutical interventions (social distancing, PPE, border control); protecting first responders; operational support and logistics; social mobilisation and risk communication. Based on discussion at the workshop between diverse stakeholders, recommendations were made to guide improved prevention, mitigation and rapid response, thus providing a holistic, cross-sectoral framework for prevention of a worst-case scenario smallpox pandemic.

The risk and outcome of deep vein thrombosis (DVT) in patients who sustained spinal cord injury (SCI) remain a challenge. We aimed to assess the incidence, risk, burden, and prophylaxis of DVT after SCI. Thirty-nine studies were identified from among 250 relevant articles based on firstly, broad criterion of DVT among SCI cases. secondly, “risk factors” impacting DVT, thirdly, published reports from apex bodies of global importance such as World Health Organization, Centre for disease control, Atlanta USA, and others were given due weightage for their authenticity. SCI is characterized by loss of motor, sensory, and autonomic function with partial or total damage of the anatomical structure leading to increased risk of thrombogenesis. SCIs present a higher risk of venous DVT constituting 9.7% of deaths in the 1st year of follow-up. Currently, prophylaxis with mechanical methods, vena cava filters and antithrombotic chemoprophylaxis in SCI are interventions for the management of DVT. DVT in SCI patients is not uncommon and needs a high index of suspicion and implementation of institutional prophylaxis protocol.

This work reports on fully integrated “sample‐in‐signal‐out” microfluidic paper‐based analytical devices (μPADs) relying on bioluminescence resonance energy transfer (BRET) switches for analyte recognition and colorimetric signal generation. The devices use BRET‐based antibody sensing proteins integrated into vertically assembled layers of functionalized paper, and their design enables sample volume‐independent and fully reagent‐free operation, including on‐device blood plasma separation. User operation is limited to the application of a single drop (20–30 μL) of sample (serum, whole blood) and the acquisition of a photograph 20 min after sample introduction, with no requirement for precise pipetting, liquid handling, or analytical equipment except for a camera. Simultaneous detection of three different antibodies (anti‐HIV1, anti‐HA, and anti‐DEN1) in whole blood was achieved. Given its simplicity, this type of device is ideally suited for user‐friendly point‐of‐care testing in low‐resource environments.

Reject fines, a waste stream of short lignocellulosic fibers produced from paper linerboard recycling, are a cellulose-rich paper mill byproduct that can be hydrolyzed enzymatically into fermentable sugars. In this study, the use of hydrolyzed reject fines as a carbon source for bacterial biosynthesis of poly(R-3-hydroxyalkanoate) (PHA) and poly(γ-glutamic acid) (PGA) was investigated. Recombinant Escherichia coli harboring PHA biosynthesis genes were cultivated with purified sugars or crude hydrolysate to produce both poly(R-3-hydroxybutyrate) (PHB) homopolymer and medium chain length-containing copolymer (PHB-co-MCL). Wild-type Bacillus licheniformis WX-02 were cultivated with crude hydrolysate to produce PGA. Both PHB and short chain-length-co-medium chain-length (SCL-co-MCL) PHA yields from crude hydrolysate were a 2-fold improvement over purified sugars, and the MCL monomer fraction was decreased slightly in copolymers produced from crude hydrolysate. PGA yield from crude hydrolysate was similarly increased 2-fold. The results suggest that sugars from hydrolyzed reject fines are a viable carbon source for PHA and PGA biosynthesis. The use of crude hydrolysate is not only possible but beneficial for biopolymer production, eliminating the need for costly separation and purification techniques. This study demonstrates the potential to divert a lignocellulosic waste stream into valuable biomaterials, mitigating the environmental impacts of solid waste disposal.

The effectiveness of ClO2 bleaching as a replacement for conventional Cl2 bleaching, which is intensively practiced in developing countries, to reduce polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) in non-wood pulp and paper mills has not been field tested. The first field study was performed to investigate PCDD/F variations when ClO2 bleaching was used as a substitute for conventional Cl2 bleaching in a non-wood pulp and paper mill. It was found that the PCDD/F toxic equivalents (TEQs) in solid and effluent samples were approximately 1.3–14.9 times lower when ClO2 bleaching was used instead of the conventional Cl2 bleaching. 2,3,7,8-Substituted tetrachlorinated dibenzofurans (2,3,7,8-TCDF) were the dominant contributors to total PCDD/F TEQs in samples from the investigated mill when using conventional Cl2 bleaching. The formation amounts of 2,3,7,8-TCDF were reduced from 1.56–2.76 pg TEQ/g to 0.02–0.32 pg TEQ/g in solid samples when ClO2 bleaching was used instead of the conventional Cl2 bleaching. The replacement of Cl2 with ClO2 might decrease the chlorination reactions of dibenzofuran as potential precursors, and thus reduce the formation amounts of 2,3,7,8-TCDF. The results could provide important knowledge for suggesting the best available technique for PCDD/F reduction for non-wood pulp and paper mills in developing countries. Keywords: PCDD/Fs, Pulp and paper mill, ClO2 bleaching, Cl2 bleaching, Persistent organic pollutants

This ESC Council on Stroke/EAPCI/EBNI position paper summarizes recommendations for training of cardiologists in endovascular treatment of acute ischaemic stroke. Interventional cardiologists adequately trained to perform endovascular stroke interventions could complement stroke teams to provide the 24/7 on call duty and thus to increase timely access of stroke patients to endovascular treatment. The training requirements for interventional cardiologists to perform endovascular therapy are described in details and should be based on two main principles: (i) patient safety cannot be compromised, (ii) proper training of interventional cardiologists should be under supervision of and guaranteed by a qualified neurointerventionist and within the setting of a stroke team. Interdisciplinary cooperation based on common standards and professional consensus is the key to the quality improvement in stroke treatment.

The COVID-19 pandemic has had a huge influence in almost all areas of life, affecting societies, economics, and health care systems worldwide. The paediatric cardiology community is no exception. As the challenging battle with COVID-19 continues, professionals from the Association for the European Paediatric and Congenital Cardiology receive many questions regarding COVID-19 in a Paediatric and Congenital Cardiology setting. The aim of this paper is to present the AEPC position on frequently asked questions based on the most recent scientific data, as well as to frame a discussion on how to take care of our patients during this unprecedented crisis. As the times are changing quickly and information regarding COVID-19 is very dynamic, continuous collection of evidence will help guide constructive decision-making.

Peanuts are Leguminosae, commonly known as the legume or pea family, and peanut allergy is among the most common food allergies and the most common cause of fatal food reactions and anaphylaxis.The prevalence of peanut allergy increased 3.5-fold over the past two decades reaching 1.4–2% in Europe and the United States. The reasons for this increase in prevalence are likely multifaceted. Sensitization via the skin appears to be associated with the development of peanut allergy and atopic eczema in infancy is associated with a high risk of developing peanut allergy.Until recently, the only possible management strategy for peanut allergy was strict allergen avoidance and emergency treatment including adrenaline auto-injector in cases of accidental exposure and reaction.This paper discusses the various factors that impact the risks of peanut allergy and the burden of self-management on peanut-allergic children and their caregivers.

In many manufacturing industries, the production process involves the production of objects and the cutting of such objects into smaller pieces in order to meet a specific demand. In the optimization of these processes, one can identify the lot sizing and the cutting stock problems. In the literature, these problems are mostly separately dealt. However, treating these two problems in an integrated approach can decrease overall costs. In this research, we deal with the coupled lot sizing and cutting stock problem. It is proposed a mathematical formulation for the production and cutting of paper based on a real case, which considers setup costs and limited machine capacity in the production process of the objects. For the solution of the proposed model, we used a column generation approach and a relax-and-fix heuristic. Computational tests were carried out in order to analyze the methodology used in the resolution of the model. The results showed to be competitive in a reasonable computational time.