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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

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.

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.

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.

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.

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.

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.

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

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.

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.

With the increased awareness of reusing solid wastes for higher sustainability and the concern of water pollution associated with phosphorus over-emission, there are strong interests in developing solid waste based adsorbents for purifying phosphorus-containing wastewater. As a rich calcium resource, paper mill sludge (i.e., a major solid waste from pulping industry) can be used as phosphorus removal adsorbent after calcination. Thus, in this work, a simple and clean thermally treating route has been proposed for preparing calcium-containing biochar from paper mill sludge. The effect of the physicochemical properties of paper mill sludge and its carbonization condition on phosphorus adsorption has been analyzed. Moreover, the influence of some key adsorption parameters, e.g., biochar dosage, initial pH of solution, co-existing anions, initial phosphorus concentration and contact time has also been investigated. The results showed that the phosphorus adsorption data could be fitted well with pseudo-second-order kinetic and Langmuir isothermal models. The calculated maximum adsorption capacity of the as-prepared optimal calcium-containing biochar could reach to 68.49 mg·g−1 at 25 °C. Combined with the characterization results, it can be reasonably inferred that the adsorption process was chemisorption-dominated. Lastly, the application of this spent adsorbent in agriculture field has also been discussed. In brief, this work provided a feasible strategy for converting paper mill solid waste to an environmental functional material (i.e., calcium-rich biochar) for remediation of eutrophic water.

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.

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.

Construction sludge frequently has high alkalinity after its generation or during the intermediate treatment process. The aim of this study is to experimentally investigate the potential of combining accelerated carbonation and a paper sludge ash-based stabilizer (PSAS) to neutralize the alkalinity of construction sludge in a short period and to improve its strength for use as a recycled material. The experimental results indicate that the addition of a PSAS significantly granulated the alkaline sludge, and once granulated, the PSAS successfully accelerated the pH neutralization of the alkaline sludge. It was also found that the decrease in dry density ρd and the degree of saturation Sr of the PSAS-treated sludge was able to reduce the period required for the pH neutralization, tN. The decrease in ρd is thought to allow fresh CO2 gas to penetrate the specimen more easily. However, if Sr is below a certain limit, it does not strongly facilitate the reduction of tN. This implies that pH neutralization cannot be accelerated when the amount of water in the sludge is below a certain level. Moreover, it was found that mean particle diameter D50 also affected tN. The strength development of the PSAS-treated sludge was evaluated using a series of cone index tests. It was found that the strength of the alkaline sludge without the PSAS was significantly decreased by accelerated carbonation, but was significantly increased even after accelerated carbonation when the PSAS was present. Due to the porosities of the remaining PS ash particles, most of the contribution of the water absorption and retention performance of the PSAS to the strength development of the PSAS-treated sludge was secured after accelerated carbonation. In addition, the granulated particles of the PSAS-treated sludge retained their granular shape to some extent. Therefore, it is presumed that the friction and interlocking of the particles did not decrease significantly. It was also found that, after carbonation, the qc of the PSAS-treated sludge increased more rapidly than that of the alkaline sludge without the PSAS. A further detailed examination of the test results showed that under air-curing conditions, the qc of the treated sludge with accelerated carbonation increased relatively gradually compared to that of the treated sludge without accelerated carbonation.

Objective The objective of this study was to develop the first edition of a Chinese evidence-based position paper on the management of oral leukoplakia (OLK). Study Design The consultant group for drafting the position paper consisted of 31 oral medicine specialists and 2 evidence-based medicine specialists. English studies (searched in PubMed, EMBASE, and the Cochrane Library) and Chinese studies (searched in China National Knowledge Infrastructure and WanFang) published before January 2018 were used. The quality of the study was assessed using the Grading of Recommendations Assessment, Development, and Evaluation grid, and the strength of the recommendations was determined based on the results of 3 rounds of voting among the consultant group members using the Delphi method. Results Twenty-two evidence-based guidelines for clinical management and monitoring of OLK were established in this position paper. A clinical path diagram for oral health practitioners was constructed based on the recommendations. Conclusion Current evidence suggests that management and monitoring of patients with OLK should be performed by experienced clinicians to control the lesion and for early detection of malignant transformation. However, all recommendations are based on evidence of low or extremely low quality and may require further modification as new evidence is produced.

Funding Information: The financial support of the Austrian Federal Ministry of Digital and Economic Affairs and the National Foundation for Research, Technology and Development , Austria, is gratefully acknowledged. We also thank the industrial partners Mondi, Canon Production Printing, Kelheim Fibres, and SIG Combibloc for their support. Publisher Copyright: © 2021 Copyright: Copyright 2021 Elsevier B.V., All rights reserved. Hydrophobization of cellulosic materials and particularly paper products is a commonly used procedure to render papers more resistant to water and moisture. Here, we explore the hydrophobization of unsized paper sheets via the gas phase. We employed three different compounds, namely palmitoyl chloride (PCl), trifluoroacetic anhydride/acetic anhydride (TFAA/Ac2O)) and hexamethyldisilazane (HMDS) which were vaporized and allowed to react with the paper sheets via the gas phase. All routes yielded hydrophobic papers with static water contact angles far above 90° and indicated the formation of covalent bonds. The PCl and TFAA approach negatively impacted the mechanical and optical properties of the paper leading to a decrease in tensile strength and yellowing of the sheets. The HMDS modified papers did not exhibit any differences regarding relevant paper technological parameters (mechanical properties, optical properties, porosity) compared to the non-modified sheets. XPS studies revealed that the HMDS modified samples have a rather low silicon content, pointing at the formation of submonolayers of trimethylsilyl groups on the fiber surfaces in the paper network. This was further investigated by penetration dynamic analysis using ultrasonication, which revealed that the whole fiber network has been homogeneously modified with the silyl groups and not only the very outer surface as for the PCl and the TFAA modified papers. This procedure yields a possibility to study the influence of hydrophobicity on paper sheets and their network properties without changing structural and mechanical paper parameters.

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.

Paper and pulp mills generate substantial quantities of cellulose-rich sludge materials that are disposed in landfills at a large scale. For sustainability purposes, sludge materials can be bioprocessed to produce renewable fuels and useful chemicals. The enzymatic hydrolysis of cellulose is the process bottleneck that affects the conversion economics directly by using zero-cost raw materials. In order to study and optimize the process, the characteristics of the sludge raw materials should be first evaluated. In this work, sludge samples were obtained from paper mills located at different locations in Wisconsin and Minnesota. Part of the sludge samples was washed (de-ashed) with hydrochloric acid while the other part remained unwashed. The samples were subjected to multiple spectroscopic analyses techniques to evaluate the morphological properties of cellulose fibers and to estimate the total structural carbohydrate content. The results showed that the de-ashing process changed some fiber characteristics and cellulose crystallinity structure in all sludge samples. Sludge sample A (obtained from Kraft pulp and recycled paper mill region) showed a high percentage of fiber, with crystalline cellulose, compared to the other two sludge samples suggesting that sludge A is a valuable source to make value-added products. Aspen Plus mass and energy calculations performed in view of the ‘zero’ cost and the reliable supply of sludge raw materials producing 2 mol H2/mol glucose. Moreover, the results showed that extracting crystalline cellulose from these sludge samples is more profitable than crystalline cellulose made from the other lignocellulosic feedstocks. The results reported here showed that the utilization of these sludge materials would be an economically attractive and promising alternative for the production of hydrogen.

This paper aimed to modify the ignitability of the bagasse paper by using talc powder, 1,3-di-aniline-2,2,2,4,4,4-hexachlorocyclodiphosph(V)azane, and nanocellulose crystal. The formation of cellulose nanocrystals (CNCs) was detected using transmission electron microscopy (TEM), X-ray diffraction (XRD). Thermal analysis as thermal gravimetric analysis (TGA) of the specimens recorded the improvement of the highest % of ash residue at 750 °C compared to the untreated one. The shape of the flame spread was studied. The ignition properties were studied for the untreated and treated specimens by limiting oxygen index (LOI) and flame chamber (UL/94), which recorded enhancing compared to the untreated specimen. This improvement was recorded either by measuring the mechanical properties (tensile strength, burst strength, elongation, and elasticity) of the specimens. The current article showed that the treated specimen was recorded the highest values compared to the untreated one in all physical, mechanical, and ignition properties, so these treatment paper sheets may be used as fire-retardant packaging materials.

Inherent hydrophilicity and poor water resistance prevent using lignocellulosic materials as green plastic al- ternatives to fossil fuel-based plastics. Here, we report a facile metal-ion-modification (MIM) route, swelling with aqueous metal ion solutions, and drying to convert conventional hydrophilic paper and wood pulp into biode- gradable hydrophobic paper and tableware without the addition of hydrophobic sizing chemicals/materials. Metal ions such as Fe3+ and Zr4+ can coordinate with pulp fibers' polar groups (i.e., OH, C-O, and COOH) that induce self-assembly of their surface fibrillated "hairy" cellulose nanofibrils to form a more compact structure with fewer available OH groups for water sorption. This decreases the surface energy of pulp fibers and increases their hydrophobicity and water resistance. Only similar to 3 mg of metal ions is needed to induce the wettability tran- sition in 1 g of kraft pulp, resulting in hydrophobic paper and tableware with water contact angles (WCAs) of 120-140 degrees. The coordinated Fe3+ and Zr4+ are stable, with negligible metal leaching during use, allowing the hydrophobic paper and tableware to be used for food packaging. This MIM technique can be integrated into the existing paper-making process for the scalable production of hydrophobic papers and tableware, providing an alternative route for developing sustainable and biodegradable plastic counterparts. Published version Public domain – authored by a U.S. government employee

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.

Intra-operative ultrasound has become a relevant imaging modality in neurosurgical procedures. While B-mode, with its intrinsic limitations, is still considered the primary ultrasound modality, intra-operative contrast-enhanced ultrasound (ioCEUS) has more recently emerged as a powerful tool in neurosurgery. Though still not used on a large scale, ioCEUS has proven its utility in defining tumor boundaries, identifying lesion vascular supply and mapping neurovascular architecture. Here we propose a step-by-step procedure for performing ioCEUS analysis of the brain, highlighting its neurosurgical applications. Moreover, we provide practical advice on the use of ultrasound contrast agents and review technical ultrasound parameters influencing ioCEUS imaging.

The World Federation for Ultrasound in Medicine and Biology (WFUMB) is addressing the issue of incidental findings (IFs) with a series of publications entitled "Incidental Imaging Findings-The Role of Medical Ultrasound." IFs are less commonly encountered in the spleen than in many other abdominal organs but remain a frequent dilemma in clinical practice. A histological diagnosis is rarely necessary for patient management. Many IFs, such as secondary spleens and splenic cysts, are harmless and do not require any further investigation. The diagnosis of many other focal splenic lesions is, however, often problematic. The following overview is intended to illustrate a variety of incidentally detected spleen pathologies such as size variants, shape variants, secondary spleens, focal splenic lesions and splenic calcifications. It should aid the examiner in establishing the diagnosis. Moreover, it should help the ultrasound practitioner decide which pathologies need no further investigation, those requiring interval imaging and cases in which immediate further diagnostic procedures are required.

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.

Starch and derivatives thereof have proven their usefulness in paper coating processes. Among these derivatives, cationic starch has been widely used in the paper industry as a flocculation, dispersion and ink fixing agent. In another context, nanoscale cellulosic materials have been shown to improve the strength, retention of fillers, the barrier properties of packaging paper products, and printing qualities. This review summarizes the recent studies on the general components used in paper coating, describes the conventional and alternative synthetic processes of cationic starches and nanocellulose, and deals with their current and potential applications in papermaking, focusing primarily on surface treatments. Moreover, environmental applications have been considered to expand the understanding and usefulness of these materials. Further research on modified polysaccharides is encouraged to replace, in a feasible way, petro-based components of coating formulations, and to provide paper surfaces with new properties.

Paper is a common material that is promising for constructing microfluidic chips (lab-on-a-paper) for diagnostics and drug delivery for biomedical applications. In the past decade, extensive research on paper-based microfluidics has accumulated a large number of scientific publications in the fields of biomedical diagnosis, food safety, environmental health, drug screening and delivery. This review focuses on the recent progress on paper-based microfluidic technology with an emphasis on the design, optimization and application of the technology platform, in particular for medical diagnostics and drug delivery. Novel advances have concentrated on engineering paper devices for point-of-care (POC) diagnostics, which could be integrated with nucleic acid-based tests and isothermal amplification experiments, enabling rapid sample-to-answer assays for field testing. Among the isothermal amplification experiments, loop-mediated isothermal amplification (LAMP), an extremely sensitive nucleic acid test, specifically identifies ultralow concentrations of DNA/RNA from practical samples for diagnosing diseases. We thus mainly focus on the paper device-based LAMP assay for the rapid infectious disease diagnosis, foodborne pathogen analysis, veterinary diagnosis, plant diagnosis, and environmental public health evaluation. We also outlined progress on paper microfluidic devices for drug delivery. The paper concludes with a discussion on the challenges of this technology and our insights into how to advance science and technology towards the development of fully functional paper devices in diagnostics and drug delivery.

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link. The enhancement of fingermarks on thermal paper can be challenging due to background staining caused by polar solvents used in fingermark enhancement techniques such as ninhydrin. This study explored a commercial one-step superglue fuming process, Lumicyano™, and Vacuum Metal Deposition (VMD) to develop fingermarks on this substrate and overcome this issue. Different sequential treatments involving Lumicyano™ and a combination of VMD methods were investigated with varying degrees of success with some sequences being highly sensitive. The VMD processes, however, were observed to generally be more effective at enhancing marks, whereas Lumicyano™ provided little or no benefit on this paper type. The results indicate that Lumicyano™ is only beneficial as a pre-treatment when the entire sequence of gold/zinc and silver/zinc is taken to completion. The gold/zinc and silver/zinc VMD processes were optimised on five different thermal papers, and the optimised techniques were then directly compared to determine which was more successful on each thermal paper type as a single treatment.

Point-of-care (POC) detection is crucial in clinical diagnosis in order to provide timely and specific treatment. Combining polyamidoamine (PAMAM) dendrimer, p-phenylene diisothiocyanate (PDITC) and superparamagnetic beads, a novel method to activate the surface of filter paper to bind DNA molecules has been developed. The method is based on the primary amination of the filter paper surface with PAMAM dendrimer, followed by generation of isothiocyanate groups via PDITC, and subsequent repetition of these two steps. Different parameters of the process have been optimized, including probe printing, preparation of target DNAs and detection. The result shows that, due to the highly porous structure of filter paper, high amounts of printed probes, target DNAs and magnetic beads can provide high signal intensities in the detection area via probe/target duplex formation. This method is suitable for rapid, specific and cost-efficient DNA detection on cellulose filter paper. It can be used as a POC device, in particular for diagnosis and treatment management of infectious diseases and identification of antimicrobial drug resistance genes.

A novel all-in-one paper-based sampling concept for mass spectrometric bottom-up protein analysis is here demonstrated in a chip format integrating instant immunocapture, protein reduction, - alkylation and tryptic digestion all in-device. Conventional laboratory grade filter paper was coated with the polymer 2-hydroxyethyl methacrylate-co-2-vinyl-4,4-dimethyl azlactone (pHEMA-VDM) with a subsequent covalent immobilization of the monoclonal antibody E27 targeting the biomarker human chorionic gonadotropin (hCG). In-device protein reduction and alkylation was optimized with regards to reagent concentration and reaction pH. The sampling concept showed a high degree of performance between 10 and 1000 ng/mL (R2 > 0.99) by a five-point calibration curve sampled with hCG spiked to human serum samples and freshly collected whole blood samples, respectively. LOD (experimentally obtained at 100 pg/mL (2.64 pM/0.9 IU/L)) was demonstrated to be up to ten times lower with more than six times faster sample preparation than what has previously been reported for on-paper analysis of hCG in human serum samples.