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The prevalence of diabetes has increased over the past years. Therefore, developing minimally invasive, user-friendly and cost-effective glucose biosensors is necessary especially in low-income and developing countries. Cellulose paper-based analytical devices have attracted the attention of many researchers due to affordability, not requiring trained personnel, and complex equipment. This paper describes a microfluidic paper-based analytical device for the detection of glucose in tear with the naked eye. The paper-based biosensor fabricated by laser CO2, and GOx/HRP enzymatic solution coupled with TMB was utilized as reagents. A sample volume of 10 µl was needed for the biosensor operation and the results were observable within 5 minutes. To evaluate the device performance, color intensity-based and distance-based results were analyzed by ImageJ and Tracker. Distance-based results showed a linear behavior in the range of 0.1–0.6 mM with an R2 = 0.967 and LOD of 0.2 mM. The results could be perceived by the naked eye without any need to further equipment or trained personnel in a relatively short time (3–5 minutes). Moreover, glucose concentration could be obtained non-invasively by tears collected by this µPAD.

We demonstrated the thermally robust reduced graphene oxide (rGO)/boron nitride nanotube (BNNT) papers and their application in electromagnetic interference shielding. In order to overcome the thermal durability shortcomings of electromagnetic wave shielding paper based on rGO nanomaterial, rGO/BNNT electromagnetic interference (EMI) shielding paper having excellent thermal durability could be manufactured using BNNT nanomaterials having excellent chemical and thermal stability at high temperature. With the addition of a little BNNT, the durability against temperature can be increased by more than two times while there is little reduction in EMI performance.

Graphical abstract Enzyme-linked immunosorbent assay (ELISA) is widely used for the detection of disease biomarkers. However, it utilizes time-consuming procedures and expensive instruments, making it infeasible for point-of-care (POC) analysis especially in resource-limited settings. In this work, a multicolorimetric ELISA biosensor integrated on a paper/polymer hybrid microfluidic device was developed for rapid visual detection of disease biomarkers at point of care, without using costly equipment. This multicolormetric ELISA platform was built on multiple distinct color variants resulted from the catalytic oxidation of 3,3′,5,5′-tetramethylbenzidine (TMB) and the etching of gold nanorods (AuNRs). The vivid color changes could be easily distinguished by the naked eye, and their red mean values allowed quantitative biomarker detection, without using any sophisticated instruments. When this multicolorimetric ELISA was integrated on a paper/polymer hybrid analytical device, it not only provided integrated processing and high portability but also enabled fast assays in about 50 min due to the unique advantages of paper/polymer hybrid devices. The limit of detection of 9.1 ng/μL of the hepatitis C virus core antigen, a biomarker for hepatitis C, was achieved using this multicolorimetric ELISA platform. This multicolor ELISA analytical device provides a new versatile, user-friendly, affordable, and portable immunosensing platform with high potential for on-site detections of various viruses, proteins, and biomarkers for low-resource settings such as at home, public venues, rural areas, and developing nations. Supplementary Information The online version contains supplementary material available at 10.1007/s00216-021-03359-8.

The study aimed at the use of char produced during pyrolysis of mix plastic waste. It further focused on producing activated carbon from char and also found its efficacy as efficient adsorbent for treatment of pulp and paper mill wastewater. The activated carbon was characterized in comparison with raw char for their physical, surface and adsorptive properties. Batch type adsorption experiments were carried out using 100 ml wastewater to observe the individual effectiveness using five different variables such as adsorbent dose (0.25–2.0 g), pH (6–10), time (5–24 h), agitation speed (100–200 rpm) and temperature (30–50 °C) by keeping other variables constant which helped to find out the effective range of all the variables. The competency was evaluated on the basis of colour and lignin content of pulp and paper industry wastewater. Once the effective range of different variables was identified, the statistical analysis was conducted to monitor the mutual impact on the reduction in colour and lignin contents in wastewater. From the statistical design applied, the best result was obtained at activated carbon dose (1.25 g), pH (8.0), contact time (7 h), agitation speed (184 rpm) and temperature (40 °C). The study resulted in reduction of 96.48% in colour and 94.25% in lignin at optimized condition in comparison with 87.37 and 80.44%, respectively, at unoptimized conditions. A potential increase in reduction of 9.0% in colour and 14.0% in lignin content was achieved after optimization through statistical design that confirmed its usefulness.

A simple electrochemical approach has been strategically developed for in situ generations of ZnO nanoparticles using Zn rods as electrodes and hydrogen peroxide as the oxidant without the formation of any by-product. These ZnO nanoparticles were extended for remediation of pollutants present in paper mill effluents, and separation efficiency was found to be above 90% for hydrocarbons, 92% for lignin, 99% for phenol, and 93% of chemical oxygen demand (COD), as confirmed by gas chromatography-mass spectrometry and COD analysis. It was also observed that the experimental setup could successfully remove 99% of the color from the sample. These ZnO nanoparticles have been proven in the past to be antibacterial and were explored for its ability to inhibit the growth of both Gram-positive and Gram-negative bacteria in the effluent samples after the removal of toxic pollutants. Therefore, we proposed an electrochemical reaction for the in situ synthesis of ZnO nanoparticles for remediation of paper mill effluent as well as inhibit the bacterial growth in the treated effluent sample.

In this study, Taguchi experimental design was used to the optimize operating parameters for the degradation of paper mill effluent using electrochemical (EC) process with two-dimensional concentric aluminum tube electrodes (CATE). For this purpose, four significant experimental factors were used in four levels pH (6–9), electrolysis time (10–40 min), voltage (6–12 V) and surface area (357–624 cm(2)). The process parameters were optimized, through performing L16 orthogonal array of Taguchi technique, for the removal of chemical oxygen demand (COD) and turbidity. The percent COD and turbidity reductions were transferred into an accurate S/N ratio for a larger value is the better (LBT) response. The study presents a unique method of finding optimum combination of process parameters to illustrate their effect on the turbidity and COD reduction. The treatment conditions for the maximum elimination of the pollutants were second level of pH (7), third level of ET (30 min), fourth level of voltage (12 V) and second level of surface area (446 cm(2)). The confirmation experiment results were within the confidence intervals (CI) indicating an acceptable agreement between predicted and observed values. Based on the p-values, the electrolysis time and voltages were found to be the most significant factors for both COD and turbidity reduction. The findings of research indicated, that the Taguchi method can be used successfully for the treatment of paper industry effluent by electrochemical technique.

Malnutrition, muscle loss, and cachexia are prevalent in cancer and remain key challenges in oncology today. These conditions are frequently underrecognized and undertreated and have devastating consequences for patients. Early nutrition screening/assessment and intervention are associated with improved patient outcomes. As a multifaceted disease, cancer requires multimodal care that integrates supportive interventions, specifically nutrition and exercise, to improve nutrient intake, muscle mass, physical functioning, quality of life, and treatment outcomes. An integrated team of healthcare providers that incorporates societies’ recommendations into clinical practice can help achieve the best possible outcomes. A multidisciplinary panel of experts in oncology, nutrition, exercise, and medicine participated in a 2-day virtual roundtable in October 2020 to discuss gaps and opportunities in oncology nutrition, alone and in combination with exercise, relative to current evidence and international societies’ recommendations. The panel recommended five principles to optimize clinical oncology practice: (1) position oncology nutrition at the center of multidisciplinary care; (2) partner with colleagues and administrators to integrate a nutrition care process into the multidisciplinary cancer care approach; (3) screen all patients for malnutrition risk at diagnosis and regularly throughout treatment; (4) combine exercise and nutrition interventions before (e.g., prehabilitation), during, and after treatment as oncology standard of care to optimize nutrition status and muscle mass; and (5) incorporate a patient-centered approach into multidisciplinary care.

This work analyzes the energy performance implications of the physicochemical properties and the mineralogical elemental composition of agro-industrial wastes in the form of pellets (ISR pellets) and pine bark chips (PBCh). ISR pellets were made from a mixture of industrial wastewater treatment plant (IWTP) primary sludge, coal boiler ashes (CBA), and wood waste chips (WW), which are wastes rich in inorganic material and with a usable energy potential. All these residues were obtained from the production processes of paper company (Smurfit Kappa Colombia). ISR pellets and PBCh were tested as individual and mixed fuels in the thermochemical gasification and combustion processes. Several synergistic effects were found through the co-processing of these fuels, resulting in improvements in the performance indices normally used for the energy assessment of waste, as well as substantial environmental impact and operational behavior improvements. These effects were predicted through fusibility correlations from the elemental composition of the inorganic content, particularly the low melting point salts precursor species and fusibility temperature, as developed for coal ashes. The results of experimental co-processing validated these predictions.

Background Coronavirus Disease 2019 (COVID-19), firstly reported in China last November 2019, became a global pandemic. It has been shown that periods of isolation may induce a spike in alcohol use disorder (AUD). In addition, alcohol-related liver disease (ALD) is the most common consequence of excessive alcohol consumption worldwide. Moreover, liver impairment has also been reported as a common manifestation of COVID-19. Aims The aim of our position paper was to consider some critical issues regarding the management of ALD in patients with AUD in the era of COVID-19. Methods A panel of experts of the Italian Society of Alcohology (SIA) met via “conference calls” during the lockdown period to draft the SIA’s criteria for the management of ALD in patients with COVID-19 as follows: (a) liver injury in patients with ALD and COVID-19 infection; (b) toxicity to the liver of the drugs currently tested to treat COVID-19 and the pharmacological interaction between medications used to treat AUD and to treat COVID-19; (c) reorganization of the management of compensated and decompensated ALD and liver transplantation in the COVID-19 era. Results and Conclusions The COVID-19 pandemic has rapidly carried us toward a new governance scenario of AUD and ALD which necessarily requires an in-depth review of the management of these diseases with a new safe approach (management of out-patients and in-patients following new rules of safety, telemedicine, telehealth, call meetings with clinicians, nurses, patients, and caregivers) without losing the therapeutic efficacy of multidisciplinary treatment.

Since the first statement of the German Society of Oto-Rhino-Laryngology, hypoglossal nerve stimulation (HNS) is meanwhile an established treatment option for obstructive sleep apnea (OSA). There are three HNS systems available in Germany which differ in their technical details of the underlying comparable basic principle. For the unilateral HNS with respiratory sensing, several comparative studies, high-volume register analysis and long-term reports exist. The continuous HNS without respiratory sensing does not require a sleep endoscopy for indication. For the bilateral continuous HNS as the single partially implantable device, a feasibility study exists. For indication, the assessment of positive airway pressure failure by sleep medicine is crucial, and the decision for HNS should be made in discussion of other treatment options for at least moderate OSA. The implantation center holds primarily responsibility among the interdisciplinary sleep team and is primary contact for the patient in problems. This depicts why structural processes are required to secure outcome quality and minimize the complications. The aftercare of HNS patients can be provided interdisciplinary and by different medical institutions, whereat, minimal reporting standards to document outcome and usage are recommended.

Allergo journal international 30(5), 155-168 (2021). doi:10.1007/s40629-021-00178-2, Published by Urban & Vogel, München

Rearrangements in the anaplastic lymphoma kinase (ALK) and proto-oncogene tyrosine-protein kinase ROS (ROS1) genes characterise two distinct molecular subsets of non-small cell lung cancer (NSCLC) tumours. Lorlatinib is a third-generation ALK/ROS1 tyrosine kinase inhibitor (TKI) shown to have systemic and intracranial activity in treatment-naive patients and in those who progressed on first- and second-generation TKIs. Despite being generally well tolerated, lorlatinib has a unique and challenging safety profile that includes hyperlipidaemia and central and peripheral nervous system adverse events (AEs). This article summarises a set of strategies designed to monitor and manage lorlatinib-related AEs that were agreed upon by a multidisciplinary panel of specialists in a meeting held in July 2020. Among the recommendations hereby described, special emphasis was placed on communication: prescribing physicians should inform patients and their families/caregivers about the likelihood and nature of lorlatinib AEs, encouraging them to report any symptoms, while at the same time reassuring them that most events are manageable and resolve spontaneously and have little to no interference with cancer treatment. Importantly, all patients should undergo a set of baseline assessments, including biochemical analysis, evaluation of cardiovascular risk, electrocardiogram (ECG), neurological evaluation and contrast-enhanced magnetic resonance imaging of the brain, which should be repeated regularly during lorlatinib treatment. Supportive medications to treat or relieve lorlatinib AEs were also discussed, as were the conditions requiring specialist consultations and/or adjustments in lorlatinib therapy. The overall goal of this article is to serve as a practical guide for oncologists to systematically and effectively approach lorlatinib AEs.

Feedback is beneficial to students’ learning process and overall achievement, but one of the common complaints from students about college education is regarding feedback. So, this study aimed to examine whether digital written feedback positively influences students’ learning experience and attitude toward learning. Digital written feedback refers to feedback provided through a learning management system as handwritten feedback added to a scanned copy of the student’s paper-based assessment using a smart pad and smart pencil. The study surveyed a diverse set of college students’ (n = 175) perceptions regarding feedback satisfaction, learning satisfaction, the usefulness of digital written feedback, and perceived achievement via an online survey. A one-way analysis of variance found a significant difference between feedback satisfaction and learning satisfaction according to the feedback method. A multiple regression analysis indicated the satisfaction and perceived usefulness of digital written feedback predicted perceived achievement. From the students’ open responses regarding the benefits of digital written feedback, five themes emerged, namely usability, psychological relief, accessibility, self-regulation, and acceptance. The implications for digital written feedback are discussed.

Social aggression is a pervasive feature of insect societies. In eusocial Hymenoptera, aggression among females can affect task performance and competition over direct reproduction (egg laying); in most species males participate in social interactions relatively rarely. Males of the independent-founding paper wasp Mischocyttarus mastigophorus are exceptional: they are aggressive toward female nestmates, leading us to explore the function of this unusual behavior. We applied social network analyses to data on M. mastigophorus social aggression to quantify sex differences in giving and receiving social aggression. The network analyses supported the pattern of biased male aggression toward female nestmates; females are relatively rarely aggressive to males. We then asked whether male aggression toward females was biased by females’ relative ovary development. Males were more aggressive toward females with better-developed ovaries, opposite to patterns of aggression among females. Because food brought to the colonies is often monopolized by dominant females, we suggest that males direct aggression toward socially dominant females with better-developed ovaries to obtain food. The implications of biased male aggression for female task performance and physiology are unknown.

In this study, we developed a microfluidic paper analysis device (μPAD) for distance-based detection of Ag+ in water. The μPAD was manufactured by wax printing method on filter paper. Then, a layer of gold nanoparticles (AuNPs) was deposited and ascorbic acid was printed on the channel. In the detection, Ag+ was reduced by ascorbic acid and coated on the surface of the AuNPs on the channel, forming Au@Ag core/shell nanoparticles. Based on the capillary flow principle, different concentrations of Ag+ formed different distances of color ribbons. Thus, quantitative detection of Ag+ can be achieved by measuring the distance of the color ribbon. The detection limit of this method was as low as 1 mg·L−1 within 15 min and the interference of common metal ions in water can be eliminated. In conclusion, this method had successfully realized the leap from colorimetry to direct reading, realizing fast read and easy manipulation with low-cost.

The present study illustrates the electrocoagulation remediation of paper mill wastewater for multiple response optimization. Multiple response optimization can be combined into one desirability function. All variables and responses varied for a unique global solution. The effect of basic electrocoagulation process variables pH (3–10), conductivity (3.15–10 mS/cm), electrode distance (1–2.5 cm) and current density (5–20 mA/cm2) on four response parameters such as chemical oxygen demand, color, total dissolved solids and total organic carbon has been analyzed experimentally and statistically. The global solution for these variables and responses obtained by software over a hundred design points. For unit desirability function variables conditions were pH 7.49, Conductivity 8.34 mS/cm, electrode distance 2.06 cm and current density 9.32 mA/cm2. In these global variable conditions, responses were observed to be COD 70.19%, Color 75.03%, TDS 70.69% and TOC 71.93%, respectively.

Process-monitoring laboratories in the pulp and paper industry generally use a combination of wet chemical analyses and physical measurements to certify the fitness of a production pulp for a specific end-use. These laboratory tests require time and the effort of trained personnel, limiting their utility for real-time process control. Here we show that Raman probes of unrefined cellulosic pulps, well-suited to the online measurement of in-process materials, can predict the quality attributes of manufactured papers. The accuracy of prediction improves when the covariance is modelled in a reduced measurement space selected by a data-driven, feature-selection technique referred to as a Template Oriented Genetic Algorithm (TOGA). TOGA, combined with discrete wavelet transform (DWT), isolates functional-group features that correlate best with mechanical properties paper derived from refined pulp. Paper makers refine market pulps to build sheet strength using a beating process that decreases freeness as it increases fibre-fibre bonding. Methods demonstrated here predict manufactured sheet properties obtainable after any specified degree of refining from the Raman spectrum of an unrefined pulp. This analysis capacity will enable both vendors of market pulp and makers of sheet paper to specify in advance the amount of beating required to produce a desired product, thereby saving cost and conserving resources.

In this study, a microfluidic paper-based analytical device (mu PAD) was integrated with a smartphone app capable of offline (without internet access) image processing and analysis for the rapid colorimetric detection of glucose. A self-inking stamp was used to form hydrophobic channels on a piece of paper-towel due to its superior water absorption efficiency. As demonstrated, the developed sensor was employed for the colorimetric detection of glucose in artificial saliva in the linear scope of 0 - 1 mM with a calculated detection limit of 29.65 mu M. The experimental results show that the quantitative analysis of glucose with the proposed smartphone platform could be completed in less than one minute. The app developed for the smartphone platform is capable of extracting the color-changing area with an embedded image processing tool which could address the problem of color uniformity in the detection zones of mu PAD. The integrated platform has great potential to be used for non-invasive measurements of glucose in body fluids, like tears, sweat and saliva.

In order for enterprise imaging to be successful across a multitude of specialties, systems, and sites, standards are essential to categorize and classify imaging data. The HIMSS-SIIM Enterprise Imaging Community believes that the Digital Imaging Communications in Medicine (DICOM) Anatomic Region Sequence, or its equivalent in other data standards, is a vital data element for this role, when populated with standard coded values. We believe that labeling images with standard Anatomic Region Sequence codes will enhance the user’s ability to consume data, facilitate interoperability, and allow greater control of privacy. Image consumption—when a user views a patient’s images, he or she often wants to see relevant comparison images of the same lesion or anatomic region for the same patient automatically presented. Relevant comparison images may have been acquired from a variety of modalities and specialties. The Anatomic Region Sequence data element provides a basis to allow for efficient comparison in both instances. Interoperability—as patients move between health care systems, it is important to minimize friction for data transfer. Health care providers and facilities need to be able to consume and review the increasingly large and complex volume of data efficiently. The use of Anatomic Region Sequence, or its equivalent, populated with standard values enables seamless interoperability of imaging data regardless of whether images are used within a site or across different sites and systems. Privacy—as more visible light photographs are integrated into electronic systems, it becomes apparent that some images may need to be sequestered. Although additional work is needed to protect sensitive images, standard coded values in Anatomic Region Sequence support the identification of potentially sensitive images, enable facilities to create access control policies, and can be used as an interim surrogate for more sophisticated rule-based or attribute-based access control mechanisms. To satisfy such use cases, the HIMSS-SIIM Enterprise Imaging Community encourages the use of a pre-existing body part ontology. Through this white paper, we will identify potential challenges in employing this standard and provide potential solutions for these challenges.

In this study, the synthesis of the {001} facet of anatase TiO2 (T-{001}) was hydrothermally carried out by a two-step process (without using fluoride ions as capping agent); the synthesized T-{001} sample was characterized by XRD, FESEM and HRTEM. The T-{001} was used for improvement in biodegradability of paper mill wastewater in the batch and continuous system under UV light irradiation. The performance of T-{001} was compared to commercial TiO2 (P25). In the batch system, the effect of the pH, time and photocatalyst dosage on the COD removal were investigated. The results showed that alkaline condition enhanced photocatalytic degradation of COD. For batch system, biodegradability index (BOD5/COD ratio) improved from 0.12 to 0.71 by application of the T-{001}; whereas this improvement was 0.52 for P25 sample. For the continuous system, the TiO2 samples were immobilized on the glass media and utilized in a packed bed photoreactor (PBPR). The effect of different flowrates on the COD removal was investigated. To investigate the stability of the samples, the photocatalytic experiments were continuously carried out for 3 h; both samples showed considerable stability during this time. The final values of BOD5/COD ratio at flowrate of the 5.4 ml/min were 0.64 and 0.42 for CT-{001} and CP25, respectively.

Maturity of vermicomposted end products obtained from citronella bagasse (CB) and a mixture of citronella bagasse and paper mill sludge (CB + PMS) was determined employing the epigeic earthworm species Eisenia fetida. Two of the primary biological indicators—enzyme assay and germination index—were used for evaluation of vermicompost maturity. The enzyme assay includes the changes in dehydrogenase and urease activities in the final products. The test for germination index was performed on two economically important plant species Abelmoschus esculentus and Solanum melongena. The results revealed a significant increase in dehydrogenase and urease activities in the vermicompost samples over the raw materials and traditional compost. The enhancement was recorded 215.63–225.63% in dehydrogenase and 149.89–249.31% for urease in the end products obtained after 45 days of experimental trials. Further, the higher values of germination index in the vermicompost treatments as against the control confirm the suitability and stability of the vermicomposted final products.

A discussion is currently under way in the literature on the sustainable benefits of recycling material, particularly paper, which has high global consumption and polluting capacity. Optimized planning of waste paper recycling networks stimulates sustainable processing efficiency, motivating the investigation of quantitative methods to guide decision-making. The objective of this article is to review papers that present quantitative models for planning waste paper recycling networks considering optimization of the echelons of this process, to analyze the evolution of research, find research opportunities and contribute to future research. The article presents an analysis of five categories of the selected studies: I—evolution of publications; II—echelons considered in different waste paper recycling systems; III—the sustainability pillars considered in the objectives of the formulated model; IV—formulations and techniques used; and V—uncertainty analysis. The proposal for waste paper recycling networks involves summary of the echelons considered in selected articles, to help future analysis. Research suggestions involving sustainability objectives, especially considering social issues, using different solution techniques and considering uncertainty were identified. This study, by reviewing the articles and identifying possibilities for future research, contributes to the development of research using quantitative methods for the efficient management of waste paper recycling networks or similar arrangements.

This study demonstrates a method for patterning paper-based microfluidic devices. An octadecyltrichlorosilane (OTS) solution is used to coat a chromatography paper to make it hydrophobic. A low-temperature (~ 32.9 °C) atmospheric-pressure dielectric-barrier-discharge jet with a shadow mask is then used to pattern hydrophilic stripes on the OTS-coated hydrophobic paper. In this manner, 1-mm-wide hydrophilic stripes are patterned successfully. Liquids are demonstrated to be transported and mixed in the hydrophilic stripes. Water contact angle measurement, X-ray photoelectron spectroscopy, surface profiler, optical emission spectroscopy, and scanning electron microscopy are used to characterize effect of pattering.

Over the last few years, the microfluidics phenomenon coupled with the Internet of Things (IoT) using innovative nano-functional materials has been recognized as a sustainable and economical tool for point-of-care testing (POCT) of various pathogens influencing human health. The sensors based on these phenomena aim to be designed for cost-effectiveness, make it handy, environment-friendly, and get an accurate, easy, and rapid response. Considering the burgeoning importance of analytical devices in the healthcare domain, this review paper is based on the gist of sensing aspects of the microfabricated paper-based analytical devices (μPADs). The article discusses the various used design methodologies and fabrication approaches and elucidates the recently reported surface modification strategies, detection mechanisms viz., colorimetric, electrochemical, fluorescence, electrochemiluminescence, etc. In a nutshell, this article summarizes the state-of-the-art research work carried out over the nano functionalized paper-based analytical devices and associated challenges/solutions in the point of care testing domain.

In recent years, the paper industry is developing strongly and plays an important role in the industry of our country. Most of the factories have their own wastewater treatment systems. In general, wastewater in paper mill is very difficult to treat and to handle, especially color (Pt–Co) index. In this research, activated carbon with a high surface area and high adsorption capacity was prepared from corn stalks, an agricultural by-products. The suitable conditions of pyrolysis were investigated to prepare activated bio-char from corn stalk. Then, as-obtained carbon material was applied for color treatment of effluent from paper mill. The activated carbon showed high efficiency and capability in color removal of waste water, with the color reduction of 77%.

Purpose To study respiratory effects of exposure to soft paper dust exposure, a relationship that is rarely studied. Methods Soft tissue paper mill workers at a Swedish paper mill were investigated using a questionnaire and lung function and atopy screening. Spirometry without bronchodilation was performed with a dry wedge spirometer, and forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) were obtained and expressed as percent predicted. Exposure to soft paper dust was assessed from historical stationary and personal measurements of total dust, in addition to historical information about the work, department, and production. The impact of high exposure to soft paper dust (> 5 mg/m3) vs. lower exposure ≤ 5 mg/m3, as well as cumulative exposure, was analyzed using multiple linear regression models. Multivariate models were adjusted for smoking, atopy, gender, and body mass index. Results One hundred ninety-eight current workers (124 male and 74 female) were included. There were significant associations between both cumulative exposure and years of high exposure to soft paper dust and impaired lung function. Each year of high exposure to soft paper dust was associated with a 0.87% decrease in FEV1 [95% confidence interval (CI) − 1.39 to − 0.35] and decreased FVC (− 0.54%, 95% CI − 1.00 to − 0.08) compared to the lower exposed workers. Conclusions The present study shows that occupational exposure to soft paper dust (years exceeding 5 mg/m3 total dust) is associated with lung function impairment and increased prevalence of obstructive lung function impairment.

Abstract Tissue paper softness relies on two major factors, the bulk softness, which can be indicated by the elasticity of the sheet, and surface softness. Measurement of surface softness is complicated and often requires a multi-step process. A key parameter defining surface softness is the topography of the surface, particularly the crepe structure and its periodicity. Herein, we present a novel approach to measure and quantify the tissue paper surface crepe structure and periodicity based on the detection of waviness along the sample using laser scanning confocal microscopy (LSM) and X-ray tomography (XRT). In addition, field emission scanning electron microscope (FESEM) was used to characterize the tissue paper surface. We demonstrate that surface topography is directly correlated to the erosion of the doctor blade, which is used to remove the dry tissue paper from the Yankee cylinder. Because of its accuracy and simplicity, the laser confocal microscopy method has the potential to be used directly on the production line to monitor the production process of the tissue paper. XRT revealed more structural details of the tissue paper structure in 3D, and it allowed for the reconstruction of the surface and the internal structure of the tissue paper. Graphic abstract

Wearable devices have received tremendous interests in human sweat analysis in the past few years. However, the widely used polymeric substrates and the layer-by-layer stacking structures greatly influence the cost-efficiency, conformability and breathability of the devices, further hindering their practical applications. Herein, we report a facile and low-cost strategy for the fabrication of a skin-friendly thread/paper-based wearable system consisting of a sweat reservoir and a multi-sensing component for simultaneous in situ analysis of sweat pH and lactate. In the system, hydrophilic silk thread serves as the micro-channel to guide the liquid flow. Filter papers were functionalized to prepare colorimetric sensors for lactate and pH. The smartphone-based quantitative analysis shows that the sensors are sensitive and reliable. Although pH may interfere the lactate detection, the pH detected simultaneously could be employed to correct the measured data for the achievement of a precise lactate level. After being integrated with a hydrophobic arm guard, the system was successfully used for the on-body measurement of pH and lactate in the sweats secreted from the volunteers. This low-cost, easy-to-fabricate, light-weight and flexible thread/paper-based microfluidic sensing device may hold great potentials as a wearable system in human sweat analysis and point-of-care diagnostics.

This work describes the log-MAP (BCJR) algorithm implementation of a close to capacity dirty paper coding CODEC. The CODEC consists of eight deep pipeline processors. It decodes blocks of 975 bits in 26.9 ms using less than 9.7% of low-cost FPGA (and no DSP blocks). Two pipelines, for alpha and beta, calculate the values of gamma (of the BCJR) to reduce the storage requirements. The final log-likelihood ratio (LLR) is calculated together with alpha, reusing intermediate results. The number of bits used by the different signals of the processor is easily configurable. It was set to six bits to the channel measure signals and eight bits to log of probability signals like alpha, beta, and others. The CODEC clock was 100 MHz. The achieved bit rate is 36.2 Kbps per CODEC, but multiple CODECs can be fit into a single chip. The CODEC is 3.49 dB from the channel capacity.

Directed evolution has become an important method to unleash the latent potential of enzymes to make them uniquely suited for human purposes. However, the need for a large reagent volume and sophisticated instrumentation hampers its broad implementation. In an attempt to address this problem, here we report a paper-based high-throughput screening approach that should find broad application in generating desired enzymes. As an example case, the dehalogenation reaction of the halohydrin dehalogenase was adopted for assay development. In addition to visual detection, quantitative measurements were performed by measuring the color intensity of an image that was photographed by a smartphone and processed using ImageJ free software. The proposed method was first validated using a gold standard method and then applied to mutagenesis library screening with reduced consumption of reagents (i.e., ≤ 10 μl per assay) and a shorter assay time. We identified two active mutants (P135A and G137A) with improved activities toward four tested substrates. The assay not only consumes less reagents but also eliminates the need for expensive instrumentation. The proposed method demonstrates the potential of paper-based whole-cell screening coupled with digital image colorimetry as a promising approach for the discovery of industrially important enzymes.Key Points• A frugal method was developed for directed enzyme evolution.• Mutagenesis libraries were successfully screened on a paper platform.• Smartphone imaging was efficiently used to measure enzyme activities.

Background The study tests the effects of data collection modes on patient responses associated with the multi-item measures such as Patient-Reported Outcomes Measurement System (PROMIS®), and single-item measures such as Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE), and Numerical Rating Scale (NRS) measures. Methods Adult cancer patients were recruited from five cancer centers and administered measures of anxiety, depression, fatigue, sleep disturbance, pain intensity, pain interference, ability to participate in social roles and activities, global mental and physical health, and physical function. Patients were randomized to complete the measures on paper (595), interactive voice response (IVR, 596) system, or tablet computer (589). We evaluated differential item functioning (DIF) by method of data collection using the R software package, lordif. For constructs that showed no DIF, we concluded equivalence across modes if the equivalence margin, defined as ± 0.20 × pooled SD, completely surrounds 95% confidence intervals (CI's) for difference in mean score. If the 95% CI fell totally outside the equivalence margin, we concluded systematic score difference by modes. If the 95% CI partly overlaps the equivalence margin, we concluded neither equivalence nor difference. Results For all constructs, no DIF of any kind was found for the three modes. The scores on paper and tablet were more comparable than between IVR and other modes but none of the 95% CI’s were completely outside the equivalence margins, in which we established neither equivalence nor difference. Percentages of missing values were comparable for paper and tablet modes. Percentages of missing values were higher for IVR (2.3% to 6.5% depending on measures) compared to paper and tablet modes (0.7% to 3.3% depending on measures and modes), which was attributed to random technical difficulties experienced in some centers. Conclusion Across all mode comparisons, there were some measures with CI’s not completely contained within the margin of small effect. Two visual modes agreed more than visual-auditory pairs. IVR may induce differences in scores unrelated to constructs being measured in comparison with paper and tablet. The users of the surveys should consider using IVR only when paper and computer administration is not feasible.

The present study investigated the adsorption efficiency of laboratory-produced activated carbon (AC) from pyrolysis of mix waste plastic (MWP) for treating paper mill effluent. In the present work, adsorbent was prepared from MWP and was characterized in comparison to commercial adsorbents. A lab scale adsorption study was performed in 100 mL batch experiments to get the optimized condition of different variables by eliminating the pollutants from EOP wastewater and was found as AC dose 10.0 g/100 mL, temperature 35 °C, agitation rate 150 rpm, contact time 7 h, and pH 9.0. The EOP wastewater was analyzed for different quality parameters after treating with prepared AC (PW-AC) and two commercial ACs (SC-AC and M-AC) at optimized conditions. The efficiency of ACs was found to be in order as M-AC>PW-AC>SC-AC. The optimized conditions were applied for the removal of chlorophenols using different ACs in comparison to control EOP wastewater. The study revealed that elimination of chlorophenolic compounds from EOP wastewater (7824 ng/L) was the highest in M-AC treatment followed by PW-AC and SC-AC, i.e., 1426 ng/L, 1759 ng/L, and 2200 ng/L, respectively. PW-AC had major impacts on reduction of chloroguaiacols (82%) as well as chlorophenols (80.7%) that were present in chief amount in EOP wastewater. PW-AC was found to be a capable adsorbent for the removal of chlorophenolic compounds from the most toxic bleaching effluents of pulp and paper industry.

Bone mineral abnormalities (defined as Chronic Kidney Disease Mineral Bone Disorder; CKD-MBD) are prevalent and associated with a substantial risk burden and poor prognosis in CKD population. Several lines of evidence support the notion that a large proportion of patients receiving maintenance dialysis experience a suboptimal biochemical control of CKD-MBD. Although no study has ever demonstrated conclusively that CKD-MBD control is associated with improved survival, an expanding therapeutic armamentarium is available to correct bone mineral abnormalities. In this position paper of Lombardy Nephrologists, a summary of the state of art of CKD-MBD as well as a summary of the unmet clinical needs will be provided. Furthermore, this position paper will focus on the potential and drawbacks of a new injectable calcimimetic, etelcalcetide, a drug available in Italy since few months ago.

Loop-mediated isothermal amplification or LAMP has been identified to be an efficient technology for point-of-care diagnostics. Paper-based LAMP technique has tremendous potential in replacing the existing tube-based technology as the manufacturing cost of a paper-based device is comparatively lower and easy-to-use. LAMP-based paper diagnostic device for Mycobacterium tuberculosis (MTB) detection is of extreme importance as it will help in early and rapid diagnosis of the affected patients. The fabrication of these devices requires assessment of design parameters on the extent of LAMP amplification reaction. Hence, CFD studies would be extremely beneficial from the design perspective. The current work presents an insight into the CFD simulations for LAMP amplification reaction on a porous paper membrane (nitrocellulose membrane). The convection-diffusion-reaction model is solved on a COMSOL Multiphysics 5.0 platform. Studies on effect of pore size, aspect ratio and initial DNA concentration on the extent of DNA amplification reaction have been carried out. The current paper-based technique is effective in detecting a minimum of 5 copies of DNA contrasting the previous semi-quantitative technique which demonstrated the detection of minimum 98 copies. Overall, the simulation results displayed almost 96% enhancement in the DNA amplification rate on paper membrane. Graphical abstract Graphical abstract for the computational study of DNA amplification reaction via LAMP technique on a porous paper membrane.

The present research deals with multivariate regression modeling of heavy metals uptake by cultivated Eichhornia crassipes (water hyacinth: WH) in the wastewater of paper and pulp processing industry. The WH plants were grown in different treatments of wastewater of paper and pulp processing industry (25, 50, 75, and 100%), while the control experiment was performed using borewell water. The influence of pH and metal quantity in the wastewater of paper and pulp processing industry over effective metal accumulation (∆Y: mg kg− 1) by WH was statistically modeled. Results showed that the established models had high R2 (

Pollutants emerging from the effluents of paper mills eventually destroy the environment of our ecosystem. To find a proper solution of it, a cost-effective and environmentally benign technique is proposed here to remediate contaminants present in the effluent of paper mill in a sequential steps using advanced oxidation processes including Fenton reaction (FO) (Fe(II)/H2O2), modified Fenton oxidation (MFO) (Fe(II)/Zn(II)/H2O2) and biological flocculation process. A comparison and compilation among these techniques were carried out on the basis of the percentage removal of chemical oxygen demand (COD) as well as the observed degradation pattern in gas chromatography–mass spectrometry. Results revealed that MFO could remove ≥ 90% of COD at ~ 90 min, whereas FO could eliminate ≥ 80% COD at ~ 120 min. Further, the bioflocculation technique was found to reduce the heavy metal contents such as Fe, Mn, Zn, Co, Cd and Pb by ≥ 60%. In the sequential treatment process, lignin, phenolic and colour contents were also found to be reduced by ~ 84% ~ 97% and ~ 96%, respectively. Again, the bioassay tests were performed to verify the toxicity reduction in the industrial effluent after the application of the sequential treatment process. This study demonstrates that the sequential treatment technique could be an effective alternative for the treatment of paper mill effluent.

Huge quantity of paper mill wastes are dumped at the outskirt of factory as unwanted materials. Vermicomposting is an eco-friendly technique for beneficial conversion of different biodegradable/organic wastes into useful organic manure utilizing earthworms. Solid wastes generated in paper mills contain appreciable quantity of organic matter. Attempt was made for bio-conversion of Emami paper mill wastes with different numbers of Eisenia fetida (5–30 earthworms/2 kg substrate) for studying its influence on vermi-conversing time and quality of prepared vermicompost. Vermicomposting was carried out in trays following heap method and quality of final product was determined following both chemical analysis and bioassay on wheat seedlings. Application of more earthworms up to 20 numbers per 2 kg substrate made bio-conversion quicker but further addition of earthworm, however, delayed the process as some earthworms came out of beds and died probably due to competition for food among earthworms inside beds. Ten earthworms per kg paper mill wastes–saw dust–cow dung mixture (1:0.5:0.5 weight wise) was found as optimum earthworm population for preparing quality vermicompost having more major and secondary plant nutrients. Bioassay of this manure on wheat seedlings also confirmed the analytical findings. It is confirmed that earthworm population in vermibed played vital role in faster decomposition of paper mill wastes and releasing of more nutrients, which ultimately helped in better growth of wheat seedlings. Successful demonstration of vermicomposting technique will encourage local farmers for beneficial utilization of paper mill wastes in their agriculture.

Direct oral anticoagulants (DOAC) are mostly prescribed to prevent cardioembolic stroke in patients with non-valvular atrial fibrillation (AF). An increasing number of guidelines recommend DOAC in AF patients with preserved renal function for the prevention of thromboembolism and an increased use of DOAC in daily practice is recorded also in elderly patients. Aging is associated with a reduction of glomerular filtration rate and impaired renal function, regardless of the cause, increases the risk of bleeding. Multiple medication use (polypharmacy) for treating superimposed co-morbidities is common in both elderly and chronic kidney disease (CKD) patients and drug-drug interaction may cause accumulation of DOAC, thereby increasing the risk of bleeding. There is uncertainty on the safety profile of DOAC in patients with CKD, particularly in those with severely impaired renal function or end stage renal disease, due to the heterogeneity of studies and the relative paucity of data. This document reports the position of three Italian scientific societies engaged in the management of patients with atrial fibrillation who are treated with DOAC and present with CKD.

The paper discusses current research efforts focusing on security and privacy for 5G cellular networks. It then outlines research directions.

The diagnosis of dengue infection is still a critical factor determining success in the clinical management and treatment of patients. Here, the development of microfluidic paper-based analytical devices (μPADs) utilizing a sandwich immunoassay on wax patterned paper functionalized with anti-dengue NS1 monoclonal antibodies for point-of-care detection of dengue NS1 (DEN-NS1-PAD) is reported. Various assay conditions, including the length of the channel and diluent, were optimized, and the response detected by the naked eye and digitized images within 20–30 min. The DEN-NS1-PAD was successfully tested in the field for detecting dengue NS1 in buffer, cell culture media, and human serum. The limit of detection (LoD) of the DEN-NS1-PAD obtained with the naked eye, scanner, and a smartphone camera was 200, 46.7, and 74.8 ng mL−1, respectively. The repeatability, reproducibility, and stability of the DEN-NS1-PAD were also evaluated. High true specificity and sensitivity in the serum of pediatric patients were observed. These evaluation results confirm that the DEN-NS1-PAD can potentially be used in point-of-care dengue diagnostics, which can significantly impact on the spreading of mosquito-borne diseases, which are likely to become more prevalent with the effects of global warming.

Electromagnetic interference (EMI) shielding materials with high performance and low density are urgently needed with the rapid development of electronic communications. In this work, tuning solid–air interface of graphene paper was carried out to enhance multiple reflections of incident electromagnetic waves for high-performance EMI shielding. The large amount solid–air interface (57.8 m2 g−1) endowed the porous graphene paper with a high EMI shielding effectiveness (SE) of 31.0 dB, 50% enhancement from its counterpart of solid graphene paper. This porous graphene paper also showed an ultralow density of 0.02 g cm−3, an 18.5-fold decrease from its counterpart of solid graphene paper. Moreover, the EMI SE of obtained graphene papers exhibited proportional relationship with their specific surface area, further confirming the vital role of solid–air interface in the enhancement of EMI shielding. This work quantitatively demonstrates the significance of solid–air interface area for enhancing the EMI shielding performance and proposes an efficient guideline for the design of high-performance and low-density EMI shielding materials.

Chronic kidney disease (CKD) represents a major public health issue worldwide and entails a high burden of cardiovascular events and mortality. Dyslipidaemia is common in patients with CKD and it is characterized by a highly atherogenic profile with relatively low levels of HDL-cholesterol and high levels of triglyceride and oxidized LDL-cholesterol. Overall, current literature indicates that lowering LDL-cholesterol is beneficial for preventing major atherosclerotic events in patients with CKD and in kidney transplant recipients while the evidence is less clear in patients on dialysis. Lipid lowering treatment is recommended in all patients with stage 3 CKD or worse, independently of baseline LDL-cholesterol levels. Statin and ezetimibe are the cornerstones in the management of dyslipidaemia in patients with CKD, however alternative and emerging lipid-lowering therapies may acquire a central role in near future. This position paper endorsed by the Italian Society of Nephrology aims at providing useful information on the topic of dyslipidaemia in CKD and at assisting decision making in the management of these patients.

Diagnostic and evidential static image, video clip, and sound multimedia are captured during routine clinical care in cardiology, dermatology, ophthalmology, pathology, physiatry, radiation oncology, radiology, endoscopic procedural specialties, and other medical disciplines. Providers typically describe the multimedia findings in contemporaneous electronic health record clinical notes or associate a textual interpretative report. Visual communication aids commonly used to connect, synthesize, and supplement multimedia and descriptive text outside medicine remain technically challenging to integrate into patient care. Such beneficial interactive elements may include hyperlinks between text, multimedia elements, alphanumeric and geometric annotations, tables, graphs, timelines, diagrams, anatomic maps, and hyperlinks to external educational references that patients or provider consumers may find valuable. This HIMSS-SIIM Enterprise Imaging Community workgroup white paper outlines the current and desired clinical future state of interactive multimedia reporting (IMR). The workgroup adopted a consensus definition of IMR as “interactive medical documentation that combines clinical images, videos, sound, imaging metadata, and/or image annotations with text, typographic emphases, tables, graphs, event timelines, anatomic maps, hyperlinks, and/or educational resources to optimize communication between medical professionals, and between medical professionals and their patients.” This white paper also serves as a precursor for future efforts toward solving technical issues impeding routine interactive multimedia report creation and ingestion into electronic health records.

Environmentally recalcitrant pollutants (chromium and sulphate) from mixed effluents of tannery and paper mills were treated simultaneously using highly metal-resistant dissimilatory sulphate-reducing bacteria. The remedial efficiency of the bacteria appeared zero when the bacterial pure culture was employed without the addition of any growth substrate from external source, while the bacterial sulphate reduction and consequent metal removal appeared maximum when sodium lactate was added as growth substrate in another set of experiments. In this set of experiments, almost 100% precipitation of the chromium (700 ppm) occurred in the first 7 days of anaerobic incubation. Sulphate was also removed totally (1225 ppm) in the first 7 days of incubation. pH of the media remained in the neutral to slightly basic range throughout the experimental trial. The achievement of maximum remedial efficiency also depicts the ultimate preference of lactate as carbon source by sulphate-reducing bacteria. The outcomes of the present investigation can be fruitful for designing efficient, environment-friendly and economical bioremedial strategies.

There have been many empirical studies regarding mergers in Japan’s paper industry from the standpoint of productivity and cost effectiveness. However, such studies only compared effectiveness based on data regarding existing companies. This article creates simulations of data on hypothetical mergers. A relative comparison will be made between such simulated data and the actual merger data regarding cost effectiveness using a data envelopment analysis (DEA). The results of the DEA efficiency analysis using such data show that, in mergers between large companies and midsized companies, in the long run, their efficiency tends to improve. A series of mergers in Japan’s paper industry, in general, can be positively evaluated since these mergers did not significantly reduce the cost-effective value of the surviving companies.

The copper(II) ion (Cu2+) has played an indispensable role in diverse kinds of functional physiological processes of organisms, which has become of growing interest. Despite the fact that numerous Cu2+ test papers using fluorescent probes have been fabricated, sensors featuring the ratiometric property that integrates quenched probes and an inner standard dye are rarely reported. Herein, a two-component ratiometric sensor in a paper-based device is proposed to realize highly selective Cu2+ detection. To overcome shortcomings such as low signal-to-noise ratio and incorrect response of the quenching probe, a novel BODIPY-based turn-off probe (P2017) is designed and introduced into the paper-based device with better water solubility and selectivity for Cu2+ detection. Furthermore, a reference dye (B001), exhibiting an emission at 690 nm when the excitation wavelength is 480 nm, is also introduced into the paper-based device. These two components can enhance the quality of the signal as P2017 is sensitively quenched by Cu2+, while B001 with a photostable property, serving as an internal benchmark, is unable to react with Cu2+. The results indicated that the two components provided a new concept for optimizing paper-based device fabrication and developing accurate, simple, and inexpensive Cu2+ detection methods, which could be potentially applied to monitor human health and the environment in remote areas.

There are many pulp and paper industries all around the globe and in Ethiopia as well different companies are involved in the production and distribution of paper and paper products. Most of the industries especially those in developing countries like Ethiopia produce paper from pulp obtained from wood cellulose. Ethiopia is not producing its pulp and mostly the paper industries depend on imported pulp or recycled paper. There are critical limitations in synthesizing pulp and paper from wood-based cellulose resources mainly the scarcity of wood in some countries and the impact on altering the ecological balance and through frequent deforestation and replantation practice. The present review assesses the potential sources from non-wood resources which can be used as a substitute cellulose raw material for the pulp and paper industry. The study encompasses possible beneficiation routes for manufacturing pulp from non-wood cellulose resources available in Ethiopia for diversified application in the paper industry. With this regard, potential non-wood raw materials for pulping are assed in line with the fulfilment of the target for import substitution strategy, the realization of a safe working environment, and socio-economic betterment of the nation with specific reference to the paper industry.

The coronavirus disease 2019 (COVID-19) pandemic has led to preventive measures worldwide. With the decline of infection rates, less stringent restrictions for sports and exercise are being implemented. COVID-19 is associated with significant cardiovascular complications; however there are limited data on cardiovascular complications and long-term outcomes in both competitive (elite) athletes and highly active individuals. Based on different categories of disease severity (asymptomatic, regional/systemic symptoms, hospitalisation, myocardial damage, and/or myocarditis), in this point-of-view article we offer the (sports) cardiologist or sports physician in the Netherlands a practical guide to pre-participation screening, and diagnostic and management strategies in all athletes >16 years of age after COVID-19 infection.

Paper-based microfluidic analytical devices (μPADs) have shown great potential in the field of analysis due to their advantages of rapid analysis, environmental friendliness and the ability to realize the flow of fluid without external power. Saliva is an emerging biofluid which is used in diseases diagnostic and screening for the easy collection and the reflection of the physiological state. This review focuses on the fabrication methods for two-dimensional (2D) and three-dimensional (3D) μPADs and their applications on the saliva analysis. In the first part, the flow mechanism in μPADs is discussed. The second part mainly introduces the fabrication methods for the μPADs and compares the different methods. The third part presents the application of μPADs in the detection of biomarkers such as nitrite, glucose, and thiocyanate in saliva. Finally, the research directions of saliva analysis are discussed in the conclusion. There have been a lot of researches on μPADs, but the fabrication methods and applications need to be further studied to meet the commercial needs.