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The spread of invasive alien plant species (IAPS) is a leading reason for worldwide environmental change due to their effects on biodiversity and humans. Some valued goods from IAPS have been produced, e.g. paper that consists of cellulose fibres from Japanese knotweed. Therefore, the aim of this study was to establish the usability of this paper grade as a printing substrate, since it does not have ideal optical properties as it is expected from commercial office paper. Because it is widely used, inkjet printing technology was employed. Print permanence is essential, especially when printing documents. However, typographic characteristics must be considered to make a text more legible. Two widely used typefaces (Arial and Times) were tested in three commonly used type sizes (8 pt, 10 pt, and 12 pt). The results showed that the paper made from Japanese knotweed could have valuable properties and suitable legibility, especially when using typefaces with a moderate counter size, high x-height, and minimal differences in the letter stroke width to obtain an appropriate typographic tonal density with an adequate type size. Even after exposure to light, the texts printed in a proper type size and stroke width remained visible.

Ultraviolet (UV) radiation systems are a common method of inactivating bacteria in municipal water treatment but has not been applied in a paper mill operations. Determining the feasibility of installing such a system is the purpose of this report. Directly treating a starch solution of sufficient concentration proved impossible as the transmittance required was far too low. Water used in the onsite water recycling facility’s cooling towers had a transmittance over 90% and so was very treatable. Lab scale testing with a designed 15 liter laboratory benchtop ultraviolet treatment system showed that UV treatment can reduce the aerobic bacteria count by two fold for up to 24 hour of operation and significantly lower results for 48 and 72 hour of operation. Therefore, UV treatment can be considered a valuable process for the treatment of cooling tower water.

Microfluidic paper-based analytical devices (μPADs) allow user-friendly and portable chemical determinations, although they provide limited applicability due to insufficient sensitivity. Several approaches have been proposed to address poor sensitivity in μPADs, but they frequently require bulky equipment for power and/or read-outs. Universal serial buses (USB) are an attractive alternative to less portable power sources and are currently available in many common electronic devices. Here, USB-powered μPADs (USB μPADs) are proposed as a fusion of both technologies to improve performance without adding instrumental complexity. Two ITP USB μPADs were developed, both powered by a 5 V potential provided through standard USB ports. The first device was fabricated using the origami approach. Its operation was analyzed experimentally and numerically, yielding a two-order-of-magnitude sample focusing in 15 min. The second ITP USB μPAD is a novel design, which was numerically prototyped with the aim of handling larger sample volumes. The reservoirs were moved away from the ITP channel and capillary action was used to drive the sample and electrolytes to the separation zone, predicting 25-fold sample focusing in 10 min. USB μPADs are expected to be adopted by minimally-trained personnel in sensitive areas like resource-limited settings, the point-of-care and in emergencies. Fil: Schaumburg, Federico. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Instituto de Desarrollo Tecnológico para la Industria Química. Universidad Nacional del Litoral. Instituto de Desarrollo Tecnológico para la Industria Química; Argentina Fil: Kler, Pablo Alejandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Centro de Investigaciones en Métodos Computacionales. Universidad Nacional del Litoral. Centro de Investigaciones en Métodos Computacionales; Argentina Fil: Carrell, Cody S.. State University of Colorado - Fort Collins; Estados Unidos Fil: Berli, Claudio Luis Alberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Instituto de Desarrollo Tecnológico para la Industria Química. Universidad Nacional del Litoral. Instituto de Desarrollo Tecnológico para la Industria Química; Argentina Fil: Henry, Charles S.. State University of Colorado - Fort Collins; Estados Unidos

"Background: This position paper highlights the opportunistic integral role of the pharmacist across the patient pathway utilizing cardiovascular care as an example. The paper aims to highlight the potential roles that pharmacists worldwide can have (or already have) to provide efficient patient care in the context of interprofessional collaboration. Methods: It results from a literature review and experts seeking advice to identify existing interventions and potential innovative interventions. We developed a conceptual framework highlighting seven critical phases in the patient pathway and for each of those listed some of the initiatives identified by our experts worldwide. Results: Existing pharmacists' interventions in each of these phases have been identified globally. Various examples in the area of prevention and self‐management were found to exist for long; the contribution for early detection and subsequently to timely diagnosis were also quite clear; integration of care was perhaps one of the areas needing greater development, although interventions in secondary care were also quite common. Tertiary care and end of life interventions were found to often be left for other healthcare professionals. Conclusion: On the basis of the findings, we can argue that much has been done but globally consider that pharmacists are still an untapped resource potentially useful for improved patient care." info:eu-repo/semantics/publishedVersion

Creation of new digital technologies let automate the reproduction of text and graphic information, led to the creation and development of the digital printing. Digital printing is a technology for producing prints in the printer based on the original layout, created as corresponding codes with a computer. One of the technologies of digital printing is a computer-to-press and one of the devices in this direction is risograph. The risograph printing quality is worse than offset printing. The text is printing with medium sharpness and images remind photos in old newspapers and require special preparation. But risograph is the most profitable solution for small and medium circulations from 50 up to 1000 sheets. Wide usage of risograph printing in typographies demands increase performance of the equipment with the high print quality of digital images. To improve the quality of risographic printing, the creation of methods is required to form the initial indicators of the original layout (clarity, correct transmission of halftones, contrast). At the same time, the result of obtaining high-quality images obtained by printing on a risograph is affected by surface microgeometry and the physical and mechanical properties of paper. So, the optical density of the ink layer on the print is largely determined by the structure of the sections of paper, in particular, absorbency and porosity. To obtain high-quality images on prints, it is necessary not only to customize the original layout, but also to select paper with such characteristics that would allow you to get the best result when printing on a risograph. Since the risograph occupies an intermediate place in quality between copying equipment and laser printing, a laser print is taken as the standard for print quality. And one of the tasks of the quality of risographic prints is to increase it to the quality of laser printing.

This study aims to analyze the effect of managing the diversity of human resources on the performance of employees of PT. Lontar Papyrus Pulp & Paper Industry. The study population was all employees of PT. Lontar papyrus pulp & paper industry, West Tanjung Jabung Regency, totaling 3,023 people. the size or number of samples in this study is determined based on the theory developed by Slovin with a value of e = 10%, so that a sample of 97 people is obtained. The approach in this study uses a quantitative approach to the survey method and uses Partial Least Square (PLS) data analysis. But before the analysis, the outer model test is first performed through the validity and reliability test. Furthermore, the Inner Model test is carried out through the R-Square (Coefficient of determination) and F-Square (f2 effect size) tests. The results showed that the management of diversity in human resources affected the performance of the employees of PT. Lontar Papyrus Pulp & Paper Industry. management of diversity in human resources affected the performance of the employees of PT. Lontar Papyrus Pulp & Paper Industry.

This paper introduces the concept of "Drawing-PADs" (Drawing paper-based microfluidic analytical devices) allowing to intuitively evaluate the urinary albumin (Alb) index, a clinically important parameter used for the early detection of renal deficiencies related to diabetes, among others. To enable regular monitoring of the Alb index, a simple examination method suitable for self-diagnosis is highly desirable. The Drawing-PADs rely on the simultaneous naked eye detection of Alb and creatinine (Cre) on a single device according to the distance-based microfluidic PAD (μPAD) approach. The Alb index is visualized by simply drawing a straight line connecting the top of two color-changed assay channel sections (Alb and Cre channels), followed by visually confirming the position of the intercept of the drawn straight line. The semiquantitative Alb index evaluation performed with Drawing-PADs does not require any equipment such as a camera, software, or a color reference chart. The obtained results are independent of the sample volume and are not influenced by changes in the absolute Alb and Cre concentrations caused by urine excretion variations, making spot urine assays possible. Classification of Alb index values according to clinically relevant criteria (normoalbuminuria, microalbuminuria, and macroalbuminuria) is readily achieved within 15 min and has been validated for 15 human urine samples including diabetic patients and healthy volunteers.

In this study, the viability of acetylation in cellulose fibers waste (CFW) from pulp and paper mill sludge was investigated in comparison to bleached cellulose fibers (BCF). Four acetylation metho...

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.

Mineral oil hydrocarbons (MOH) are widely used in the food industry for applications such as printing inks, additives, adhesives, and processing aids for food additives. Recently, the migration of MOH from food contact paper and board into foods has raised public health concerns. In this study, a total of 110 food contact paper and board samples, including baking and cooking paper (23), baking cups (28), food packaging bags (22), lunch boxes (8), party plates (26), and straws (3) were evaluated to quantify the content and short-term migration levels of MOH. The MOH were separated into mineral oil saturated hydrocarbons (MOSH)/polyolefin oligomeric saturated hydrocarbons (POSH) and mineral oil aromatic hydrocarbons (MOAH) via a validated on-line liquid chromatography-gas chromatography-flame ionisation detection (LC-GC-FID) technique. The coating materials of the sample products comprised polyethylene, polypropylene, polyethylene terephthalate, and silicone. The effects of the coating materials on the content and migration of MOH/POSH were evaluated. Quantitative analysis of the MOH in the samples showed that the MOSH/POSH and MOAH content varied widely, ranging from 16 to 5626 mg kg

Background: Although some have noted that combining technical and marketing content is precarious, technical communication professionals are increasingly involved in content marketing, which includes the creation of white papers. Literature review: The little existing literature on white papers provides conflicting guidance about managing the combination of technical and marketing content. Both soft-sell and hard-sell marketing approaches have been recommended. One source of such inconsistent guidance may be the lack of agreement about definitions. Research on print advertisements has described hard and soft selling as multidimensional rather than binary aspects of persuasive appeals. Research question: Which dimensions of hard- and soft-sell appeals are predominant in white papers? Research methodology: To complete our descriptive study, we collected a corpus of documents labeled as white papers in TechRepublic, and then selected and trained three raters to complete a series of judgments about dimensions of persuasive appeals in the corpus. We aggregated those ratings, calculating the mean and standard deviation for the dimensions to describe their distribution across the corpus. Results/discussion: Overall, hard-sell dimensions were more prevalent than soft-sell dimensions. However, the soft-sell category of “implicitness” was also dominant. Conclusion: Our results demonstrate the value of treating hard and soft selling as multidimensional, complementary, and combinatory marketing appeals that allow, for example, a single white paper to be both “subjective” (soft sell), and “precise” (hard sell), or both “creative” (soft sell) and “informative” (hard sell).

This White Paper by the European Society for Swallowing Disorders (ESSD) reports on the current state of screening and non-instrumental assessment for dysphagia in adults. An overview is provided on the measures that are available, and how to select screening tools and assessments. Emphasis is placed on different types of screening, patient-reported measures, assessment of anatomy and physiology of the swallowing act, and clinical swallowing evaluation. Many screening and non-instrumental assessments are available for evaluating dysphagia in adults; however, their use may not be warranted due to poor diagnostic performance or lacking robust psychometric properties. This white paper provides recommendations on how to select best evidence-based screening tools and non-instrumental assessments for use in clinical practice targeting different constructs, target populations and respondents, based on criteria for diagnostic performance, psychometric properties (reliability, validity, and responsiveness), and feasibility. In addition, gaps in research that need to be addressed in future studies are discussed. The following recommendations are made: (1) discontinue the use of non-validated dysphagia screening tools and assessments; (2) implement screening using tools that have optimal diagnostic performance in selected populations that are at risk of dysphagia, such as stroke patients, frail older persons, patients with progressive neurological diseases, persons with cerebral palsy, and patients with head and neck cancer; (3) implement measures that demonstrate robust psychometric properties; and (4) provide quality training in dysphagia screening and assessment to all clinicians involved in the care and management of persons with dysphagia.

Background/Aims: The incidence of disease outbreaks in clinical settings arising from ultrasound examinations is well documented, and is a source of worry. The ultrasound transducers and the coupling gel are potential sources of these infections since they come in direct contact with the patient’s skin. In this study, we examine the efficacy of the widespread practice of the use of plain non-sterile tissue paper in some low-cost private ultrasound centres in our locality as a method of disinfecting ultrasound transducers after each use. Its potential impact on nosocomial infection management in clinical practice is also examined. Methods: Swab samples from convex ultrasound transducers before and after transabdominal scanning of three consecutive patients were obtained from 10 different ultrasound centres in urban and rural areas of Enugu state. Ultrasound coupling gel samples were equally obtained, and all samples cultured for bacteria growth which was quantified in colony-forming units per ml (CFU/ml) and reported in 1000/ml. Paired sampled t-test was used to check for significance in a reduction in a bacterial load before and after the transducer was cleaned. Results: Nine different bacterial strains were isolated. Staphylococcus aureus and Klebsiella spp had the highest percentage of occurrence in all centres. Significant bacteria growth was recorded in the morning before the examination, and plain tissue paper significantly reduced the bacteria load in the ultrasound transducer. Conclusion: Even though disinfecting ultrasound transducers with non-sterile plain tissue paper alone is statistically effective and has the potential to minimize nosocomial infection, it is however not clinically effective and hence not advised.

With the development of printed electronics technology, the demand for printed conductive inks had also put forward higher standards. The shortcomings of traditional printed circuit boards, such as complex technology, consumables, and pollution, had also been resolved with the development of 3D printing technology. In this paper, low-content silver nanoparticles were blended with graphene alcohol slurry and dissolved in a non-polluting solvent such as absolute ethanol. The synergistic effect of the composite of the hexagonal structure of the graphene sheet and the silver nanoparticles improved the ink’s performance of electrical conductivity, adding water-based polyurethane/acrylic resin system to improve the adhesion between ink and paper. The conductive ink can be used to 3D print circuit circuits on paper. After drying, the resistance was measured. After the battery, diode, and switch were connected, a circuit diagram was made. After pressing the diode emits was lighted. This work is expected to be applied to flexible circuit boards to provide basic research.

Refereed/Peer-reviewed At a paper manufacturing mill (PML) that had been previously part of an integrated pulp (bisulphite) and paper mills industry, cyanobacterial blooms were observed in the mill’s aerated stabilization basin (ASB) ponds at about 3 years after pulping had been discontinued. This study aimed to determine the factors that led to bloom occurrences and potential control strategies applicable to the paper manufacturing mill’s, aerated stabilization basin system that discharges wastewaters into a coastal lake. Following discontinuation of pulping, the colour of the wastewaters reduced to low levels (~ 10 Hazen units or less), while the levels of nutrient remained potentially supportive of cyanobacteria growth with total phosphorus at ~ 0.1 mg/L and total nitrogen at > 2.5 mg/L. Incidences of blooms in the ABS were associated with preceding average monthly rainfalls and wind speeds being less (~ 44% and ~ 7%, respectively) and average direct sunlight hours being greater (~ 9%) than the long-term average values. Zinc was investigated for control of cyanobacteria as this metal is less toxic to aquatic organisms and microflora than copper algaecides. In laboratory culture trials, zinc was found to inhibit growth of M. aeruginosa (strain MIC338) and Pseudanabaena sp. when dosed at ~ 2.5 mg/L. The inhibition of cyanobacteria by zinc was found to vary between ASB pond samples which had different in situ chlorophyll a levels. This study found that the PML wastewaters investigated can be supportive of cyanobacterial growth to bloom levels after discontinuation of pulping processes and that zinc has potential as a cyanobacteria control agent.

[Abstract] The accepted use of left ventricular assist device (LVAD) technology as a good alternative for the treatment of patients with advanced heart failure together with the improved survival of the LVAD-supported patients on the device and the scarcity of donor hearts has significantly increased the population of LVAD-supported patients. The expected and non-expected device-related and patient-device interaction complications impose a significant burden on the medical system exceeding the capacity of the LVAD implanting centres. The ageing of the LVAD-supported patients, mainly those supported with the 'destination therapy' indication, increases the risk for those patients to experience comorbidities common in the older population. The probability of an LVAD-supported patient presenting with medical emergency to a local emergency department, internal, or surgical ward of a non-LVAD implanting centre is increasing. The purpose of this trilogy is to supply the immediate tools needed by the non-LVAD specialized physician: ambulance clinicians, emergency ward physicians, general cardiologists, internists, anaesthesiologists, and surgeons, to comply with the medical needs of this fast-growing population of LVAD-supported patients. The different issues discussed will follow the patient's pathway from the ambulance to the emergency department and from the emergency department to the internal or surgical wards and eventually to the discharge home from the hospital back to the general practitioner. In this first part of the trilogy on the management of LVAD-supported patients for the non-LVAD specialist healthcare provider, after the introduction on the assist devices technology in general, definitions and structured approach to the assessment of the LVAD-supported patient in the ambulance and emergency department is presented including cardiopulmonary resuscitation for LVAD-supported patients.

The possibility of exfoliating graphite into graphene sheets allows the researchers to produce a material, termed "graphene paper" (G-paper), conductive as graphite but more flexible and processable. G-paper is already used for electronic applications, like conductors, antennas, and heaters, outperforming metal conductors thanks to its high flexibility, lightness, chemical stability, and compatibility with polymeric substrates. Here, the effectiveness in the use of G-paper for the realization of electrodes on flexible plastic substrates and textiles, and their applicability as amperometric sensors are demonstrated. The performance of these devices is compared with commercial platforms made of carbon-based inks, finding that they outperform commercial devices in sensing nicotinamide adenine dinucleotide (NADH), a key molecule for enzymatic biosensing; the electrodes can achieve state-of-the-art sensitivity (107.2 ?A mm cm) and limit of detection (0.6 × 10 m) with no need of additional functionalization. Thanks to this property, the stable deposition of a suitable enzyme, namely lactate dehydrogenase, on the electrode surface is used as a proof of concept of the applicability of this new platform for the realization of a biosensor. The possibility of having a single material suitable for antennas, electronics, and now sensing opens new opportunities for smart fabrics in wearable electronic applications.

Human trafficking is a pandemic human rights violation with an emerging paradigm shift that reframes an issue traditionally seen through a criminal justice lens to that of a public health crisis, particularly for children. Children and adolescents who are trafficked or are at risk for trafficking should receive evidence-based, trauma-informed, and culturally responsive care from trained health care providers (HCPs). The purpose of this article was to engage and equip pediatric HCPs to respond effectively to human trafficking in the clinical setting, improving health outcomes for affected and at-risk children. Pediatric HCPs are ideally positioned to intervene and advocate for children with health disparities and vulnerability to trafficking in a broad spectrum of care settings and to optimize equitable health outcomes.

We breathe in a world where growing electronic wastages are a serious threat to our ecosystem, and therefore biodegradable devices are more in demand. We have unprecedentedly demonstrated broad-ban...

Objectives: The aim of the study was to review the evidence regarding the clinical use and value of fecal calprotectin (FC) measurements in different gastrointestinal disorders in children. Methods: A literature search was conducted in the PubMed, MEDLINE, EMBASE, and Cochrane databases until October 31, 2019. Subtopics were identified and each assigned to individual authors. Results: A total of 28 recommendations were voted on using the nominal voting technique. Recommendations are given related to sampling, measurement methods, and results interpretation. The 14 authors anonymously voted on each recommendation using a 9-point scale (1 strongly disagree to 9 fully agree). Consensus was considered achieved if at least 75% of the authors voted 6, 7, 8, or 9. Conclusions: Consensus was reached for all recommendations. Limitations for the use of FC in clinical practice include variability in extraction methodology, performance of test kits as well as the need to establish local reference ranges because of the influence of individual factors, such as age, diet, microbiota, and drugs. The main utility of FC measurement at present is in the diagnosis and monitoring of inflammatory bowel disease (IBD) as well as to differentiate it from functional gastrointestinal disorders (FAPDs). FC, however, has neither utility in the diagnosis of infantile colic nor to differentiate between functional and organic constipation. A rise in FC concentration, may alert to the risk of developing necrotizing enterocolitis and help identifying gastrointestinal involvement in children with Henoch-Schonlein purpura. FC measurement is of little value in Cow's Milk Protein Allergy, coeliac disease (CD), and cystic fibrosis. FC does neither help to distinguish bacterial from viral acute gastroenteritis (AGE), nor to diagnose Helicobacter Pylori infection, small intestinal bacterial overgrowth (SIBO), acute appendicitis (AA), or intestinal polyps.

Organic electrochemical transistors (OECTs) have attracted great interest in the last few years as biochemical sensors due to their outstanding analytical performance, versatility, stability, and e...

BACKGROUND: It is important to identify patients with monogenic IBD as management may differ from classical IBD. In this position statement we formulate recommendations for the use of genomics in evaluating potential monogenic causes of IBD across age groups. METHODS: The consensus included paediatric IBD specialists from the Paediatric IBD Porto group of the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and specialists from several monogenic IBD research consortia. We defined key topics and performed a systematic literature review to cover indications, technologies (targeted panel, exome and genome sequencing), gene panel setup, cost-effectiveness of genetic screening, and requirements for the clinical care setting. We developed recommendations that were voted upon by all authors and Porto group members (32 voting specialists). RESULTS: We recommend next-generation DNA-sequencing technologies to diagnose monogenic causes of IBD in routine clinical practice embedded in a setting of multidisciplinary patient care. Routine genetic screening is not recommended for all IBD patients. Genetic testing should be considered depending on age of IBD-onset (infantile IBD, very early-onset IBD, paediatric or young adult IBD), and further criteria, such as family history, relevant comorbidities, and extraintestinal manifestations. Genetic testing is also recommended in advance of hematopoietic stem cell transplantation. We developed a diagnostic algorithm that includes a gene panel of 75 monogenic IBD genes. Considerations are provided also for low resource countries. CONCLUSIONS: Genomic technologies should be considered an integral part of patient care to investigate patients at risk for monogenic forms of IBD.

In Taiwan, the incidence and prevalence of psoriatic arthritis (PsA) have risen significantly in recent years. Moreover, data from the Taiwan National Health Insurance Research Database (NHIRD) show that more than 85% of PsA patients are treated with just non-steroidal anti-inflammatory drugs (NSAIDs) and/or conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs). Taiwanese clinicians have also expressed concerns regarding uncertainties in the diagnosis of PsA and the delayed, interrupted, and/or tapered use of biologics, as well as differences in therapeutic preferences between and within dermatologists and rheumatologists. To address these issues, the Taiwan Rheumatology Association and the Taiwanese Association for Psoriasis and Skin Immunology jointly convened a committee of 28 clinicians from the fields of rheumatology, dermatology, orthopedics, and rehabilitation, to develop evidence-based consensus recommendations for the practical management of PsA in Taiwan. A total of six overarching principles and 13 recommendations were developed and approved, as well as a treatment algorithm with four separate tracks for axial PsA, peripheral PsA, enthesitis, and dactylitis. Psoriasis (PsO) management was not discussed here, as the Taiwanese Dermatological Association has recently published a comprehensive consensus statement on the management of PsO. Together, these recommendations provide an up-to-date, evidence-based framework for PsA care in Taiwan.

BackgroundChronic rhinosinusitis is regarded as a chronic airway disease. According to WHO recommendations, it may be a risk factor for COVID-19 patients. In most CRSwNP cases, the inflammatory changes affecting the nasal and paranasal mucous membranes are type-2 (T2) inflammation endotypes. MethodsThe current knowledge on COVID-19 and on treatment options for CRS was analyzed by a literature search in Medline, Pubmed, international guidelines, the Cochrane Library and the Internet. ResultsBased on international literature, on current recommendations by WHO and other international organizations as well as on previous experience, a panel of experts from EAACI and ARIA provided recommendations for the treatment of CRS during the COVID-19 pandemic. ConclusionIntranasal corticosteroids remain the standard treatment for CRS in patients with SARS-CoV-2 infection. Surgical treatments should be reduced to a minimum and surgery preserved for patients with local complications and for those with no other treatment options. Systemic corticosteroids should be avoided. Treatment with biologics can be continued with careful monitoring in noninfected patients and should be temporarily interrupted during the course of the COVID-19 infection.

The paper industry is an important component in the Colombian economy, the need for the continuous use of paper and cardboard in different activities results in the generation of paper sludge, for this reason there is an imminent need to generate alternatives for the use of these industrial wastes. which have been on the rise in recent years. This study is divided into two stages, the first is the evaluation through experimental analysis of the demonstration of the effectiveness of paper mud as an important source of carbon in composting processes, the second is the life cycle analysis (LCA) of the Alternative replacement of Composting vs. Synthetic Fertilizers. The product obtained from the evaluation corresponds to a stabilized compost with chicken manure, which is an important source of Carbon, Nitrogen and Calcium Carbonate, resulting in an environmentally sustainable alternative compared to the use of synthetic fertilizers. In the future, an increase in the use of fertilizers is expected, due to the growth of the world population, which generates an expansion of food production and an imminent need to attend to it. The ALC provides a better understanding of the process and its environmental impacts, the results will allow us to conclude on the most appropriate management option by showing the advantages and disadvantages associated with the use of compost. Organic fertilizers, unlike synthetic fertilizers, improve the fertility, texture and structure of the soil in the long term, promoting good drainage, aeration, water retention and root penetration, in addition to contributing to the stabilization of pH in acidic soils. The main challenges in integrating composting from paper sludge and chicken manure is to balance the C / N ratio, making a balance of the nutrient mixture and thus improving composting times, the loss of humidity, temperature gain, microbiological control and porosity.

The Veterans Health Administration (VHA) is the United States' largest integrated health care delivery system, serving over 9 million enrollees at nearly 1300 health care facilities. In addition to providing health care to the nation's military veterans, the VHA has a research and development program, trains thousands of medical residents and other health care professionals, and conducts emergency preparedness and response activities. The VHA has been celebrated for delivering high-quality care to veterans, early adoption of electronic medical records, and high patient satisfaction. However, the system faces challenges, including implementation of an expanded community care program, modernization of its electronic medical records system, and providing care to a population with complex needs. The position paper offers policy recommendations on VHA funding, the community care program, medical and health care professions training, and research and development.

The steady growth of corporate interest and influence in the health care sector over the past few decades has created a more business-oriented health care system in the United States, helping to spur for-profit and private equity investment. Proponents say that this trend makes the health care system more efficient, encourages innovation, and provides financial stability to ensure access and improve care. Critics counter that such moves favor profit over care and erode the patient-physician relationship. American College of Physicians (ACP) underscores that physicians are permitted to earn a reasonable income as long as they are fulfilling their fiduciary responsibility to provide high-quality, appropriate care within the guardrails of medical professionalism and ethics. In this position paper, ACP considers the effect of mergers, integration, private equity investment, nonprofit hospital requirements, and conversions from nonprofit to for-profit status on patients, physicians, and the health care system.

Childhood obesity has high societal and economic impact but current treatment approaches are sub-optimal. In the last decade, important studies have been conducted aiming to identify strategies to prevent obesity during critical periods of life. Updated recommendations for childhood obesity prevention are needed. We present data from systematic reviews and meta- analysis, randomised controlled trials (RCTs) and large observational studies, published from 2011 onwards that consider the possible role of the following factors in obesity development: breast-feeding; macronutrient composition and method of complementary feeding; parenting style; dietary patterns; sugar-sweetened beverage consumption; eating behaviour (eg, skipping breakfast, family dinners. etc); meal frequency and composition (fast foods, snacking), portion size; dietary modulators of gut microbiota (including pre-, pro-, and synbiotics); physical activity and sedentary behaviour. We used the Medline database and the Cochrane Library to search for relevant publications. Important research gaps were also identified. This position paper provides recommendations on dietary factors, food habits, and lifestyle to prevent childhood obesity development, based on the available literature and expert opinion. Clinical research and high-quality trials are urgently needed to resolve numerous areas of uncertainty.

The main environmental risks in the area of landfills are considered, all aspects of their technological reclamation using waste from the Baikal PPM are discussed. The data on the creation of soil and grounds using lignin-destroying microbiological preparations are presented. The final stage of the remediation of the Solzan landfill is the creation of cadastral maps 8, 9, 10 modern forest nurseries on the site, protected by flood and mudflow protection structures.

The integration of literature in English Language Teaching (ELT) has been a contentious issue although it is commonly accepted that literature caters to a whole bunch of opportunities for foreign language teaching. The aim of this study is to point to the idea that incorporating literature into ELT classes can direct foreign language classes into more innovative path as it fosters language development with both traditional and digitally-supported communicative activities designed to develop critical thinking abilities, creativity and learner autonomy. In this regard short stories, with their privileges due to their reader-friendly length, creativity in language use encompassing refined literary elements, and the wide range of subjects they deal with offer many opportunities. In this study to link the theory with real life experiences step by step, following the critical considerations about literature, language and meaning construction, text-selection and the methodology, possible applications based on the short story called The Paper Menagerie by Ken Liu are suggested. Activities encompassing all the phases of reading process are developed to help teachers to overcome potential difficulties in collaboration with their students while creating a classroom atmosphere based on negotiation. The article concludes that reflective teachers, starting to develop their own understanding of literature, language, meaning construction and reading, enable their learners to experience the authenticity and creativity of this valuable source when forming an identity as an independent reader of literature in the second language. Literature holds many opportunities to renovate language classrooms to keep up with the 21st century improvements.

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.

This article discusses a scoping review of position papers aimed at enhancing the quality of life of people with intellectual disabilities. It describes the approach taken to conducting the scoping...

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.

pH of fluids is an important indicator in biomedical and environmental studies. Conventional pH analysis techniques are often either instrumentation-intensive, expensive or qualitative in nature. Microfluidics based analytical devices have emerged as powerful alternative to overcome some of the existing limitations. These devices are characterized by low reagent and sample volumes, controlled flow, cost-effectiveness and portability. In this work, we report a microfluidic paper-based lab-on-a-chip pH sensing platform that incorporates passive fluid flow of samples. The colorimetric pH detection is integrated with mobile phone based image acquisition, followed by digital image processing and analysis for quantitative interpretation of data. The images are analyzed using image processing algorithms and color space. Regression analysis of data acquired from digital image analysis was used to evaluate the mathematical model for estimation of pH. The insights gained by this work would prove useful in development and deployment of portable and miniaturized sensors.

The present investigation was designed to study the effect of sublethal concentration of paper mill effluent on the total protein and amino acid contents in muscles, liver and gill of Channa punctatus after exposure to 96 hours. A significant decrease in protein content with increase in amino acids content in muscles, liver and gill of effluent exposed fishes was observed. A reduction in the protein content and enhancement of free amino acids in the muscles, liver and gill of experimental fish suggests that the tissue protein might have undergone proteolysis, during the stressful situation. Thus, the present study concludes that the protein metabolism of fish Channa punctatus affected during effluent exposure and reduces the nutritive value of fish.

Biologicals have transformed the management of severe disease phenotypes in asthma, atopic dermatitis, and chronic spontaneous urticaria. As a result, the number of approved biologicals for the treatment of atopic diseases is continuously increasing. Although atopic diseases are among the most common diseases in the reproductive age, investigations, and information on half-life, pharmacokinetics defining the neonatal Fc receptors (FcRn) and most important safety of biologicals in pregnancy are lacking. Given the complex sequence of immunological events that regulate conception, fetal development, and the intrauterine and postnatal maturation of the immune system, this information is of utmost importance. We conducted a systematic review on biologicals in pregnancy for indications of atopic diseases. Evidence in this field is scare and mainly reserved to reports on the usage of omalizumab. This lack of evidence demands the establishment of a multidisciplinary approach for the management of pregnant women who receive biologicals and multicenter registries for long-term follow-up, drug trial designs suitable for women in the reproductive age, and better experimental models that represent the human situation. Due to the very long half-life of biologicals, pre-conception counseling, and health care provider education is crucial to offer the best care for mother and fetus. This position paper integrates available data on safety of biologicals during pregnancy in atopic diseases via a systematic review with a detailed review on immunological considerations how inhibition of different pathways may impact pregnancy.

Abstract Artificial intelligence developments are essential to the successful deployment of community-wide, MRI-driven prostate cancer diagnosis. AI systems should ensure that the main benefits of biopsy avoidance are delivered while maintaining consistent high specificities, at a range of disease prevalences. Since all current artificial intelligence / computer-aided detection systems for prostate cancer detection are experimental, multiple developmental efforts are still needed to bring the vision to fruition. Initial work needs to focus on developing systems as diagnostic supporting aids so their results can be integrated into the radiologists’ workflow including gland and target outlining tasks for fusion biopsies. Developing AI systems as clinical decision-making tools will require greater efforts. The latter encompass larger multicentric, multivendor datasets where the different needs of patients stratified by diagnostic settings, disease prevalence, patient preference, and clinical setting are considered. AI-based, robust, standard operating procedures will increase the confidence of patients and payers, thus enabling the wider adoption of the MRI-directed approach for prostate cancer diagnosis. Key Points • AI systems need to ensure that the benefits of biopsy avoidance are delivered with consistent high specificities, at a range of disease prevalence. • Initial work has focused on developing systems as diagnostic supporting aids for outlining tasks, so they can be integrated into the radiologists’ workflow to support MRI-directed biopsies. • Decision support tools require a larger body of work including multicentric, multivendor studies where the clinical needs, disease prevalence, patient preferences, and clinical setting are additionally defined.

In society, there is widespread and growing acceptance of the value of cooperation between industry and universities being collaborative Research and Development (R&D) domain and industrial policy the fuel of knowledge-based economies. In this paper, different domains of cooperation between the University and Industry as well as their generated benefits for each partner are identified. These benefits have been assigned to each domain of cooperation, showing a large number of benefits associated to collaborative R&D. Leading us to make a statement - collaborative R&D is the key cooperation domain for sustainable long-term university-industry partnerships. Suggestions are given about how to continue this research study.

Microfluidic paper-based analytical devices (µPADs) has been broadly used and gained many researchers attention for clinical medicine and health, food quality inspection and environmental analysis. Qualitative analysis on several related articles managed to review the development of µPADs and as a result the proposal on its fabrication techniques by using waste paper for the application in environmental analysis through colorimetric detection is determined. The deinking process of waste paper can be carried out by using enzymatic treatment while the fabrication of µPADs can be carried out by using wax printing technique. Therefore, the device is subjected to be tested with detection of metal ions from water sample through colorimetric detection

Intestinal failure requires the placement and maintenance of a long-term central venous catheter for the provision of fluids and/or nutrients. Complications associated with this access contribute to significant morbidity and mortality, while the loss of access is an increasingly common reason for intestinal transplant referral. As more emphasis has been placed on the prevention of central line-associated bloodstream infections and new technologies have developed, care for central lines has improved; however, because care has evolved independently in local centers, care of central venous access varies significantly in this vulnerable population. The present position paper from the Intestinal Failure Special Interest Group of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) reviews current evidence and provides recommendations for central line management in children with intestinal failure.

Perinatal depression can have enduring adverse effects on women and their children and families, incurring substantial ongoing economic and personal costs. A significant proportion of the cost of perinatal depression relates to adverse impacts on the child, most likely mediated through impairment to the mother-infant relationship. In recognition of this problem, Australia has invested in routine perinatal depression screening. Our previous research produced convergent findings suggesting that expected benefits for children have not yet been realised through perinatal depression screening. We question the potential of including a measure of personality in current perinatal depression screening for identifying maternal mental health problems and suboptimal mother-infant relationships. This paper reviews our previous research findings within the broader context of perinatal depression screening. We propose a position, that perinatal depression screening in Australia should be redesigned to more precisely detect vulnerable mother-infant relationships, parenting, maternal mental health, and infant psychosocial and psychological development. Practice change to appropriately target antenatal interventions may more efficiently improve both maternal and child outcomes, thereby contributing to greater efficiency and cost savings for the health system.

Background: The cost-effectiveness of using a mobile diary app as an adjunct in dialectical behavior therapy (DBT) in patientswith borderline personality disorder is unknown.Objective: This study aims to perform an economic evaluation of a mobile diary app compared with paper-based diary cardsin DBT treatment for patients with borderline personality disorder in a psychiatric outpatient facility.Methods: This study was conducted alongside a pragmatic, multicenter, randomized controlled trial. The participants wererecruited at 5 Danish psychiatric outpatient facilities and were randomized to register the emotions, urges, and skills used in amobile diary app or on paper-based diary cards. The participants in both groups received DBT delivered by the therapists. Acost-consequence analysis with a time horizon of 12 months was performed. Consequences included quality-adjusted life years(QALYs), depression severity, borderline severity, suicidal behavior, health care use, treatment compliance, and system usability.All relevant costs were included. Focus group interviews were conducted with patients, therapists, researchers, and industryrepresentatives to discuss the potential advantages and disadvantages of using a mobile diary app.Results: A total of 78 participants were included in the analysis. An insignificantly higher number of participants in the papergroup dropped out before the start of treatment (P=.07). Of those starting treatment, participants in the app group had an averageof 37.1 (SE 27.55) more days of treatment and recorded an average of 3.16 (SE 5.10) more skills per week than participants inthe paper group. Participants in both groups had a QALY gain and a decrease in depression severity, borderline severity, andsuicidal behavior. Significant differences were found in favor of the paper group for both QALY gain (adjusted difference −0.054;SE 0.03) and reduction in depression severity (adjusted difference −1.11; SE 1.57). The between-group difference in total costsranged from US $107.37 to US $322.10 per participant during the 12 months. The use of services in the health care sector wassimilar across both time points and groups (difference: psychiatric hospitalization and 2.02; SE 3.19). Overall, the patients showed high acceptability and considered the app as being easy to use. Therapists worriedabout potential negative influences on the therapist-patient interaction from new work tasks accompanying the introduction ofthe new technology but pointed at innovation potential from digital database registrations.Conclusions: This study suggests both positive and negative consequences of mobile diary apps as adjuncts to DBT comparedwith paper diary cards. More research is needed to draw conclusions regarding its cost-effectiveness. Background:The cost-effectiveness of using a mobile diary app as an adjunct in dialectical behavior therapy (DBT) in patients with borderline personality disorder is unknown.Objective:This study aims to perform an economic evaluation of a mobile diary app compared with paper-based diary cards in DBT treatment for patients with borderline personality disorder in a psychiatric outpatient facility.Methods:This study was conducted alongside a pragmatic, multicenter, randomized controlled trial. The participants were recruited at 5 Danish psychiatric outpatient facilities and were randomized to register the emotions, urges, and skills used in a mobile diary app or on paper-based diary cards. The participants in both groups received DBT delivered by the therapists. A cost-consequence analysis with a time horizon of 12 months was performed. Consequences included quality-adjusted life years (QALYs), depression severity, borderline severity, suicidal behavior, health care use, treatment compliance, and system usability. All relevant costs were included. Focus group interviews were conducted with patients, therapists, researchers, and industry representatives to discuss the potential advantages and disadvantages of using a mobile diary app.Results:A total of 78 participants were included in the analysis. An insignificantly higher number of participants in the paper group dropped out before the start of treatment (P=.07). Of those starting treatment, participants in the app group had an average of 37.1 (SE 27.55) more days of treatment and recorded an average of 3.16 (SE 5.10) more skills per week than participants in the paper group. Participants in both groups had a QALY gain and a decrease in depression severity, borderline severity, and suicidal behavior. Significant differences were found in favor of the paper group for both QALY gain (adjusted difference −0.054; SE 0.03) and reduction in depression severity (adjusted difference −1.11; SE 1.57). The between-group difference in total costs ranged from US $107.37 to US $322.10 per participant during the 12 months. The use of services in the health care sector was similar across both time points and groups (difference: psychiatric hospitalization Conclusions:This study suggests both positive and negative consequences of mobile diary apps as adjuncts to DBT compared with paper diary cards. More research is needed to draw conclusions regarding its cost-effectiveness.