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The pursuit for sustainability in the papermaking industry calls for the elimination or reduction of synthetic additives and the exploration of renewable and biodegradable alternatives. Cellulose nanofibrils (CNFs), due to their inherent morphological and biochemical properties, are an excellent alternative to synthetic additives. These properties enable CNFs to improve the mechanical, functional, and barrier properties of different types of paper. The nanosize diameter, micrometre length, semicrystalline structure, high strength, and modulus of CNFs have a direct influence on the mechanical properties of paper, such as tensile index, burst index, Scott index, breaking length, tear index, Z-strength, E-modulus, strain at break, and tensile stiffness. This review details the role played by CNFs as an additive to improve strength properties of paper and the factors affecting the improvement in paper quality when CNFs are added as additives. The paper also includes techno-economic aspects of the process and identifies areas that need further research.

Infections caused by resistant microorganisms are a complex global public health challenge, and the way to combat the increase of resistance is the development of more modern and faster techniques for resistance detection. This study aimed to evaluate the transport of inactivated bacteria impregnated in a filter paper disk to detect carbapenem resistance genes by multiplex real-time PCR (qPCR) using high-resolution melting (HRM). A total of 88 isolates of 10 different species of Enterobacterales harboring well-characterized carbapenem resistance genes were evaluated. A full 10-µL loop of fresh growth of bacteria were impregnated in a filter paper disk, which was left at room temperature for 2 days in order to simulate the time spent in transportation. Bacterial inactivation was performed with 70% ethanol at 15 min. Afterwards, the DNA was extracted from the paper disks for further analysis by qPCR HRM. The time of 15 min in 70% ethanol was enough to inactivate all the isolates tested. It was possible to correctly identify the presence of the carbapenem resistance gene by HRM qPCR in 87 isolates (98.87%) that were transported in the filter paper disks. Our results indicated that it is possible to use filter paper to transport inactivated bacteria and to identify carbapenem resistance genes by qPCR HRM. This alternative tends to facilitate the access to this technology by many laboratories which do not have the qPCR equipment.

In this research work, we present a synthesis of silver and cobalt bimetal nanoparticles stabilized by a carboxymethyl cellulose biopolymer (CMC-AgCo) and its coating on a cellulose filter paper (CFP) to prepare the dip-catalyst. All the prepared samples were subjected to characterization by scanning electron microscopy for surface morphology, EDX, XRD and thermogravimetric analysis. The catalytic properties of the CFP/CMC-AgCo as dip-catalysts were evaluated in the reduction of organic nitroaromatic pollutants of 2,6-dinitrophenol to 2,6-diaminophenol as well as the 4-nitrophenol to 4-aminophenol. It was found that the reduction reaction advanced with the pseudo-first-order kinetics. The CFP/CMC-AgCo catalyzed the 2,6-diaminophenol and 4-nitrophenol with a reaction rate constant of 0.1244 and 0.177 min− 1, respectively. The separation of the CFP/CMC-AgCo was easy as it required a simple pulling of the strip from the reaction medium. Importantly, the catalytic reaction rates and conversion percentages of the two nitroaromatics were well-maintained for multiple times during recycling experiments.

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.

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.

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.

Many studies have been conducted on measuring avian influenza viruses and their hemagglutinin (HA) antigens via electrochemical principles; most of these studies have used gold electrodes on ceramic, glass, or silicon substrates, and/or labeling for signal enhancement. Herein, we present a paper-based immunosensor for label-free measurement of multiple avian influenza virus (H5N1, H7N9, and H9N2) antigens using flexible screen-printed carbon nanotube-polydimethylsiloxane electrodes. These flexible electrodes on a paper substrate can complement the physical weakness of the paper-based sensors when wetted, without affecting flexibility. The relative standard deviation of the peak currents was 1.88% when the electrodes were repeatedly bent and unfolded twenty times with deionized water provided each cycle, showing the stability of the electrodes. For the detection of HA antigens, approximately 10-μl samples (concentration: 100 pg/ml–100 ng/ml) were needed to form the antigen–antibody complexes during 20–30 min incubation, and the immune responses were measured via differential pulse voltammetry. The limits of detections were 55.7 pg/ml (0.95 pM) for H5N1 HA, 99.6 pg/ml (1.69 pM) for H7N9 HA, and 54.0 pg/ml (0.72 pM) for H9N2 HA antigens in phosphate buffered saline, and the sensors showed good selectivity and reproducibility. Such paper-based sensors are economical, flexible, robust, and easy-to-manufacture, with the ability to detect several avian influenza viruses.

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%.

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.

Background Microfluidic chip detection technology is considered a potent tool for many bioanalytic applications. Rapid detection of foodborne pathogens in the early stages is imperative to prevent the outbreak of foodborne diseases, known as a severe threat to human health. Conventional bacterial culture methods for detecting foodborne pathogens are time-consuming, laborious, and lacking in pathogen diagnosis. To overcome this problem, we have created an embedded paper-based microchip based on isothermal loop amplification (LAMP), which can rapidly and sensitively detect foodborne pathogens. Results We embed paper impregnated with LAMP reagent and specific primers in multiple reaction chambers of the microchip. The solution containing the target pathogen was injected into the center chamber and uniformly distributed into the reaction chamber by centrifugal force. The purified DNA of Escherichia coli O157:H7, Salmonella spp., Staphylococcus aureus, and Vibrio parahaemolyticus has been successfully amplified and directly detected on the microchip. The E. coli O157:H7 DNA was identified as low as 0.0134 ng μL− 1. Besides, the potential of this microchip in point-of-care testing was further tested by combining the on-chip sample purification module and using milk spiked with Salmonella spp.. The pyrolyzed milk sample was filtered through a polydopamine-coated paper embedded in the inside of the sample chamber. It was transported to the reaction chamber by centrifugal force for LAMP amplification. Then direct chip detection was performed in the reaction chamber embedded with calcein-soaked paper. The detection limit of Salmonella spp. in the sample measured by the microchip was approximately 12 CFU mL− 1. Conclusion The paper embedded LAMP microchip offers inexpensive, user-friendly, and highly selective pathogen detection capabilities. It is expected to have great potential as a quick, efficient, and cost-effective solution for future foodborne pathogen detection.

Oily water contamination has been sighted as one of the most global environmental pollution. Herein, copper hydroxide nanorods layer was constructed onto cellulosic filter paper surface cured with polydopamine, Ag nanoparticles, and Cu NPs through immersion method. This work has been aimed to produce a superhydrophobic and superoleophilic cellulosic filter paper. The structure, crystalline, and morphological properties of these modified cellulosic filter paper were investigated. Scanning electron microscope images confirmed that the modified surface was rougher compared with the pristine surface. The contact angle measurement confirmed the hydrophobic nature of these modified surfaces with a water contact angle of 169.7°. The absorption capacity was 8.2 g/g for diesel oil and the separation efficiency was higher than 99%. It was noted that the flux in the case of low viscosity solvent as n-hexane was 9663.5 Lm−2 h−1, while for the viscous oil as diesel was 1452.7 Lm−2 h−1.

Recycled paper and some hardwood paper often display poorer mechanical properties, which hinder its practical applications and need to be addressed. In this work, cellulose nanofibrils (CNFs) obtained by a combined process of enzymatic hydrolysis and grinding (EG-CNFs), grinding and microfluidization (GH-CNFs) or TEMPO-mediated oxidation and grinding (TE-CNFs) were characterized by scanning electron microscopy (SEM) and atomic force microscopy (AFM). Moreover, CNFs were made into films on which some characterizations including X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), and UV–Vis transmittance spectroscopy were implemented. Results showed that CNF fibrillation was promoted as times of passes increased in microfluidization, and CNFs pretreated by enzyme possessed shorter length. Crystallinity of CNFs was related to CNF manufacturing methods, while CNF films’ transparency was correlated to CNF diameter distributions. Moreover, CNFs were applied with different dosages on recycled and hardwood paper. Lengths of CNFs, strength of CNF network, and pulp properties were critical factors affecting the mechanical strength of CNFs-enhanced paper. GH-CNFs showed better strengthened effect on tensile strength of paper than TE-CNFs and EG-CNFs. The best overall improvement was achieved at GH-CNF10 dosage of 5.0 wt% on hardwood paper. The increment of tensile index, burst index, and folding endurance were 108.32%, 104.65%, and 600%, respectively. This work aims to find out the relationship between production methods and morphologies of CNFs and how the morphological characteristics of CNFs affecting the mechanical performance of paper when they are added as strength additives.

In this work, nanokaolin (K) and nanometakaolin (MK) were synthesized from waste paper via planetary ball milling and characterized by means of X-ray diffraction (XRD), Fourier transform infrared vibrational spectroscopy (FTIR), and scanning electron microscopy (SEM). Suspensions of carboxymethyl cellulose (CMC) and the synthesized nanominerals at 1.5, 3, 6, and 9% led to nanocomposites 30, 60, 90, and 120 μm thick. Nanocomposites coated papers were analyzed by means of XRD, FTIR, SEM, tensile index, strain rate, burst index, and air passage resistance. The highest tensile index, burst index, and air permeability resistance values of 80.78 $$\frac{N.m}{g}$$ , 5.24 $$\frac{kPa.{m}^{2}}{g}$$ , and 286.66 $$ml/min$$ , respectively, were obtained for CMC-9%MK-120. These results indicated that paper coated with CMC nanometakaolin composite is suitable for packaging.

Polyethylene laminated disposable paper cups are commonly used as a container for hot drinks, yet there is limited knowledge on the transfer of contaminants from the cup to the drink. Here we poured 95◦C hot water in 14 cups, to simulate the preparation of hot beverage for daily use. We studied the water composition after 15 min by inductively coupled plasma mass spectrometry (ICP-MS) and ion chromatography. Results show the presence of metals such as vanadium, chromium, copper, cobalt and arsenic at concentration ranging from 0.04 to 1.80 µg/L. Nitrate, nitrite, chloride, bromate, fluoride and sulfate ions were also detected at concentration from 0.003 to 49.21 mg/L. All concentrations are below the WHO maximum permissible limits in drinking water. However, the levels of vanadium at 1.24 µg/L and fluoride ions at 1.03 mg/L are likely to induce a health risk by bioaccumulation after long-term water ingestion. Therefore paper cups composition should be modified to avoid the release of contaminants in hot drinks.

Purpose: Some universal accessibility practitioners have voiced that they experience a mismatch in the research focus and the need for knowledge within specialized problem domains. This study thus set out to identify the balance of research into the main areas of accessibility, the impact of this research, and how the research profile varies over time and across geographical regions. Method: All UAIS papers indexed in Scopus were analysed using bibliometric methods. The WCAG taxonomy of accessibility was used for the analysis, namely perceivable, operable, and understandable. Results: The results confirm the expectation that research into visual impairment has received more attention than papers addressing operable and understandable. Although papers focussing on understandable made up the smallest group, papers in this group attracted more citations. Funded research attracted fewer citations than research without funding. The breakdown of research efforts appears consistent over time and across different geographical regions. Researchers in Europe and North America have been active throughout the last two decades, while Southeast Asia, Latin America, and Middle East became active in during the last five years. There is also seemingly a growing trend of out-of-scope papers. Conclusions: Based on the findings, several recommendations are proposed to the UAIS editorial board.

Spinocerebellar ataxias (SCAs) represent a large group of hereditary degenerative diseases of the nervous system, in particular the cerebellum, and other systems that manifest with a variety of progressive motor, cognitive, and behavioral deficits with the leading symptom of cerebellar ataxia. SCAs often lead to severe impairments of the patient's functioning, quality of life, and life expectancy. For SCAs, there are no proven effective pharmacotherapies that improve the symptoms or substantially delay disease progress, i.e., disease-modifying therapies. To study SCA pathogenesis and potential therapies, animal models have been widely used and are an essential part of pre-clinical research. They mainly include mice, but also other vertebrates and invertebrates. Each animal model has its strengths and weaknesses arising from model animal species, type of genetic manipulation, and similarity to human diseases. The types of murine and non-murine models of SCAs, their contribution to the investigation of SCA pathogenesis, pathological phenotype, and therapeutic approaches including their advantages and disadvantages are reviewed in this paper. There is a consensus among the panel of experts that (1) animal models represent valuable tools to improve our understanding of SCAs and discover and assess novel therapies for this group of neurological disorders characterized by diverse mechanisms and differential degenerative progressions, (2) thorough phenotypic assessment of individual animal models is required for studies addressing therapeutic approaches, (3) comparative studies are needed to bring pre-clinical research closer to clinical trials, and (4) mouse models complement cellular and invertebrate models which remain limited in terms of clinical translation for complex neurological disorders such as SCAs.

This work describes a simple, rapid, and cost-effective method for fabrication of paper-based carbon electrode (US$

The possibility of determining the active substances of antibacterial drugs of the tetracycline series (tetracycline, doxycycline, oxytetracycline, demeclocycline, metacycline, and chlortetracycline) using solid-phase fluorescence digital colorimetry is considered. The intrinsic fluorescence of tetracyclines and tetracycline-sensitized fluorescence of europium on cellulose paper and a thin layer of silica gel was studied. Yellow-green (tetracyclines) and pink (europium) fluorescence were observed upon irradiation with UV light (365 nm) of spots of tetracycline solutions applied to the matrix. The fluorescence intensity on the matrix surface was measured using a smartphone. Values of colorimetric parameters in the RGB system were used as the analytical signals (Ar). The limits of detection and quantitation were 1 – 5 and 3 – 17 μg/mL, respectively, for all analytes. The ranges of the determined concentrations were 3 – 500 μg/mL. The technique was tested for medicinal products. The relative standard deviation of the analytical results was ≤0.06.

We designed and synthesized novel haptens to produce monoclonal antibodies (mAb) against vitamin B6 (VB6). A group-specific mAb (2F9) that recognized pyridoxine (PN), pyridoxamine (PM), and pyridoxal (PL) was prepared using a homologous strategy with 50% maximal inhibitory concentration (IC50) values of 106.60, 250.57, and 400.11 ng/mL, respectively. Based on this, a gold nanoparticles (AuNPs)-based immunochromatographic strip (ICS) test was established for the detection of VB6 in energy drinks and B-vitamin complex tablets. The developed ICS test results could be semi-quantitatively evaluated by the naked eye within 10 min, and displayed the visual limit of detection (vLOD) values of 250, 500, and 1,000 ng/mL for PN, PM, and PL, respectively. For quantitative analysis, the results obtained by strip reader, with calculated LOD values for PN, PM, and PL were 14.10, 55.58, and 56.25 ng/mL, respectively. Commercial energy drinks and B-vitamin complex tablet samples were detected by the strips and the results were confirmed with high-performance liquid chromatography. Overall, the developed AuNPs-based immunochromatographic sensor was suitable and promising for the group-specific recognition and rapid detection of VB6 in fortified foods and dietary supplements.

This study's objective was to assess which caring recruitment behaviors correlate with the successful recruitment of older African-American adults-a two-step cross-sectional design employing a vignette-based survey methodology. Kristen Swanson's middle-range theory of caring was used to guide the examination of African-American adults' (65 years of age and older) perceptions of research-study-recruiter recruitment behaviors. This study's main findings are twofold: Step 1: Seven of ten invited experts identified major revisions of the two core vignettes, written at an eighth-grade reading level and high school comprehension. Step 2: A 51% response rate yielded findings that this methodology successfully captured older African-American adults' perception of research study recruiters' behavioral characteristics during the recruitment process. Older African-Americans who received the hypothetical caring vignette were twice as likely to indicate their willingness to enroll in a research study with a high commitment (i.e., brain donation) compared to their counterparts who received the hypothetical uncaring recruitment scenario. Vignette-based survey methodology holds promise as a tool for informing the recruitment of older African-American adults and other minorities into federally funded health-related research studies.

The wettability of the paper surface is greatly affected by the wettability of the pulp fibers. We conducted this study in order to understand the relationship between the wettability of a single fiber of recycled pulp and the strength of recycled paper, as well as the inter-fiber bonding strength. The contact angle was determined from a series of photographs of the pulp fiber and the water silhouettes at the point of contact. The contact line and profile history were continuously photographed in every 1 s after the initial contact. The recycled softwood kraft pulp fibers were clearly much less hydrophilic than the original fibers, regardless of whether the fibers had been bleached or not. The contact angle of the original chemi-thermomechanical pulp fiber was much higher than that of the original softwood bleached kraft pulp fiber. Furthermore, increased number of recycling decreased the contact angle of the chemi-thermomechanical pulp fiber. The Page equation was used to evaluate the strength contributions of single fiber and fiber–fiber bonding to tensile strength of paper. As a result, an increase in weakness factor of fiber–fiber bonding strength was obtained for the recycled softwood kraft pulp handsheet. On the other hand, the weakness factor of the original chemi-thermomechanical pulp handsheet decreased with recycling. In addition, the weakness factor of fiber–fiber bonding strength and the contact angles of the provided softwood bleached kraft pulp fibers bore a proportional relationship to each other.

Three-dimensional visualization of cellular and subcellular-structures in histological-tissues is essential for understanding the complexities of biological-phenomena, especially with regards structural and spatial relationships and pathologlical-diagnosis. Recent advancements in tissue-clearing technology, such as Magnified Analysis of Proteome (MAP), have significantly improved our ability to study biological-structures in three-dimensional space; however, their wide applicability to a variety of tissues is limited by long incubation-times and a need for advanced imaging-systems that are not readily available in most-laboratories. Here, we present optimized MAP-based method for paper-thin samples, Paper-MAP, which allow for rapid clearing and subsequent imaging of three-dimensional sections derived from various tissues using conventional confocal-microscopy. Paper-MAP successfully clear tissues within 1-day, compared to the original-MAP, without significant differences in achieved optical-transparency. As a proof-of-concept, we investigated the vasculature and neuronal-networks of a variety of human and rodent tissues processed via Paper-MAP, in both healthy and diseased contexts, including Alzheimer’s disease and glioma.

A fluorescent paper strip immunoassay in conjunction with carbon nanodots@silica (CND@SiO2) as a label was developed for the quantitative measurements of human serum amyloid A1 (hSAA1) in serum at clinically significant concentrations for lung cancer diagnosis. Monodispersed CND@SiO2 was prepared by cohydrolysis between silane-crosslinked carbon nanodots and silica precursors via the Strober method and further attached covalently to anti-hSAA1 (14F8) monoclonal antibody [anti-hSAA1(14F8)] specific to the hSAA1 target. The hSAA1 concentrations were then determined by quantifying the blue fluorescence intensity upon 365 nm excitation of the captured hSAA1 with anti-hSAA1(14F8)-CND@SiO2 conjugates in the test line on a paper strip where anti-hSAA1 (10G1) monoclonal antibody was physisorbed. The developed fluorescent paper strip with CND@SiO2 can detect hSAA1 at concentrations ranging from 0.1 to 5 nM (R2 = 0.995), with a limit of detection of 0.258 nM in 10 mM phosphate buffer pH 7.4 containing human serum albumin. The performance of recovery (90.98–109.17%) and repeatability (coefficients of variation

BackgroundHealth information systems are crucial to provide data for decision-making and demand for data is constantly growing. However, the link between data and decisions is not always rational or linear and the management of data ends up overloading frontline health workers, which may compromise quality of healthcare delivery. Despite limited evidence, there is an increasing push for the digitalization of health information systems, which poses enormous challenges, particularly in remote, rural settings in low- and middle-income countries. Paper-based tools will continue to be used in combination with digital solutions and this calls for efforts to make them more responsive to local needs. Paper-based Health Information Systems in Comprehensive Care (PHISICC) is a transdisciplinary, multi-country research initiative to create and test innovative paper-based health information systems in three sub-Saharan African countries.Methods/DesignThe PHISICC initiative is being carried out in remote, rural settings in Côte d’Ivoire, Mozambique and Nigeria through partnership with ministries of health and research institutions. We began with research syntheses to acquire the most up-to-date knowledge on health information systems. These were coupled with fieldwork in the three countries to understand the current design, patterns and contexts of use, and healthcare worker perspectives. Frontline health workers, with designers and researchers, used co-creation methods to produce the new PHISICC tools. This suite of tools is being tested in the three countries in three cluster-randomized controlled trials. Throughout the project, we have engaged with a wide range of stakeholders and have maintained the highest scientific standards to ensure that results are relevant to the realities in the three countries.DiscussionWe have deployed a comprehensive research approach to ensure the robustness and future policy uptake of findings. Besides the innovative PHISICC paper-based tools, our process is in itself innovative. Rather than emphasizing the technical dimensions of data management, we focused instead on frontline health workers’ data use and decision-making. By tackling the whole scope of primary healthcare areas rather than a subset of them, we have developed an entirely new design and visual language for a suite of tools across healthcare areas. The initiative is being tested in remote, rural areas where the most vulnerable live.

The early diagnosis of active hepatitis C virus (HCV) infection remains a significant barrier to the treatment of the disease and to preventing the associated significant morbidity and mortality seen, worldwide. Current testing is delayed due to the high cost, long turnaround times and high expertise needed in centralised diagnostic laboratories. Here we demonstrate a user-friendly, low-cost pan-genotypic assay, based upon reverse transcriptase loop mediated isothermal amplification (RT-LAMP). We developed a prototype device for point-of-care use, comprising a LAMP amplification chamber and lateral flow nucleic acid detection strips, giving a visually-read, user-friendly result in, Current HCV nucleic acid-based diagnosis is largely performed in centralised laboratories. Here, the authors present a pan-genotypic RNA assay, based on reverse transcriptase loop mediated isothermal amplification and develop a low-cost prototype paper-based lateral flow device for point-of-care use, providing a visually read result within 40 min.

Cellulose fibers are a major industrial input, but due to their irregular shape and anisotropic material response, accurate material characterization is difficult. Single fiber tensile testing is the most popular way to estimate the material properties of individual fibers. However, such tests can only be performed along the axis of the fiber and are associated with problems of enforcing restraints. Alternative indirect approaches, such as micro-mechanical modeling, can help but yield results that are not fully decoupled from the model assumptions. Here, we compare these methods with nanoindentation as a method to extract elastic material constants of the individual fibers. We show that both the longitudinal and the transverse elastic modulus can be determined, additionally enabling the measurement of fiber properties in-situ inside a sheet of paper such that the entire industrial process history is captured. The obtained longitudinal modulus is comparable to traditional methods for larger indents but with a strongly increased scatter as the size of the indentation is decreased further.

BackgroundSmall bowel obstruction (SBO) is a common surgical emergency, causing high morbidity and healthcare costs. The majority of SBOs are caused by adhesions that result from previous surgeries. Bowel obstruction, however, also occurs in patients without previous operation or known pathology, a so called virgin abdomen. It is unknown if small bowel obstruction in the virgin abdomen (SBO-VA) can be managed according to the same principles as other cases of small bowel obstruction. The aim of this position paper is to evaluate the available evidence on etiology and management of small bowel obstruction in the virgin abdomen.MethodsThis is a narrative review with scoping aspects. Clinical topics covered in this review include epidemiology and etiology of SBO-VA, diagnosis and imaging, initial assessment, the role of surgical management in SBO-VA, and the role of non-operative management in SBO-VA.ResultsOur scoping search revealed seven original studies reporting original patient data related to SBO-VA. All the included studies are retrospective cohorts, with populations ranging between 44 and 103 patients with SBO-VA. Adhesions were found to be the cause of the obstruction in approximately half of the reported cases of SBO-VA. A relatively high number of cases of SBO-VA were managed surgically with studies reporting 39–83%. However, in cases where a trial of non-operative management was started, this was generally successful.ConclusionThe data available suggest that etiology and treatment results for patients with SBO-VA are largely comparable to the results in patients with SBO after previous abdominal surgery. We therefore propose that patients with a virgin abdomen could be treated according to existing guidelines for SBO and adhesive small bowel obstruction.

Background This article is a duplicated publication from the Japanese version of “2019 JSDT Guidelines for Peritoneal Dialysis” with permission from the Japanese Society for Dialysis Therapy (JSDT). This clinical practice guideline (CPG) was developed primarily by the Working Group on Revision of Peritoneal Dialysis (PD) Guidelines of the Japanese Society for Dialysis Therapy. Recently, the definition and creation process for CPGs have become far more rigorous; traditional methods and formats no longer adhere to current standards. To improve the reliability of international transmission of our findings, CPGs are created in compliance with the methodologies developed by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) working group. Part 2 of this PD guideline is the first CPG developed by our society that conforms to the GRADE approach. Methods Detailed processes were created in accordance with the Cochrane handbook and the GRADE approach developed by the GRADE working group. Results Clinical question (CQ)1: Is the use of renin-angiotensin system inhibitors (RAS inhibitors), such as angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB), effective in PD patients? Recommendation: We suggest the usage of RAS inhibitors (ACEI and ARB) in PD patients (GRADE 2C). CQ2: Icodextrin or glucose solution: which is more useful as a dialysate among patients with PD? Recommendation: We suggest using icodextrin when managing body fluids in PD patients (GRADE 2C). CQ3: Is it better to apply or not apply mupirocin/gentamicin ointment to the exit site? Recommendation: We suggest not applying mupirocin/gentamicin ointment to the exit sites of PD patients (GRADE 2C). CQ4: Which surgical approach is more desirable when a PD catheter is placed, open surgery or laparoscopic surgery? No recommendation. CQ5: Which administration route of antibiotics is better in PD patients with peritonitis, intravenous or intraperitoneal? Recommendation: We suggest intraperitoneal administration of antibiotics in PD patients with peritonitis (GRADE 2C). Note: The National Insurance does not currently cover intraperitoneal administration. CQ6: Is peritoneal dialysis or hemodialysis better as the first renal replacement therapy in diabetic patients? No recommendation. Conclusions In the future, we suggest that society members construct their own evidence to answer CQs not brought up in this guideline, and thereby show the achievements of Japan worldwide.

[No Abstract Available]

Wood degradation caused by fungi and insects is a major problem for the rubberwood industry. This study evaluated the potential of using pyrolysis liquids (wood vinegar) from Dyera costulata as a natural biocide against termites. The infestation rates of Coptotermes curvignathus on filter paper samples treated with 0.5%, 1.0%, 5.0% and 10.0% of Dyera costulata wood vinegar were observed in laboratory conditions. The effects of D. costulata wood vinegar treatment depended on the concentration. Filter paper samples treated with 10% D. costulata wood vinegar had the highest resistance against C. curvignathus attack, with the lowest relative mass loss, followed in rank order by the 5% and 1% treatments. Results from tests on Hevea brasiliensis wood treated with wood vinegar also showed a similar trend. The results suggest that D. costulata wood vinegar acts as a wood preservative against termites, provided proper concentration is used.

The interest in using magnetic nanoparticle (MNPs) as a carrier for immobilization is overwhelming due to high surface area and lightweight properties. However, the conventional synthesis of MNPs required use of high amount of chemicals and is a time-consuming process. Thus, in the present research, magnetized multiwall carbon nanotubes (m-MWCNTs) were successfully synthesized via water-based system using simple steps. The synthesized m-MWCNTs was used as carrier for the immobilization of cellulase. Cellulase was proven to be successfully bounded on m-MWCNTs using Fourier transform infrared spectroscopy that revealed a peak at 580.33 cm−1 indicating Fe–O stretching in parallel with observation of rougher and coarser surface of m-MWCNTs through scanning electron microscope. The total binding efficiency of cellulase to the m-MWCNTs was determined to be 95% at 5 mg/mL of the enzyme concentration. The activity of the immobilized cellulase was evaluated using carboxymethyl cellulose (CMC) as a substrate. Both of free and immobilized cellulase showed optimum working condition at 50 °C and pH 5. Furthermore, the immobilized cellulase was found to be able to retain more than 50% of its initial activity at the fifth cycle of the hydrolysis of CMC and filter paper. A similar activity was recorded with paddy straw at the third cycle of hydrolysis.

This paper is the second of two in a series. In our first paper, we presented a social justice framework emerging from an extensive literature review and incorporating core social determinants specific to mental health in the age of COVID-19 and illustrated specific social determinants impacting mental health (SDIMH) of our resettled Bhutanese refugee population during the pandemic. This second paper details specific barriers to the SDIMH detrimental to the basic human rights and social justice of this population during this pandemic. The SDIMH, as described, further informs the need for social justice measures and cultural humility in mental healthcare, public health, law, and community engagement. This work concludes with a proposed call to action toward mental health improvement and fair treatment for refugee populations in three core areas: communication and education, social stigma and discrimination, and accessibility and availability of resources.

This paper concerns a problem, the global pandemic COVID-19, which has influenced religious practices with respect to health protection across the Muslim world. Rapid transmission of the virus between people has become a serious challenge and a threat to the health protection of many countries. The increase in the incidence of COVID-19 in the Muslim community took place during and after the pilgrimages to Iran's Qom and as a result of the Jamaat Tabligh movement meetings. However, restrictions on religious practices have become a platform for political discussions, especially among Muslim clergy. This paper is an analysis of the religious and political situation in Muslim countries, showing the use of Islam to achieve specific goals by the authorities, even at the price of the health and life of citizens.

The Society of Skeletal Radiology (SSR) Practice Guidelines and Technical Standards Committee identified musculoskeletal infection as a White Paper topic, and selected a Committee, tasked with developing a consensus on nomenclature for MRI of musculoskeletal infection outside the spine. The objective of the White Paper was to critically assess the literature and propose standardized terminology for imaging findings of infection on MRI, in order to improve both communication with clinical colleagues and patient care.A definition was proposed for each term; debate followed, and the committee reached consensus. Potential controversies were raised, with formulated recommendations. The committee arrived at consensus definitions for cellulitis, soft tissue abscess, and necrotizing infection, while discouraging the nonspecific term phlegmon. For bone infection, the term osteitis is not useful; the panel recommends using terms that describe the likelihood of osteomyelitis in cases where definitive signal changes are lacking. The work was presented virtually to SSR members, who had the opportunity for review and modification prior to submission for publication.

Purpose International uniformity of definition and classification are crucial for diagnosis and management of cauda equina syndrome (CES). They are also useful for clinicians when discussing CES with patients and relatives, and for medicolegal purposes. Methods We reviewed published literature using PubMed on definition and classification of cauda equina syndrome since 2000 (21 years). Using the search terms ‘cauda equina’ and ‘definition’ or ‘classification’, we found and reviewed 212 papers. Results There were 17 different definitions of CES used in the literature. There were three well-defined methods of classification of CES. The two-stage system of incomplete CES (CESI) versus CES with retention (CESR) is the most commonly used classification, and has prognostic value although the details of this continue to be debated. Conclusion We used the existing literature to propose a clear definition of CES. We also drew on peer-reviewed published literature that has helped to amplify and expand the CESI/CESR dichotomy, adding categories that are both less severe than CESI, and more severe than CESR, and we propose clear definitions in a table form to assist current and future discussion and management of CES.

The COVID-19 pandemic has affected all countries irrespective of their state of development. In countries with traditional societies, religious leaders have been acknowledged as key stakeholders in community engagement activities, including disease prevention. A community-level prevention model was established in 2020 by the Health Promotion Bureau (HPB), Sri Lanka, which incorporated mobilisation of the clergy to support the prevention and response schemes to COVID-19 with non-governmental stakeholders. This model was part of a more extensive community engagement network established by the HPB in cooperation with the country offices for WHO and UNICEF. Building trust, empowering behavioural traits applicable to minimise risks from COVID-19, leadership and coordination, message dissemination, addressing stigma and discrimination, supporting testing procedures, contact tracing activities and vaccination, building community resilience, spiritual and psychosocial support, and welfare provision are some of the useful factors that were identified in the model. Furthermore, a much broader and holistic approach is needed to focus on health behaviours and social and cultural aspects in a multi-faceted nature. This paper highlights a novel COVID-19 prevention model with active involvement of religious leaders that can be implemented in low resource settings. Our experience from Sri Lanka demonstrates the feasibility of implementing this model to mitigate the disastrous situation following the COVID-19 outbreak.

Many advanced technologies have shown encouraging results in removing antibiotics from domestic wastewater. However, as activated sludge treatment is the most common sewage treatment system employed worldwide, improving its effect on antibiotic removal would be more desirable. Understanding the removal mechanisms, kinetics and factors that affect antibiotic removal in the activated sludge process is important as it would allow us to improve the treatment performance. Although these have been discussed in various literature covering different types of antibiotics and wastewater, a specific review on antibiotics and domestic wastewater is clearly missing. This review paper collates, discusses and analyses the removal of antibiotics from sewage in the activated sludge process along with the removal mechanisms and kinetics. The antibiotics are categorised into six classes: β-lactam, dihydrofolate reductase inhibitor, fluoroquinolone, macrolide, sulfonamides and tetracycline. Furthermore, the factors affecting the system performance with regard to antibiotic removal are examined.

The aim of this review is to investigate the recent development of kenaf derived biochar and its composites in various engineering and agricultural applications including nanostructure catalysts and polymer composites as kenaf biochar and activated carbon are mainly used as material adsorbents and soil amendments. A systematic review on the effect of process parameters of thermal decomposition, pyrolysis towards the production of desired biochar, therefore, is in crucial needs. Based on existing literature, the properties and production of kenaf biomass and resultant biochar are discussed in this paper. This analysis focuses on the unique characteristics of kenaf crops and the resulting biochar, which has a surprisingly large surface area and increased pore volume, to explain their prospective applications, whether in environmental utilization or engineering applications. Range of optimum surface areas for kenaf biochar are around 800–1000 m2/g where they show high adsorption properties. Whereas, the pore volume of activated carbon usually exceeds 1 cm3/g. Recent developments in engineered kenaf biochar technology and its future directions for research and development are also discussed.