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Instead of typical household trash, the heavy metal complexes, organic chemicals, and other poisons produced by huge enterprises threaten water systems across the world. In order to protect our drinking water from pollution, we must keep a close eye on the situation. Nanotechnology, specifically two-dimensional (2D) nanomaterials, is used in certain wastewater treatment systems. Graphene, g-C3N4, MoS2, and MXene are just a few examples of emerging 2D nanomaterials that exhibit an extraordinary ratio of surface (m3), providing material consumption, time consumption, and treatment technique for cleaning and observing water. In this post, we'll talk about the ways in which 2D nanomaterials may be tuned to perform certain functions, namely how they can be used for water management. The following is a quick overview of nanostructured materials and its possible use in water management: Also discussed in length are the applications of 2D nanomaterials in water purification, including pollutant adsorption, filtration, disinfection, and photocatalysis. Fluorescence sensors, colorimetric, electrochemical, and field-effect transistors are only some of the devices being studied for their potential use in monitoring water quality using 2D nanomaterials. Utilizing 2D content has its benefits and pitfalls when used to water management. New developments in this fast-expanding business will boost water treatment quality and accessibility in response to rising awareness of the need of clean, fresh water among future generations. Resumo Em vez do lixo doméstico típico, os complexos de metais pesados, produtos químicos orgânicos e outros venenos produzidos por grandes empresas ameaçam os sistemas de água em todo o mundo. Para proteger nossa água potável da poluição, devemos ficar de olho na situação. A nanotecnologia, especificamente nanomateriais bidimensionais (2D), é usada em certos sistemas de tratamento de águas residuais. Grafeno, g-C3N4, MoS2 e MXene são apenas alguns exemplos de nanomateriais 2D emergentes que exibem uma extraordinária proporção de superfície (m3), proporcionando consumo de material, consumo de tempo e técnica de tratamento para limpeza e observação da água. Neste trabalho, trataremos das maneiras pelas quais os nanomateriais 2D podem ser ajustados para desempenhar determinadas funções, ou seja, como eles podem ser usados para o gerenciamento de água. A seguir, uma breve visão geral dos materiais nanoestruturados e seu possível uso no gerenciamento de água. Serão também discutidas detalhadamente as aplicações de nanomateriais 2D na purificação de água, incluindo adsorção de poluentes, filtração, desinfecção e fotocatálise. Sensores de fluorescência, colorimétricos, eletroquímicos e transistores de efeito de campo são apenas alguns dos dispositivos que estão sendo estudados para uso potencial no monitoramento da qualidade da água usando nanomateriais 2D. A utilização de conteúdo 2D tem seus benefícios e armadilhas quando utilizada para gerenciamento de água. Novos desenvolvimentos neste negócio em rápida expansão visam aumentar a qualidade e a acessibilidade do tratamento de água em resposta à crescente conscientização sobre a necessidade de água limpa e fresca entre as gerações futuras.

Objective: We aim to 1) use the UpPriority tool to identify which clinical questions (CQs) within the clinical guidelines (CGs) need to be prioritized for updating and 2) assess the implementation of the tool in a real-world set of CGs. Study Design and Setting: We systematically assessed CQs from a sample of CGs developed in the Spanish National Health System CG program. We applied the UpPriority tool to each CG using a step-by-step process that included: 1) establishment of the UpPriority Implementation Working Group, 2) mapping of the original CG questions and recommendations, 3) development of a survey to prioritize CQs, 4) assessment of CQ's priority according to six items, 5) calculation and ranking of priority scores, 6) decision of prioritized CQs for updating, and 7) development of the priority report. We assessed the tool implementation process (appraisers' experience when using the tool) and the inter-observer reliability of the tool, and we provided suggestions for improvement. Results: We included four CGs with a total of 107 CQs on the following topics: chronic heart failure (10 CQs), inherited retinal dystrophies (39 CQs), menopause (20 CQs), and open-angle glaucoma (38 CQs). We included a total of 30 participants, most of them clinicians that were members of the original CG development groups. CQs were classified in three groups: 1) high priority (CQs prioritized for updating [16/107; 15.0%]), 2) medium priority (CQs that could be prioritized for updating [47/107; 43.9%]), and low priority (CQs that were not prioritized for updating [44/107; 41.1%]). The mean time each appraiser needed to assess the CQs with the tool was 3.8 hours (range 0.5 to 10). Agreement among the appraisers varied among the CGs. Appraisers considered that the tool was useful. We suggest some areas for consideration when using the tool including: 1) identification of key appraisers, 2) customization of training materials, 3) establishment of priority thresholds, and 4) provision of methodological support. Conclusion: The UpPriority is a useful tool to identify which CQs within a CG need to be prioritized for update in a real-world scenario. Recruitment and training of topic experts are the main challenges when using the tool. (c) 2021 Elsevier Inc. All rights reserved.

BACKGROUND: The optimal diuretic treatment strategy for patients with acute heart failure and renal dysfunction remains unclear. Plasma carbohydrate antigen 125 (CA125) is a surrogate of fluid overload and a potentially valuable tool for guiding decongestion therapy. The aim of this study was to determine if a CA125 guided diuretic strategy is superior to usual care in terms of short-term renal function in patients with acute heart failure and renal dysfunction at presentation.; METHODS: This multicenter, open-label study randomized 160 patients with acute heart failure and renal dysfunction into two groups (1:1). Loop diuretics doses were established according to CA125 levels in the CA125-guided group (n=79), and to clinical evaluation in the usual care group (n=81). Changes in estimated glomerular filtration rate (eGFR) at 72 and 24h were the co-primary endpoints, respectively.; RESULTS: The mean age was 78±8years, the median amino-terminal pro-brain natriuretic peptide was 7765pg/mL, and the mean eGFR was 33.7±11.3mL/min/1.73m2. Over 72h, the CA125-guided group received higher furosemide equivalent dose compared to usual care (p=0.011), which translated into higher urine volume (p=0.042). Moreover, patients in the active arm with CA125>35U/mL received the highest furosemide equivalent dose (p

BACKGROUND: The optimal diuretic treatment strategy for patients with acute heart failure and renal dysfunction remains unclear. Plasma carbohydrate antigen 125 (CA125) is a surrogate of fluid overload and a potentially valuable tool for guiding decongestion therapy. The aim of this study was to determine if a CA125-guided diuretic strategy is superior to usual care in terms of short-term renal function in patients with acute heart failure and renal dysfunction at presentation. METHODS: This multicenter, open-label study randomized 160 patients with acute heart failure and renal dysfunction into 2 groups (1:1). Loop diuretics doses were established according to CA125 levels in the CA125-guided group (n = 79) and in clinical evaluation in the usual-care group (n = 81). Changes in estimated glomerular filtration rate (eGFR) at 72 and 24 hours were the co-primary endpoints, respectively. RESULTS: The mean age was 78 +/- 8 years, the median amino-terminal pro-brain natriuretic peptide was 7765 pg/mL, and the mean eGFR was 33.7 +/- 11.3 mL/min/1.73m(2). Over 72 hours, the CA125-guided group received higher furosemide equivalent dose compared to usual care (P = 0 .011) , which translated into higher urine volume (P = 0 .0 42) . Moreover, patients in the active arm with CA125 >35 U/mL received the highest furosemide equivalent dose (P

Background The objective of this study was to determine whether carrying a heavy schoolbag is associated to a higher prevalence of low back pain (LBP). Methods A systematic review and meta-analysis was conducted (PROSPERO, CRD42018077839). Observational studies analysing the relationship between schoolbag weight and LBP, were searched for in 20 electronic databases and 12 specialized journals until February 28th, 2019, without date or language restrictions. All studies which included >= 50 subjects aged 9 to 16, were reviewed. Methodological quality was assessed by two reviewers separately, using validated tools. A meta-analysis and an individual patient data (IPD) meta-analysis were conducted to examine the relationship between schoolbag weight and LBP. Certainty of evidence was assessed using an adapted GRADE methodology. Results 5,524 citations were screened, 21 studies (18,296 subjects) were reviewed and 11 studies (9,188 subjects) were included in the meta-analysis. The IPD meta-analysis included 9,188 subjects from seven studies. Among the 21 studies reviewed, the mean score for methodological quality was 78.3 of 100. Only one study suggested an association between heavier schoolbags and LBP. Neither the meta-analysis nor the IPD meta-analysis found an association between carrying schoolbags weighing > 10% of bodyweight, and LBP. No differences based on age, gender or sport activity were found. Discussion Available evidence does not support that schoolbags weighing > 10% of bodyweight are associated with a higher prevalence of LBP among schoolchildren aged 9-16. The certainty of evidence is low. Further research is required on the relationship between schoolbag weight and LBP. Significance This systematic review, with a meta-analysis and an IPD meta-analysis, failed to find a link between schoolbags weighing >= 10% of body weight and LBP among schoolchildren aged 9 to 16. Further longitudinal studies, with large samples, long follow-up periods, and rigorous methods taking into account duration of carry and the physical capacity of each subject, are required in this field.

This study considers the problem of optimizing the routes of vehicles used in an agricultural cooperative that distributes animal feed to its customers. Different peculiarities distinguish our problem from the general Vehicle Routing Problem because there exists a type of time window constraint, truck capacity is limited, trucks are compartmentalized, there are access restrictions for trucks to some farms and our problem has the main objective of maximizing the amount of feed distributed every day and an auxiliary criterion of minimizing the transport costs. We present a mathematical programming formulation of the model that represents the logistics management problem. As solving the exact model is computationally expensive, we opt for a hybrid heuristic approach that first uses an insertion heuristic algorithm to obtain an initial solution and then improvement processes are performed using the so-called simulated annealing metaheuristic. We have built a graphical interface that allows easy use of the system and, in particular, efficient post-optimality analysis. Moreover, this interface can easily interface with other management tools. The utility of our model is shown with real and simulated data sets.