Search

In people with bone and soft tissue injuries of the wrist, hand and/or fingers, do feedback-guided exercises performed on a tablet touchscreen hasten return to work, reduce healthcare usage and improve clinical recovery more than a home exercise program prescribed on paper? Randomised, parallel-group trial with concealed allocation, assessor blinding and intention-to-treat analysis. Seventy-four workers with limited functional ability due to bone and soft tissue injuries of the wrist, hand and/or fingers. Participants in the experimental and control groups received the same in-patient physiotherapy and occupational therapy. Participants in the experimental group received a home exercise program using the ReHand tablet application, which guides exercises performed on a tablet touchscreen with feedback, monitoring and progression. Participants in the control group were prescribed an evidence-based home exercise program on paper. The primary outcome was the time taken to return to work. Secondary outcomes included: healthcare usage (number of clinical appointments); and functional ability, pain intensity, and grip and pinch strength 2 and 4 weeks after randomisation. Compared with the control group, the experimental group: returned to work sooner (MD –18 days, 95% CI –33 to –3); required fewer physiotherapy sessions (MD –7.4, 95% CI –13.1 to –1.6), rehabilitation consultations (MD –1.9, 95% CI –3.6 to 0.3) and plastic surgery consultations (MD –3.6, 95% CI –6.3 to –0.9); and had better short-term recovery of functional ability and pinch strength. In people with bone and soft-tissue injuries of the wrist, hand and/or fingers, prescribing a feedback-guided home exercise program using a tablet-based application instead of a conventional program on paper hastened return to work and improved the short-term recovery of functional ability and pinch strength, while reducing the number of required healthcare appointments. ACTRN12619000344190 [ABSTRACT FROM AUTHOR]

The SIR Iber highlights the geographical location of Ibero-American universities by positioning them according to the indicators grouped into three main factors: research, innovation and social impact. The 2020 edition highlights the formation of three groups of countries according to the production capacity of higher education institutions. In group 1 we have: Brazil, Mexico, Chile, Argentina, and Colombia as Latin American countries that managed to publish more than 60,000 papers in the period 2014-2018. This paper analyzes and compares the indicators from the five (05) Latin American countries in group 1 of the SIR Iber 2020 referring to investment in I+S as a percentage of its Gross Domestic Product (PIB), the number of full-time equivalent researchers (Inv JCE), the production (%) of scientific works in the university education sector, to name a few. A conglomerate formed with the Normalized Impact (NI) of public and private IESs is presented, regarding the global average of citation, with the data published in the SIR IBER 2020 Report, and highlights that Chile has a normalized impact above the World average for both public and private IES publications. [ABSTRACT FROM AUTHOR]

The article discusses the positive pain reduction outcomes of a personalized care pathway for chronic knee pain post-total knee replacement.

• The use of the ProFibro app for six weeks was not more effective than the use of a traditional paper book with similar content for health-related quality of life, symptoms, or self-care agency in individuals with fibromyalgia. • Improvements on severity of symptoms in both groups suggest that the self-care program using a mobile app or a paper book may be beneficial in individuals with fibromyalgia. • The Sleep Strategies was the most used function of the ProFibro app, followed by the Exercise Program, and the diary for the practice of gratitude. The ProFibro application (app) was developed as a Mobile Health resource to promote self-care in fibromyalgia management. This study aimed to assess the effects of the use of the ProFibro app for six weeks compared to the use of a traditional paper book of similar content to improve health-related quality of life, symptoms, and self-care agency in individuals with fibromyalgia. Forty individuals with fibromyalgia were included in this randomized, single-blind, parallel trial. One group received intervention content using the ProFibro app on a smartphone while the other received similar information using a paper book. Participants were assessed at baseline and after six weeks. The primary outcome was the Revised Fibromyalgia Impact Questionnaire. Secondary outcomes were Widespread Pain Index, Pain Visual Analog Scale, Symptom Severity Scale, and Appraisal of Self-Care Agency Scale – Revised. No differences in changes were found between groups at the end of the treatment for any outcome. Both groups showed improvements in symptom severity. The use of the ProFibro app for six weeks was not more effective than the use of a traditional paper book with similar content for health-related quality of life, symptoms, or self-care agency in individuals with fibromyalgia. Both groups showed improvements from baseline on severity of symptoms, suggesting that the self-care program using a mobile app or a paper book may be beneficial for individuals with fibromyalgia. [ABSTRACT FROM AUTHOR]

This paper reports on a study evaluating the value of a documentary as a key medium to communicate design research. We present information from the evaluation of a second screen application using video as well as a scientific paper, in order to assess how the efficacy and usefulness of using such a documentary for science communication is perceived when compared to a scientific paper. Techniques of a method called Design Documentary , developed to inspire design research teams through video, combined with science journalism were the basis of the production. Twelve researchers and students were shown the documentary and asked to read the paper in counter-balanced order. Our qualitative results show that the documentary as a complementary means of communication can bring benefits to research communication, since it delivers information the paper cannot provide. However, the fact the video is not suited for peer review might restrict its place when compared to the paper. On the overall, participants thought both formats are valuable and are complementary. [ABSTRACT FROM AUTHOR]

Abstract: More than just being a substrate, paper can also provide evidence for the provenance of documents. An earlier paper described a method to compare paper structure, based on the Fourier power spectra of light transmission images. Good results were obtained by using the 2D correlation of images derived from the power spectra as a similarity score, but the method was very computationally intensive. Different comparison algorithms are evaluated in this paper, using information theoretical criteria. An angular invariant algorithm turned out to be as effective as the original one but 4 orders of magnitude faster, making the use of much larger databases possible. [Copyright &y& Elsevier]

We conduct a comparative life cycle assessment of two business card options: a smartphone software and the common paper- based alternative. Life cycle impacts of production, distribution and use of business cards were compared and contrasted for both systems. Given the prevalence and multifunctionality of digital devices and services, we analyze the environmental impacts of the two systems and evaluate their total energy consumption, Greenhouse Gas (GHG) emissions and toxic releases by conducting a two-stage life cycle assessment with alternating functional units. The results indicate that, for a small-scale functional unit, the paper-based business card system causes slightly less environmental impact and has lower energy demand than the software-based (digital) business card system. Whereas when considering the more likely, large scale (real world scenario) functional unit, the digital business card system is more environmentally friendly and economical in terms of energy consumption. By comparing these two systems, this paper serves businesses and consumers when considering environmental consequences and energy depletion of their business networking options. [ABSTRACT FROM AUTHOR]

Abstract: A set of inks was analyzed using Py/GC/MS technique. They were prepared following some ancient Armenian recipes and then analyzed after being dried in air to obtain solid samples. A simple analytical procedure was adopted which excludes any treatment of the samples and consists in introducing the solid sample directly into the injector of the furnace pyrolyzer. Inks were also written on whatman paper by calamum and analyses of papers containing ink were carried out. A real sample analysis was reported. Comparing the pyrograms it was possible to discriminate fragments derived from ink, from that formed by the decomposition of paper by the influence of ink. In order to understand the origin of the fragments formed during the pyrolysis of inks the standard compounds used to prepare them were carried out, too. [Copyright &y& Elsevier]

Abstract: There are a number of issues which are involved with organizing a conference. Among these issues, assigning conference-papers to reviewers is one of the most difficult tasks. Assigning conference-papers to reviewers is automatically the most crucial part. In this paper, we address this issue of paper-to-reviewer assignment, and we propose a method to model the reviewers, based on the matching degree between the reviewers and the papers by combining a preference-based approach and a topic-based approach. We explain the assignment algorithm and show the evaluation results in comparison with the Hungarian algorithm. [Copyright &y& Elsevier]

Abstract: Patients with advanced-stage cancer often have a high symptom burden and reduced functional status, implying that the patients themselves should be involved in development and testing of interactive assessment tools. This paper reports on an assessment of use of a pain tool, which led to changes in both medium and program in order to adapt to the patients’ needs and abilities. Our study shows how a change in medium for pain assessment from paper via laptop to iPad affects the interaction with the tool on important aspects of use. We also show how changes of medium affect the readability of the output for health care workers. We achieved better results with an iPad-based pain assessment tool developed through user-centered design compared to both a paper-based and conventional laptop-based tool. [Copyright &y& Elsevier]

Abstract: MobilePaperAccess is a wearable camera-glasses system with tangible user interface allowing mobile interaction. We access the digital information from a paper interface extending the input space. The system is devised to validate our concepts of Environment Dependent Interface (EDI) and Environment Independent Interface (EII), which focus on enabling people to access their personal data as well as public resources at any time and in any place. In this paper, we propose a continuum from physical interface to digital interface in relation with EDI and EII, and we present design, implementation and evaluation aspects of our MobilePaperAccess system. We compare two interfaces (EDI and EII) and three input techniques (finger input, mask input and page input). [Copyright &y& Elsevier]

In the very few recently published paper by Alavidoost et al. [1] , they proposed a novel fuzzy adaptive genetic algorithm for multi-objective assembly line balancing problem, in continue of their previous presented work by Alavidoost et al. [2] , as a modification on genetic algorithm for assembly line balancing with fuzzy processing times. Despite the fact that both of them are well-written, and completely discussed their contributions, this note looks forward to collate these papers together. Likewise provides the correct order of the figures in [1] matching with their corresponding caption. [ABSTRACT FROM AUTHOR]

The article offers information on the task-oriented exercise which improved disability, pain and quality of life compared with general physiotherapy for surgically treated proximal humeral fractures.

The article reflects on large-scale randomized controlled trial aimed to compare arthroscopic hip surgery with physiotherapy and activity modification in patients with femoroacetabular impingement; the study compared routine arthroscopic care and postoperative physiotherapy, as provided in England, to a goal-based physiotherapy and activity modification program developed for conducting this specific randomized controlled trial only the surgical arm was pragmatic.

Abstract: Cooling tower emissions are harmful for several reasons such as air polluting, wetting, icing and solid particle deposition, but mainly due to human health hazards (i.e. Legionella). There are several methods for measuring drift drops. This paper is focussed on the sensitive paper technique, which is suitable in low drift scenarios and real conditions. The lack of an automatic classification method motivated the development of a digital image process algorithm for the Sensitive Paper method. This paper presents a detailed description of this method, in which, drop-like elements are identified by means of the Canny edge detector combined with some morphological operations. Afterwards, the application of a J48 decision tree is proposed as one of the most relevant contributions. This classification method allows us to discern between stains whose origin is a drop and stains whose origin is not a drop. The method is applied to a real case and results are presented in terms of drift and PM10 emissions. This involves the calculation of the main features of the droplet distribution at the cooling tower exit surface in terms of drop size distribution data, cumulative mass distribution curve and characteristic drop diameters. The Log-normal and the Rosin–Rammler distribution functions have been fitted to the experimental data collected in the tests and it can been concluded that the first one is the most suitable for experimental data among the functions tested (whereas the second one is less suitable). Realistic PM10 calculations include the measurement of drift emissions and Total Dissolved Solids as well as the size and number of drops. Results are compared to the method proposed by the U.S. Environmental Protection Agency assessing its overestimation. Drift emissions have found to be 0.0517% of the recirculating water, which is over the Spanish standards limit (0.05%). [Copyright &y& Elsevier]

Abstract: Objective: To assess whether a user-centred prototype clinical decision support system (CDSS) providing patient-specific advice better supports healthcare practitioners in terms of (a) types of usability problems detected and (b) effective and efficient retrieval of childhood cancer survivor's follow-up screening procedures compared to an expert-driven paper-based guideline. Methods and materials: A user-centred design (UCD) process was employed to design a prototype CDSS. Usability problems in information retrieval with the paper-based guideline were assessed by think-aloud analysis with 13 participants. Both simple and more complex tasks were applied. The analysis provided input for the UCD process of the prototype. The usability of the prototype CDSS was subsequently evaluated by think-aloud analysis with the same participants. Usability problems of the paper-based guideline and the prototype CDSS were compared by using the classification of usability problems scheme. In addition, efficiency (time to complete task) and effectiveness (completeness of retrieved screening procedures) of information retrieval of participants in the expert-driven paper-based guideline and the user-centred prototype CDSS were compared. Results: Usability problems in both the paper-based guideline and the CDSS prototype were mainly classified as ‘incongruent with participants’ mental model’. The prototype CDSS reduced this type of problem from 17 to 6 problems. The time to perform simple information retrieval tasks increased by 58s when using the prototype CDSS, however, it resulted in a 58% improvement in task completeness compared to the paper-based guideline. The time to perform complex scenarios decreased by 3:50min with the prototype CDSS, with 17% higher completeness compared to the paper-based guideline. Conclusion: Analysis showed that usability problems experienced by healthcare practitioners when using a paper-based guideline could be overcome by implementing the guideline in a user-centred CDSS design. Although different types of usability problems were experienced with the prototype CDSS, they did not inhibit effective and efficient performance of tasks in the system. The usability problem analysis of the paper-based guideline effectively supported comparison of usability problems found in the two information retrieval systems and it supported the UCD of the CDSS. [Copyright &y& Elsevier]

Highlights: [•] Assessment documentation practices are varying across aged care organizations. [•] EHRs produce higher amount and more comprehensive assessment data. [•] Electronic assessment forms are better signed and dated than the paper forms. [•] EHRs need to improve the completeness and timeliness of assessment documentation. [ABSTRACT FROM AUTHOR]

Abstract: In this study, the effects of white-rot fungus (Coriolus versicolor) on the properties of high density polyethylene (HDPE)/wood flour/paper sludge composites were examined. In addition, the effectiveness of using coupling agent on the durability of decayed and undecayed WPCs was investigated. Two different types of sludge materials, namely paper making waste water sludge (PS) and ink-eliminated sludge (IES) were used. The mechanical properties, morphology, and water absorption of fabricated composites were investigated. At a similar wood flour loading, except for modulus of elasticity, the fungi treated composites showed lower mechanical properties (such as modulus of rupture and unnotched Izod impact strength), and higher water absorption compared to untreated composites. According to the results, addition of wood flour decreased the resistance of the composites to moisture and fungal environment. The exposure of the composites to a 4-cycle (2, 24, 48 and 72h) water immersion caused serious damage to the interfacial adhesion between wood flour and polymer matrix due to contraction and swelling stresses developed during the cyclic exposure. The detrimental effect of fungal treatment on the water uptake of the composites could be explained by the degradation of lignin which made the cellulose content more accessible. Further, it makes chains of cavities that accelerate water absorption. However, the weight losses of all cases of treated composites were low (less than 2.5%), while PS filled composites were more susceptible to white-rot fungi. The addition of coupling agent during the compounding of wood flour and HDPE prevented the colonization and proliferation of fungus on the surface of the composites, and had an advantageous effect on the water uptake and mechanical properties of both treated and untreated composites. [Copyright &y& Elsevier]

Abstract: Wood extractives present in pulp and paper mill effluents may cause reproductive disturbances in fish. A chronic-exposure toxicity experiment using immature rainbow trout (Oncorhynchus mykiss) was conducted in order to assess the endocrine disrupting effects of two Chilean pulp and paper mill specific extracts (solid phase extraction, SPE) obtained from primary and secondary treated effluents. The (anti)estrogenic potencies and toxicity of the wood extractives regularly present in pulp mill effluent such as dehydroabietic acid (DHAA), β-sitosterol (BS), and model estrogen 17β-estradiol (E2) were evaluated by analysis of plasma vitellogenin (VTG) levels, gonadal somatic index (GSI) and liver ethoxyresorufin-O-deethylase (EROD) activity, respectively. The protocol involved the use of multiple intra-peritoneal injections (1 injection every 7 days for a total exposure period of 28 days). Analysis of variance/covariance, demonstrated no differences associated with fish gender other than GSI. The phytosterol BS, E2 and both pulp mill effluent extracts showed significant inductions of EROD and increased VTG levels after 4, 7, 14, 21 and 28 of exposure. While fish injected with secondary treated effluent extract showed a delayed induction in VTG levels compared to primary effluent injected fish, no effects on VTG and EROD levels were observed in DHAA injected fish. Moreover simultaneous injection of DHAA+E2 reduced the VTG levels found in E2 injected fish, indicating a potential indirect anti-estrogenic effect of this resin acid. The results of this study indicate that Chilean pulp and paper mill effluent extracts are estrogenic in rainbow trout males and females. [Copyright &y& Elsevier]

Isotope ratio mass spectrometry (IRMS) using carbon isotopes has previously been shown to be a robust and discriminating technique for the comparison of document papers. This study aims to examine the inter and intra sample variability for oxygen isotopes measured in standard 80gsm white document papers, to inform the comparison of document papers in forensic casework. 123 paper samples collected from Australia and New Zealand over a 24-month period were measured for their bulk oxygen isotopic abundance and were found to sit within a range of 15‰. A homogeneity study was undertaken which included examining the variability of samples at the sheet, ream and brand source levels. The results of this study were used to construct guidelines for sample comparison and as such, 95% confidence intervals were observed to be inappropriate for use given the high intra sample variability. Instead, a 1.4‰ discrimination range (0.7‰ either side of the measured value) was defined for use as a benchmark for discrimination when samples were measured in the same sequence. Utilising this value, 82% of the samples could be discriminated using a paired comparison, demonstrating a strong potential for use within forensic casework. [ABSTRACT FROM AUTHOR]

Highlights: [•] Investigates benchmarked performance of global and emerging knowledge cities. [•] Introduces a knowledge-based urban development performance assessment model. [•] Applies the assessment model into an international comparative study. [•] Reveals insights on scrutinizing the development perspectives of knowledge cities. [ABSTRACT FROM AUTHOR]

Thin layer chromatography (TLC) is a simple and inexpensive type of chromatography that is extensively used in forensic laboratories for drugs of abuse analysis. In this work, TLC is optimized to analyze cocaine and its adulterants (caffeine, benzocaine, lidocaine and phenacetin) in which the sensitivity (visual determination of LOD from 0.5 to 14mgmL(-1)) and the selectivity (from the study of three different eluents: CHCl3:CH3OH:HCOOHglacial (75:20:5v%), (C2H5)2O:CHCl3 (50:50v%) and CH3OH:NH4OH (100:1.5v%)) were evaluated. Aiming to improve these figures of merit, the TLC spots were identified and quantified (linearity with R(2)>0.98) by the paper spray ionization mass spectrometry (PS-MS), reaching now lower LOD values (>1.0μgmL(-1)). The method developed in this work open up perspective of enhancing the reliability of traditional and routine TLC analysis employed in the criminal expertise units. Higher sensitivity, selectivity and rapidity can be provided in forensic reports, besides the possibility of quantitative analysis. Due to the great simplicity, the PS(+)-MS technique can also be coupled directly to other separation techniques such as the paper chromatography and can still be used in analyses of LSD blotter, documents and synthetic drugs. [ABSTRACT FROM AUTHOR]

The Phadebas® Forensic Press Test is routinely used for the detection of saliva. However, assessment of the use of Phadebas® paper for this purpose has not been studied extensively. The suitability of Phadebas® paper as a presumptive screening tool for saliva on forensic exhibits, was investigated by analysing the following: (1) sensitivity, (2) specificity, (3) effects of temperature on sensitivity and specificity, (4) detection of saliva in mixed body fluid samples, and (5) influence of substrate porosity. The results of this study demonstrated that Phadebas® paper is more sensitive to α-amylase activity and less specific for saliva than previously reported. The use of an examination temperature of 37°C had no effect on sensitivity, but increased the incidence of cross-reactivity with other forensically relevant body fluid stains. Blood, urine and vaginal secretions can inhibit the detection of α-amylase activity with Phadebas® paper in mixed stains of saliva and body fluid. Substrate porosity is a weak predictor for the time taken for a saliva stain to achieve a strong positive result on Phadebas® paper. Overall, this study demonstrated that the Phadebas® Forensic Press Test has limitations as a presumptive test for the accurate identification of saliva. [ABSTRACT FROM AUTHOR]

The aim of this research was to quantify and compare the environmental impact of a number of different deinking sludge utilization approaches. A comparative life cycle assessment of deinking sludge material and energy recovery was performed for the baseline scenario—landfill disposal, and four alternative scenarios: two cement plants, a lightweight aggregate plant, and a stone wool plant. Sludge pretreatment and transportation processes were included in the scenario analyses. The results of the life cycle assessment showed that the use of dry deinking sludge in a cement plant in Finland, 45 km from the point of supply of the deinking sludge, to substitute 46% of the petcoke and 2.7% of the limestone showed the best performance. Therein, a global warming potential reduction of 13% and an eutrophication potential reduction of 12% – the highest reduction out of all impact categories studied – were achieved. A similar reduction in global warming potential of 12% was achieved when deinking sludge was incinerated and the ash utilized in cement production in a Russian plant located 350 km from the paper mill. However, abiotic depletion potential and acidification potential slightly increased by 2.6 and 1.5%, respectively. A maximum reduction of 2.1% out of al impact categories was achieved when dry sludge was used in a lightweight aggregate plant. That is considerably less compared to the reduction achieved at the cement plants. The use of deinking sludge ash in a stone wool plant to substitute 25% of cement resulted in a maximum reduction of 25% in the ozone layer depletion potential. Thus, the utilization of deinking sludge in construction materials production while preventing its landfilling has beneficial effects on the environment, in particular decreased greenhouse gas emissions. [ABSTRACT FROM AUTHOR]

Background: Electronic data collection is increasingly being used for discrete choice experiments (DCEs).Objectives: To study whether paper or electronic administration results in measurement effects.Methods: Respondents were drawn from the same sample frame (an Internet panel) and completed a nearly identical DCE survey either online or on paper during the same period. A DCE on preferences for basic health insurance served as a case study. We used panel mixed logit models for the analysis.Results: In total, 898 respondents completed the survey: 533 respondents completed the survey online, whereas 365 respondents returned the paper survey. There were no significant differences with respect to sociodemographic characteristics between the respondents in both samples. The median response time was shorter for the online sample than for the paper sample, and a smaller proportion of respondents from the online sample were satisfied with the number of choice sets. Although some willingness- to-pay estimates were higher for the online sample, the elicited preferences for basic health insurance characteristics were similar between both modes of administration.Conclusions: We find no indication that online surveys yield inferior results compared with paper-based surveys, whereas the price per respondent is lower for online surveys. Researchers might want to include fewer choice sets per respondent when collecting DCE data online. Because our findings are based on a nonrandomized DCE that covers one health domain only, research in other domains is needed to support our findings. [ABSTRACT FROM AUTHOR]

Nine paddy straw-degrading microbial consortia were isolated from 253 paddy straw samples from northern China and the Yangtze River Valley, which are two major rice production regions in China. The microbial consortia completely degraded filter paper within 15 d at 25 °C. The V4 region of the microbial consortia 16S rRNA gene was amplified, and the amplicons were sequencing using the Illumina Miseq high-throughput platform. Compilobacterota and Bacteroidota were the predominant phyla in the samples. At the genus level, the relative abundance of Macellibacteroides was the highest in Y2, and Arcobacter was predominant in the other samples. Analysis of the microbial community structure revealed that the diversity and richness in samples from the Yangtze River Valley were significantly higher compared with those of the samples from northern China, and the community structure of the four microbial consortia from the northern region had higher similarity than the five consortia from the Yangtze River Valley. • Campilobacterota and Bacteroidetes were the predominant phyla of microbial consortia. • The major genera in the two regions were significantly different. • Pseudomonas , Comamonas , Fibrobacter , Sphingobacterium , Ruminiclostridium , and Ruminococcus are the functional bacteria. • The northern bacterial community richness and diversity were lower than the Yangtze River Valley. • The northern microbial community structure was higher in similarity than the Yangtze River Valley. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to assess the measurement equivalence of individual response scale types by using a patient reported outcome measure (PROM) collected on paper and migrated into electronic format for use on the subject's own mobile device (BYOD) and on a provisioned device (site device).Methods: Subjects suffering from chronic health conditions causing daily pain or discomfort were invited to participate in this single-site, single visit, three-way crossover study. Association between individual item and instrument subscale scores was assessed by using the intraclass correlation coefficient (ICC) and its CI. Participant attitudes toward the use of BYOD in a clinical trial were assessed through use of a questionnaire.Results: In this study, 155 subjects (females 83 [54%]; males 72 [46%]) ages 19 to 69 years (mean ± SD: 48.6 ± 13.1) were recruited. High association between the modes of administration (paper, BYOD, site device) was shown with analysis of ICCs (0.79-0.98) for each response scale type, including visual analogue scale, numeric rating scale, verbal response scale, and Likert scale. Of the subjects, 94% (146 of 155) stated that they would definitely or probably be willing to download an app onto their own mobile device for a forthcoming clinical trial. Forty-five percent of subjects felt BYOD would be more convenient compared with 15% preferring a provisioned device (40% had no preference).Conclusions: This study provides strong evidence supporting the use of BYOD for PROM collection in terms of the conservation of instrument measurement equivalence across the most widely used response scale types, and high patient acceptance of the approach. [ABSTRACT FROM AUTHOR]

Context: Researchers administering surveys seek to balance data quality, sources of error, and practical concerns when selecting an administration mode. Rarely are decisions about survey administration based on the background of study participants, although socio-demographic characteristics like age, education, and race may contribute to participants' (non)responses.Objectives: In this study, we describe differences in paper- and web-based surveys administered in a national cancer survivor study of women with a history of cancer to compare the ability of each survey administrative mode to provide quality, generalizable data.Methods: We compared paper- and web-based survey data by socio-demographic characteristics of respondents, missing data rates, scores on primary outcome measure, and administrative costs and time using descriptive statistics, tests of mean group differences, and linear regression.Results: Our findings indicate that more potentially vulnerable patients preferred paper questionnaires and that data quality, responses, and costs significantly varied by mode and participants' demographic information. We provide targeted suggestions for researchers conducting survey research to reduce survey error and increase generalizability of study results to the patient population of interest.Conclusion: Researchers must carefully weigh the pros and cons of survey administration modes to ensure a representative sample and high-quality data. [ABSTRACT FROM AUTHOR]

Objective: Most preventable adverse drug events and medication errors occur during medication ordering. Medication order entry and clinical decision support are available on paper or as computerized systems. In this post-hoc analysis we investigated frequency and clinical impact of blood glucose (BG) documentation- and user-related calculation errors as well as workflow deviations in diabetes management. We aimed to compare a paper-based protocol to a computerized medication management system combined with clinical workflow and decision support.Methods: Seventy-nine hospitalized patients with type 2 diabetes mellitus were treated with an algorithm driven basal-bolus insulin regimen. BG measurements, which were the basis for insulin dose calculations, were manually entered either into the paper-based workflow protocol (PaperG: 37 patients) or into GlucoTab(®)-a mobile tablet PC based system (CompG: 42 patients). We used BG values from the laboratory information system as a reference. A workflow simulator was used to determine user calculation errors as well as workflow deviations and to estimate the effect of errors on insulin doses. The clinical impact of insulin dosing errors and workflow deviations on hypo- and hyperglycemia was investigated.Results: The BG documentation error rate was similar for PaperG (4.9%) and CompG group (4.0%). In PaperG group, 11.1% of manual insulin dose calculations were erroneous and the odds ratio (OR) of a hypoglycemic event following an insulin dosing error was 3.1 (95% CI: 1.4-6.8). The number of BG values influenced by insulin dosing errors was eightfold higher than in the CompG group. In the CompG group, workflow deviations occurred in 5.0% of the tasks which led to an increased likelihood of hyperglycemia, OR 2.2 (95% CI: 1.1-4.6).Discussion: Manual insulin dose calculations were the major source of error and had a particularly strong influence on hypoglycemia. By using GlucoTab(®), user calculation errors were entirely excluded. The immediate availability and automated handling of BG values from medical devices directly at the point of care has a high potential to reduce errors. Computerized systems facilitate the safe use of more complex insulin dosing algorithms without compromising usability. In CompG group, missed or delayed tasks had a significant effect on hyperglycemia, while in PaperG group insufficient precision of documentation times limited analysis. The use of old BG measurements was clinically less relevant.Conclusion: Insulin dosing errors and workflow deviations led to measurable changes in clinical outcome. Diabetes management systems including decision support should address nurses as well as physicians in a computerized way. Our analysis shows that such systems reduce the frequency of errors and therefore decrease the probability of hypo- and hyperglycemia. [ABSTRACT FROM AUTHOR]

Background: The adoption and use of health information technology (IT) continues to grow around the globe. In Switzerland, the government nor professional associations have to this day provided incentives for health IT adoption.Objective: We aim to assess the proportion of physicians who are routinely working with electronic health data and describe to what extent physicians exchange electronic health data with peers and other health care providers. Additionally, we aim to estimate the effect of physicians' attitude towards health IT on the adoption of electronic workflows.Methods: Between May and July 2013, we conducted a cross-sectional survey of 1200 practice based physicians in Switzerland. Respondents were asked to report on their technical means and where applicable their paper-based workarounds to process laboratory data, examination results, referral letters and physician's letters. Physicians' view of barriers and facilitators towards health IT use was determined by a composite score.Results: A response rate of 57.1% (n=685) was reached. The sample was considered to be representative for physicians in Swiss ambulatory care. 35.2% of the respondents documented patients' health status with the help of a longitudinal semi-structured electronic text record generated by one or more encounters in the practice. Depending on the task within a workflow, around 11-46% of the respondents stated to rely on electronic workflow practices to process laboratory and examination data and dispatch referral notes and physician's letters. The permanent use of electronic workflow processes was infrequent. Instead, respondents reported paper-based workarounds affecting specific tasks within a workflow. Physicians' attitude towards health IT was significantly associated with the adoption of electronic workflows (OR 1.04-1.31, p<0.05), but the effect sizes of factors related to the working environment (e.g., regional factors, medical specialty, type of practice) were larger.Conclusion: At present, only a few physicians in Swiss ambulatory care routinely work with electronic health data. Until more of their peers participate in electronic exchange of structured clinical information, most physicians will continue to stay in paper-based systems and workarounds. The survey found that physicians with a positive attitude towards health IT were more likely to adopt electronic workflows, but the impact is minor. It will likely be necessary to introduce financial incentives and develop national standards in order to promote the adoption by a critical mass of practicing clinicians. [ABSTRACT FROM AUTHOR]

Abstract: The feasibility of using Indigo carmine (IC) as a probe of free radical production in photocatalysis was elucidated by comparative studies of its bleaching by γ radiolysis and TiO2 photocatalysis. The γ radiation result from pH 3 to 10 shows that both 2 ch IC and that the bleaching yields of independent at ∼0.7 molecules per uantum yields (ϕ) of egussa p25 TiO2 photocatalysis from pH 3 to 10 was determined. It was found that ϕ was about 4% at pH 10 and dropped to below 1% at pH 3. This agrees well with the result of photocatalysis of Fricke dosimetry at pH 1. The effects of some common inorganic anions that may affect photocatalytic systems in technical applications (Cl−, SO4 2−, Br−, HPO4 2−, B4O7 2−, HCO3 −/CO3 2−) was also investigated, showing that these ions does not inhibit the photocatalytic bleaching efficiency of IC. [Copyright &y& Elsevier]

Highlights: [•] Evaluation of new HWP accounting method leads to significant GHG emission reduction for Canada. [•] Use of harvested wood for energy and of construction lead to largest GHG savings. [•] A cascade-use for wood and paper products is paramount for further GHG improvement. [•] The end-of-life effect of using recycled waste wood for energy is delayed due to longer carbon uptake. [•] Cradle-to-cradle utilization of wood waste has an underdeveloped reduction potential. [Copyright &y& Elsevier]

Background: Fermentation is a widely used method of natural food preservation that has consequences on the nutritional value of the transformed food. Fermented dairy products are increasingly investigated in view of their ability to exert health benefits beyond their nutritional qualities.Objective: To explore the mechanisms underpinning the health benefits of fermented dairy intake, the present study followed the effects of milk fermentation, from changes in the product metabolome to consequences on the human serum metabolome after its ingestion.Methods: A randomized crossover study design was conducted in 14 healthy men [mean age: 24.6 y; mean body mass index (in kg/m2): 21.8]. At the beginning of each test phase, serum samples were taken 6 h postprandially after the ingestion of 800 g of a nonfermented milk or a probiotic yogurt. During the 2-wk test phases, subjects consumed 400 g of the assigned test product daily (200 g, 2 times/d). Serum samples were taken from fasting participants at the end of each test phase. The serum metabolome was assessed through the use of LC-MS-based untargeted metabolomics.Results: Postprandial serum metabolomes after milk or yogurt intake could be differentiated [orthogonal projections to latent structures discriminant analysis (OPLS-DA) Q2 = 0.74]. Yogurt intake was characterized by higher concentrations of 7 free amino acids (including proline, P = 0.03), reduced concentrations of 5 bile acids (including glycocholic acid, P = 0.04), and modulation of 4 indole derivative compounds (including indole lactic acid, P = 0.01). Fasting serum samples after 2 wk of daily intake of milk or yogurt could also be differentiated based on their metabolic profiles (OPLS-DA Q2 = 0.56) and were discussed in light of the postprandial results.Conclusion: Metabolic pathways related to amino acids, indole derivatives, and bile acids were modulated in healthy men by the intake of yogurt. Further investigation to explore novel health effects of fermented dairy products is warranted.This trial was registered at clinicaltrials.gov as NCT02230345. [ABSTRACT FROM AUTHOR]

Objectives: A new patient-reported outcome (PRO) instrument to measure fatigue symptoms and impacts in relapsing multiple sclerosis (RMS) was developed in a qualitative stage, followed by psychometric validation and migration from paper to an electronic format.Methods: Adult patients with relapsing-remitting multiple sclerosis (RRMS) were interviewed to elicit fatigue-related symptoms and impacts. A draft questionnaire was debriefed in cognitive interviews with further RRMS patients, and revised. Content confirmation interviews were conducted with patients with progressive-relapsing multiple sclerosis (PRMS) and relapsing secondary-progressive multiple sclerosis (RSPMS). Psychometric analyses used data from adult patients with different RMS subtypes and matched non-RMS controls in a multicenter, observational study. After item reduction, the final instrument was migrated to a smartphone (eDiary) and usability was confirmed in interviews with additional adult RMS patients.Results: The qualitative stage included 37 RRMS, 5 PRMS, and 5 RSPMS patients. Saturation of concepts was reached during concept elicitation. Cognitive interviews confirmed that participants understood the instructions, items, and response options of the instrument-named FSIQ-RMS-as intended. Psychometric validation included 164 RMS and 74 control patients. Internal consistency and test-retest reliability were demonstrated. The symptoms domain discriminated along the RMS symptom-severity continuum and between patients and controls. Patients were able to attribute fatigue-related symptoms to RMS. Usability and conceptual equivalence of the eDiary were confirmed (n = 10 participants).Conclusions: With 7 symptom items and 13 impact items (in 3 impacts subdomains: physical, cognitive and emotional, and coping) after item reduction, the FSIQ-RMS is a comprehensive, valid, and reliable measure of fatigue-related symptoms and impacts in RMS patients. [ABSTRACT FROM AUTHOR]

Iron deficiency is the most common micronutrient deficiency worldwide, and transferrin receptor (TfR) level has been identified as an important measure of iron status that is not confounded by inflammation. However, logistical constraints associated with sample collection and processing have limited efforts to measure TfR, particularly at the community level. Standardized filter paper provides a relatively convenient and minimally invasive means for collecting and transporting samples of whole blood from simple finger pricks, and we present results of our validation of an improved method for quantifying TfR in dried blood spots. The method is based on commercially available reagents and uses capillary blood that is applied directly from the finger to filter paper, eliminating the need for premeasurement at the collection site. The blood spot TfR assay is precise and reliable, agrees well with plasma TfR, and can be performed at any facility with a microplate reader and basic laboratory equipment. Concentrations of TfR remain stable for at least 4 wk when blood spots are stored at room temperature, but begin to deteriorate after 3 d of exposure to higher temperatures. The advantages and disadvantages of the blood spot TfR method are discussed, as well as its potential contribution to future field-based studies of iron deficiency. [ABSTRACT FROM AUTHOR]

The detection and identification of body fluids at a crime scene shed light on the events which might have occurred and the people involved in the crime; the techniques used being lengthy, makes the on-scene detection a tough process to carry out and handle. This study aims to develop an on-spot detection method for serological testing using silica gel encapsulation technique and a modified microfluidic paper-based analytical device (μPADs). Kastle-Meyer reagent was incorporated into the μPAD and Silica Gel plate and was subsequently validated for the detection of blood. This study revealed that the μPAD was a better option. The emerging technique of μPADs allows a cost-effective and simple method of detection for body fluids. The fibrous network of the paper is manipulated to fabricate a guided channel for the fluid flow. The guided channels in the modified μPADs were fabricated by patterning a hydrophobic barrier out of wax. The analyte of interest for this study is blood but the principle can be modified to include other biological fluids. [ABSTRACT FROM AUTHOR]

Rationale and Objectives: The aims of this study were to label the versatile amino acid l-lysine with 99mTc using 2,3-dimercapto-succinic acid (DMSA) as a chelator, and to assess its tumor imaging feasibility under in vivo and in vitro conditions, and finally to determine the subcellular biodistribution of this radiopharmaceutical. Materials and Methods: DMSA-l-lysine was chemically synthesized and labeled with sodium pertechnetate. Nuclear magnetic resonance (NMR) and mass spectral analysis of DMSA-l-lysine were conducted. Radiochemical purity was determined by thin-layer chromatography (TLC) and paper chromatography. Cellular uptake, competition and subcellular localization studies were performed in rat breast cancer cells (13762). In vivo studies of planar imaging and biodistribution studies were performed on female Fischer 344 rats. Medical Internal Radiation Dose (MIRD) dosimetry estimates were calculated. Results: Radiochemical purity (determined by radio-TLC and high-performance liquid chromatography) of these compounds was >95%. 99mTc-DMSA-l-lysine showed good uptake in in vitro cell culture assays and uptake was reduced in competition studies. 99mTc-DMSA-l-lysine accumulates in the nucleus as much as in the cytoplasm and it was also shown that accumulation of the 99mTc-DMSA-l-lysine in the nucleus increases as a function of a time. There was an increase in tumor-to-blood and tumor-to-muscle count density ratios. Tumor/background ratios were 5.75 at 1 hour and 6.87 at 2 hours. In vivo tissue distribution studies revealed that radiation dosimetry of blood-forming organs were within radiation dose limits. Conclusion: DMSA-l-lysine kits can be labeled with 99mTc easily and efficiently, with high radiochemical purity and cost-effectiveness. In vitro cellular uptake and scintigraphic imaging studies demonstrated the pharmacokinetic distribution and feasibility of using 99mTc-DMSA-l-lysine for tumor imaging. [Copyright &y& Elsevier]

Parkinson's disease (PD) is a prevalent and debilitating neurological disorder affecting millions worldwide, necessitating early and precise diagnosis for effective management and therapy. Recent breakthroughs in artificial intelligence (AI) applications within the medical field have showcased promising potential in disease identification and diagnosis. This study presents a comprehensive analysis of cutting-edge AI-based methods for the identification of Parkinson's disease. This paper encompasses extensive testing on substantial datasets containing both PD patients and healthy individuals, aiming to assess the efficacy of AI models. Performance metrics such as sensitivity, specificity, accuracy, and the area under the receiver operating characteristic curve (AUC-ROC) are employed to evaluate model performance rigorously. This paper is not only reviewing the state-of-the-art AI techniques for Parkinson's disease identification but also introduces novel contributions in the field. Our results demonstrate the potential of AI in achieving early and accurate PD diagnosis, offering hope for improved patient care and treatment outcomes. Furthermore, this study paves the way for future research and development in the domain of AI-driven healthcare, with the ultimate goal of enhancing the quality of life for individuals suffering from Parkinson's disease and similar neurodegenerative conditions. [ABSTRACT FROM AUTHOR]

Functional foods can be considered to be those whole, fortified, enriched or enhanced foods that provide health benefits beyond the provision of essential nutrients (e.g., vitamins and minerals), when they are consumed at efficacious levels as part of a varied diet on a regular basis. Linking the consumption of functional foods or food ingredients with health claims should be based on sound scientific evidence, with the "gold standard" being replicated, randomized, placebo-controlled, intervention trials in human subjects. However, not all foods on the market today that are claimed to be functional foods are supported by enough solid data to merit such claims. This review categorizes a variety of functional foods according to the type of evidence supporting their functionality, the strength of that evidence and the recommended intakes. Functional foods represent one of the most intensively investigated and widely promoted areas in the food and nutrition sciences today. However, it must be emphasized that these foods and ingredients are not magic bullets or panaceas for poor health habits. Diet is only one aspect of a comprehensive approach to good health. [ABSTRACT FROM AUTHOR]

The impact of orbitally shaking bioreactors (OSRs) on the biopharmaceutical industry is becoming increasingly important. In the preliminary exploration of the orbitally shaking bioreactor performance, the vessel wall shape has a crucial influence on the mixing and mass transfer in the bioreactor. However, the shape of OSRs still maintains a cylindrical structure, significantly limiting the advantages of the orbital shaking mixing. Therefore, in order to further improve the mixing and mass transfer performance of OSRs, a novel wall shape is proposed in this paper. This novel wall shape consists of cylindrical and square parts and looks like a square tank with a large circular chamfer (STCC), which was found could effectively enhance the efficiency of material mixing and mass transfer theoretically. Based on the same specific volumetric power consumption, a comparative analysis was conducted on the mixing time and oxygen transfer efficiency of OSRs with different shape walls using simulation and experimental methods. The results showed that the OSR with STCC was expected to perform higher mixing and oxygen transfer efficiency than the OSR with cylindrical wall. These findings suggested a promising prospect for the future application of the OSRs with STCC. • Developing a novel wall structure (STCC) improving the mixing performance of OSRs. • Both oxygen mass transfer and mixing efficiency were increased with the STCC effect. • Improving the bioreactor performance with low calculated shear stress. • Mixing speed was found significantly lower in the vortex center than other regions. • Promising prospect for the future application of the OSRs with STCC. [ABSTRACT FROM AUTHOR]

Flooding is a threatening human/climate-induced hazard and the expected increase in the frequency and severity of floods is challenging cities worldwide. Modern flood risk management advocates the diversification of measures and strategies to face floods. This diversification is endorsed by the risk-based approach that – unlike the standards-based approach – emphasizes the need of addressing both the probability and consequences of floods and stresses the importance of collaboration between spatial planners and water managers in the field of flood risk management. In this paper, the politicized Institutional Analysis and Development (IAD) framework is used as an analytical ordering device to systematically examine the interplay between discursive, institutional, and contextual factors in enabling or hampering the shift toward a risk-based approach in flood management policies for the Metropolitan City of Naples and the Metropolitan City of Milan. Striking similarities across the cases and recurring patterns reveal three main entangled governance issues hampering the shift toward a risk-based approach, namely: poor coordination across levels of government, communities of actors, and policy domains. The paper concludes with a set of recommendations for policy-makers on how to address these three governance challenges for successful flood adaptation policy responses. • This research advances our understanding of the poor spatialization of flood risk management strategies. • By drawing on a multiple-case design, flood policies in Naples and Milan are comparatively analyzed. • Institutional, discursive, and contextual factors enable or constrain the shift toward a risk-based approach. • Due to poor multi-level, multi-actor, and multi-sector coordination, this shift has largely failed. • Recommendations on how to enhance vertical and horizontal coordination are provided. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to analyze the development paths leading to the transition to cleaner bleaching technologies in the pulp industry. It devotes particular attention to the key features of the Swedish transition, but also compares this to the Finnish experiences. The empirical investigation builds on an analytical framework highlighting the conditions under which pollution regulations can provide efficient incentives for deep emission reductions at industrial plants. Existing and new archive material, including not least comprehensive license trial acts for Swedish pulp mills over an extended time period, are studied. Based on this historical analysis our findings contradict previous literature, the latter emphasizing that pressures from consumers and the public were the most significant driving forces behind the adoption of–and innovation in–alternative bleaching technologies during the late 1980s. Instead, this paper asserts, the green pulp transition was characterized by regulation-induced technological change and was made possible by long history of industry-wide cooperation in environmental R&D. Furthermore, while previous research has emphasized the leading role of the Nordic countries in green pulp innovation, we identify a number of profound differences between Finland and Sweden. These emerge from various national contexts in terms of, for instance, industry structures and strategies, political cultures, and regulatory styles. Finally, at a more general level the paper provides a few policy implications for supporting the ongoing transition towards a forest-based bioeconomy. [ABSTRACT FROM AUTHOR]

This paper presents a comparative analysis of Multi-Temporal Interferometric Synthetic Aperture Radar (MT-InSAR) algorithms in a corner reflector located in Lisbon, Portugal. The reflector was monitored using daily observations from the Global Navigation Satellite System (GNSS) technique with submillimeter precision. The study focuses on comparing the performance and accuracy of different MT-InSAR approaches i) the Persistent Scatterer Interferometry (PSI) method using the open-source software StaMPS, ii) the PSI method using the commercial software SARPROZ, iii) the Quasi-PS method implemented with the SARPROZ software, as well as iv) a hybrid method Persistent scatterer – Distributed Scatterer (PS-DS) obtained from the European Ground Motion Service (EGMS) with SqueeSAR algorithm. The study period assumed was from October 2017 to January 2019, by considering the same initial information (ascending orbit Sentinel images). Statistical analysis of the time series was also performed, and the density of points in the vicinity was evaluated. To provide a comprehensive evaluation of accuracy, the uncertainties associated with both the GNSS and InSAR techniques were assessed. The findings of this comparative analysis offer valuable insights into the strengths and limitations of various MT-InSAR algorithms by using a more precise technique as a benchmark. The results improve the understanding of deformation monitoring in geodetic applications and highlight the potential for enhanced accuracy in such assessments. [ABSTRACT FROM AUTHOR]

There are several system modeling notations based on system thinking. So far, these notations have not been compared. In this paper, we propose the GPDAC (Goal, Process, Data, Actor, Control) as a framework for creating new systems engineering knowledge by recombining knowledge from different academic fields. Moreover, a comparative study reveals the relationship among system modeling notations such as Systemigram, OPM (Object Process Methodology), and ArchiMate. [ABSTRACT FROM AUTHOR]

This paper describes an application dedicated to collecting and mining reports of software safety vulnerabilities and exposures in physical systems. This work focuses on the clustering problem of such reports, which means grouping them through automated computing process. The clustering is carried out in two stages. In the first stage, potential similarities between the reports, together with the number of clusters are detected through automated text analysis. In the second stage, a hierarchical clustering is conducted to reduce the number of these clusters to provide potential number of appropriate clusters of the group of reports. The clustering of the second stage provides the user with greater flexibility in viewing individual reports. This paper focuses mainly on the first stage of described clustering method. Two selected clustering algorithms have been compared with the aim to show how to detect the most appropriate number of groups between scraped documents. The computational experiment results are presented and discussed in the experimental section of this work. [ABSTRACT FROM AUTHOR]

The immense growth of Android mobile malware threats has pushed cybersecurity researchers to develop efficient systems that can detect new Android malware. In spite of the academic and industrial attempts to establish a robust, reliable, and efficient solution for Android, malware classification is considered an open problem with many challenges. This paper sheds light on the performance of several machine learning algorithms and analyzes their efficiency in detecting android malware. Moreover, it applies Synthetic Minority Oversampling Technique (SMOTE), normalizes the numerical features and PCA to reach the maximum accuracy. Furthermore, the paper develops a Light Gradient Boosting Model to identify Android malware and classify their families into five classes: Adware, Banking Malware, SMS Malware, Mobile Riskware, and Benign. The paper uses a large and recent dataset, which consists of 11,598 APK collected from several sources and provided by the Canadian Institute of Cybersecurity. [ABSTRACT FROM AUTHOR]

Video Super-Resolution (VSR) is gaining massive attention in the digital age across various application domains such as video surveillance and ultra-high-definition displays. Deep learning (DL) has recently made significant progress in research and industry domains. Existing researchers used numerous VSR methods based on deep learning to improve the resolution. VSR is based on inter-frame information utilization. Video frames provide the leverage information of data that modalities record sequentially, i.e.; the object's temporal changes cause inconsistent measurements. Consequently, suitable models and algorithms must be developed to provide artifact-free images. This paper goes through two reconstruction methods incorporating various motion data sources. Initially, it describes an iterative approach that implicitly treats dynamic behavior as uncertainty in the forward model. Further direct reconstruction techniques can be derived for an explicit motion map. This paper compares both explicit and implicit motion compensation-based methods. Convolutional neural networks (CNN) and recurrent, residual network (RRN) based methods from a deep learning environment are analyzed to reconstruct the High-Resolution (HR) frames. This paper shows numerical findings for both methods using simulated data. Observations show that RRN can boost the super-resolution (SR) performance and achieve considerable visual quality after reconstruction; however, performance is limited to small datasets due to shallow network parameters. Extensive experiments show that RRN significantly impacts SR results due to its substantial computational efficiency. [ABSTRACT FROM AUTHOR]

Methadone has several unique characteristics that make it an attractive option for pain relief in serious illness, but the safety of methadone has been called into question after reports of a disproportionate increase in opioid-induced deaths in recent years. The American Pain Society, College on Problems of Drug Dependence, and the Heart Rhythm Society collaborated to issue guidelines on best practices to maximize methadone safety and efficacy, but guidelines for the end-of-life scenario have not yet been developed. A panel of 15 interprofessional hospice and palliative care experts from the U.S. and Canada convened in February 2015 to evaluate the American Pain Society methadone recommendations for applicability in the hospice and palliative care setting. The goal was to develop guidelines for safe and effective management of methadone therapy in hospice and palliative care. This article represents the consensus opinion of the hospice and palliative care experts for methadone use at end of life, including guidance on appropriate candidates for methadone, detail in dosing, titration, and monitoring of patients' response to methadone therapy. [ABSTRACT FROM AUTHOR]