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In this paper, we report a novel method for enhancing the flame retardancy of wood-based paper by utilizing natural biomaterials. The research constructed a bilayered structure coating on paper fiber surfaces, incorporating mixed starch (MS), adenosine triphosphate (ATP), and phytic acid (PA) as natural bio-based flame retardants. The structural configuration of the coating comprises MS/ATP and MS/PA, which were sequentially assembled as bottom and top parts, respectively, through pneumatic spraying. The surface morphological features and elemental distribution analysis of treated paper indicated that bio-materials were successfully assembled, which resulted in a uniform flame retardant coating on the paper fiber surface. Compared to the untreated paper, the limiting oxygen index of 20 bilayers (BL) treated paper increased substantially from 19.07% to 24.00%, and the thermogravimetric analysis showed out the residual char yield enhanced from 23.80% to 38.10% under nitrogen atmosphere. The cone calorimeter test results of 20 BL treated paper have approximately a 50.00% reduction than the untreated paper in both peak and total heat release rates. During thermal exposure, the top and bottom parts of the bilayered structure coating are successively flame retarded prior to paper fiber degrading. The method presented in this paper provides an environmentally sustainable approach for producing flame retardant wood-based paper.

In this paper, we report a novel method for enhancing the flame retardancy of wood-based paper by utilizing natural biomaterials. The research constructed a bilayered structure coating on paper fiber surfaces, incorporating mixed starch (MS), adenosine triphosphate (ATP), and phytic acid (PA) as natural bio-based flame retardants. The structural configuration of the coating comprises MS/ATP and MS/PA, which were sequentially assembled as bottom and top parts, respectively, through pneumatic spraying. The surface morphological features and elemental distribution analysis of treated paper indicated that bio-materials were successfully assembled, which resulted in a uniform flame retardant coating on the paper fiber surface. Compared to the untreated paper, the limiting oxygen index of 20 bilayers (BL) treated paper increased substantially from 19.07% to 24.00%, and the thermogravimetric analysis showed out the residual char yield enhanced from 23.80% to 38.10% under nitrogen atmosphere. The cone calorimeter test results of 20 BL treated paper have approximately a 50.00% reduction than the untreated paper in both peak and total heat release rates. During thermal exposure, the top and bottom parts of the bilayered structure coating are successively flame retarded prior to paper fiber degrading. The method presented in this paper provides an environmentally sustainable approach for producing flame retardant wood-based paper. [ABSTRACT FROM AUTHOR]

Microfluidic paper-based analytical devices (µPADs) have gained significant attention in analytical science and technology due to their numerous advantages over traditional analytical techniques, including cost-effectiveness, miniaturization, and sustainability. µPADs are widely used in point-of-care diagnostics, health monitoring, environmental detection, food safety, forensics, and security. Since the first report in 2007, there have been substantial advancements in their fabrication techniques, detection methods, and applications. Over the years, significant efforts and advancements have been made to improve the cost-effectiveness, manufacturing scalability, user-friendliness, and sustainability of µPADs. In this review, we explore the general trends and advancements in the fabrication, sensing methods, and applications of µPADs, highlighting key improvements and innovations. We also examine the eco-friendliness of µPADs and present real-world success stories from field studies and citizen science initiatives. Additionally, we address the challenges associated with transitioning µPADs from the lab to the field. Finally, we examine the outlook for µPADs and propose strategies to improve their usefulness in various fields.

IntroductionThis systematic review and meta-analysis present a comprehensive evaluation of paper-based microfluidic devices, focusing on their applications in immunoassays. These devices are emerging as innovative solutions to democratize access to diagnostic technologies, especially in resource-limited settings. Our review consolidates findings from diverse studies to outline advancements in paper-based microfluidic technology, including design intricacies and operational efficacy. Key advantages such as low cost, portability, and ease of use are highlighted.Materials and MethodsThe review categorizes literature based on the design and operational nuances of these diagnostic tools, exploring various methodologies, fabrication techniques, detection methods, and applications, particularly in protein science. The meta-analysis extends to the diverse applications of these technologies, providing a framework for classifying and stratifying their uses in diagnostics.Results and discussionNotable findings include a critical analysis of performance metrics, such as sensitivity and specificity. The review addresses challenges, including the need for further validation and optimization for broader clinical applications. A critical discussion on the validation processes, including cross-validation and rigorous control testing, is provided to ensure the robustness of microfluidic devices. This study offers novel insights into the computational strategies underpinning these technologies and serves as a comprehensive roadmap for future research, potentially broadening the impact across the protein science universe.

BackgroundPaper mulberry is a promising alternative fodder source due to its high protein and the abundance of active components. However, paper mulberry often faces susceptibility to contamination during silage fermentation, and there is a need to improve the quality of silage fermentation of paper mulberry through exotic additives. Sea buckthorn pomace (BP) is a feed additive containing antimicrobial and antioxidant substances that help to enhance silage fermentation. Therefore, the objective of this study was to evaluate the effects of BP and Lactiplantibacillus as additives on silage fermentation and bacterial community of paper mulberry.ResultsThe results showed that BP and Lactiplantibacillus significantly reduced the pH and ammonium nitrogen content of paper mulberry silage (P < 0.05) and significantly increased the content of lactic acid and acetic acid (P < 0.05), resulting in more residual water-soluble carbohydrate and crude protein contents and less fiber content relative to the control. The key microorganisms in paper mulberry silage fermentation are Lactiplantibacillus pentosus and Weissella cibaria. Among these, Lactiplantibacillus favored a rapid increase in Lactiplantibacillus pentosus abundance during the pre-silage fermentation period, whereas BP favored the promotion of Lactiplantibacillus pentosus growth, resulting in higher contents of lactic and acetic acid than those of the control.ConclusionsSimultaneously adding Lactiplantibacillus and BP can effectively improve the quality of paper mulberry silage and increase the abundance of beneficial microorganisms in paper mulberry silage.

Background: Paper symptom diaries are a common tool for assessing motor fluctuations in Parkinson's disease (PD) patients, but there are concerns about inaccuracies in the assessment of motor fluctuation due to recall bias and poor compliance. We, therefore, developed an electronic diary with reminder and real-time recording functions. Objectives and methods: To evaluate the effectiveness of the electronic diary, we compared compliance and motor fluctuation assessment with a paper diary. Nineteen PD patients were recruited and recorded paper diaries every 30 min from 8 am to 8 pm for 7 days, followed by 7 days of electronic diary recording using a smartphone and smartwatch. Prior to the recording period, the Parkinson's Disease Questionnaire (PDQ)-39 and the Movement Disorders Society-sponsored Unified Parkinson's Disease Rating Scale-Revised (MDS-UPDRS) 1, 2, 3, 4 were measured. Patients completed a patient questionnaire on the usability of the diaries after the recording period. Results: Total reported time was significantly longer in paper diaries, but there was no significant difference in the number of entries (paper 115 [71–147] vs. electronic 109 [93–116], p = 0.77). There was a significant correlation between paper and electronic diaries with respect to motor status. ON time rate recorded in the electronic diary was significantly correlated with PDQ-39, MDS-UPDRS 1, 2, and 4, while MDS-UPDRS 1 was only correlated with ON time rate in the paper diary. The usability of our electronic diary was found to be satisfactory based on the results of patient questionnaire. Conclusion: Electronic diaries are useful tools that more accurately reflect PD motor fluctuations. [ABSTRACT FROM AUTHOR]

Paper and board are widely used as food contact materials. For such sensitive applications, consumer safety regarding the transfer of chemical components and contaminants to the food needs to be established. Such safety assessments are becoming increasingly challenging not only due to intentionally added substances but also non-intentionally added substances. In the European Union, compliance testing and safety evaluation of paper in food contact are largely based on national legislation and standards. The underlying tests are conventional methods, often overestimating and sometimes underestimating the migration into food. In this article, the relevant standard test methods are contrasted with currently available scientific knowledge. The scientific approaches to develop and identify suitable test methods are critically reviewed. Furthermore, theoretical predictions via mathematical modeling, with the aim to realistically simulate transfer to food, are presented and discussed in comparison with available migration studies with foods. Objectives are to (i) summarize the actual scientific knowledge in the field and draw conclusions regarding the potential and limitations of the existing test methods and (ii) identify research gaps toward a better qualitative and quantitative understanding of transport processes of volatile and non-volatile substances from paper and board into foods.

Developing land use strategies to optimize carbon sinks and improve carbon footprints involves proposing efficient nature-based solutions that industries and businesses can implement while considering financial and legislative constraints. The pulp and paper industry is associated with significant greenhouse gas (GHG) emissions, primarily due to the substantial carbon dioxide (CO2) footprint of its mills. Also, some forestry operations contribute to the release of carbon to the atmosphere in the form of CO2 and methane (CH4). Conversely, this industry could potentially be a significant ally in the fight against climate change by favoring forestry practices that reduce carbon emissions and increase its sequestration, namely, by adding value to industrial by-products (e.g., biosolids) instead of treating them as wastes and landfilling them. Notably, the pulp and paper industry has been seeking alternative uses of its by-products, such as fertilizers to maximize tree growth. In this paper, we identify opportunities and challenges that exist for the pulp and paper industry in regard to recycling industrial by-products to: 1) lower GHG emissions directly at the mill and 2) improve its GHG budget by increasing carbon sequestration in forests and plantations. We illustrate our analyses by describing a case study of a pulp and paper mill in southern Quebec, Canada, that uses its biosolids and other by-products as fertilizers. This case study highlights that this strategy could not only contribute to the reduction of GHGs but could also create added value and improve economic returns of forest operations.

BackgroundPaper symptom diaries are a common tool for assessing motor fluctuations in Parkinson’s disease (PD) patients, but there are concerns about inaccuracies in the assessment of motor fluctuation due to recall bias and poor compliance. We, therefore, developed an electronic diary with reminder and real-time recording functions.Objectives and methodsTo evaluate the effectiveness of the electronic diary, we compared compliance and motor fluctuation assessment with a paper diary. Nineteen PD patients were recruited and recorded paper diaries every 30 min from 8 am to 8 pm for 7 days, followed by 7 days of electronic diary recording using a smartphone and smartwatch. Prior to the recording period, the Parkinson’s Disease Questionnaire (PDQ)-39 and the Movement Disorders Society-sponsored Unified Parkinson’s Disease Rating Scale-Revised (MDS-UPDRS) 1, 2, 3, 4 were measured. Patients completed a patient questionnaire on the usability of the diaries after the recording period.ResultsTotal reported time was significantly longer in paper diaries, but there was no significant difference in the number of entries (paper 115 [71–147] vs. electronic 109 [93–116], p = 0.77). There was a significant correlation between paper and electronic diaries with respect to motor status. ON time rate recorded in the electronic diary was significantly correlated with PDQ-39, MDS-UPDRS 1, 2, and 4, while MDS-UPDRS 1 was only correlated with ON time rate in the paper diary. The usability of our electronic diary was found to be satisfactory based on the results of patient questionnaire.ConclusionElectronic diaries are useful tools that more accurately reflect PD motor fluctuations.

Poor-quality medicines (substandard or counterfeit) can lead to treatment failure. There is a vast global imbalance in cancer treatment outcomes due to the difficulty of accessing quality chemotherapeutic products. Early diagnosis of cancer brings more hope for curative treatment of cancer and increases the demand for chemotherapeutic products. Consequently, it creates opportunities for unethical manufacturers and suppliers to develop substandard and/or counterfeit products. An ongoing review of cost-effective analytical methods is therefore paramount to tracking and tracing poor chemotherapeutic pharmaceutical products. Low- and middle-income country (LMIC) regulators lack safety equipment and standard operating procedures to handle chemotherapeutic products safely in the drug analysis laboratory and have limited capacity to perform post-marketing surveillance on these products. This review aimed to provide a compressive review of the Chemotherapeutic Paper Analytical Device (ChemoPAD). ChemoPAD is an important tool for quality screening of commonly used chemotherapeutic products in LMIC settings. It is an efficient, fast, simple, accessible, cost-effective, and transferable analytical method for verifying substandard and/or counterfeit chemotherapeutic products. Designed as a complete paper-based laboratory the size of a playing card, the ChemoPAD provides a promising solution for healthcare providers, patients, and other parties involved in post-marketing surveillance of chemotherapeutic products. Thus, in the near future, scientists could probably witness the use of the ChemoPAD technology platform to trace and track substandard and/or counterfeit chemotherapeutic products.

Conventional techniques for sharing paper documents in teleconferencing tend to introduce two inconsistencies: 1) media inconsistency: a paper document is converted into a digital image on the remote site; 2) space inconsistency: a workspace deliberately inverts the partner’s handwriting to make a document easy to read. In this paper, we present a novel system that eliminates these inconsistencies. The media and space inconsistencies are resolved by reproducing a real paper document on a remote site and allowing a user to handover the paper document to a remote partner across a videoconferencing display. From a series of experiments, we found that reproducing a real paper document contributes to a higher sense of information sharing. We also found that handing over a document enhances a sense of space sharing, regardless of whether the document is digital or paper-based. These findings provide insights into designing systems for sharing paper documents across distances.

BackgroundIn this study, we aimed to address the low utilization of straw and poor fermentation quality of paper mulberry silage (under natural fermentation conditions). Straw was combined with paper mulberry for ensiling, and the fermentation characteristics, bacterial community, and metabolite composition of the mixed straw and paper mulberry silage were investigated. Four treatment groups were established: corn-straw treatment 2 (3:7 ratio of corn straw to paper mulberry), corn-straw treatment 3 (5:5 ratio of corn straw to paper mulberry), wheat-straw treatment 2 (3:7 ratio of wheat straw to paper mulberry), wheat-straw treatment 3 (5:5 ratio of wheat straw to paper mulberry), and a control group (ensiling of paper mulberry alone).ResultsThe control group demonstrated the highest pH and ammonia (AN) and acetic acid (AA) content compared with all the treatment groups. Corn-straw treatment 2 had the highest lactic acid content (54.70 g/kg dry weight) compared with the control and other treatment groups. The relative abundance of Enterobacter (7.085%) was the lowest in the control than in the other treatment groups (p

IntroductionPaper folding and punched hole tests are used to measure spatial abilities in humans. These abilities are relevant since they are associated with success in STEM (Science, Technology, Engineering, and Mathematics). This study addresses the challenge of teaching spatial reasoning skills using an educational videogame, the Paper Folding Reasoning Game.MethodsThe Paper Folding Reasoning Game is an interactive game which presents activities intended to help users train and understand how to fold a paper to get a specific shape (Part I) and the consequence of punching a hole on a folded paper (Part II). This educational videogame can automatically generate paper-folding-and-punched-hole questions with varying degrees of difficulty depending on the number of folds and holes made, thus producing additional levels for training due to its embedded reasoning mechanisms (Part III).ResultsThis manuscript presents the results of analyzing the gameplay data gathered by the Paper Folding Reasoning Game in its three parts. For Parts I and II, the data provided by 225 anonymous unique players are analyzed. For Part III (Mastermode), the data obtained from 894 gameplays by 311 anonymous unique players are analyzed. In our analysis, we found out a significant difference in performance regarding the players who trained (i.e., played Parts I and II) before playing the Mastermode (Part III) vs. the group of players who did not train. We also found a significant difference in players' performance who used the visual help (i.e., re-watch the animated sequence of paper folds) vs. the group of players who did not use it, confirming the effectiveness of the Paper Folding Reasoning Game to train paper-folding-and-punched-hole reasoning skills. Statistically significant gender differences in performance were also found.

Paper mulberry (Broussonetia papyrifera) is a high-quality silage protein feed material that can help address feed shortages and support livestock development. Although some studies have investigated the relationships between microbial communities and silage quality, these relationships and the underlying community assembly processes remain complex, requiring further research to clarify them. Additionally, limited research has explored the relationship between microbial community fermentation functions and silage quality. In this study, we aimed to explore B. papyrifera and wheat bran mixed silage quality driven by the characteristics of the microbial community. After 50 days of silage fermentation, high-quality and low-quality samples were selected from every mixing ratio (90:10, 80:20, and 65:35). The silage chemical composition, lignocellulose degradation enzyme activity, microbial community composition, and potential functions were used to explore the relevance between silage quality and the characteristics of the microbial community. The contents of hemicellulose, neutral detergent fiber, pH, and the activities of endoglucanase and exoglucanase were significantly affected by mixing ratios and silage quality grade. There were higher crude protein content, lignocellulose degrading enzyme activity, and lower pH, lignin, and acid detergent fiber in the mixing of 65:35 (BP65%) samples. The PERMANOVA results showed that mixing ratios had significant impacts on microbial community composition and bacterial fermentation functions. There was a higher bacterial diversity, lower fungal diversity, and better functional potentials for fermentation and lignocellulose degradation in BP65% high-quality silage. The dominant genera were Lactobacillus, Cladosporium, and Wallemia in all samples. The relative abundance of Clostridium, Rhodococcus, Turicibacter, Ralstonia, and Burkholderia was significantly higher in BP65% high-quality samples. There was a higher abundance of Wallemia in the BP65% samples than in other mixing ratios samples. Notably, silage quality showed a close relationship with Lactobacillus, Turicibacter, Romboutsia, Wallemia, and Pichia. In summary, 65:35 was a suitable mixing ratio for B. papyrifera and wheat bran silage, but high-quality silage still required the participation of multiple specific rare microbial taxa. The higher bacterial diversity and specific microbial taxa abundance could be critical for improving B. papyrifera silage quality. We expect that our findings will provide new insights into silage quality driven by the characteristics of the microbial community.

This study assessed the progression of stroke using bibliometric methods. By March 31, 2024, highly cited papers on stroke were collected from the Web of Science Core Collection. Collaboration and keyword conjunction analyses, along with their visual representations, were conducted using VOSviewer. CiteSpace was employed to identify keywords and reference sources. A comprehensive review of 2,509 highly cited studies on stroke was conducted. Notably, the United States, China, and the United Kingdom have emerged as leading contributors to this research domain, with the New England Journal of Medicine having the highest number of publications. YUSUF S had the highest H-index among all authors. The key terms frequently encountered were “stroke,” “atrial fibrillation,” and “cardiovascular disease.” This study performed a detailed bibliometric review of stroke research over the past decade, shedding light on the participation of various countries, organizations, authors, journals, and articles in the field. These insights offer a broad snapshot of the global stroke research trends.

Microfluidic paper-based analytical devices (µPADs) have gained significant attention in analytical science and technology due to their numerous advantages over traditional analytical techniques, including cost-effectiveness, miniaturization, and sustainability. µPADs are widely used in point-of-care diagnostics, health monitoring, environmental detection, food safety, forensics, and security. Since the first report in 2007, there have been substantial advancements in their fabrication techniques, detection methods, and applications. Over the years, significant efforts and advancements have been made to improve the cost-effectiveness, manufacturing scalability, user-friendliness, and sustainability of µPADs. In this review, we explore the general trends and advancements in the fabrication, sensing methods, and applications of µPADs, highlighting key improvements and innovations. We also examine the eco-friendliness of µPADs and present real-world success stories from field studies and citizen science initiatives. Additionally, we address the challenges associated with transitioning µPADs from the lab to the field. Finally, we examine the outlook for µPADs and propose strategies to improve their usefulness in various fields. [ABSTRACT FROM AUTHOR]

BackgroundClustering mental, physical and oral conditions reduce drastically the life expectancy. These conditions are precipitated and perpetuated by adverse social, economic, environmental, political and healthcare contextual factors, and sustained through bidirectional interactions forming potentially a ‘syndemic’. No previous study has investigated such potential syndemic. Thus, the present project aimed to (i) test for syndemic interactions between social adversity (socioeconomic adversity and traumatic events) and mental, physical and oral multimorbidity using the syndemic theoretical framework; and (ii) determine whether the syndemic relationships vary by age, sex and ethnicity.MethodsData from three large-scale population-based databases: UK BioBank, US National Health and Nutrition Examination Survey (NHANES) and the Research with East London Adolescents Community Health Survey (RELACHS) will be analysed. Structural equation modelling (SEM) will be utilised to conceptualise syndemic factors and model complex relationships between directly observed and indirectly observed (latent) variables (syndemic constructs).Discussionthe syndemic conceptualisation provides a valuable framework to understand health and illness, and hence to better design and deliver effective and cost-effective preventative and curative integrated (syndemic) care to improve patient and population health. Such syndemic care aims to address the social determinants of health, whilst simultaneously managing all interlocked conditions.

BackgroundMaternal mental health is vital to overall well-being, particularly among expectant and postpartum Black and Latina women who experience higher stress levels and mental health challenges. Traditional healthcare systems often fail to meet these needs, underscoring the need for innovative and accessible interventions. NurtureVR, a digital maternal mental health and educational program, leverages virtual reality to offer mindfulness, relaxation, and guided imagery to support these women.ObjectivesThis protocol aims to evaluate whether NurtureVR, a digital therapeutic, can reduce stress levels and mental health symptoms in pregnant and postpartum Black and Latina women, improve sleep, enhance pregnancy and childbirth experiences, and increase pregnancy and postpartum health literacy.MethodsThe Nurturing Moms study uses a pre- and post-intervention design with a 5-week NurtureVR program. Fifty participants, 25 expectant and 25 postpartum Black and Latina women, will be recruited through clinics, community organizations, and online platforms. The study involves three phases: baseline assessments of stress, mood, self-efficacy, demographics, and health history; daily use of NurtureVR for 15 minutes during the third trimester and six weeks postpartum; and follow-up assessments at six weeks postpartum. The program includes 49 modules on labor and delivery, stress during pregnancy, nutrition, breastfeeding, hormonal changes, 3D VR representations of fetal development, pain management simulations, and mindfulness exercises for labor. Participants will report stress, anxiety, mood, and pain levels following each VR session. Additional qualitative insights will be gathered through focus groups, and an optional survey will be administered one-year post-intervention to evaluate long-term effects.ConclusionsThe Nurturing Moms study seeks to create a more inclusive and equitable healthcare landscape, demonstrating that digital interventions like NurtureVR are essential for providing high-quality maternal care. By democratizing access to clinical research and healthcare, this decentralized trial promotes equity, improves the generalizability of findings, and accelerates the development of new treatments. The study’s innovative approach has the potential to improve maternal experiences of stress, sleep, and overall health outcomes for Black and Latina mothers and children, despite limitations such as sample size, language barriers, and the preliminary nature of a pilot and feasibility study.

Kaihua paper is a type of precious hand-made paper in China that has been used throughout Chinese history. Due to its extraordinary whiteness and fine texture, it was adopted by the imperial palace in the reign of Emperor Kang Xi and Yong Zheng of the Qing Dynasty of China in the 17th and 18th century. It is stained by a special type of yellowish-brown spot after years of storage, which is called a “peachy spot.” The formation of such spots remains unclear, although complicated physicochemical processes or microbial activities might be involved. We performed nondestructive sampling and high-throughput sequencing on peachy spot surfaces, unstained areas, and air samples in the stack room to analysis the the bacterial and fungal communities, and performed prediction of functional genes of the bacterial communities. The results showed that peachy spot formation was mainly related to bacterial communities rather than fungal communities. Significantly more potential acid- producing, acidophilic or cellulase-producing bacteria, such as, Streptococcus, Staphylococcus, and Lysinibacillus, and pigment-producing bacteria, such as Methylobacterium and Rubrobacter, were identified in the peachy spot samples. Prediction of the functional genes of the bacterial community also suggested the production of acidic substance pigments. These findings provide new insights into the pigment formation mechanism in ancient paper and open an opportunity to develop new strategies to preserve the ancient paper documents.

Power transformers are critical equipment responsible for the transmission and transformation of electrical energy, and they are an important component of power system. Under the combined effects of electric field, thermal field, and mechanical stress, insulation degradation is prone to occur in oil-paper insulation structures. Among them, the “liquid-solid” interface formed by oil and oil-immersed pressboard is the weak point in transformer insulation, and extensive operational experience has shown that creeping flashover of insulating pressboard is a common fault in power transformers. Creeping flashover of insulating pressboard can rapidly destroy the insulation structure, leading to irreversible damage to the transformer and posing a serious risk of transformer accidents. In recent years, many scholars have conducted in-depth research on the characteristics and mechanisms of creeping flashover in oil-paper insulation structures using various experimental methods. They have obtained significant findings that have important theoretical and practical implications for optimizing the structure of power transformers and improving their reliability. This paper first introduces the characteristics of the electromagnetic environment inside the power transformer and the common forms of creeping flashover accidents in engineering. Then, classified according to the uneven degree of electric field and creepage distance of test electrodes used in relevant research, and the test methods and flashover characteristics of small size (

Since the ban on single-use plastic articles in Europe, the food contact material (FCM) industry has been forced to move to more sustainable alternatives. Paper and board FCM are convenient alternatives but must be safe for consumers. This study aims to investigate potential migrations of various substances (e.g., plasticizers, photoinitiators, primary aromatic amines, mineral oil, and bisphenols) from straws and takeaway articles made of paper and board. Twenty straws and fifty-eight takeaway articles were carefully selected and investigated using liquid and gas chromatography coupled with tandem mass spectrometry or flame ionization detector. Fourteen substances of all the targeted categories were found in takeaway articles, including seven plasticizers, two photoinitiators, one primary aromatic amine, two bisphenols, and the saturated and aromatic fraction of mineral oil (MOSH and MOAH, respectively). In straws, fewer substances were detected, i.e., six substances, including three plasticizers, one photoinitiator, MOSH, and MOAH. At least one of the target substances was detected in 88% of the samples, demonstrating the importance of further evaluation of these materials. Finally, the associated risks were assessed, highlighting the potential risks for several types of articles regarding bisphenol A, one primary aromatic amine (3.3-DMB), and MOSH and MOAH.

IntroductionAccording to the Institute of Medicine patient-centered medicine is one of the six crucial dimensions of health care quality. Although the patient-centered care model is widely recognized for its ethical underpinnings and effectiveness, its practical implementation still raises challenges, especially in end-of-treatment situations. This discussion paper offers an overview of the challenges facing the physician-patient relationship in end-of-treatment situations.MethodsWe developed three clinical vignettes and made some theoretical considerations about ethical issues related to the decision-making process leading to the end of treatment.ResultsWe identified two main challenges that end-of-treatment situations pose to patient-centered care: (1) when the patient’s autonomy challenges the best clinical treatment; and (2) when the proposed treatment (discontinuation of treatment) challenges the patient’s preferences.DiscussionsPatient-centered care supports personalized decision-making, in which the physician’s approach varies according to the patient’s situation and individuality. The idea of beneficence may change during care, because of acceptance of the patient’s principles or a change in the primary goal of care.

PreambleRobotic magnetic navigation (RMN)-guided catheter ablation (CA) technology has been used for the treatment of cardiac arrhythmias for almost 20 years. Various studies reported that RMN allows for high catheter stability, improved lesion formation and a superior safety profile. So far, no guidelines or recommendations on RMN-guided CA have been published.PurposeThe aim of this consensus paper was to summarize knowledge and provide recommendations on management of arrhythmias using RMN-guided CA as treatment of atrial fibrillation (AF) and ventricular arrhythmias (VA).MethodologyAn expert writing group, performed a detailed review of available literature, and drawing on their own experience, drafted and voted on recommendations and summarized current knowledge and practice in the field. Recommendations on RMN-guided CA are presented in a guideline format with three levels of recommendations to serve as a reference for best practices in RMN procedures. Each recommendation is accompanied by supportive text and references. The various sections cover the practical spectrum from system and patient set-up, EP laboratory staffing, combination of RMN with fluoroscopy and mapping systems, use of automation features and ablation settings and targets, for different cardiac arrhythmias.ConclusionThis manuscript, presenting the combined experience of expert robotic users and knowledge from the available literature, offers a unique resource for providers interested in the use of RMN in the treatment of cardiac arrhythmias.

IntroductionHeavy work in scorching temperatures can cause dehydration and heat stress, which can lead to a number of heat-related diseases. Heavy work in intense heat without rest or hydration is the main cause. The “Water, Rest, Shade” (WRS) intervention program for outdoor workers in hot weather reduces heat stress.MethodsThis study follows a quasi-experimental design involving 250 outdoor workers from both agriculture and brick kilns. To assess the environmental heat exposure levels, Quest Temp 3 M WBGT Monitor will be used. Tympanic temperature, Heart rate (HR), Sweat rate (SwR), and Urine specific gravity (USG) to assess the physiological responses to heat exposure using standard protocols. Blood samples will be collected to measure serum creatinine and calculate Glomerular filtration rate (GFR), and urine samples to measure pH, leucocytes, proteinuria, and hematuria. Then administer a validated and modified HOTHAPS questionnaire to capture the perception data. After the baseline assessments, Categorize the workers into two groups based on the selection criteria and the participants’ willingness. Then provide a week-long WRS intervention to the intervention group (IG). The non-intervention group will collect the same data without any intervention to assess the efficacy of the intervention by comparing both groups and measuring outcome indicators.Expected outcomeThe study will generate much-needed information to raise awareness of the importance of heat stress prevention for outdoor workers.ConclusionThis study will demonstrate the effectiveness of an intervention, provide much-needed strategies for reducing heat stress, assess both health impacts and implementation quality, and design comprehensive workplace and labor laws aim to minimise risks to millions of unorganised outdoor workers health.

In locally advanced (LA) laryngeal/hypopharyngeal squamous cell carcinoma (LHSCC), larynx preservation (LP) strategies aim at the cure of the disease while preserving a functional larynx, thus avoiding total laryngectomy and the associated impact on the quality of life. In the last decades, apart from transoral and open-neck organ preservation approaches, several non-surgical regimens have been investigated: radiotherapy alone, alternate, concurrent or sequential chemoradiation, and bioradiotherapy. Despite major progress, the identification of reliable and effective predictors for treatment response remains a clinical challenge. This review examines the current state of LP in LA-LHSCC and the need for predictive factors, highlighting the importance of the PRESERVE trial in addressing this gap. The PRESERVE trial represents a pivotal initiative aimed at finding the optimal therapy for laryngeal preservation specific to each patient through a retrospective analysis of data from previous LP trials and prospectively validating findings. The goal of the PRESERVE trial is to develop a comprehensive predictive classifier that integrates clinical, molecular, and multi-omics data, thereby enhancing the precision and efficacy of patient selection for LP protocols.

To address the challenges encountered by Chinese primary school students, particularly left-behind and migrant children, who exhibit a preference for animations, video games, and short videos over reading books and struggle with Chinese-English bilingual skills, this study introduces an educational robot AI-assisted method for simultaneous bilingual reading. To assess the effectiveness of this method, a 6-month Chinese-English bilingual extracurricular reading comparative experiment was conducted involving 85 grade 5 students from two classes in a primary school in Hangzhou, China. The AI-assisted class freely read 100 bilingual/English electronic picture books and 200 Chinese electronic classic serial picture books by employing the AI-assisted human-computer interactive electronic reading mode of the “Educational Robot+Audio Electronic Picture Book+Character-play Based Reading.” In contrast, the paper book group read the same content presented in the traditional paper book format, following the “regular independent reading” mode. Post-experimental analyses were conducted employing t-tests and MANCOVA and the results revealed that: the primary factors influencing reading effectiveness are the choice of reading materials, reading tools, and reading mode, while reading time does not emerge as the principal influencing factor. Furthermore, students in the AI class demonstrated significant enhancements in bilingual reading motivation, reading amount, reading comprehension, independent learning ability, pronunciation proficiency, and test scores compared to their peers in the paper book class. The AI-assisted reading mode utilizing educational robots garnered positive feedback from teachers, parents, and students. It offers the potential to effectively substitute parental involvement in parent–child reading and English tutoring, while also enabling the simultaneous acquisition of bilingual proficiency in both Chinese and English. This approach proves to be highly effective, cost-efficient, and convenient, particularly for enhancing children’s foreign language abilities. Moreover, it fosters positive reading habits and independent learning skills among primary school students, contributes to the establishment of lofty aspirations, and enhances bilingual performance. Overall, this innovative mode offers an effective means of facilitating children’s acquisition of bilingualism and foreign language skills, as well as promoting reading education.

IntroductionTeenage parenthood presents multifaceted implications, affecting adolescent parents, their children, and extended families. Despite a decrease in teenage pregnancy rates across Europe, the phenomenon continues to present significant challenges, impacting not only the adolescent parents but also their offspring and extended families.MethodsA comprehensive literature review was conducted. Key factors influencing teenage pregnancies, including socioeconomic background, family structure, and access to sex education and contraception, were examined. This review was supplemented by expert opinions from the European Academy of Paediatrics (EAP) and the European Confederation of Primary Care Paediatricians (ECPCP).ResultsThe triad of mother, father, and child presents individual distinct healthcare needs and vulnerabilities, highlighting the importance of specialized support and healthcare. This paper explores the psychological, social, and educational repercussions of teenage parenthood on both parents and their children, including higher risks of postpartum depression, school dropout, and repeat pregnancies. Furthermore, it underscores the critical role that paediatricians and primary care providers play in supporting these young families.DiscussionThe position paper advocates for comprehensive care for adolescent parents and their children. It recommends preventive measures such as proper sex education and access to contraception to reduce unplanned teenage pregnancies. Additionally, it emphasizes the need for specialized healthcare and support for teenage parents to address their unique challenges and improve outcomes for both parents and their children.

BackgroundThis study has two primary objectives. Firstly, it aims to measure the time savings achieved through the digitization of paper forms filled out by nurses in the inpatient care process. Secondly, it seeks to reveal the financial savings resulting from reduced paper consumption due to the digitalization. The Health Information Management System Society (HIMSS)—Electronic Medical Record Adaption Model (EMRAM), which makes stage-based (0–7) evaluations, serves as a tool to measure the rate of technology utilization in public hospitals in Turkey. The study is based on the HIMSS EMRAM criteria for 2018. Bahçelievler State Hospital, a public hospital in Turkey, was chosen as the research facility. In 2017, it was accredited as Stage 6 with HIMSS EMRAM. However, not all its wards have been digitalized. Initially, pilot selected wards were digitized. Therefore, digital and non-digital wards serve together. In this context, 4 wards were randomly selected and time, paper and toner savings before and after digitalization were measured.MethodA table was created in Microsoft Excel,listing the forms used by nurses in inpatient care and the time required to fill them out.The time spent for filling paper-based forms and digital-based forms was measured in randomly selected wards.ResultThe analysis showed that digital forms saved more time, paper and toner. For example, filling out the patient history form took 45 min when using paper, compared to 12 min in digital environment. Approximately 27% time savings are achieved only for the patient history form. The total time savings delivered by digitalization for 1,153 inpatients during the year were found as 117 care days, and the savings on total paper consumption was 41.289 pages. For 1,153 inpatients throughout the year, the total time savings from digitalization was 117 care days and the total paper consumption savings was 41,289 pages. In addition, in 4 wards with a total bed capacity of 25, annual paper savings of $1,705.86 and toner savings of $283,736 were achieved.DiscussionThis study reveals the benefits of digitalisation in hospitals for nurses. It saves the time that nurses allocate for filling out paper forms with digitalised forms. Thus, it is a good practice example in terms of using the time allocated for form filling for patient care.When we extend this study to Turkey in general, it can be considered that the time savings achieved by nurses by digitizing inpatient forms varies between 10.8% and 13%. The number of nurses working in public hospitals in Turkey is approximately 160,000. Assuming that 60% of the nurses work in the inpatient ward, it is understood that the annual savings achieved by digitizing the forms corresponds to a range of 398–559 nursing hours.

Telemedicine applications present virtually limitless prospects for innovating and enhancing established and new models of patient care in the field of Internal Medicine. Although there is a wide range of innovative technological solutions in Europe, there are overarching elements associated with such technologies when applied to the practices of Internal Medicine specialists. The European Federation of Internal Medicine (EFIM) strongly advocates for active leadership and influence from the Internal Medicine societies and specialist physicians across Europe in the development and application of telemedicine and digital technologies in healthcare. This position paper’s conclusions were drawn via Delphi method, which was developed collaboratively from July 2021 to December 2023. The panel, consisting of experts in clinical medicine, public health, health economics and statistics, assessed various aspects related to telemedicine. Participants assigned scores on a Likert scale reflecting perceived value and potential risks. The findings were consolidated in a comprehensive checklist aligning with relevant literature and a SWOT analysis. Specifically, key issues that need to be addressed include promoting the professional development of e-health competencies in the healthcare and medical workforce, using educational campaigns to promote digital literacy among patients and caregivers, designing and implementing telemedicine applications tailored to local conditions and needs and considering the ethical and legal contexts under which these applications are employed. Importantly, there is currently no consensus on care models or standardized protocols among European Internal Medicine specialists regarding the utilization of telemedicine. This position paper aims to outline the opportunities and challenges associated with the application of telemedicine in Internal Medical practice in Europe.

The development and rapid progression of cancer are major social problems. Medical diagnostic techniques and smooth clinical care of cancer are new necessities that must be supported by innovative diagnostic methods and technologies. Current molecular diagnostic tools based on the detection of blood protein markers are the most common tools for cancer diagnosis. Biosensors have already proven to be a cost-effective and accessible diagnostic tool that can be used where conventional laboratory methods are not readily available. Paper-based biosensors offer a new look at the world of analytical techniques by overcoming limitations through the creation of a simple device with significant advantages such as adaptability, biocompatibility, biodegradability, ease of use, large surface-to-volume ratio, and cost-effectiveness. In this review, we covered the characteristics of exosomes and their role in tumor growth and clinical diagnosis, followed by a discussion of various paper-based biosensors for exosome detection, such as dipsticks, lateral flow assays (LFA), and microfluidic paper-based devices (µPADs). We also discussed the various clinical studies on paper-based biosensors for exosome detection.

Introduction: Paper folding and punched hole tests are used to measure spatial abilities in humans. These abilities are relevant since they are associated with success in STEM (Science, Technology, Engineering, and Mathematics). This study addresses the challenge of teaching spatial reasoning skills using an educational videogame, the Paper Folding Reasoning Game. Methods: The Paper Folding Reasoning Game is an interactive game which presents activities intended to help users train and understand how to fold a paper to get a specific shape (Part I) and the consequence of punching a hole on a folded paper (Part II). This educational videogame can automatically generate paper-folding-and-punched-hole questions with varying degrees of difficulty depending on the number of folds and holes made, thus producing additional levels for training due to its embedded reasoning mechanisms (Part III). Results: This manuscript presents the results of analyzing the gameplay data gathered by the Paper Folding Reasoning Game in its three parts. For Parts I and II, the data provided by 225 anonymous unique players are analyzed. For Part III (Mastermode), the data obtained from 894 gameplays by 311 anonymous unique players are analyzed. In our analysis, we found out a significant difference in performance regarding the players who trained (i.e., played Parts I and II) before playing the Mastermode (Part III) vs. the group of players who did not train. We also found a significant difference in players' performance who used the visual help (i.e., re-watch the animated sequence of paper folds) vs. the group of players who did not use it, confirming the effectiveness of the Paper Folding Reasoning Game to train paper-folding-and-punched-hole reasoning skills. Statistically significant gender differences in performance were also found. [ABSTRACT FROM AUTHOR]

The development of university students’ skills to successfully produce scientific documents has been a recurring topic of study in academia. This paper analyzes the implementation of a training experience using a digital environment mediated by video content materials starring humanoid robots. The research aimed to scale complex thinking and its sub-competencies as a hinge to strengthen basic academic research skills. Students from Colombia, Ecuador, and Mexico committed to preparing a scientific document as part of their professional training participated. A pretest to know their initial level of perception, a posttest to evaluate if there was a change, and a scientific document the students delivered at the end of the training experience comprised the methodology to demonstrate the improvement of their skills. The results indicated students’ perceived improvement in the sub-competencies of systemic, creative, scientific, and innovative thinking; however, their perceptions did not align with that of the tutor who reviewed the delivered scientific product. The conclusion was that although the training experience helped strengthen the students’ skills, variables that are determinants for a student to develop the knowledge necessary to prepare scientific documents and their derived products remain to be analyzed.

The concept of pre-diabetes has led to provision of measures to reduce disease progression through identification of subjects at risk of diabetes. We previously considered the idea of pre-asthma in relation to allergic asthma and considered that, in addition to the need to improve population health via multiple measures, including reduction of exposure to allergens and pollutants and avoidance of obesity, there are several possible specific means to reduce asthma development in those most at risk (pre- asthma). The most obvious is allergen immunotherapy (AIT), which when given for allergic rhinitis (AR) has reasonable evidence to support asthma prevention in children (2) but also needs further study as primary prevention. In this second paper we explore the possibilities for similar actions in late onset eosinophilic asthma.

BackgroundCoping with residual cognitive and gait impairments is a prominent unmet need in community-dwelling chronic stroke survivors. Motor-cognitive exergames may be promising to address this unmet need. However, many studies have so far implemented motor-cognitive exergame interventions in an unstructured manner and suitable application protocols remain yet unclear. We, therefore, aimed to summarize existing literature on this topic, and developed a training concept for motor-cognitive exergame interventions in chronic stroke.MethodsThe development of the training concept for personalized motor-cognitive exergame training for stroke (PEMOCS) followed Theory Derivation procedures. This comprised (1.1) a thorough (narrative) literature search on long-term stroke rehabilitation; (1.2) a wider literature search beyond the topic of interest to identify analogies, and to induce creativity; (2) the identification of parent theories; (3) the adoption of suitable content or structure of the main parent theory; and (4) the induction of modifications to adapt it to the new field of interest. We also considered several aspects of the “Framework for Developing and Evaluating Complex Interventions” by the Medical Research Council. Specifically, a feasibility study was conducted, and refining actions based on the findings were performed.ResultsA training concept for improving cognitive functions and gait in community-dwelling chronic stroke survivors should consider the principles for neuroplasticity, (motor) skill learning, and training. We suggest using a step-based exergame training for at least 12 weeks, 2–3 times a week for approximately 45 min. Gentile's Taxonomy for Motor Learning was identified as suitable fundament for the personalized progression and variability rules, and extended by a third cognitive dimension. Concepts and models from related fields inspired further additions and modifications to the concept.ConclusionWe propose the PEMOCS concept for improving cognitive functioning and gait in community-dwelling chronic stroke survivors, which serves as a guide for structuring and implementing motor-cognitive exergame interventions. Future research should focus on developing objective performance parameters that enable personalized progression independent of the chosen exergame type.

Despite numerous studies on microplastics, the biological impacts of polypropylene microplastics (PP-MPs) and its toxicity on freshwater fish have yet to be fully revealed. The purpose of this research was to look at the potentially harmful effects of PP-MPs in freshwater African catfish Clarias gariepinus and bioremediation using Spirulina. After acclimatization to laboratory conditions, 108 fish (125 ± 3 gm and 27 ± 2 cm) were assigned into triplicate six experimental groups (12 fish/group), a control group, Spirulina group (SP), PP-MP-treated groups (0.14 and 0.28 mg/l PP-MPs), and PP-MP + Spirulina-treated groups (0.14 mg/l PP-MPs + 200 mg/L SP and 0.28 mg/l PP-MPs +200 mg/L SP) for 15-day exposure and 45-day recovery after that. The hematological parameters exhibiting significance (RBCs, Hct, Hb, and MCV) or non-significance (MCH and MCHC) either decreased with the increase in PP-MP doses from 0.0 in the control to 0.28 mg/L red blood cells (RBCs), hematocrit (Hct), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), hemoglobin (Hb) and platelets or increased with such an increase in doses (mean corpuscular volume (MCV)). The liver enzyme activity, aspartate aminotransferase (AST), alkaline phosphatase (ALP), and alanine aminotransferase (ALT) exhibited non-significant (p ≥ 0.05) or significant (p < 0.05) increases in (0.14 and 0.28 mg/L) PP-MP-exposed groups, respectively, except ALP. Furthermore, there was a significant (p < 0.05) or non-significant (p ≥ 0.05) increase in 0.14 and 0.28 mg/l PP-MP +200 mg/L-exposure groups, respectively, compared to the control group and the same exposure group without Spirulina. In comparison to the control group, PP-MPs (0.14 and 0.28 mg/L) induced a significant (p < 0.05) increase in the percentage of poikilocytosis and nuclear abnormalities of RBCs. The liver tissue from fish exposed to PP-MPs exhibited varying degrees of pathological changes. These results indicated that these pathological changes increased with PP-MP concentration, suggesting that the effect of PP-MPs was dose-dependent. After 45 days of recovery under normal conditions, it was obvious that there was a significant improvement in the percentage of poikilocytosis and nuclear abnormalities of RBCs, as well as a non-significant improvement in hemato-biochemical parameters and liver tissue.

Type 2 diabetes mellitus has a worldwide prevalence of 10.5% in the adult population (20–79 years), and by 2045, the prevalence is expected to keep rising to one in eight adults living with diabetes. Mild cognitive impairment has a global prevalence of 19.7% in adults aged 50 years. Both conditions have shown a concerning increase in prevalence rates over the past 10 years, highlighting a growing public health challenge. Future forecasts indicate that the prevalence of dementia (no estimations done for individuals with mild cognitive impairment) is expected to nearly triple by 2050. Type 2 diabetes mellitus is a risk factor for the development of cognitive impairment, and such impairment increase the likelihood of poor glycemic/metabolic control. High phytate intake has been shown to be a protective factor against the development of cognitive impairment in observational studies. Diary phytate intake might reduce the micro- and macrovascular complications of patients with type 2 diabetes mellitus through different mechanisms. We describe the protocol of the first trial (the PHYND trial) that evaluate the effect of daily phytate supplementation over 56 weeks with a two-arm double-blind placebo-controlled study on the progression of mild cognitive impairment, cerebral iron deposition, and retinal involvement in patients with type 2 diabetes mellitus. Our hypothesis proposes that phytate, by inhibiting advanced glycation end product formation and chelating transition metals, will improve cognitive function and attenuate the progression from Mild Cognitive Impairment to dementia in individuals with type 2 diabetes mellitus and mild cognitive impairment. Additionally, we predict that phytate will reduce iron accumulation in the central nervous system, mitigate neurodegenerative changes in both the central nervous system and retina, and induce alterations in biochemical markers associated with neurodegeneration.

A large amount of contaminants are collected on the cardboard surface of the valve-side bushing outlet of a converter transformer that has been operating for a long period, and can cause the performance of the oil–paper insulation to degrade. The analysis of their energy spectrum has shown that these contaminants contain free carbon. To investigate causes of the formation of these carbon traces, the authors of this study analyze their law of growth on the surface of the insulating paper in the presence of pure insulating oil and insulating oil containing carbon particles. We examined the influence of carbon tracks of different lengths on the breakdown voltage along the surface of the oil–paper insulation. The results showed that carbonization on the surface of the insulating paper generated carbon traces in pure insulating oil and eventually led to the formation of conductive channels. Moreover, carbon traces were generated by carbon particles deposited on the surface of the insulating paper in insulating oil containing carbon particles. The carbon traces grew from the high-voltage electrode to the ground electrode along the direction of the electric field in both types of oils. The formation of the conductive channel through the poles of the paper in insulating oil containing carbon particles required a lower voltage and a shorter discharge time than that in pure insulating oil. As the concentration of the carbon particles increased, the rate of growth of carbon traces on the surface of the insulating paper increased such that the oil–paper insulation failed earlier than otherwise. Long carbon traces were formed on the surface of the insulating paper in case of a high concentration of carbon particles under the DC pre-pressure mode, and this led to a reduction in the breakdown voltage along the surface of the oil–paper insulation.

We share the story of how we made this paper, the first executable paper in Heliophysics, through cross-disciplinary collaboration to highlight the benefits of our process. Executable papers are interactive documents that put a publication’s text inline with the code used in the research in a containerized environment with the data and dependencies needed to run the code. This approach enables readers to reproduce every step taken to arrive at the publication’s conclusions and to easily build upon and extend the work—all important components of open science. Open science is, broadly speaking, transparent and accessible knowledge that is shared and developed through collaborative networks. In this work, we present an adaptable workflow to compare magnetosphere models to spacecraft observations. It is one example of many other workflows that can be developed through collaborations between software developers and scientists in a move towards open science. Most of the authors are members of the Python in Heliophysics Community (PyHC), an international, multi-organizational community that serves as a knowledge base for performing Heliophysics research in the Python programming language. PyHC promotes the executable paper format as a supplemental tool to improve the reproducibility of publications and support open science. A key takeaway is that our collaboration made such a complex task an easy feat in the end. Additionally, the executable version of our paper makes it trivial for others to reproduce our work, and it gives them a better launching point to extend it. These facts underscore the success of our approach. In highlighting this new open science approach, we hope to be an example to our field and encourage this way of doing science.

Tuberculosis (TB) poses a serious threat to human health and social development. Accurate diagnosis of mycobacterium tuberculosis infection plays a critical role in the prevention and treatment of tuberculosis. Interferon-γ (INF-γ) release assay (IGRA) is currently the only quantitative tuberculosis infection diagnosis method. An accurate, fast, and easily handled INF-γ detection method is the key to obtaining accurate results. Herein, we report a novel paper-based electrochemiluminescence (ECL) method based on lateral flow immunosensors that combines the easy handling characteristics of immunochromatography and the high sensitivity of electrochemiluminescence to detect IFN-γ. To our knowledge this is the first INF-γ detection method that combines immunochromatography with electrochemiluminescence. The paper-based ECL-LFI test consists of a sample pad, conjugation pad (with binding antibody IFN-γ-Ab1 conjugated with ruthenium tripyridine), detection pad (with capture antibody IFN-γ-Ab2 immobilized on nanospheres), absorbent pad, and electrode for signal activation. The ECL signal is obtained by cyclic voltammetry scanning at a speed of 0.1 V/s in the detection area of the paper-based ECL-LFI test. In our experiments, the paper-based ECL-LFI test exhibited a minimum detection limit of 2.57 pg/mL within 12 min, and a broad detection range of 2.57–5,000 pg/mL, with repeatability of 8.10% and stability of 4.97%. With the advantage of high accuracy and sensitivity, easy handling, and low user training requirements, this ECL-LFI test might be used as point-of-care testing (POCT) in the IGRA for tuberculosis diagnosis.

IntroductionMastitis is one of the most serious diseases affecting dairy farming, causing huge economic losses worldwide. Streptococcus agalactiae is the main pathogenic bacterium of contagious mastitis and can deliver a devastating blow to a farm's economy. Rapid detection is the key to disease control.MethodsIn this study, a rapid detection method for S. agalactiae was established. This method combines filter paper extraction, multienzyme isothermal rapid amplification (MIRA), and lateral flow dipsticks (LFD). To simplify the extraction procedure, we designed a disposable extraction device (DED). First, DED performance was evaluated by polymerase chain reaction (PCR) and then the lysis formula and extraction time were optimized. Second, this study compared the extraction performance of a filter paper and an automatic nucleic acid extraction instrument. After screening primers, MIRA for S. agalactiae was established and combined with LFD. Specificity and sensitivity were evaluated after optimizing the reaction conditions.ResultsThe results showed that the lowest extraction line for DED was 0.01–0.001 ng/μl. In the specificity study, 12 different bacteria were tested, and only S. agalactiae was found to be positive. In the sensitivity study, seven dilution gradients were established, and the lowest detection line was 3.52 × 102 CFU/ml.DiscussionIn summary, the method established in this study does not require laboratory equipment and is suitable for on-site detection. The entire method takes only 15 min, is low in cost, has high precision and low technical requirements for operators, which is in contrast with the high cost and cumbersome operation of traditional methods, and is suitable for on-site testing in areas with limited facilities.

Here, we propose a printed 96-well microtiter paper-based chemosensor array device (PCSAD) to simultaneously detect metal ions for river water assessment. Colorimetric chemosensors for metal ions have been designed based on molecular self-assembly using off-the-shelf catechol dyes and a phenylboronic acid (PBA) derivative. The colorimetric self-assembled chemosensors consisting of catechol dyes and a PBA derivative on a 96-well microtiter paper substrate demonstrated various color changes according to the disassembly of the ensembles by the addition of nine types of metal ions. An in-house-made algorithm was used to automate imaging analysis and extract color intensities at seven types of color channels from a captured digital image, allowing for rapid data processing. The obtained information-rich inset data showed fingerprint-like colorimetric responses and was applied to the qualitative and quantitative pattern recognition of metal ions using chemometric techniques. The feasibility of the 96-well microtiter PCSAD for environmental assessment has been revealed by the demonstration of a spike-and-recovery test against metal ions in a river water sample.

Pulp-paper mills (PPMs) are known for consistently generating a wide variety of pollutants, that are often unidentified and highly resistant to environmental degradation. The current study aims to investigate the changes in the indigenous bacterial communities profile grown in the sediment co-contaminated with organic and inorganic pollutants discharged from the PPMs. The two sediment samples, designated PPS-1 and PPS-2, were collected from two different sites. Physico-chemical characterization of PPS-1 and PPS-2 revealed the presence of heavy metals (mg kg−1) like Cu (0.009–0.01), Ni (0.005–0.002), Mn (0.078–0.056), Cr (0.015–0.009), Pb (0.008–0.006), Zn (0.225–0.086), Fe (2.124–0.764), Al (3.477–22.277), and Ti (99.792–45.012) along with high content of chlorophenol, and lignin. The comparative analysis of organic pollutants in sediment samples using gas chromatography–mass spectrometry (GC–MS) revealed the presence of major highly refractory compounds, such as stigmasterol, β-sitosterol, hexadecanoic acid, octadecanoic acid; 2,4-di-tert-butylphenol; heptacosane; dimethyl phthalate; hexachlorobenzene; 1-decanol,2-hexyl; furane 2,5-dimethyl, etc in sediment samples which are reported as a potential toxic compounds. Simultaneously, high-throughput sequencing targeting the V3–V4 hypervariable region of the 16S rRNA genes, resulted in the identification of 1,249 and 1,345 operational taxonomic units (OTUs) derived from a total of 115,665 and 119,386 sequences read, in PPS-1 and PPS-2, respectively. Analysis of rarefaction curves indicated a diversity in OTU abundance between PPS-1 (1,249 OTUs) and PPS-2 (1,345 OTUs). Furthermore, taxonomic assignment of metagenomics sequence data showed that Proteobacteria (55.40%; 56.30%), Bacteoidetes (11.30%; 12.20%), and Planctomycetes (5.40%; 4.70%) were the most abundant phyla; Alphproteobacteria (20.50%; 23.50%), Betaproteobacteria (16.00%; 12.30%), and Gammaproteobacteria were the most recorded classes in PPS-1 and PPS-2, respectively. At the genus level, Thiobacillus (7.60%; 4.50%) was the most abundant genera grown in sediment samples. The results indicate significant differences in both the diversity and relative abundance of taxa in the bacterial communities associated with PPS-2 when compared to PPS-1. This study unveils key insights into contaminant characteristics and shifts in bacterial communities within contaminated environments. It highlights the potential for developing efficient bioremediation techniques to restore ecological balance in pulp-paper mill waste-polluted areas, stressing the importance of identifying a significant percentage of unclassified genera and species to explore novel genes.

IntroductionCore stability is crucial for preventing and rehabilitating lumbar spine injuries. An external focus instruction using a paper balloon is an effective way to activate the trunk muscles. However, the degree of trunk and lower extremity muscle activation during single leg stance with external focus instruction using a paper balloon is unknown. This study aimed to investigate the core muscle involving activity in the trunk and lower extremities on both the support and non-support sides with or without using external focus instruction using a paper balloon during isometric single-leg stance.MethodsThirteen healthy males aged 20–28 years volunteered to take part in this study and performed a single leg stance task with and without an external focus instruction, pressing their non-supporting foot onto a paper balloon without crushing it. The participant's muscle electrical activity was recorded during the single leg task using surface EMG and intramuscular EMG for six trunk muscles (transversus abdominis, internal oblique, external oblique, rectus abdominis, multifidus, and lumbar erector spinae) and five lower extremity muscles (gluteus maximus, gluteus medius, adductor longus, rectus femoris, and biceps femoris)ResultsCompared to the normal single leg stance, the external focus instruction task using a paper balloon showed significantly increased transversus abdominis (p

The progressive improvement of the living conditions and medical care of the population in industrialized countries has led to improvement in healthcare interventions, including rehabilitation. From this perspective, Telerehabilitation (TR) plays an important role. TR consists of the application of telemedicine to rehabilitation to offer remote rehabilitation services to the population unable to reach healthcare. TR integrates therapy-recovery-assistance, with continuity of treatments, aimed at neurological and psychological recovery, involving the patient in a family environment, with an active role also of the caregivers. This leads to reduced healthcare costs and improves the continuity of specialist care, as well as showing efficacy for the treatment of cognitive disorders, and leading to advantages for patients and their families, such as avoiding travel, reducing associated costs, improving the frequency, continuity, and comfort of performing the rehabilitation in its own spaces, times and arrangements. The aim of this consensus paper is to investigate the current evidence on the use and effectiveness of TR in the cognitive field, trying to also suggest some recommendations and future perspectives. To the best of our knowledge, this is the first consensus paper among multiple expert researchers that comprehensively examines TR in different neurological diseases. Our results supported the efficacy and feasibility of TR with good adherence and no adverse events among patients. Our consensus summarizes the current evidence for the application of cognitive TR in neurological populations, highlighting the potential of this tool, but also the limitations that need to be explored further.

BackgroundCongo Red Dot Paper Test (CRDPT) appears to be a simple, cost-effective, non-invasive diagnostic tool for hypertensive disorders of pregnancy (HDP). The main objective of the study is to assess the effectiveness of CRDPT in detecting HDP.MethodsThis is a systemic review and meta-analysis of published studies on the effectiveness of CRDPT in the detection of HDP. The study was conducted in line with the PRISMA-DTA guidelines. The PICOS framework was used to search for relevant articles using Medline, PubMed, Google Scholar, Web of Science, and the Cochrane Library databases. The articles were screened against a set of inclusion and exclusion criteria and analysed using the Review Manager 5.4 software.ResultsA title, abstract and full article screening was conducted on 18,153 potential articles based on the inclusion and exclusion criteria. The screening yielded five articles for meta-analysis. The total number of normotensive pregnant women (n = 3,380) in the included studies was five times higher than the total number of women with pre-eclampsia (n = 535). A difference between the HDP and normotensive group was noted. This is indicated by a significantly decreased in the effectiveness of CRDPT in detecting HDP as compared to normotensive group [Risk Ratio (RR) = 6.32 (2.17, 18.43) p

Papers and patents can respectively present the latest progress of scientific research and technological development. Combining the two for correlation analysis has certain reference significance for technology opportunity discovery. Therefore, this paper proposes a method for technology opportunity discovery of proton exchange membrane fuel cell from the perspective of papers-patents correlation analysis. Firstly, papers and patent data are collected from papers and patent databases and the LDA model is applied to extract paper and patent topics. Secondly, the indicators of topic heat and novelty are calculated to select high-value paper topics. After that, the similarity analysis between high-value paper topics and all patent topics is considered to select the patent topics with development potential. Finally, the patent texts with high relevance to these patent topics with development potential are positioned. The technical keywords in them are extracted by text mining tool and classified into innovation dimensions according to their attributes and the TEMPEST model. After that, the innovation rules in the SCAMPER model are introduced to combine with the technical keywords in each innovation dimension to identify specific technology opportunities. An empirical study on the technology of proton exchange membrane fuel cell provides sufficient evidence of the method’s ability to discover technology opportunities. This paper contributes by generating four specific technology opportunities, which can make up for the existing defects of proton exchange membrane fuel cells and provide useful guidance for companies to carry out technological innovation.

Many questions are raised, and challenges faced in the new era of (intranasal) bovine respiratory disease complex vaccination. An increase in vaccination rate is expected, due to its positive impact on cattle health, reduction of antimicrobial use and economic factors. However, engagement of farmers and veterinarians with regard to vaccination is often affected by limitations, resulting in the development of barriers to vaccination, but also opportunities to overcome these. The objective of the report is to provide practical recommendations and a consensus on best practises for BRDC vaccination, addressing barriers faced by veterinarians and farmers. The report combines an evidence review with expert opinions and includes discussions on different vaccination approaches, such as intranasal and systemic protocols. As result of the discussions, several barriers to BRDC vaccination were identified, including a lack of knowledge or visibility of the disease’s impact, the preference for blanket antibiotic use over vaccination, resistance to change, the need for visible success, uncertainty about the best time to vaccinate, and concerns about adverse reactions and vaccine efficacy in the presence of maternal antibodies. While these barriers seem substantial, they provide opportunities for the veterinary sector. Indeed, veterinarians are encouraged to use the argumentation presented, along with local case studies and diagnostic testing to highlight the impact of disease, while conducting calf health audits, ensuring expectations are managed to achieve visible success. Overall, this consensus paper aims to provide practical recommendations and support for veterinarians and farmers to overcome barriers and increase BRDC vaccination rates in cattle.

Physical literacy (PL), a concept commonly associated with the early years, physical education, and youth sport development, can become a meaningful determinant of health and longevity for the adult and older adult population. A review of 55 recent publications from 2018 to 2023 that encompassed physical literacy conceptual frameworks, assessments, and intervention-based studies was undertaken through an heuristic inspired by the philosophy which gave birth to PL. With particular interest in how PL has evolved in response to the needs of an aging population, this position paper tracks a key shift in focus from the individual to the relational context. It references positive interaction and social participation in recent models as significant features of an across-the-lifespan PL perspective.The concluding position is that fostering joyful inter-action be at the heart of PL promotion, resource development and assessment practices, especially in the case of an aging population.