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This study focused on the investigation of hydrocarbon potential, thermal maturity and ranking of the coal from the Salt Range in Pakistan. Four different mines located in different areas of the Salt Range were selected for sample acquisition. The samples were further processed and analyzed in laboratory using proximate analysis, ultimate analysis and Rock-Eval pyrolysis. Proximate analysis illustrate that coal of the Salt Range is of low rank because of low moisture content and high volatile material. The ultimate analysis indicates that the coal is immature with lower carbon contents. The coals have total organic carbon contents in the range of 36.45 to 48.68 wt.% and hydrogen index values between 277 and 445 mg HC/TOC indicate that the organic matter type is dominated by type II. Moreover, Rock-Eval pyrolysis parameters further support it as an excellent source rock having type II kerogen, oil-prone nature with some gas-prone character. These data suggest that the coal samples are in low conversion state and thermally immature. [ABSTRACT FROM AUTHOR]

Fruits of five different varieties of Olea europea were taken from the farms cultivated in Pothohar region of Pakistan. Oils were extracted using cold press technique. Different colored oils were obtained in different yields. Physicochemical parameters were carried out by American Oil Chemists Society (AOCS) official methods. Fatty acid profiles were calculated by gas chromatograph equipped with flame ionization detector, after methanolic esterification of olive oils. The most abundant of the fatty acids was oleic acid (62.1-70.15%). The yield percentages (15.3-17.7%), moisture contents (0.4-0.73%), refractive indices (1.4689-1.4691 at 20°C, 1.4613-1.4615 at 40°C, 1.4537-1.4540 at 60°C), saponification value (188-191 mg KOH/g), colors measured by Lovibond tintometer (20Y/2-6 R), acid value (0.17-0.44 mg KOH/g), peroxide value (7.83-17.75 meq/Kg), free fatty acid value (0.08-0.22), iodine value (87-92) were determined. Olive cultivars from Pothohar region indicated very close characteristics to the standard olive oil recommended by International Olive Oil Council (IOOC). Characterized local olive cultivars can contribute as an import substitute of edible oil and a lot of foreign exchange can be saved, as well as lot can be earned by exporting it. [ABSTRACT FROM AUTHOR]

This research was carried out to monitor the occurrence of aflatoxins (B1, B2, G1, and G2) in unpacked rice (50 samples) and cattle feed (60 samples). These samples were analyzed using TLC & ELISA techniques. 30% rice samples showed aflatoxins (AFTs) in the range of 1-20 ppb while 10% samples showed AFTs above 20 ppb. For cattle feed, AFTs detected in the range of 1.9-20.4 ppb in maize, 9.6-28.5 ppb in corn, 9.8-27.3 ppb in barely, 5.4-21.3 ppb in hay samples and 6.7-28.5 ppb in silage samples. The contaminated samples were treated for detoxification. The detoxification promised by specific natural compounds like sodium bicarbonate, citric acid, Allium sativum and black seed oil were from 63-100%. The foods contaminated with AFTs are toxic for human health. High doses of AFTs can be the major cause of liver diseases like cirrhosis, liver cancer and death in humans and animals. [ABSTRACT FROM AUTHOR]

Electro-catalytic water splitting for the generation of sustainable energy, is one of the most promising way to convert renewable energy resources into fuel. Water splitting is an impressive and effective process due to its complete lack of CO 2 emissions and its efficiency as an energy storage system. The growth of stable, low cost and active electro-catalyst has imperative role for achieving the electro-catalytic hydrogen generation from water splitting process. Herein, a very simple synthesis strategy of sol gel method was used to reduce the production cost of electro-catalysts. Particular characterization techniques including X-ray diffraction (XRD), scanning electron microscopy (SEM), and cyclic voltammetry (CV) were accomplished. Transition metals and their oxides were found highly stable, active and shows long term durability for water oxidation process, while manganese (Mn) doped samarium oxide (Sm 2 O 3) electro-catalyst showed promising catalytic performance and found exceptionally very active towards overall water splitting process. Thus, the as-prepared catalysts can be employed for hydrogen generation from water splitting, which is one of imperative sources of renewable energy production. • Electro-catalytic water splitting for the generation of sustainable energy. • Conversion of renewable energy resources into fuel in the form of hydrogen. • Cost-effective electro-catalyst was prepared for water splitting process. • Sol gel method was used to reduce the production cost of electro-catalysts. • Mn-doped samarium oxide electro-catalyst showed high catalytic performance. [ABSTRACT FROM AUTHOR]

The purpose of this research work was to detect antibiotic remnants from chicken meat and to quantify them. For this purpose, the chicken was collected from three poultry farms in Lahore Sheikhupura area. These chickens were categorized according to quality (A, B and C grade) and on the basis of the day of collection (7th, 21st and 35th Growth day). The qualitative analysis was done by agar well diffusion method against B. subtilis, P. aeruginosa, E. coli and S. aureus. Analysis was done for muscles, kidney and liver samples. The highest residual potential was observed for liver extract (7th day) while the minimum for muscle extract (35th day). The samples with the highest zones of inhibition against pathogens were analyzed by HPLC. [ABSTRACT FROM AUTHOR]

The study focusses on investigation of source rock generative characteristics and nature of crude oils from Upper Indus Basin (UIB), Pakistan. The source rock sediments and crude oil samples were geochemically analyzed. These samples belong to Lockhart, Patala, Datta and Kingriali formations from Kohat-Potwar region. The sediments samples were extracted using soxhlet extractor with organic solvents. Soluble organic matter (SOM) and crude oil were fractionated into saturates, aromatics, NSOs and asphaltenes. SOM and Total organic carbon (TOC) values reveal good generative potential of rocks. SOM and TOC values increase with depth which point out the increasing thermal maturity with depth. Bitumen to TOC ratio exhibits that samples are within the oil window. High API gravity, absence of unresolved complex mixture (UCM) and very low sulfur content indicate the non-biodegraded nature of the crude oils. The metals were present in a trace amount. This study provides scientific insight particularly for those involved in oil exploration in region under study. [ABSTRACT FROM AUTHOR]

The wound dressings fabricated by polymers and oregano essential oil (OEO) can be very effective as a hydrogel. The current study has been focused on fabricating the hydrogel membranes of oregano oil encapsulated as an antibacterial agent into sodium alginate (SA) solution by solvent casting method and then evaluated the antibacterial, antioxidant activity, and physicochemical performance of SA/OEO-based polymeric membranes. The polymeric interactions, surface morphology, water absorption capability, thermal stability, and encapsulation efficiency were investigated by FT-IR, SEM, swelling ratio, DSC, and encapsulation efficiency. The percentage encapsulation efficiency of essential oil was 40.5%. FTIR validated the presence of molecular interaction between individual components. SEM images showed a rough and porous appearance for hydrogel membranes. Moreover, DSC showed that the fabricated membranes were thermally stable. The inclusion of more content OEO decreased swelling ratios. The antioxidant test was carried out by DPPH assay and antibacterial test through disc diffusion method against microbes. The results revealed that membranes containing the highest content of OEO had more excellent antioxidant and antibacterial efficacy. Therefore, the polymeric membranes of sodium alginate loaded with oregano essential oil can be employed as an effective wound-healing candidate. [ABSTRACT FROM AUTHOR]

The sediment samples from Cretaceous sequences, Lower Indus Basin, were investigated using biomarkers approach to predict the source, depositional environment and lithology of organic matter. The Parh and Upper Goru Formations demonstrate the presence of algal organic matter deposited under anoxic and suboxic conditions. The interpretation was supported by relatively high distribution of C275α (H), 14α (H), 17α (H) 20R (ααα-20R) steranes. The samples of Lower Goru Formation reveal mixed organic matter, predominantly terrestrial and oxic, as apparent from biomarkers distribution. The Sembar Formation specifies mixed input of organic matter more terrigenous input at intervals, deposited under anoxic and suboxic conditions. Geochemical analyses performed on Cretaceous strata show that hydrocarbons were derived from organic matter of mixed origin, predominantly terrestrial, deposited under anoxic and oxic conditions. [ABSTRACT FROM PUBLISHER]

The sediment samples from cretaceous sequences, Lower Indus basin, were analyzed using diagnostic biomarkers to predict the thermal maturity of organic matter. The sediments were tested for aliphatic biomarkers ratios, i.e. homohopanes and steranes isomerization ratios and carbon preference indices. These biomarker maturity parameters reveal that the Lower Goru (including its members Upper shale, Lower shale, and Talhar shale) and Sembar Formations in the Lower Indus Basin of Cretaceous age have reached the maturity level equivalent to the main zone of hydrocarbons generation, whereas Parh and Upper Goru Formations are immature and far from oil window. Geochemical analyses carried out stresses that hydrocarbons derived from the Sembar and Lower Goru Formations (particularly deeper Members) are within the zone of peak oil generation. [ABSTRACT FROM AUTHOR]

This study includes geochemical characterization of source rock samples from the Upper shale, Lower shale, Talhar shale units of Sembar Formation and Badin shale, Turk shale units of Lower Goru Formation. Fourteen (14) sediment samples have been obtained from various wells located in Badin area of Lower Indus Basin and were analyzed to evaluate thermal history, depositional settings and generative potential. The bitumens obtained by soxhlet extraction were fractionated into saturates, aromatics, NSOs and asphaltenes/resins by column chromatography on silica gel. Saturated fractions isolated by column chromatography were analyzed by Gas Chromatography-Flame Ionization Detector. TOC determined by wet combustion titration method revealed fair to good source rock potential. Pr/Ph ratios and hydrocarbons distributions show anoxic to oxic depositional environment. The TAR ratio,nC31/nC19ratio, and odd carbon number predominance suggest land plant organic matter input. The values of CPI, OEP and Bit/TOC suggest that these Cretaceous sequences of Sembar and Lower Goru formation are of intermediate maturity and lie within the onset of oil genesis zone. [ABSTRACT FROM PUBLISHER]

In previous studies, Patala-Nammal Composite Total Petroleum System (TPS) was recognized as a potential source of hydrocarbon in the Upper Indus Basin, and Sembar-Goru Composite TPS in the Lower Indus Basin. However, petroleum source-rock potential of Cretaceous strata in the Indus Basin is poorly known. In the current study, Rock Eval and total organic carbon (TOC) analyses were conducted to investigate the thermal maturity and source-rock potential of Cretaceous unit in the Lower Indus Basin. The Parh Formation of the Lower Indus Basin is lean in organic contents (TOC < 0.73%) and consistent with immature type-III/IV kerogen. The Upper Goru Formation is fair in organic contents and presents similar characteristics to the Parh Formation with respect to the hydrocarbon generation zone. The Lower Goru Formation presents fair to very good organic contents. The members of Lower Goru Formation have enough organic matter (OM) and are mature, with the exception of Badin shales. The OM, throughout the formation, is predominantly gas prone. The Sembar Formation is fair in organic contents and mature with respect to hydrocarbons generation. These results support that the Lower Goru rocks are comparatively more prospective with respect to hydrocarbons. [ABSTRACT FROM AUTHOR]

Geochemical analyses of the 10 crude oils from Cretaceous sequences, Lower Indus Basin, Pakistan, are performed to characterize source, depositional environment, biodegradation, and thermal maturity to establish genetic relationship. Low sulfur, high pristane/phytane (Pr/Ph) ratios, and high American Petroleum Institute gravity indicate oxic depositional environment and terreginous input of organic matter (OM). Full suite ofn-alkanes, low isoprenoid/n-alkane ratios, elevated saturates/aromatics ratios, and the absence of unresolved complex mixture indicate typical non-biodegraded light crude oils. The carbon preference index, odd even predominance, Pr/n-C17, and Ph/n-C18ratios reveal that source rocks generating Lower Indus Basin crude oils are thermally mature. Based on geochemical analyses, the source OM input is probably terreginous mixed with marine, deposited under suboxic to oxic depositional environments. [ABSTRACT FROM PUBLISHER]

Heart failure (HF) is highly prevalent among older patients in skilled nursing facilities (SNFs). HF outcomes for SNF patients suffer because of many factors, including staff training, lack of physician availability, and failure to implement evidence-based care. AMDA – The Society for Post-Acute and Long-Term Care Medicine has recently updated the Clinical Practice Guidelines for Heart Failure Management in SNFs. This review supplements the Guidelines with a robust focus on best practices for transitional care, symptom management, treatment and monitoring, and palliative care in patients with HF. [ABSTRACT FROM AUTHOR]

Physician burnout is a critical factor influencing the quality of care delivered in various healthcare settings. Although the prevalence and consequences of burnout have been well documented for physicians in various jurisdictions, no studies to date have reported on burnout in the postacute and long-term care setting. In this exploratory study, we sought to quantify the prevalence of burnout among 3 cohorts of physicians, each practicing in nursing homes in the United States (US), Canada, or The Netherlands. International comparisons were solicited to highlight cultural and health system factors potentially impacting burnout levels. Using standard survey techniques, a total of 721 physicians were solicited to participate (Canada 393; US 110; The Netherlands 218). Physicians agreeing to participate were asked to complete the “Maslach Burnout Inventory” using the Survey Monkey platform. A total of 118 surveys were completed from The Netherlands, 59 from Canada, and 65 from the US for response rates of 54%, 15%, and 59%, respectively. While US physicians demonstrated more negative scores in the emotional exhaustion subscale compared with their counterparts in Canada and The Netherlands, there were no meaningful differences on the depersonalization and personal accomplishments subscales. Factors explaining these differences are explored as well as approaches to future research on physician burnout in postacute and long-term care. [ABSTRACT FROM AUTHOR]

The article explores how social media can be used in medical applications during global crises. The author, a geriatric doctor, describes how social media applications like WhatsApp have assisted them in their work caring for patients in Pakistan. The COVID-19 pandemic and its impact is also discussed in some length by the author.

The Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms: Transforming Institutional Care ( OPTIMISTIC) project aims to reduce avoidable hospitalizations of long-stay residents enrolled in 19 central Indiana nursing facilities. This clinical demonstration project, funded by the Centers for Medicare and Medicaid Services Innovations Center, places a registered nurse in each nursing facility to implement an evidence-based quality improvement program with clinical support from nurse practitioners. A description of the model is presented, and early implementation experiences during the first year of the project are reported. Important elements include better medical care through implementation of Interventions to Reduce Acute Care Transfers tools and chronic care management, enhanced transitional care, and better palliative care with a focus on systematic advance care planning. There were 4,035 long-stay residents in 19 facilities enrolled in OPTIMISTIC between February 2013 and January 2014. Root-cause analyses were performed for all 910 acute transfers of these long stay residents. Of these transfers, the project RN evaluated 29% as avoidable (57% were not avoidable and 15% were missing), and opportunities for quality improvement were identified in 54% of transfers. Lessons learned in early implementation included defining new clinical roles, integrating into nursing facility culture, managing competing facility priorities, communicating with multiple stakeholders, and developing a system for collecting and managing data. The success of the overall initiative will be measured primarily according to reduction in avoidable hospitalizations of long-stay nursing facility residents. [ABSTRACT FROM AUTHOR]

The study focused on the petroleum geochemistry of crude oils produced from Cretaceous reservoirs. Geochemical portrayal of crude oils has been carried out by means of diagnostic biomarker parameters like relative distribution of steranes (C 27 –C 28 –C 29 ααα-20R steranes), C 19 and C 23 tricyclic terpanes (TT), C 24 tetracyclic terpanes (TeT) and hopanes. These parameters suggest that the crude oils contain terrigenous organic matter (OM) mixed with small input of marine OM. The OM of the source rocks was deposited in oxic depositional environment. Maturity parameters, C 32 22S/(22S+22R) homohopanes and sterane isomerization ratios [20S/(20S+20R), αββ/(αββ+ααα) for C 29 steranes] indicate that these crude oil are produced from the source rocks at early mature stage to mature stage. [ABSTRACT FROM AUTHOR]

Objectives To evaluate the effect of cognitive impairment on rehospitalization in older adults. Design One-year longitudinal study. Setting Medical service of an urban, 340-bed public hospital in Indianapolis between July 2006 and March 2008. Participants Individuals aged 65 and older admitted to the medical service (N = 976). Measurements Rehospitalization was defined as any hospital admission after the index admission. Participant demographics, discharge destination, Charlson Comorbidity Index, Acute Physiology Score, and prior hospitalizations were measured as the confounders. Participants were considered to have cognitive impairment if they had two or more errors on the Short Portable Mental Status Questionnaire. Results After adjusting for confounders, a significant interaction between cognitive impairment and discharge location was found to predict rehospitalization rate ( P = .008) and time to 1-year rehospitalization ( P = .03). Participants with cognitive impairment discharged to a facility had a longer time to rehospitalization (median 142 days) than participants with no cognitive impairment (median 98 days) (hazard ratio ( HR) = 0.77, 95% confidence interval ( CI) = 0.58-1.02, P = .07), whereas participants with cognitive impairment discharged to home had a slightly shorter time to rehospitalization (median 182 days) than those without cognitive impairment (median 224 days) ( HR = 1.15, 95% CI = 0.92-1.43, P = .23). These two nonsignificant HRs in opposite directions were significantly different from each other ( P = .03). Conclusion Discharge destination modifies the association between cognitive impairment and rehospitalization. Of participants discharged to a facility, those without cognitive impairment had higher rehospitalization rates, whereas the rates were similar between cognitively impaired and intact participants discharged to the community. [ABSTRACT FROM AUTHOR]

Abstract: Background: The role of interdisciplinary interventions in the nursing home (NH) setting remains unclear. We conducted a systematic evidence review to study the benefits of interdisciplinary interventions on outcomes of NH residents. We also examined the interdisciplinary features of successful trials, including those that used formal teams. Data Sources: Medline was searched from January 1990 to August 2011. Search terms included residential facilities, long term care, clinical trial, epidemiologic studies, epidemiologic research design, comparative study, evaluation studies, meta-analysis and guideline. Study Selection: We included randomized controlled trials (RCTs) evaluating the efficacy of interdisciplinary interventions conducted in the NH setting. Measurements: We used the Cochrane Collaboration tools to appraise each RCT, and an RCT was considered positive if its selected intervention had a significant positive effect on the primary outcome regardless of its effect on any secondary outcome. We also extracted data from each trial regarding the participating disciplines; for trials that used teams, we studied the reporting of various team elements, including leadership, communication, coordination, and conflict resolution. Results: We identified 27 RCTs: 7 had no statistically significant effect on the targeted primary outcome, 2 had a statistically negative effect, and 18 demonstrated a statistically positive effect. Participation of residents’ own primary physicians (all 6 trials were positive) and/or a pharmacist (all 4 trials were positive) in the intervention were common elements of successful trials. For interventions that used formal team meetings, presence of communication and coordination among team members were the most commonly observed elements. Conclusion: Overall interdisciplinary interventions had a positive impact on resident outcomes in the NH setting. Participation of the residents’ primary physician and/or a pharmacist in the intervention, as well as team communication and coordination, were consistent features of successful interventions. [Copyright &y& Elsevier]

Background: Behavioral and psychological symptoms associated with dementia are common in nursing home residents. Quality indicators (QI) assessing quality of care for these residents are minimally risk adjusted and can provide inaccurate information regarding the quality of care provided by the facility. Objective: Evaluate the performance of a new QI for the incidence of worsening behaviors in nursing home residents with behavioral and psychological symptoms association with dementia. Design: Retrospective cohort study. Setting: A total of 381 Minnesota nursing homes with 26,165 residents. Data Sources: Minimum Data Set records for the first 2 calendar quarters of 2008. Measurements: We calculated incidence of worsening behaviors QI by comparing items from the “behavior” section of the Minimum Data Set records from 2 consecutive quarters and reported the incidence rates by both the residents’ level of cognitive impairment and the presence or absence of special care unit for dementia (SCU). Results: The incidence rates of the worsening behavior QI in SCU ranged from 14% in residents with very severe cognitive impairment (a cognitive performance score = 6) to 30% in those with moderate cognitive impairment (a cognitive performance score = 3). The incidence QI rates among residents residing in conventional unit ranged from 15% among those with very severe cognitive impairment to 20% among those with moderate cognitive impairment. These differences in QI rates between the 2 units were statistically significant with a P value = .001. After risk adjustment for level of cognitive impairment, number of facilities with SCUs that flagged for problem behaviors dropped from 18.4% to 12.4% and the number of conventional units in the low-risk category from 16.8% to 4.7%. Conclusion: Resident cognitive function and the facility utility of SCU are associated with worsening behavior QI and should be adjusted for in any nursing home quality reporting measure. [Copyright &y& Elsevier]

A series of cobalt ferrite/cadmium oxide (CFO/CO) hetero-junctions were synthesized via an ultra-sonication approach. The compositions were examined based on ferroelectric, optical and photo-catalytic properties. X-ray diffraction (XRD), UV–visible (UV–Vis) spectroscopy and photo-luminescence (PL) were employed for the characterization of the prepared materials. XRD analysis confirmed a distorted cubic phase with space group fm3m and grain size was in 17.6–19.2 nm range. The ferroelectric parameters were enhanced significantly by the addition of CO (CdO) into the CFO (CoFe 2 O 4) crystal lattice. The band-gap energy was decreased significantly of hetero-junctions from 3.29 to 2.54 eV. The enhanced ferroelectric polarization with low band-gap energy boosts their ferroelectric and optical responses. A reduction in PL intensity was observed in hetero-junctions. The photo-catalytic activity (PCA) of CFO and cobalt ferrite/cadmium oxide (1–4) hetero-junctions CFO/CO (1–4) was examined by photo-degradation of Methylene Blue (MB) dye under visible light exposure. The CFO/CO4 photo-catalyst exhibited superior PCA of 92% within 90 min irradiation. Additionally, photo-catalyst dose and pH effect on the kinetics of MB dye degradation was also examined. Superior PCA of CFO/CO4 in comparison to pure CFO makes this material a promising candidate for the removal of hazardous dyes in effluents under visible light irradiation. [ABSTRACT FROM AUTHOR]

As heavy metals are very noxious for health also known as one of the most poisonous classes of water contaminants. Typically, metal pollutants are non-biodegradable and impervious towards oxidants, heat, and light. Thus, it is a precisely demanding task to eliminate them from water to reduce water pollution. In current studies, the process of adsorption was employed for deracination of Zn and Fe with modified surface of natural material as an adsorbent. TiO 2 NPs were synthesized by using leaf extract of Putranjiva roxburghii and its nanocomposites were made with the fish scale biomass. Prime conditions for proficient removal of zinc were recognized at pH = 4 and for iron at pH = 6 having an initial concentration 100 mg/L, adsorbent dose rate of 0.1 g and contact time 120 minutes. Thermodynamic study revealed that process was spontaneous, and exothermic, resulted in increase in entropy with rise in temperature. Adsorption process has been certified with different isotherm and kinetic models, where the experimental data was brought into being good agreement with pseudo second order ( R 2 = 0.986) and Freundlich isotherm ( R 2 = 0.993) as compared with other models. For characterization of synthesized adsorbents scanning electron microscopy, UV–visible spectroscopy and Fourier-transform Infrared spectroscopy, X-ray diffraction, and energy-dispersive X-ray were used. Average particle size of the adsorbent used ranged from 1 to 5 µm. [ABSTRACT FROM AUTHOR]

This work emphasis on the synthesis of Ni0.2Mn0.02Zn0.02O nanoparticles by facile sol‐gel method. The photocatalytic activity was studied for the degradation of methylene blue (MB) dye under the UV light as a function of dye initial concentration, catalyst dose and pH of the medium. Scanning electron microscopy (SEM) and energy dispersive X‐ray (EDX) were utilized for the study of morphological and elemental composition, while XRD analysis was employed for structural study of the prepared material, which formation the phase purity and size was in 20–24 nm range. The bandgap of Zn/Mn co‐doped NiO NPs (3.24 eV) was reduced as compared to pure NiO NPs (3.43 eV). The degradation efficiency of pure NiO NPs and Zn/Mn co‐doped NiO NPs was found to be 70 % (60 min) and 94 % at optimum conditions. The dielectric properties were also studied, which were also improved in response of doping. The findings revealed that the optical and catalytic properties of Zn/Mn co‐doped NiO NPs were improved versus pure NiO NPs, which could be employed for the remediation of dyes in effluents. [ABSTRACT FROM AUTHOR]

Introduction: For end‐stage renal disease (ESRD) patients residing in skilled nursing facilities (SNFs), the logistics and physical exhaustion of life‐saving hemodialysis therapy often conflict with rehabilitation goals. Integration of dialysis care with rehabilitation programs in a scalable and cost‐efficient manner has been a significant challenge. SNF‐resident ESRD patients receiving onsite, more frequent hemodialysis (MFD) have reported rapid post‐dialysis recovery. We examined whether such patients have improved Physical Therapy (PT) participation. Methods: We conducted a retrospective electronic medical records review of SNF‐resident PT participation rates within a multistate provider of SNF rehabilitation care from January 1, 2022 to June 1, 2022. We compared three groups: ESRD patients receiving onsite MFD (Onsite‐MFD), ESRD patients receiving offsite, conventional 3×/week dialysis (Offsite‐Conventional‐HD), and the general non‐ESRD SNF rehabilitation population (Non‐ESRD). We evaluated physical therapy participation rates based on a predefined metric of missed or shortened (<15 min) therapy days. Baseline demographics and functional status were assessed. Findings: Ninety‐two Onsite‐MFD had 2084 PT sessions scheduled, 12,916 Non‐ESRD had 225,496 PT sessions scheduled, and 562 Offsite‐Conventional‐HD had 9082 PT sessions scheduled. In mixed model logistic regression, Onsite‐MFD achieved higher PT participation rates than Offsite‐Conventional‐HD (odds ratio: 1.8, CI: 1.1–3.0; p < 0.03), and Onsite‐MFD achieved equivalent PT participation rates to Non‐ESRD (odds ratio: 1.2, CI: 0.3–1.9; p < 0.46). Baseline mean ± SD Charlson Comorbidity score was significantly higher in Onsite‐MFD (4.9 ± 2.0) and Offsite‐Conventional‐HD (4.9 ± 1.8) versus Non‐ESRD (2.6 ± 2.0; p < 0.001). Baseline mean self‐care and mobility scores were significantly lower in Onsite‐MFD versus Non‐ESRD or Offsite‐Conventional‐HD. Discussion: SNF‐resident ESRD patients receiving MFD colocated with rehabilitation had higher PT participation rates than those conventionally dialyzed offsite and equivalent PT participation rates to the non‐ESRD SNF‐rehabilitation general population, despite being sicker, less independent, and less mobile. We report a scalable program integrating dialysis and rehabilitation care as a potential solution for ESRD patients recovering from acute hospitalization. [ABSTRACT FROM AUTHOR]

Nanoparticles obtained from physical and chemical methods are uniformly sized having long term stabilities. However, their syntheses usually involve expensive chemicals which are toxic, carcinogenic and require high temperature and pressure. These issues can be addressed by facile and eco-friendly green synthesis. This study focuses on to synthesis of zinc oxide nanoparticles (ZnO NPs) using Cymbogobon Citratus aqueous extract with zinc acetate. The prepared particles were calcined at 450°C. The synthesized NPs were categorized using FTIR, UV-Visible, XRD and SEM techniques. FTIR verified zinc oxide vibrational frequency at 551 cm-1. UV-Visible spectrum displayed the ZnO absorption peak at λmax of 370 nm. XRD studies showed average particle size about 4.96 nm much smaller as compared to most of the ZnO NPs reported earlier. SEM image demonstrated crystalline and porous nano-sheets for the prepared NPs. These NPs were also evaluated against Staphylococcus aureus, Escherichia coli, Salmonella typhi, Microsporum cannis, Aspergillus flavus and Fusarium solani. The synthesized ZnO NPs exhibited highest antibacterial and antifungal potential against S. Aureus and A. flavus, respectively. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented about the case of an 82-year-old male patient who had inserted a pencil into his urethra that broke off inside.

In the present investigation, zinc oxide nanorods (ZnO-NR) were synthesized via the hydrothermal method using ZnCl2 as a zinc ion precursor in the presence of cetyltrimethylammonium bromide. Synthesized ZnO-NR was featured using advanced techniques including XRD, PL, SEM, and UV-visible spectroscopy. The role of these assynthesized ZnO-NR was evaluated for the sequestration of lead ions in batch mode. The elimination of lead ions was achieved at pH 6-7 using a 0.06 g adsorbent dose, 25 min contact time, 25 mg/L initial lead ion concentration, 323 K temperature, and 200 rpm agitation speed. A thermodynamic study revealed the endothermic nature of lead ion sequestration onto ZnO-NR. The lead ion sequestration followed kinetic (pseudo-second-order) and isotherm (Langmuir) models. The lead ions were eliminated up to 142 mg/g at the optimum level of affecting variables. The ZnO-NR might be a potential adsorbent for lead ion removal from industrial effluents. [ABSTRACT FROM AUTHOR]

Textile and other dye house effluents from different industries have many worst effects on aquatic as well as non-aquatic life. The present work was carried out for the conditions optimization of degradation of Allura Red AC dye. This was done by UV treatment and examining the effects of different parameters on degradation i.e. pH, concentration of the dye, temperature, radiation exposure time and concentration of TiO2. The efficiency of the treatment was monitored by checking the highest degradation value, parameters of water quality such as chemical oxygen demand (COD), biological oxygen demand (BOD) and toxicity. The end products of degradation of dye were checked out by UV/visible spectrophotometer, Fourier transform-infra red (FT-IR) and gas chromatographymass spectrometry (GC-MS) techniques. From the results, it was concluded that the degradation efficiency was in the order UV/H2O2/TiO2> UV/H2O2> UV alone. Furthermore, it was also concluded that UV/H2O2/TiO2 could be implemented on industrial scale for the removal of the toxic pollutants from industrial effluents. [ABSTRACT FROM AUTHOR]

Our nation's nursing home industry has been in need of overhaul for decades—a situation made all the more evident by COVID-19. AMDA–The Society for Post-Acute and Long-Term Care Medicine is dedicated to quality in post-acute and long-term care process and outcomes. This special article presents 5 keys to solving the COVID-19 crisis in post-acute and long-term care, related to policy, collaboration, individualization, leadership, and reorganization. Taking action during this crisis may prevent sinking back into the complacency and habits of our pre-COVID-19 lives. [ABSTRACT FROM AUTHOR]

Since ancient times, medicinal plants have been used as traditional medicine to treat a variety of ailments. Aloe vera (AV) gel's therapeutic potential is one of the most effective approach in the fabrication of functional materials. The current study aimed to prepare the AV and chitosan (CS) membranes using various cross-linkers that were characterized using X-ray diffraction (XRD), scanning electron microscopy (SEM), Fourier transform-infrared (FT-IR) spectroscopy, thermal gravimetric analysis (TGA), and ultraviolet-visible (UV-Visible) techniques, as well as swelling ratio and antimicrobial studies. SEM analysis revealed that the membrane is porous, with interconnected pores. The inclusion of AV contents in the membrane improved thermal stability and crystallinity. The swelling ratio of the ACPG-3 membrane with a 2:1 CS to AV ratio was 366%. The membranes showed promising antimicrobial activity against Escherichia coli, Staphylococcus aureus, Bacillus subtilis, and Pasteurella multocida strains. The findings revealed that polymeric CS/AV membranes have effective potential for use in the biomedical field. [ABSTRACT FROM AUTHOR]

The pollution due to dyes from textile sector is one of the major issues faced worldwide. This study was focused on the removal of the reactive dye, Drimaren Turquoise CL-B using Schizophyllum commune, a white rot fungus (WRF) keeping in mind the current environmental conditions. Different parameters like pH, sources of carbon & nitrogen, temperature, concentration of dye and C/N ratio were used to investigate their effect on the process. Maximum dye removal of 95.45% was obtained at pH 4.5, temperature 35°C, inoculum size 3 mL, veratryl alcohol (mediator), glucose (carbon source) and ammonium nitrate (nitrogen source). The enzyme activity was determined by employing enzyme assay. Laccase and Lignin peroxidase (LiP) activity was low while Manganese peroxidase (MnP) activity was highest. Maximum bio-sorption was achieved at pH 1 and 313 K. The pseudo-2nd-order kinetic model & Freundlich isotherm was best suited for the process of removal of dye. From these data, it is concluded that white rot fungus could possibly be the excellent biomaterial for elimination of synthetic dyes from wastewater. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: Prevention and public reporting of falls have suffered due to inadequate attention given to the association of falls and cognitive impairment (CI) among nursing home (NH) residents. This study examines the relationship between CI, residence on dementia special care units (SCUs) and other resident characteristics and likelihood of residents experiencing new falls in NHs. Design: Retrospective cohort study. Setting and Participants: A total of 21,587 residents from 381 Minnesota NHs. Measurements: The NH Minimum Data Set (MDS) for 21,587 residents from 381 Minnesota NHs in the first calendar quarter of 2008 were analyzed. New falls, (fall noted on a current MDS assessment but not on a prior assessment); cognitive status, (as defined by Cognitive Performance Scale); residence on an SCU, and health and functional status covariates were recorded. A random effects logistic regression model was used to examine relationships between new falls and the resident''s cognitive status, type of unit, and covariates. Results: The likelihood of a new fall had a nonlinear association with CI. Compared with residents with normal or mild CI, the likelihood of a new fall was significantly higher among residents with moderate CI (OR = 1.43). The risk decreased slightly (OR = 1.34) for residents with more advanced CI, whereas the presence of severe CI was not significantly associated with new falls. Overall the likelihood of new falls was significantly higher for residents on SCUs compared with those on conventional units (OR = 1.27). Conclusions: Severity of CI and residence on SCU impact fall incidence and should be accounted for in future fall- prevention interventions and quality-reporting indicators and measures. [Copyright &y& Elsevier]

Objectives The objective of this study was to evaluate the feasibility and impact of implementing a person-centered medical care model for post-acute care residents within a skilled nursing facility (SNF). Design A mixed-method (qualitative and quantitative) pilot evaluation. Setting An 89-bed SNF located within a large midwestern city. Participants Forty SNF post-acute patients admitted to the facility during a 6-month period were enrolled in the pilot evaluation. The patients were 75% women, 57% African American, and had an average age of 73. To meet inclusion criteria, patients must have been admitted to the facility for rehabilitation with a plan for community discharge, and be cognitively able to consent as indicated by a cognitive screening tool or assent to participation with family member consent. Intervention The person-centered medical care model included (1) biweekly interdisciplinary care plan meetings, scheduled at a time of patients' preference and held in the patient's room; (2) patient selection of health-related goals that guide team discussions; (3) use of lay-language that facilitated patient understanding; (4) team accountability to the patient for patient care preferences; and (5) monthly care-team meetings to exchange feedback regarding the team's performance and the model. Measurement Evaluation data included admission and discharge Patient Activation Measure surveys; admission and discharge Care of Chronic Conditions surveys; admission and biweekly modified Castle Satisfaction Surveys; admission and discharge Patient and Caregiver Engagement surveys; and semistructured interviews with a sample of staff, family members, and patients. Results A significant ( P < .01) improvement was noted between admission and discharge on both the Care for Chronic Conditions and the Patient Activation Measure surveys. Patient satisfaction surveys trended toward higher ratings over time on most questions, with significant improvement in 2 questions addressing satisfaction with their medical provider. Interviews revealed a perception that the model encouraged an environment of respect and honesty in patient communications, and an overall positive experience. The challenges of scheduling and time were noted by respondents. Conclusions Implementation of person-centered medical care within an SNF was feasible, yet required changing care processes to better address individual goals and facilitate communication among patients, providers, and SNF staff. Overall pilot results indicated that patients and staff members viewed the person-centered care experience positively. Further research is needed to examine long-term effects of the model on resident outcomes. [ABSTRACT FROM AUTHOR]