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1.
Artigo em Inglês | MEDLINE | ID: mdl-38822978

RESUMO

PURPOSE: Colorectal cancer screening is recommended starting at age 45, but there has been little research on strategies to promote screening in patients younger than 50. METHODS: An outreach program quasi-randomly assigned patients aged 45-50 without recent fecal immunochemical test (FIT), colonoscopy or contraindications to screening to two intervention arms: electronic outreach with email and text (electronic outreach only) versus electronic outreach plus mailed outreach with FIT, an instructional letter and a prepaid return envelope (mailed + electronic outreach). In response to known disparities in screening uptake, all Black patients were assigned to receive mailed + electronic outreach. RESULTS: Among patients quasi-randomly assigned to an intervention (non-Black patients), the 180-day FIT completion rate was 18.8% in the electronic outreach only group (n = 1,318) and 25.0% in the mailed + electronic outreach group (n = 1,364) (difference 6.2% [95% CI 3.0, 9.4]). FIT completion was 16.6% among Black patients (n = 469), 8.4% (95% CI 4.1, 12.6) lower than among non-Black patients also assigned to mailed + electronic outreach. CONCLUSION: Among patients aged 45-50, mailed + electronic outreach had a greater effect on FIT completion than electronic outreach alone. Crossover between intervention groups likely lead to an underestimation of the effect of mailed outreach.

2.
Environ Pollut ; 354: 124134, 2024 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-38734050

RESUMO

This review article explores the challenges associated with landfill leachate resulting from the increasing disposal of municipal solid waste in landfills and open areas. The composition of landfill leachate includes antibiotics (0.001-100 µg), heavy metals (0.001-1.4 g/L), dissolved organic and inorganic components, and xenobiotics including polyaromatic hydrocarbons (10-25 µg/L). Conventional treatment methods, such as biological (microbial and phytoremediation) and physicochemical (electrochemical and membrane-based) techniques, are available but face limitations in terms of cost, accuracy, and environmental risks. To surmount these challenges, this study advocates for the integration of artificial intelligence (AI) and machine learning (ML) to strengthen treatment efficacy through predictive analytics and optimized operational parameters. It critically evaluates the risks posed by recalcitrant leachate components and appraises the performance of various treatment modalities, both independently and in tandem with biological and physicochemical processes. Notably, physicochemical treatments have demonstrated pollutant removal rates of up to 90% for various contaminants, while integrated biological approaches have achieved over 95% removal efficiency. However, the heterogeneous nature of solid waste composition further complicates treatment methodologies. Consequently, the integration of advanced ML algorithms such as Support Vector Regression, Artificial Neural Networks, and Genetic Algorithms is proposed to refine leachate treatment processes. This review provides valuable insights for different stakeholders specifically researchers, policymakers and practitioners, seeking to fortify waste disposal infrastructure and foster sustainable landfill leachate management practices. By leveraging AI and ML tools in conjunction with a nuanced understanding of leachate complexities, a promising pathway emerges towards effectively addressing this environmental challenge while mitigating potential adverse impacts.

3.
Artigo em Inglês | MEDLINE | ID: mdl-38769769

RESUMO

OBJECTIVE: To develop a semiautomated electronic medical record (EMR) system to track pediatric endoscopic procedural adverse event (AE) at a tertiary referral children's hospital. METHODS: We developed an automated EMR based query for postprocedure AEs. Main outcome measurements within 30 days of procedure: return to emergency department, return to surgery, unplanned admissions and admissions with longer than intended stays. Events were graded using a recently described classification system for postendoscopy events and tracked for a 36-month period, from January 2017 to December 2019. RESULTS: Development of a semi-automated system was successful in comprehensive identification of endoscopy and sedation related AE. A total of 193 AEs (2%) were identified in all three categories. Seventy cases (0.7%) were noted to be a direct result of an endoscopic procedure. Of these cases, 31 (44%) were noted to be Grade 3, 5 cases (7%) Grade 4, and no Grade 5 AE occured. Higher rates of AE were observed after therapeutic procedures versus diagnostic (2.6% vs. 0.3%, p = <0.00001). AEs related to sedation occurred in 0.5% of procedures with the majority (84%) reported in patients with American Society of Anesthesia classification of 3 or greater. CONCLUSIONS: Diagnostic endoscopy remains a safe procedure and risk of both endoscopy and sedation related AE are low. Therapeutic procedures carry a higher risk but are still overwhelmingly safe. Institutional investment in this EMR based system allowed for sustainability and comprehensive tracking of endoscopy related AE.

5.
J Environ Manage ; 357: 120636, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38552514

RESUMO

Although aerobic composting is usually utilized in livestock manure disposal, the emission of odorous gases from compost not only induces harm to the human body and the environment, but also causes loss of nitrogen, sulfur, and other essential elements, resulting in a decline in product quality. The impact of biotrickling filter (BTF) and insertion of carbon-based microbial agent (CBMA) on compost maturation, odor emissions, and microbial population during the chicken manure composting were assessed in the current experiment. Compared with the CK group, CBMA addition accelerated the increase in pile temperature (EG group reached maximum temperature 10 days earlier than CK group), increased compost maturation (GI showed the highest increase of 41.3% on day 14 in EG group), resulted in 36.59% and 14.60% increase in NO3--N content and the total nitrogen retention preservation rate after composting. The deodorization effect of biotrickling filter was stable, and the removal rates of NH3, H2S, and TVOCs reached more than 90%, 96%, and 56%, respectively. Furthermore, microbial sequencing showed that CBMA effectively changed the microbial community in compost, protected the ammonia-oxidizing microorganisms, and strengthened the nitrification of the compost. In addition, the nitrifying and denitrifying bacteria were more active in the cooling period than they were in the thermophilic period. Moreover, the abundance of denitrification genes containing nirS, nirK, and nosZ in EG group was lower than that in CK group. Thus, a large amount of nitrogen was retained under the combined drive of BTF and CBMA during composting. This study made significant contributions to our understanding of how to compost livestock manure while reducing releases of odors and raising compost quality.


Assuntos
Inoculantes Agrícolas , Compostagem , Animais , Humanos , Esterco/microbiologia , Galinhas , Odorantes , Nitrogênio/análise , Carbono , Solo
6.
Pediatrics ; 153(4)2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38511227

RESUMO

BACKGROUND AND OBJECTIVES: Nasal intermittent positive pressure ventilation (NIPPV) has been shown to be superior to nasal continuous positive airway pressure (CPAP) postextubation in preterm neonates. However, studies have not permitted high CPAP pressures or rescue with other modes. We hypothesized that if CPAP pressures >8 cmH2O and rescue with other modes were permitted, CPAP would be noninferior to NIPPV. METHODS: We conducted a pragmatic, comparative-effectiveness, noninferiority study utilizing network-based real-world data from 22 Canadian NICUs. Centers self-selected CPAP or NIPPV as their standard postextubation mode for preterm neonates <29 weeks' gestation. The primary outcome was failure of the initial mode ≤72 hours. Secondary outcomes included failure ≤7 days, and reintubation ≤72 hours and ≤7 days. Groups were compared using a noninferiority adjusted risk-difference (aRD) margin of 0.05, and margin of no difference. RESULTS: A total of 843 infants extubated to CPAP and 974 extubated to NIPPV were included. CPAP was not noninferior (and inferior) to NIPPV for failure of the initial mode ≤72 hours (33.0% vs 26.3%; aRD 0.07 [0.03 to 0.12], Pnoninferiority(NI) = .86), and ≤7 days (40.7% vs 35.8%; aRD 0.09 [0.05 to 0.13], PNI = 0.97). However, CPAP was noninferior (and equivalent) to NIPPV for reintubation ≤72 hours (13.2% vs 16.1%; aRD 0.01 [-0.05 to 0.02], PNI < .01), and noninferior (and superior) for reintubation ≤7 days (16.4% vs 22.8%; aRD -0.04 [-0.07 to -0.001], PNI < .01). CONCLUSIONS: CPAP was not noninferior to NIPPV for failure ≤72 hours postextubation; however, it was noninferior to NIPPV for reintubation ≤72 hours and ≤7 days. This suggests CPAP may be a reasonable initial postextubation mode if alternate rescue strategies are available.


Assuntos
Ventilação com Pressão Positiva Intermitente , Síndrome do Desconforto Respiratório do Recém-Nascido , Recém-Nascido , Humanos , Pressão Positiva Contínua nas Vias Aéreas , Recém-Nascido Prematuro , Canadá , Idade Gestacional , Síndrome do Desconforto Respiratório do Recém-Nascido/terapia
7.
Br J Haematol ; 2024 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-38485116

RESUMO

Infection and lymphopenia are established bendamustine-related complications. The relationship between lymphopenia severity and infection risk, and the role of antimicrobial prophylaxis, is not well described. This multicentre retrospective study analysed infection characteristics and antimicrobial prophylaxis in 302 bendamustine-treated indolent non-Hodgkin lymphoma patients. Lymphopenia (<1 × 109 /L) was near universal and time to lymphocyte recovery correlated with cumulative bendamustine dose. No association between lymphopenia severity and duration with infection was observed. Infections occurred in 44% of patients (50% bacterial) with 27% hospitalised; 32% of infections occurred ≥3 months post bendamustine completion. Infection was associated with obinutuzumab and/or maintenance anti-CD20 therapy, prior therapy and advanced stage. Twenty-four opportunistic infections occurred in 21 patients: ten varicella zoster virus (VZV), seven herpes simplex virus (HSV), one cytomegalovirus, one progressive multifocal leucoencephalopathy, one nocardiosis, one Pneumocystis jiroveci pneumonia (PJP) and three other fungal infections. VZV/HSV and PJP prophylaxis were prescribed to 42% and 54% respectively. Fewer VZV/HSV infections occurred in patients receiving prophylaxis (HR 0.14, p = 0.061) while PJP prophylaxis was associated with reduced risk of bacterial infection (HR 0.48, p = 0.004). Our study demonstrates a significant infection risk regardless of lymphopenia severity and supports prophylaxis to mitigate the risk of early and delayed infections.

8.
J Pediatr ; 269: 113976, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38401787

RESUMO

OBJECTIVE: To describe the prevalence of and between-center variations in care practices and clinical outcomes of moderate and late preterm infants (MLPIs) admitted to tertiary Canadian neonatal intensive care units (NICUs). STUDY DESIGN: This was a retrospective cohort study including infants born at 320/7 through 366/7 weeks of gestation and admitted to 25 NICUs participating in the Canadian Neonatal Network between 2015 and 2020. Patient characteristics, process measures represented by care practices, and outcome measures represented by clinical in-hospital and discharge outcomes were reported by gestational age weeks. NICUs were compared using indirect standardization after adjustment for patient characteristics. RESULTS: Among 25 669 infants (17% of MLPIs born in Canada during the study period) included, 45% received deferred cord clamping, 7% had admission hypothermia, 47% received noninvasive respiratory support, 11% received mechanical ventilation, 8% received surfactant, 40% received antibiotics in the first 3 days, 4% did not receive feeding in the first 2 days, and 77% had vascular access. Mortality, early-onset sepsis, late-onset sepsis, or necrotizing enterocolitis occurred in <1% of the study cohort. Median (IQR) length of stay was 14 (9-21) days among infants discharged home from the admission hospital and 5 (3-9) days among infants transferred to community hospitals. Among infants discharged home, 33% were discharged on exclusive breastmilk and 75% on any breastmilk. There were significant variations between NICUs in all process and outcome measures. CONCLUSIONS: Care practices and outcomes of MLPIs varied significantly between Canadian NICUs. Standardization of process and outcome quality measures for this population will enable benchmarking and research, facilitating systemwide improvements.


Assuntos
Recém-Nascido Prematuro , Unidades de Terapia Intensiva Neonatal , Humanos , Canadá , Recém-Nascido , Estudos Retrospectivos , Feminino , Masculino , Centros de Atenção Terciária , Idade Gestacional , Avaliação de Processos e Resultados em Cuidados de Saúde , Doenças do Prematuro/terapia , Doenças do Prematuro/epidemiologia
9.
Pediatrics ; 153(2)2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-38186292

RESUMO

BACKGROUND AND OBJECTIVES: Research on outcomes of prematurity frequently examines neurodevelopment in the toddler years as an end point, but the age range at examination varies. We aimed to evaluate whether the corrected age (CA) at Bayley-III assessment is associated with rates of developmental delay in extremely preterm children. METHODS: This retrospective cohort study included children born at <29 weeks' gestation who were admitted in the Canadian Neonatal Network between 2009 and 2017. The primary outcomes were significant developmental delay (Bayley-III score <70 in any domain) and developmental delay (Bayley-III score <85 in any domain). To assess the association between CA at Bayley-III assessment and developmental delay, we compared outcomes between 2 groups of children: those assessed at 18 to 20 months' CA and 21-24 months. RESULTS: Overall, 3944 infants were assessed at 18-20 months' CA and 881 at 21-24 months. Compared with infants assessed at 18-20 months, those assessed at 21-24 months had higher odds of significant development delay (20.0% vs 12.5%; adjusted odds ratio, 1.75; 95% confidence interval [CI], 1.41-2.13) and development delays (48.9% vs 41.7%, adjusted odds ratio 1.33; 95% CI, 1.11-1.52). Bayley-III composite scores were on average 3 to 4 points lower in infants evaluated at 21-24 months' CA (for instance, adjusted mean difference and 95% CI for language: 3.49 [2.33-4.66]). Conversely, rates of cerebral palsy were comparable (4.6% vs 4.7%) between the groups. CONCLUSIONS: Bayley-III assessments performed at 21-24 months' CA were more likely to diagnose a significant developmental delay compared with 18- to 20-month assessments in extremely preterm children.


Assuntos
Desenvolvimento Infantil , Deficiências do Desenvolvimento , Recém-Nascido , Lactente , Criança , Humanos , Deficiências do Desenvolvimento/diagnóstico , Deficiências do Desenvolvimento/epidemiologia , Estudos Retrospectivos , Canadá/epidemiologia , Recém-Nascido Prematuro
10.
Environ Sci Pollut Res Int ; 31(5): 7712-7727, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38170352

RESUMO

The multi-source hazardous waste co-disposal system, a recent innovation in the industry, offers an efficient approach for hazardous waste disposal. The incineration fly ash (HFA) produced by this system exhibits characteristics distinct from those of typical incineration fly ash, necessitating the use of adjusted disposal methods. This study examined the physicochemical properties, heavy metal content, heavy metal leaching concentration, and dioxin content of HFA generated by the new co-disposal system and compared them with those of conventional municipal waste incineration fly ash. This study investigated the solidification and stabilization of HFA disposal using the organic agent sodium diethyl dithiocarbamate combined with cement on a field scale. The findings revealed significant differences in the structure, composition, and dioxin content of HFA and FA; HFA contained substantially lower levels of dioxins than FA did. Concerning the heavy metal content and leaching; HFA exhibited an unusually high concentration of zinc, surpassing the permitted emission limits, making zinc content a critical consideration in HFA disposal. After stabilization and disposal, the heavy metal leaching and dioxin content of HFA can meet landfill disposal emission standards when a 1% concentration of 10% sodium diethyldithiocarbamate (DDTC) and 150% silicate cement were employed. These results offer valuable insights into the disposal of fly ash resulting from incineration of mixed hazardous waste.


Assuntos
Dioxinas , Metais Pesados , Eliminação de Resíduos , Cinza de Carvão/química , Eliminação de Resíduos/métodos , Material Particulado , Resíduos Sólidos/análise , Resíduos Perigosos , Carbono , Incineração , Metais Pesados/análise , Zinco , Ditiocarb
11.
Pediatr Crit Care Med ; 25(2): 92-105, 2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-38240534

RESUMO

OBJECTIVES: To implement an early rehabilitation bundle in two Canadian PICUs. DESIGN AND SETTING: Implementation study in the PICUs at McMaster Children's Hospital (site 1) and London Health Sciences (site 2). PATIENTS: All children under 18 years old admitted to the PICU were eligible for the intervention. INTERVENTIONS: A bundle consisting of: 1) analgesia-first sedation; 2) delirium monitoring and prevention; and 3) early mobilization. MEASUREMENTS AND MAIN RESULTS: Primary outcomes were the duration of implementation, bundle compliance, process of care, safety, and the factors influencing implementation. Secondary endpoints were the impact of the bundle on clinical outcomes such as pain, delirium, iatrogenic withdrawal, ventilator-free days, length of stay, and mortality. Implementation occurred over 26 months (August 2018 to October 2020). Data were collected on 1,036 patients representing 4,065 patient days. Bundle compliance was optimized within 6 months of roll-out. Goal setting for mobilization and level of arousal improved significantly (p < 0.01). Benzodiazepine, opioid, and dexmedetomidine use decreased in site 1 by 23.2% (95% CI, 30.8-15.5%), 26.1% (95% CI, 34.8-17.4%), and 9.2% (95% CI, 18.2-0.2%) patient exposure days, respectively, while at site 2, only dexmedetomidine exposure decreased significantly by 10.5% patient days (95% CI, 19.8-1.1%). Patient comfort, safety, and nursing workload were not adversely affected. There was no significant impact of the bundle on the rate of delirium, ventilator-free days, length of PICU stay, or mortality. Key facilitators to implementation included institutional support, unit-wide practice guidelines, dedicated PICU educators, easily accessible resources, and family engagement. CONCLUSIONS: A rehabilitation bundle can improve processes of care and reduce patient sedative exposure without increasing patient discomfort, nursing workload, or harm. We did not observe an impact on short-term clinical outcomes. The efficacy of a PICU-rehabilitation bundle requires ongoing study. Lessons learned in this study provide evidence to inform rehabilitation implementation in the PICU setting.


Assuntos
Delírio , Dexmedetomidina , Criança , Humanos , Adolescente , Dexmedetomidina/uso terapêutico , Estado Terminal/terapia , Canadá , Dor/tratamento farmacológico , Delírio/prevenção & controle , Unidades de Terapia Intensiva Pediátrica
12.
Nutr Clin Pract ; 39(1): 184-192, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37302062

RESUMO

BACKGROUND: Optimization of nutrition prior to inflammatory bowel disease (IBD)-related surgery could improve outcomes. The aim of this study was to assess the perioperative nutrition status and management of children undergoing intestinal resection for treatment of their IBD. METHODS: We identified all patients with IBD who underwent primary intestinal resection. We identified malnutrition using established criteria and methods of nutrition provision at various time points (preoperative outpatient evaluation, admission, and postoperative outpatient follow-up) for elective cases (who underwent their procedure at a scheduled admission) and urgent cases (who underwent an unplanned surgical intervention). We also recorded data on postsurgical complications. RESULTS: A total of 84 patients were identified in this single-center study (male sex: 40%, mean age: 14.5 years, Crohn's disease: 65%). Thirty-four patients (40%) had some degree of malnutrition. Prevalence of malnutrition in the urgent and elective cohorts was similar (48% vs 36%; P = 0.37). Of these patients, 29 (34%) were noted to be on some type of nutrition supplementation prior to surgery. Postoperatively, BMI z scores increased (-0.61 vs -0.42; P = 0.0008), but the percentage of patients who were malnourished did not change from preoperative status (40% vs 40%; P = 0.10). Despite this, use of nutrition supplementation was only noted in 15 (17%) patients at postoperative follow-up. Complications were not associated with nutrition status. CONCLUSION: Utilization of supplemental nutrition decreased postprocedure despite no change in malnutrition prevalence. These findings support the development of a pediatric-specific perioperative nutrition protocol in the setting of IBD-related surgery.


Assuntos
Doença de Crohn , Doenças Inflamatórias Intestinais , Desnutrição , Humanos , Masculino , Criança , Adolescente , Estado Nutricional , Doenças Inflamatórias Intestinais/complicações , Doenças Inflamatórias Intestinais/cirurgia , Desnutrição/etiologia , Desnutrição/complicações , Doença de Crohn/complicações , Doença de Crohn/cirurgia , Cuidados Pré-Operatórios , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia
13.
J Pediatr ; 266: 113863, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38096975

RESUMO

OBJECTIVE: To quantify site-specific costs and their association with survival without major morbidity (SWMM) in Canada for neonates <28 weeks of gestation admitted to large tertiary neonatal intensive care units. METHODS: We conducted a retrospective analysis of infants born at <28 weeks of gestation and admitted to Canadian Neonatal Network sites from 2010 through 2021. Sites that cared for at least 50 eligible infants by gestational age in weeks over the study period were included. Using a validated costing algorithm that assessed physician, nursing, respiratory therapy, diagnostic imaging, transfusions, procedural, medication, and certain indirect costs, we calculated site and resource-specific costs in 2017 Canadian dollars (CAD) and evaluated their relationship with SWMM. RESULTS: Seven sites with 8180 (range 841-1605) eligible neonates with a mean (SD) gestation of 25.4 [1.3] weeks were included. Survival to discharge or transfer was 85.3% with a mean (SD) length of stay of 75 (46) days. The mean (SD) total and daily costs per neonate varied between $94 992 ($60 283) and $174 438 ($130 501) CAD and $1833 ($916) to $2307 ($1281) CAD, respectively. Between sites, there was no relationship between costs and SWMM. CONCLUSIONS: There was marked variation in costs and SWMM between sites in Canada with universal health care. The lack of concordance between both outcomes and costs among sites may provide possibilities for outcomes improvement and cost containment.


Assuntos
Lactente Extremamente Prematuro , Unidades de Terapia Intensiva Neonatal , Recém-Nascido , Lactente , Humanos , Estudos Retrospectivos , Canadá , Idade Gestacional
14.
J Hazard Mater ; 463: 132944, 2024 02 05.
Artigo em Inglês | MEDLINE | ID: mdl-37951173

RESUMO

Herein, a facile combination approach of chalcopyrite and sodium percarbonate (CuFeS2+ SPC) was established to augment both TCC removal efficiency and sludge dewatering. Results showed that utilizing the CuFeS2 dosage of 600 mg/g total solids (TS) under the optimal condition, along with the SPC dosage of 12.5 mg/g TS, an initial pH of 4.0, and a reaction duration of 40 min, led to a substantial reduction of 53.9% in the TCC content within the sludge, accompanied by a notable decrease of 36.9% in the water content. Compared to well-studied iron-based advanced oxidation processes, CuFeS2 + SPC treatment proved to be more cost-effective and environmentally friendly. Mechanistic findings demonstrated that •OH oxidation played a significant role in TCC removal, with O2•- and 1O2 acting as secondary factors. During the CuFeS2 + SPC process, the received •OH, O2•-, and 1O2 destroyed the main binding sites of extracellular polymeric substances to TCC, including tryptophan-like protein, amide, CO stretch, and -COO- functional groups. As a result, approximately 50% of TCC was partially degraded within the solid sludge phase after the attack of radicals. Meanwhile, the decreased macromolecular organic compounds in solid sludge attenuated the binding efficacy of TCC, giving rise to the transfer of partial TCC to the liquid phase. Ultimately, the TCC in sludge was successfully removed, and five transformation products were identified. This study significantly contributes to our understanding regarding TCC transformation and removal in the sludge conditioning process.


Assuntos
Carbonatos , Esgotos , Esgotos/química , Oxirredução , Água , Eliminação de Resíduos Líquidos
15.
Heliyon ; 9(12): e23140, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38076152

RESUMO

Developing low-cost and high-activity catalysts is one of the keys to promoting the catalytic pyrolysis of waste plastics to fuels for plastic recycling. This work studied the effect of clay as the catalyst on mixed plastic pyrolysis for fuel and energy recovery. Four kinds of clay, including nanoclay, montmorillonite, kaolin, and hydrotalcite, were used as catalysts for the pyrolysis of mixed plastic consisted of polyethylene terephthalate, polystyrene, polypropylene, low-density polyethylene, and high-density polyethylene. The product yield and distribution varied with different clay in pyrolysis. The highest yield of oil was 71.0 % when using montmorillonite as the catalyst. While the highest contents of gasoline range hydrocarbons and diesel range hydrocarbons in the oil were achieved when using kaolin and nanoclay, respectively as catalysts. For the gas products, the CO, C2H4, C2H6, C3H6, and C4H10 increased with decreased CO2 in the gaseous products when using clay as catalysts. In general, the mild acidity of clay catalyst was essential to improve the oil yields and the proportion of the gasoline or diesel range fuels in the catalytic pyrolysis of mixed plastic waste.

16.
Malays J Med Sci ; 30(5): 206-220, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37928783

RESUMO

An accurate and reliable neurological examination is pivotal in diagnosing patients with neurological and neurosurgical conditions. Despite the advancement of neuroscientific knowledge and the ever-progressing technologies and modalities that are being adopted to help achieve the challenge of accurate diagnosis, the neurologic examination is still crucial in both ambulatory and emergency settings. It provides the physician a tool to recognise neurologic involvement in certain disease states, and thereby allow proper work-up and treatment for patients. A basic neurologic examination can be performed rapidly with practice. Manual muscle testing of the lower limbs was carried out in accordance with a bedside clinical examination involving a clinical personnel examiner and a patient. This testing was performed in a rostro-caudal manner, starting from the hip and progressing to the toes. The neurological exam can be intimidating to perform for a lot of physicians. Deficiencies in accurate muscle testing have always presented a challenge for medical students and clinicians. By referring to the examination methods mentioned in our text and with the help of related video, it is our aim to improve the quality of neurological examination among medical personnel so that diseases may be recognised and managed earlier in their course.

17.
Physiother Theory Pract ; : 1-14, 2023 Nov 28.
Artigo em Inglês | MEDLINE | ID: mdl-38014841

RESUMO

BACKGROUND: Previous research has indicated significant concerns regarding attrition of early career physiotherapists in Australia. Despite the importance of retaining skilled and experienced professionals within the profession, the workplace and workforce intentions of early career physiotherapists remain relatively unexplored. PURPOSE: The aim of this study was to investigate and explore factors influencing the workplace and workforce intentions of early career physiotherapists in Australia. METHODS: The Turnover Intention Theory was used to guide a whole-of-person qualitative exploration through semi-structured interviews with 14 participants. Transcribed interview data was subjected to reflexive thematic analysis. RESULTS: Four themes were generated, constructed as questions to represent participants' temporary holding of intentions: 1) What drives me?; 2) Do my expectations align?; 3) Do my values align?; and 4) What does the future hold? CONCLUSION: Early career physiotherapists' perspectives encompass diverse and varied experiences that reflect an alignment, or in some cases a misalignment, of the expectations, values and resulting practices of becoming and being a physiotherapist. Early career physiotherapists experience a range of challenges within their workplaces, including significant experiences of stress, yet they express an underlying commitment to the wider profession.

18.
Quant Imaging Med Surg ; 13(10): 6942-6951, 2023 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-37869338

RESUMO

Background: The effect of dehydration of ex vivo cartilage samples and rehydration with native synovial fluid or normal saline on quantitative ultrashort echo time (UTE) biomarkers are unknown. We aimed to investigate the effect of cartilage dehydration-rehydration on UTE biomarkers and to compare the rehydration capabilities of native synovial fluid and normal saline. Methods: A total of 37 cartilage samples were harvested from patients (n=5) who underwent total knee replacement. Fresh cartilage samples were exposed to air to dehydrate for 2 hours after baseline magnetic resonance (MR) scanning, then randomly divided into two groups: one soaking in native synovial fluid (n=17) and the other in normal saline (n=20) to rehydrate for 4 hours. UTE-based biomarkers [T1, adiabatic T1r (AdiabT1r), macromolecular fraction (MMF), magnetization transfer ratio (MTR), and T2*] and sample weights were evaluated for fresh, dehydrated, and rehydrated cartilage samples. Differences and agreements between groups were assessed using the values of fresh cartilage samples as reference standard. Results: Dehydrating in air for 2 hours resulted in significant weight loss (P=0.000). T1, AdiabT1r, and T2* decreased significantly while MMF and MTR increased significantly (all P<0.02). Non-significant differences were observed in cartilage weights after rehydrating in both synovial fluid and normal saline, with P values being 0.204 and 0.769, respectively. There were no significant differences in T1, AdiabT1r, MMF, and MTR after rehydrating in synovial fluid (P>0.0167, with Bonferroni correction) while T2* (P=0.001) still had significant differences compared with fresh samples. However, no significant differences were detected for any of the evaluated UTE biomarkers after rehydrating in normal saline (all P>0.05). No differences were detected in the agreement of UTE biomarker measurements between fresh samples and samples rehydrated with synovial fluid and normal saline. Conclusions: Cartilage dehydration resulted in significant changes in UTE biomarkers. Rehydrating with synovial fluid or normal saline had non-significant effect on all the evaluated UTE biomarkers except T2* values, which still had significant differences compared with fresh samples after rehydrating with synovial fluid. No significant difference was observed in the rehydration capabilities of native synovial fluid and normal saline.

19.
Appl Microbiol Biotechnol ; 107(21): 6703-6716, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37676290

RESUMO

The continuous obstacles of cropping cause severe economic loss, which seriously threaten agricultural sustainable development. In addition, managing excess waste, such as potato peel and mineral waste residues, is a vital burden for industry and agriculture. Therefore, we explored the feasibility of reductive soil disinfestation (RSD) with potato peel and amendment with iron mineral waste residues for the production of Fritillaria thunbergii, which is vulnerable to continuous obstacles. In this study, the influences of iron mineral, RSD with different organic maters, as well as the combined effects of iron mineral and RSD on Fritillaria rhizosphere soil physicochemical properties, microbial communities, and Fritillaria production were investigated. The results revealed that the RSD treatments with potato peel significantly reduced the soil salinity and increased the soil pH, microbial activity, organic matter, and the contents of K and Ca. RSD with potato peel also significantly thrived of the beneficial microbes (Bacillus, Azotobacter, Microvirga, and Chaetomium), and down-regulated potential plant pathogens. RSD with potato peel significantly promoted F. thunbergii yield and quality. Moreover, the combined effects of RSD and iron mineral amendment further enhanced soil health, improved microbial community composition, and increased the yield and peimisine content of F. thunbergii by 24.2% and 49.3%, respectively. Overall, our results demonstrated that RSD with potato peel and amendment with iron mineral waste residues can efficiently improve soil fertility, modify the microbial community, and benefit for both the sustainable production of F. thunbergii and the management of waste. KEY POINTS: • RSD increases soil pH, organic matter, microbial activity, and mineral content • RSD with potato peel enriches beneficial microbes and decreases plant pathogens • PP + Fe treatment increases Fritillaria yield by 24.2% and peimisine content by 49.3.

20.
Curr Atheroscler Rep ; 25(8): 479-485, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37378698

RESUMO

PURPOSE OF REVIEW: Decreasing sedentary behaviors has been proposed as one approach to reduce the rate of obesity in youth. This review summarizes the contemporary literature examining the efficacy of these interventions in the school and community along with an additional focus on the role of socioeconomic status in these interventions. RECENT FINDINGS: Studies that focus on decreasing sedentary behavior have utilized a wide variety of strategies in a number of settings. The effects of these interventions are often hindered by non-standard outcome measures, study infidelity, and subjective measures of sedentary time. However, interventions that incorporate engaged stakeholders and include younger subjects appear to be the most likely to succeed. Promising interventions to decrease sedentary behaviors have been shown in recent clinical trials; however, replicating and sustaining these results is challenging. From the available literature, school-based interventions have the potential of reaching the largest group of children. In contrast, interventions in younger children, particularly those with invested parents, seem to be the most effective.


Assuntos
Obesidade Infantil , Criança , Humanos , Adolescente , Obesidade Infantil/prevenção & controle , Comportamento Sedentário
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