Radiographers' perspectives on immobilisation and restraint mechanisms in paediatric radiography.

INTRODUCTION: The utilisation of immobilisation or restraint during paediatric radiography is a multifactorial issue with associated legal and ethical considerations. Current practice regularly presents challenges for radiographers, with a notable absence of any professional best-practice guidance. This study investigated radiographers' perspectives in Ireland on the use of immobilisation or restraint methods and the factors influencing these choices and aimed to fill the 20-year gap in European radiographers' perspectives gaining an up-to-date understanding and contribute to the global conversation in this regard. METHODS: An anonymous online survey design was constructed using the Google Forms platform and distributed to hospital radiology departments across the Southern region of Ireland. Additionally, a short survey was send to the head of the nine radiology departments to audit the existing availability of immobilisation and/or restraint devices for paediatric radiography. Descriptive statistics (frequencies and percentages) were undertaken. Bar charts were utilised where appropriate to display trends. RESULTS: One hundered and three responses were received. The majority of radiographers reported using immobilisation (95 %) or restraint (89 %) techniques during paediatric radiography, although 70 % acknowledged the lack of training regarding restraint techniques. However, 93 % reported trying alternative techniques such as distraction and negotiation to avoid immobilisation or restraint. A desire for further guidance and training was reported, with 80 % of respondents noting training as essential or potentially beneficial. CONCLUSIONS: Ambiguity remains surrounding the distinction between the terms "restraint" and "immobilisation" in paediatric radiography. Radiographers' use of restraint and immobilisation during paediatric radiography is influenced by the child's age, distress level, radiation protection and safety, and the ability of the child to understand instructions. Appropriate up-to-date guidelines and training would be recommended to clarify terminology and promote the safe practice of restraint and immobilisation during paediatric radiography.

Comparison of different immobilisation durations following open surgery for acute achilles tendon rupture: a prospective cohort study.

BACKGROUND: In recent decades, early rehabilitation after Achilles tendon rupture (ATR) repair has been proposed. The aim of this prospective cohort study was to compare different immobilisation durations in order to determine the optimal duration after open surgery for ATR repair. METHODS: This study included 1088 patients (mean age, 34.9 ± 5.9 years) who underwent open surgery for acute ATR repair. The patients were categorised into four groups (A, B, C, and D) according to postoperative immobilisation durations of 0, 2, 4, and 6 weeks, respectively. All patients received the same suture technique and a similar rehabilitation protocol after brace removal,; they were clinically examined at 2, 4, 6, 8, 10, 12, 14, and 16 weeks postoperatively, with a final follow-up at a mean of 19.0 months. The primary outcome was the recovery time for the one-leg heel-rise height (OHRH). Secondary outcomes included the time required to return to light exercise (LE) and the recovery times for the range of motion (ROM). Data regarding the surgical duration, complications, the visual analogue scale (VAS) score for pain, the Achilles tendon Total Rupture Score (ATRS), and the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale score were also collected. RESULTS: The recovery times for OHRH, LE, and ROM were significantly shorter in groups A and B than in groups C and D (P < 0.001). The VAS scores decreased over time, reaching 0 in all groups by 10 weeks. The mean scores in groups A and B were higher than those in the other groups at 2 and 4 weeks (P < 0.001), whereas the opposite was true at 8 weeks (P < 0.001). ATRS and the AOFAS Ankle-Hindfoot scale score increased across all groups over time, showing significant between-group differences from weeks 6 to 16 (P < 0.001) and weeks 6 to 12 (P < 0.001). The mean scores were better in groups A and B than in groups C and D. Thirty-eight complications (3.5%) were observed, including 20 re-ruptures and 18 superficial infections. All complications were resolved at the last follow-up, with no significant between-group differences. CONCLUSIONS: Immobilisation for 2 weeks after open surgery for ATR repair may be the optimal strategy for early rehabilitation with relatively minimal pain and other complications. TRIAL REGISTRATION: ClinicalTrials.gov (NCT04663542).

Unmasking anxiety: a head-to-head comparison of open and closed masks in head and neck cancer radiotherapy.

Background: Facemasks accurately immobilise patients with head and neck cancer (HNC) receiving radiotherapy (RT). However, such masks are associated with treatment related distress, a prognostic factor for poorer survival. Open masks offer increased comfort and patient satisfaction. We investigated whether open masks could immobilise patients without affecting treatment accuracy. Materials and methods: Over an 18-month period, all HNC RT patients with anxiety were offered open masks. Once 30 patients had completed treatment, set-up data was compared to patients in closed masks. The mean displacement and one-dimensional standard deviations (SD) of the mean, systematic and random set-up errors were calculated for translational directions: anterior-posterior (x), superior-inferior (y), medial-lateral (z). The mean and SD of the mean was calculated for rotational displacements. Mann-Whitney U was used to determine any significant differences between set-up data. Results: Sixty patients were included (30 open & 30 closed masks). There was no statistically significant difference found in the x (p = 0.701), y (p = 0.246) or z (p = 0.535) direction for the SD of the mean displacements between both masks. No statistically significant difference was found in the SD of means for rotational displacements. The calculated planning target volume (PTV) margin requirements were minimally less for the closed masks 3.5, 2.6, and 2.7 mm (x, y, z, respectively) versus 4.2, 3.2, and 3.7 mm, respectively, for open masks. Conclusion: Our study demonstrates that open masks maintain accuracy at levels comparable to closed masks in patients with anxiety. The minor difference in the calculated PTV margin could be rectified with daily on-line imaging or surface guided imaging.

Non- or minimally displaced distal radius fractures in adult patients < 50 years of age : Three weeks of cast immobilisation versus one week of brace immobilisation: study protocol for a multicentre randomised controlled trial.

BACKGROUND: Currently, non- or minimally displaced distal radius fractures are treated by 3 to 5 weeks of cast immobilisation. Many patients with a distal radius fracture suffer from long-term functional restrictions, which might be related to stiffness due to cast immobilisation. Current literature indicates that 1 week of immobilisation might be safe; however, no level 1 evidence is available. This trial aims to compare 1 week of brace immobilisation with 3 weeks of cast immobilisation in patients with distal radius fractures that do not need reduction. METHODS: The aim of this trial is to evaluate the non-inferiority of 1 week of brace immobilisation in patients with non- or minimally displaced distal radius fractures. A two-armed single blinded multicentre randomised clinical trial will be conducted in three hospitals. Adult patients, between 18 and 50 years old, independent for activities of daily living, with a non- or minimally displaced distal radius fracture can be included in this study. The intervention group is treated with 1 week of brace immobilisation, and the control group with 3 weeks of cast immobilisation. Primary outcome is the patient-reported outcome measured by the Patient-Related Wrist Evaluation score (PRWE) at 6 months. Secondary outcomes are patient-reported outcome measured by the Quick Disabilities of the Arm, Shoulder and Hand score at 6 weeks and 6 months, PRWE at 6 weeks, range of motion, patient-reported pain score measured by VAS score, radiological outcome (dorsal/volar tilt, radial height, ulnar variance, presence of intra-articular step off), complications and cost-effectiveness measured by the EuroQol 5 Dimension questionnaire, Medical Consumption Questionnaire and Productivity Cost Questionnaire. DISCUSSION: This study will provide evidence on the optimal period of immobilisation in non-operatively treated displaced and reduced distal radius fractures. Both treatment options are accepted treatment protocols and both treatment options have a low risk of complications. Follow-up will be according to the current treatment protocol. This study will provide level 1 evidence on the optimal period and way of immobilisation for non- or minimally displaced distal radius fractures in adult patients. TRIAL REGISTRATION: ABR 81638 | NL81638.029.22 | www.toetsingonline.nl . 18th of October 2023.

The Multifaceted Comparison of Effects of Immobilisation of Waste Imperial Smelting Furnace (ISF) Slag in Calcium Sulfoaluminates (CSA) and a Geopolymer Binder.

Using waste materials as replacements for sand in building materials helps reduce waste and improve the properties and sustainability of the construction materials. Authors proved the possibility of using imperial smelting furnace (ISF) slag granules as a 100% substitute for natural sand in self-compacting (SCC) cement-based mortars of calcium sulfoaluminates (CSA). The study proved that ISF slag's radioactive properties meet this area's requirements. CSA cement eliminates the noted problem in the case of concrete with Portland cement, which is the extended setting of the cement binder. The research findings indicate that using slag to replace sand up to 100% in mortars without grains smaller than 0.125 mm allows high flowability, compaction, low porosity and mechanical parameters. The compressive strength of the CSA cement mortars was about 110 MPa, and more than 140 MPa for geopolymer mortar. Unfortunately, the alkaline pH of a geopolymer causes high leachability of barium and sodium. Thus, the CSA cement is in a more favourable binder to achieve high strength, is environmentally friendly, and is a self-compacting mortar or concrete.

The performance and mechanism of sulfidated nano-zero-valent iron for the simultaneous stabilization of arsenic and cadmium.

Co-contamination of soil and groundwater with arsenic (As) and cadmium (Cd) is widespread. Sulfidized Nanoscale Zero-Valent Iron (S-nZVI) is effective in removing As and Cd from contaminated environments. However, the mechanisms governing As and Cd removal from systems containing both species are still unclear. This study investigated the effectiveness of S-nZVI in the simultaneous removal of Cd(II) and As(III) from contaminated solutions and their interaction mechanisms. Adsorption experiments were conducted under aerobic conditions to investigate the effect of Cd(II) and As(III) on their co-immobilisation at different As(III) and Cd(II) concentrations. S-nZVI was characterised before and after the reaction to elucidate the mechanism of its simultaneous immobilisation of As(III) and Cd(II). Batch experiments revealed that the presence of Cd(II) and As(III) together considerably promotes the passivation of S-nZVI. The adsorption of Cd(II) at Cd:As = 1:3 was 198.37 mg/g, which was 27.6 % higher than that in Cd(II)-only systems, and the adsorption of As(III) at As:Cd = 1:3 was 204.05 mg/g, which was 175 % higher than that in As(III)-only systems. The results of X-ray photoelectron spectroscopy and Fourier-transform infrared spectroscopy indicated that the removal of Cd(II) and As(III) by S-nZVI involves electrostatic adsorption, complexation and oxidation reactions, amongst which electrostatic adsorption and ternary-complex generation are responsible for the synergistic effect. As and Cd ions can form two types of surface complexes with FeOH or FeS on the outer layer of S-nZVI: anionic bridging to form Fe-As-Cd and cationic bridging to form Fe-Cd-As. This investigation elucidates the synergistic action of Cd(II) and As(III) during their removal using S-nZVI. Thus, S-nZVI is a promising material for the combined removal of Cd(II) and As(III), which can mitigate environmental pollution.

Evaluating soft collars in pre-hospital cervical spine immobilisation: A cohort study on neurological outcomes, patient comfort and paramedic perspectives.

OBJECTIVE: Cervical spinal immobilisation procedures often include rigid cervical collars which, despite associated complications, may provide less immobilisation than previously thought. The present study reports the incidence of worsening neurological outcomes following soft collar application, and additionally reports patient comfort, compliance with spinal immobilisation, and paramedic perspectives on usage. METHODS: This was an observational cohort study conducted in selected metropolitan and regional areas of NSW Ambulance between 1 May 2022 and 31 March 2023. Soft collars were used exclusively in place of rigid collars. The SPEED (SPinal Emergency Evaluation of Deficits) tool was used to evaluate new or worsening neurological deficits following pre-hospital soft collar application. Secondary outcomes included patient-reported comfort of the device, and paramedic assessment of efficacy. RESULTS: Overall, 2098 soft collars were applied, of which 74 patients (3.5%) were subsequently found to have a cervical spine injury. Eight patients had a spinal cord injury, of which two experienced a worsening neurological deficit after soft collar application. In both instances, comprehensive case reviews determined that this was unlikely to have been attributable to the soft collar. The majority of patients found the soft collar comfortable, and they were well-tolerated by patients who generally complied with immobility directions. Paramedics found the collar easy to apply, and felt it assisted in minimising patient movement. CONCLUSIONS: Pre-hospital use of soft collars does not appear to increase the risk of significant injury. Patients found these devices relatively comfortable, and clinicians reported overall ease of use with good patient compliance with immobility directives.

A Review of Plant-Mediated ZnO Nanoparticles for Photodegradation and Antibacterial Applications.

This review focuses on the synthesis of plant-mediated zinc oxide nanoparticles (ZnO NPs) and their applications for antibacterial and photocatalytic degradation of dyes, thereby addressing the need for sustainable and eco-friendly methods for the preparation of NPs. Driven by the significant rise in antibiotic resistance and environmental pollution from dye pollution, there is a need for more effective antibacterial agents and photocatalysts. Therefore, this review explores the synthesis of plant-mediated ZnO NPs, and the influence of reaction parameters such as pH, annealing temperature, plant extract concentration, etc. Additionally, it also looks at the application of plant-mediated ZnO NPs for antibacterial and photodegradation of dyes, focusing on the influence of the properties of the plant-mediated ZnO NPs such as size, shape, and bandgap on the antibacterial and photocatalytic activity. The findings suggest that properties such as shape and size are influenced by reaction parameters and these properties also influence the antibacterial and photocatalytic activity of plant-mediated ZnO NPs. This review concludes that plant-mediated ZnO NPs have the potential to advance green and sustainable materials in antibacterial and photocatalysis applications.

Reliability, clinical performance and trending ability of a pulse oximeter and pulse co-oximeter, in monitoring blood oxygenation, at two measurement sites, in immobilised white rhinoceros (Ceratotherium simum).

BACKGROUND: Monitoring blood oxygenation is essential in immobilised rhinoceros, which are susceptible to opioid-induced hypoxaemia. This study assessed the reliability, clinical performance and trending ability of the Nonin PalmSAT 2500 A pulse oximeter's and the Masimo Radical-7 pulse co-oximeter's dual-wavelength technology, with their probes placed at two measurement sites, the inner surface of the third-eyelid and the scarified ear pinna of immobilised white rhinoceroses. Eight white rhinoceros were immobilised with etorphine-based drug combinations and given butorphanol after 12 min, and oxygen after 40 min, of recumbency. The Nonin and Masimo devices, with dual-wavelength probes attached to the third-eyelid and ear recorded arterial peripheral oxygen-haemoglobin saturation (SpO2) at pre-determined time points, concurrently with measurements of arterial oxygen-haemoglobin saturation (SaO2), from drawn blood samples, by a benchtop AVOXimeter 4000 co-oximeter (reference method). Reliability of the Nonin and Masimo devices was evaluated using the Bland-Altman and the area root mean squares (ARMS) methods. Clinical performance of the devices was evaluated for their ability to accurately detect clinical hypoxemia using receiver operating characteristic (ROC) curves and measures of sensitivity, specificity, and positive and negative predictive values. Trending ability of the devices was assessed by calculating concordance rates from four-quadrant plots. RESULTS: Only the Nonin device with transflectance probe attached to the third-eyelid provided reliable SpO2 measurements across the 70 to 100% saturation range (bias - 1%, precision 4%, ARMS 4%). Nonin and Masimo devices with transflectance probes attached to the third-eyelid both had high clinical performance at detecting clinical hypoxaemia [area under the ROC curves (AUC): 0.93 and 0.90, respectively]. However, the Nonin and Masimo devices with transmission probes attached to the ear were unreliable and provided only moderate clinical performance. Both Nonin and Masimo devices, at both measurement sites, had concordance rates lower than the recommended threshold of ≥ 90%, indicating poor trending ability. CONCLUSIONS: The overall assessment of reliability, clinical performance and trending ability indicate that the Nonin device with transflectance probe attached to the third-eyelid is best suited for monitoring of blood oxygenation in immobilised rhinoceros. The immobilisation procedure may have affected cardiovascular function to an extent that it limited the devices' performance.

Recent Advances and Perspectives on Food-Grade Immobilisation Systems for Enzymes.

The use of enzyme immobilisation is becoming increasingly popular in beverage processing, as this method offers significant advantages, such as enhanced enzyme performance and expanded applications, while allowing for easy process termination via simple filtration. This literature review analysed approximately 120 articles, published on the Web of Science between 2000 and 2023, focused on enzyme immobilisation systems for beverage processing applications. The impact of immobilisation on enzymatic activity, including the effects on the chemical and kinetic properties, recyclability, and feasibility in continuous processes, was evaluated. Applications of these systems to beverage production, such as wine, beer, fruit juices, milk, and plant-based beverages, were examined. The immobilisation process effectively enhanced the pH and thermal stability but caused negative impacts on the kinetic properties by reducing the maximum velocity and Michaelis-Menten constant. However, it allowed for multiple reuses and facilitated continuous flow processes. The encapsulation also allowed for easy process control by simplifying the removal of the enzymes from the beverages via simple filtration, negating the need for expensive heat treatments, which could result in product quality losses.

Hazardous element inertisation in vitrified silicate ceramics: Effect of different matrices.

The ceramic industry is a production sector that can efficiently recycle its own processing residues, achieving a reuse index of almost 100%. Recently, the range of waste from other industrial sectors that can be used as secondary raw materials in ceramic bodies has expanded. However, such an expansion potentially introduces hazardous components. This study aimed to quantitatively assess the efficiency of inertising hazardous elements (HEs) through ceramisation. The ceramics were characterised through XRPD, SEM-EDS and leaching tests to determine their leaching behaviour and the mechanisms of element immobilisation in neoformation phases during the ceramisation process. The results indicate high immobilisation efficiency for Ba, Co, Cr, Cu, Pb, Sb, Sn and Zn. However, Mo is the main element of concern owing to its poor retention in ceramic bodies. This is likely due to the formation of oxyanionic complexes that are difficult to immobilise in silicate matrices. In addition, the ceramic bodies exhibit substantial differences that appear to be associated with variations in pseudo-structural components and the degree of polymerisation of their vitreous phase.

A prospective observational study evaluating two patient immobilisation methods in lung stereotactic radiotherapy.

PURPOSE: The main objective of this study was to assess inter- and intrafraction errors for two patient immobilisation devices in the context of lung stereotactic body radiation therapy: a vacuum cushion and a simple arm support. MATERIALS AND METHODS: Twenty patients who were treated with lung stereotactic body radiation therapy in supine position with arms above their head were included in the study. Ten patients were setup in a vacuum cushion (Bluebag™, Elekta) and ten other patients with a simple arm support (Posirest™, Civco). A pretreatment four-dimensional cone-beam computed tomography and a post-treatment three-dimensional cone-beam computed tomography were acquired to compare positioning and immobilisation accuracy. Based on a rigid registration with the planning computed tomography on the spine at the target level, translational and rotational errors were reported. RESULTS: The median number of fractions per treatment was 5 (range: 3-10). Mean interfraction errors based on 112 four-dimensional cone-beam computed tomographies were similar for both setups with deviations less than or equal to 1.3mm in lateral and vertical direction and 1.2° in roll and yaw. For longitudinal translational errors, mean interfraction errors were 0.7mm with vacuum cushion and -3.9mm with arm support. Based on 111 three-dimensional cone-beam computed tomographies, mean lateral, longitudinal and vertical intrafraction errors were -0.1mm, -0.2mm and 0.0mm respectively (SD: 1.0, 1.2 and 1.0mm respectively) for the patients setup with vacuum cushion, and mean vertical, longitudinal and lateral intrafraction errors were -0.3mm, -0.7mm and 0.1mm respectively (SD: 2.3, 1.8 and 1.4mm respectively) for the patients setup with arm support. Intrafraction errors means were not statistically different between both positions but standard deviations were statistically larger with arm support. CONCLUSION: The results of our study showed similar inter and intrafraction mean deviations between both positioning but a large variability in intrafraction observed with arm support suggested a more accurate immobilization with vacuum cushion.

Factors influencing parental acceptance toward the use of passive immobilisation as behaviour guidance in children during dental treatment: a scoping review.

Exploring parental opinions regarding the use of passive immobilisation during dental treatment is critical when identifying behaviour guidance application priorities. Instead of being dismissed as an inappropriate and less favourable option, this article aims to systematically evaluate factors affecting parental acceptance toward the use of passive immobilisation as behaviour guidance among children during dental treatment in various populations and regions. This research follows Arksey and O'Malley framework and updated by Joanna Briggs Institute Framework for Scoping Reviews methodology to summarise 40 research papers from 1984 to 2022 in PubMed, Web of Science, Science Direct, EBSCO Host, Scopus, grey literature and Google search outlining the research trend of parental acceptance toward passive immobilisation as behaviour guidance. Factors influencing parental acceptance toward the use of passive immobilisation were classified into parental socio-economic and demographic characteristics, exposure method of the devices to the parents, type of dental procedures, and children's cooperation and cognitive level. In conclusion, the current explorative review of the parental perspective toward passive immobilisation proposed a recommendation and facilitate the dentist to consider this technique as an alternative option for behaviour guidance in paediatric dentistry.

Surface passivation and functionalisation for mass photometry.

Interferometric scattering (iSCAT) microscopy enables the label-free observation of biomolecules. Consequently, single-particle imaging and tracking with the iSCAT-based method known as mass photometry (MP) is a growing area of study. However, establishing reliable cover glass passivation and functionalisation methods is crucial to reduce nonspecific binding and prepare surfaces for in vitro single-molecule binding experiments. Existing protocols for fluorescence microscopy can contain strongly scattering or mobile components, which make them impractical for MP-based microscopy. In this study, we characterise several different surface coatings using MP. We present approaches for cover glass passivation using 3-aminopropyltriethoxysilane (APTES) and polyethylene glycol (PEG, 2k) along with functionalisation via a maleimide-thiol linker. These coatings are compatible with water or salt buffers, and show low background scattering; thus, we are able to measure proteins as small as 60 kDa. In this technical note, we offer a surface preparation suitable for in vitro experiments with MP.

Where Do We Stand on Cervical Spine Immobilisation? A Questionnaire among Prehospital Staff.

Background: Cervical collars (CC) are routinely used in prehospital trauma treatment. However, over the past years, their application was discussed more critically since they increase intravenous pressure due to reduced venous drainage and the possibility of secondary cervical spine injury. Guidelines have been adjusted accordingly. The question is how efficient has this been put into practice, and how good, as well as up to date, is the knowledge of prehospital emergency medicine personnel about indications on cervical spine immobilisation? Methods: A 15-item questionnaire regarding the self-evaluation and result checking of the right indications for the use of a cervical collar in the prehospital setting was sent to paramedics and emergency doctors in Germany. Two hundred and nineteen completed surveys were statistically analysed. Results: Mean age of the participants was 30.45 ± 8.8. 72% were male. Regarding subjective safety, the appropriate indication of CC participants reached 79.8 ± 19.5 on a metric scale from 0 (no safety) to 100 (full safety). Mean right answers were as follows: Ambulance man (RS) 0.78 ± 0.84, paramedic (RA) 0.9 ± 0.74, paramedic (NFS) 1.03 ± 0.83 and emergency doctor (ED) 1.75 ± 1.06 (p = 0.013, Kruskal-Wallis Test). Participants who estimated their knowledge < 85% had 0.83 ± 0.8 right answers, and > 85% had 1.14 ± 0.9 right answers. Conclusions: Rational spine immobilisation is still necessary in severely injured patients. This study highlights the importance of continuing education using ongoing training, lectures or online learning with a questionnaire as a monitor for success to ensure the transfer of evidence-based medicine into daily practice.

Toddler fractures immobilisation and complications: A retrospective review.

BACKGROUND: A Toddler's Fracture (TF) is classically an isolated, nondisplaced, distal-third diaphyseal tibial spiral fracture in younger children. A TF is stable and has a low risk of complication. There is lack of uniformity as to the optimal treatment for TF. Immobilisation with full above knee casting, below knee casting, splinting, controlled ankle motion boots and no immobilisation are all strategies currently in use. There is limited data from European centres regarding those treated without immobilisation. METHODS: A retrospective review of electronic medical and radiology records was performed to identify all children presenting to a multisite department of paediatric emergency medicine in Ireland from January to December 2022. Those with radiologically confirmed TF or a presumptive diagnosis of TF were included. Data retrieved for each child included initial treatment and the number of and reason for ED reattendances relating to the injury in the 6-month period following the injury. RESULTS: 166 children were identified, 96 with radiologically confirmed TF and 70 with presumptive diagnosis TF. Girls accounted for 47 % of presentations. Fall from a standing height (33 %) was the most common mechanism. 13 % (22/166) children were managed without immobilisation. Those with radiologically confirmed fracture (91/96) were significantly more likely to be immobilised than those with a presumptive diagnosis (53/70) (p = 0.001). In total 28 patients (17 % of total) represented to the ED within 6 months. The representation rate in those immobilised was 17 %, while in those not immobilised was 13 % (p = 0.66). CONCLUSION: In this cohort, those with no radiological evidence of fracture are more likely to be managed without immobilisation. There was no significant difference in PED representations between those immobilised and not immobilised.

An effective strategy for biodegradation of high concentration phenol in soil via biochar-immobilized Rhodococcus pyridinivorans B403.

High concentration of phenol residues in soil are harmful to human health and ecological safety. However, limited information is available on the in-situ bioremediation of phenol-contaminated soil using biochar as a carrier for bacteria. In this study, bamboo -derived biochar was screened as a carrier to assemble microorganism-immobilized composite with Rhodococcus pyridinivorans B403. Then, SEM used to observe the micromorphology of composite and its bioactivity was detected in solution and soil. Finally, we investigated the effects of free B403 and biochar-immobilized B403 (BCJ) on phenol biodegradation in two types of soils and different initial phenol concentrations. Findings showed that bacterial cells were intensively distributed in/onto the carriers, showing high survival. Immobilisation increased the phenol degradation rate of strain B403 by 1.45 times (37.7 mg/(L·h)). The phenol removed by BCJ in soil was 81% higher than free B403 on the first day. Moreover, the removal of BCJ remained above 51% even at phenol concentration of 1,500 mg/kg, while it was only 15% for free B403. Compared with the other treatment groups, BCJ showed the best phenol removal effect in both tested soils. Our results indicate that the biochar-B403 composite has great potential in the remediation of high phenol-contaminated soil.

Patient Education Materials for Immobilisation Masks in Radiation Therapy for Adult Head and Neck Cancer Patients: A Scoping Review.

Immobilisation masks (IMs) are used for people with head and neck cancer (HNC) undergoing radiation therapy (RT) treatment to ensure accuracy and reproducibility between treatments. Claustrophobia-related mask anxiety in HNC patients is common and can compromise treatment due to patient distress. This scoping review aimed to describe the content of publicly available Patient Education Materials (PEMs) for people with HNC undergoing RT. Three search engines (Bing, Yahoo, and Google) were systematically searched using standard terms. PEMs in audio-visual or written formats were eligible for inclusion if the target readership was adults with HNC and included content on IMs for RT. Content was appraised using the Patient Education Materials Assessment Tool for Printable and Audio-Visual Materials to assess understandability and actionability. In total, 304 PEMs were identified of which 20 met the inclusion criteria. Sixteen PEMs were webpages, three were PDF format, and one was a standalone video. The understandability and actionability of PEMs ranged between 47 to 100% and 0 to 80%, respectively. PEMs authored by Foundations/Organisations scored higher in understandability (80-100%) and were more likely to discuss mask anxiety coping strategies. In comparison, News sites and IM manufacturers published PEMs with the lowest understandability scores (20-80%). The significant variations in the quality of IM PEMs identified suggest that some sources may be more effective at informing patients about IMs. Although multiple aspects of the PEMs were consistent across the reviewed materials, many PEMs lacked information, and a stronger focus on understandability and actionability is required.

Immobilisation remediation of arsenic-contaminated soils with promising CaAl-layered double hydroxide and bioavailability, bioaccessibility, and speciation-based health risk assessment.

Arsenic (As)-contaminated soil poses great health risk to human mostly through inadvertent oral exposure. We investigated CaAl-layered double hydroxide (CaAl-LDH), a promising immobilising agent, for the remediation of As-contaminated Chinese soils. The effects on specific soil properties and As fractionation were analyzed, and changes in the health risk of soil As were accurately assessed by means of advanced in vivo mice model and in vitro PBET-SHIME model. Results showed that the application of CaAl-LDH significantly increased soil pH and concentration of Fe and Al oxides, and effectively converted active As fractions into the most stable residual fraction, guaranteeing long-term remediation stability. Based on in vivo test, As relative bioavailability was significantly reduced by 37.75%. Based on in vitro test, As bioaccessibility in small intestinal and colon phases was significantly reduced by 25.65% and 28.57%, respectively. Furthermore, As metabolism (reduction and methylation) by the gut microbiota inhabiting colon was clearly observed. After immobilisation with CaAl-LDH, the concentration of bioaccessible As(Ⅴ) in the colon fluid was significantly reduced by 61.91%, and organic As (least toxic MMA(V) and DMA(V)) became the main species, which further reduced the health risk of soil As. In summary, CaAl-LDH proved to be a feasible option for immobilisation remediation of As-contaminated soils, and considerable progress was made in relevant health risk assessment.

Cement-based solidification of nuclear waste: Mechanisms, formulations and regulatory considerations.

This review paper provides a comprehensive analysis of cement-based solidification and immobilisation of nuclear waste. It covers various aspects including mechanisms, formulations, testing and regulatory considerations. The paper begins by emphasizing the importance of nuclear waste management and the associated challenges. It explores the mechanisms and principles in cement-based solidification, with a particular focus on the interaction between cement and nuclear waste components. Different formulation considerations are discussed, encompassing factors such as cement types, the role of additives and modifiers. The review paper also examines testing and characterisation methods used to assess the physical, chemical and mechanical properties of solidified waste forms. Then the paper addresses the regulatory considerations and compliance requirements for cement-based solidification. The paper concludes by critically elaborating on the current challenges, emerging trends and future research needs in the field. Overall, this review paper offers a comprehensive overview of cement-based solidification, providing valuable insights for researchers, practitioners and regulatory bodies involved in nuclear waste management.