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This paper is a contribution to the EUMETNET AutoPollen Programme, which is developing a prototype automatic pollen monitoring network in Europe covering all aspects of the information chain from measurements through to communicating information to the public., Background: Information about airborne pollen concentrations is required by a range of end users, particularly from the health sector who use both observations and forecasts to diagnose and treat allergic patients. Manual methods are the standard for such measurements but, despite the range of pollen taxa that can be identified, these techniques suffer from a range of drawbacks. This includes being available at low temporal resolution (usually daily averages) and with a delay (usually 3–9 days from the measurement). Recent technological developments have made possible automatic pollen measurements, which are available at high temporal resolution and in real time, although currently only scattered in a few locations across Europe. Materials & Methods: To promote the development of an extensive network across Europe and to ensure that this network will respond to end user needs, a stakeholder workshop was organised under the auspices of the EUMETNET AutoPollen Programme. Participants discussed requirements for the groups they represented, ranging from the need for information at various spatial scales, at high temporal resolution, and for targeted services to be developed. Results: The provision of real-time information is likely to lead to a notable decrease in the direct and indirect health costs associated with allergy in Europe, currently estimated between €50–150 billion/year.. Discussion & Conclusion: A European measurement network to meet end user requirements would thus more than pay for itself in terms of potential annual savings and provide significant impetus to research across a range of disciplines from climate science and public health to agriculture and environmental management.

Contemporary cardiovascular medicine is complex, dynamic, and interactive. Therefore, multidisciplinary dialogue between different specialists is required to deliver optimal and patient-centred care. This has led to the concept of explicit collaborations of different specialists caring for patients with complex cardiovascular diseases—that is ‘heart teams’. These teams are particularly valuable to minimize referral bias and improve guideline adherence as so to be responsive to patient preferences, needs, and values but may be challenging to coordinate, especially in the acute setting. This position paper—jointly developed by four cardiovascular associations—is intended to provide conceptual and practical considerations for the composition, structure, and function of multidisciplinary teams. It focuses on patients with complex coronary artery diseases in both elective and urgent setting and provide guidance on how to implement the heart team both in chronic and in acute coronary syndromes patients, including cases with mechanical complications and haemodynamic instability; it also discusses strategies for clear and transparent patient communication and provision of a patient-centric approach. Finally, gaps in evidence and research perspectives in this context are discussed.

Male infertility affects millions of males worldwide and is rising in prevalence due to social and environmental conditions. However, men often feel too embarrassed to receive a semen analysis in the hospital due to social stigmas. To overcome this problem, we developed a 3‐(4,5‐Dimethyl‐2‐thiazolyl)‐2,5‐diphenyl‐2H‐tetrazolium bromide test strip to distinguish semen samples with low total motile sperm concentration from those with normal motile sperm concentration. This is a point‐of‐care colorimetric semen analytical method with a one‐step, inexpensive, equipment‐free evaluation process, and adequate accuracy validated in a 42‐sample clinical trial. In this study, results were evaluated visually and with a smartphone application. Using visual observation methods, the area under the curve (AUC) was 0.71 (95% of confidence interval = 0.55–0.86; p = 0.021), sensitivity was 41%, specificity was 95%, positive predictive value was 90%, negative predictive value (NPV) was 59.4%, and accuracy was 67%. Using a smartphone recording and analytical system, AUC was 0.766 (95% of confidence interval = 0.612–0.92; p = 0.003), sensitivity was 96%, specificity was 65%, PPV was 75%, NPV was 92.9%, and accuracy was 80.9%. This work demonstrated a screening tool that could elevate semen analysis to the level of routine healthcare and provide for private, in‐home self‐assessment.

Recognizing the increase in cancer incidence globally and the need for effective cancer control interventions, several organizations, professional bodies, and international institutions have proposed strategies to improve treatment options and reduce mortality along with minimizing overall incidence. Despite these efforts, an estimated 9.6 million deaths in 2018 was attributed to this noncommunicable disease, making it the second leading cause of death worldwide. Left unchecked, this will further increase in scale, with an estimated 29.5 million new cases and 16.3 million deaths occurring worldwide in 2040. Although it is known and generally accepted that cancer services must include radiotherapy, such access is still very limited in many parts of the world, especially in low- and middle-income countries. After thorough review of the current status of radiotherapy including programs worldwide, as well as achievements and challenges at the global level, the International Atomic Energy Agency convened an international group of experts representing various radiation oncology societies to take a closer look into the current status of radiotherapy and provide a road map for future directions in this field. It was concluded that the plethora of global and regional initiatives would benefit further from the existence of a central framework, including an easily accessible repository through which better coordination can be done. Supporting this framework, a practical inventory of competencies needs to be made available on a global level emphasizing the knowledge, skills, and behavior required for a safe, sustainable, and professional practice for various settings. This white paper presents the current status of global radiotherapy and future directions for the community. It forms the basis for an action plan to be developed with professional societies worldwide.

Aims Quality indicators (QIs) are tools to improve the delivery of evidence-base medicine. In 2017, the European Society of Cardiology (ESC) Association for Acute Cardiovascular Care (ACVC) developed a set of QIs for acute myocardial infarction (AMI), which have been evaluated at national and international levels and across different populations. However, an update of these QIs is needed in light of the accumulated experience and the changes in the supporting evidence. Methods and results The ESC methodology for the QI development was used to update the 2017 ACVC QIs. We identified key domains of AMI care, conducted a literature review, developed a list of candidate QIs, and used a modified Delphi method to select the final set of indicators. The same seven domains of AMI care identified by the 2017 Study Group were retained for this update. For each domain, main and secondary QIs were developed reflecting the essential and complementary aspects of care, respectively. Overall, 26 QIs are proposed in this document, compared to 20 in the 2017 set. New QIs are proposed in this document (e.g. the centre use of high-sensitivity troponin), some were retained or modified (e.g. the in-hospital risk assessment), and others were retired in accordance with the changes in evidence [e.g. the proportion of patients with non-ST segment elevation myocardial infarction (NSTEMI) treated with fondaparinux] and the feasibility assessments (e.g. the proportion of patients with NSTEMI whom risk assessment is performed using the GRACE and CRUSADE risk scores). Conclusion Updated QIs for the management of AMI were developed according to contemporary knowledge and accumulated experience. These QIs may be applied to evaluate and improve the quality of AMI care.

Atherosclerotic cardiovascular disease (ASCVD) and consequent acute coronary syndromes (ACS) are substantial contributors to morbidity and mortality across Europe. Much of these diseases burden is modifiable, in particular by lipid-lowering therapy (LLT). Current guidelines are based on the sound premise that with respect to low density lipoprotein cholesterol (LDL-C), “lower is better for longer”, and the recent data have strongly emphasized the need of also “the earlier the better”. In addition to statins, which have been available for several decades, the availability of ezetimibe and inhibitors of proprotein convertase subtilisin/kexin type 9 (PCSK9) are additional very effective approach to LLT, especially for those at very high and extremely high cardiovascular risk. LLT is initiated as a response to an individual’s calculated risk of future ASCVD and is intensified over time in order to meet treatment goals. However, in real-life clinical practice goals are not met in a substantial proportion of patients. This Position Paper complements existing guidelines on the management of lipids in patients following ACS. Bearing in mind the very high risk of further events in ACS, we propose practical solutions focusing on immediate combination therapy in strict clinical scenarios, to improve access and adherence to LLT in these patients. We also define an ‘Extremely High Risk’ group of individuals following ACS, completing the attempt made in the recent European guidelines, and suggest mechanisms to urgently address lipid-medicated cardio-vascular risk in these patients.

BACKGROUND: The European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) position paper from 2015 on percutaneous endoscopic gastrostomy (PEG) required updating in the light of recent clinical knowledge and data published in medical journals since 2014. METHODS: A systematic review of medical literature from 2014 to 2020 was carried out. Consensus on the content of the manuscript, including recommendations, was achieved by the authors through electronic and virtual means. The expert opinion of the authors is also expressed in the manuscript when there was a lack of good scientific evidence regarding PEGs in children in the literature. RESULTS: The authors recommend that the indication for a PEG be individualized, and that the decision for PEG insertion is arrived at by a multidisciplinary team (MDT) having considered all appropriate circumstances. Well timed enteral nutrition is optimal to treat faltering growth to avoid complications of malnutrition and body composition. Timing, device choice and method of insertion is dependent on the local expertise and after due consideration with the MDT and family. Major complications such as inadvertent bowel perforation should be avoided by attention to good technique and by ensuring the appropriate experience of the operating team. Feeding can be initiated as early as 3 hours after tube placement in a stable child with iso-osmolar feeds of standard polymeric formula. Low-profile devices can be inserted initially using the single-stage procedure or after 2-3 months by replacing a standard PEG tube, in those requiring longer-term feeding. Having had a period of non-use and reliance upon oral intake for growth and weight gain-typically 8-12 weeks-a PEG may then safely be removed after due consultation. In the event of non-closure of the fistula the most successful method for closing it, to date, has been a surgical procedure, but the Over-The-Scope-Clip (OTSC) has recently been used with considerable success in this scenario. CONCLUSIONS: A multidisciplinary approach is mandatory for the best possible treatment of children with PEGs. Morbidity and mortality are minimized through team decisions on indications for insertion, adequate planning and preparation before the procedure, subsequent monitoring of patients, timing of the change to low-profile devices, management of any complications, and optimal timing of removal of the PEG.

Liver and kidney are strictly connected in a reciprocal manner, in both the physiological and pathological condition. The Italian Association for the Study of Liver, in collaboration with the Italian Society of Nephrology, with this position paper aims to provide an up-to-date overview on the principal relationships between these two important organs. A panel of well-recognized international expert hepatologists and nephrologists identified five relevant topics: 1) The diagnosis of kidney damage in patients with chronic liver disease; 2) Acute kidney injury in liver cirrhosis; 3) Association between chronic liver disease and chronic kidney disease; 4) Kidney damage according to different etiology of liver disease; 5) Polycystic kidney and liver disease. The discussion process started with a review of the literature relating to each of the five major topics and clinical questions and related statements were subsequently formulated. The quality of evidence and strength of recommendations were graded according to the GRADE system. The statements presented here highlight the importance of strong collaboration between hepatologists and nephrologists for the management of critically ill patients, such as those with combined liver and kidney impairment.

The European Large Geotechnical Institutes Platform (ELGIP) is a group of 14 European research organizations, leading in geotechnical engineering, which aims to promote internationally the profession, its network and its societal relevance. One ELGIP vision is that all transport infrastructure should aim for an optimal geotechnical design. The present paper shows the relationship between the pressing challenges on European transport infrastructures and the crucial role that geotechnical engineering plays in solving them, emphasising the need for improved knowledge and understanding of ground properties in transport infrastructure.

Stroke, a vascular disease of the brain, is the #1 cause of disability and a major cause of death worldwide. Stroke has a major negative impact on the life of stroke-affected individuals, their families and the society. A significant proportion of stroke victims indicate that would have preferred death over their after-stroke quality of life. Mechanical thrombectomy (MT), opening the occluded artery using mechanical aspiration or a thrombus-entrapment device, is a guideline-mandated (class I, level of evidence A) treatment modality in patients with large vessel occlusion stroke. MT clinical benefit magnitude indicates that a universal access to this treatment strategy should be the standard of care. Today there is a substantial geographic variation in MT deliverability, with large-scale disparities in MT implementation. In many countries effective access to MT remains severely limited. In addition, many of the MT-treated patients are treated too late for a good functional outcome because of logistic delays that include transportations to remotely located, scarce, comprehensive stroke centres. Position Paper from the European Society of Cardiology Council on Stroke and European Association for Percutaneous Cardiovascular Interventions on interdisciplinary management of acute ischaemic stroke, developed with the support of the European Board of Neurointervention fills an important gap in systematically enabling interventional cardiologists to support stroke intervention in the geographic areas of unmet needs in particular. We review strengths and weaknesses of the document, and suggest directions for the next steps that are swiftly needed to deliver MT to stroke patients more effectively.

Pancreatic cancer (PC) is a common cause of cancer-related death, due to difficulties in detecting early-stage disease, to its aggressive behaviour, and to poor response to systemic therapy. Therefore, developing strategies for early diagnosis of resectable PC is critical for improving survival. Diabetes mellitus is another major public health problem worldwide. Furthermore, diabetes can represent both a risk factor and a consequence of PC: nowadays, the relationship between these two diseases is considered a high priority for research. New-onset diabetes can be an early manifestation of PC, especially in a thin adult without a family history of diabetes. However, even if targeted screening for patients at higher risk of PC could be a promising approach, this is not recommended in asymptomatic adults with new-onset diabetes, due to the much higher incidence of hyperglycaemia than PC and to the lack of a safe and affordable PC screening test. Prompted by a well-established and productive multidisciplinary cooperation, the Italian Association of Medical Oncology (AIOM), the Italian Medical Diabetologists Association (AMD), the Italian Society of Endocrinology (SIE), and the Italian Society of Pharmacology (SIF) here review available evidence on the mechanisms linking diabetes and PC, addressing the feasibility of screening for early PC in patients with diabetes, and sharing a set of update statements with the aim of providing a state-of-the-art overview and a decision aid tool for daily clinical practice., Highlights • The incidence of PC is increasing and its prognosis is very poor; therefore, early detection is fundamental. • New-onset diabetes may be an early manifestation of PC, often disappearing after its resection. • Screening for PC is not currently recommended among people with new-onset diabetes, due to its high incidence. • Thin subjects >50 years old at the time of diabetes onset, with sudden weight loss and severe hyperglycaemia are at higher risk. • Currently some clinical models are promising for stratifying cancer risk in people with new-onset diabetes.

Executive SummaryWith an increasing variety of radiopharmaceuticals for diagnostic or therapeutic nuclear medicine as valuable diagnostic or treatment option, radiobiology plays an important role in supporting optimizations. This comprises particularly safety and efficacy of radionuclide therapies, specifically tailored to each patient. As absorbed dose rates and absorbed dose distributions in space and time are very different between external irradiation and systemic radionuclide exposure, distinct radiation-induced biological responses are expected in nuclear medicine, which need to be explored. This calls for a dedicated nuclear medicine radiobiology. Radiobiology findings and absorbed dose measurements will enable an improved estimation and prediction of efficacy and adverse effects. Moreover, a better understanding on the fundamental biological mechanisms underlying tumor and normal tissue responses will help to identify predictive and prognostic biomarkers as well as biomarkers for treatment follow-up. In addition, radiobiology can form the basis for the development of radiosensitizing strategies and radioprotectant agents. Thus, EANM believes that, beyond in vitro and preclinical evaluations, radiobiology will bring important added value to clinical studies and to clinical teams. Therefore, EANM strongly supports active collaboration between radiochemists, radiopharmacists, radiobiologists, medical physicists, and physicians to foster research toward precision nuclear medicine.

Background The COVID-19 pandemic has caused unprecedented global demand for personal protective equipment (PPE). A paucity of data on PPE burn rate (PPE consumption over time) in pandemic situations exacerbated these issues as there was little historic research to indicate volumes of PPE required to care for surges in infective patients and thus plan procurement requirements. Methods To better understand PPE requirements for care of suspected or confirmed COVID-19 patients in our Australian quaternary referral hospital, the number of staff-to-patient interactions in a 24-h period for three patient groups (ward-based COVID suspect, ward-based COVID confirmed, intensive care COVID confirmed) was audited prospectively from 1st to 30th April 2020. Results The average number of staff-to-patient interactions in a 24-h period was: 13.1 ± 5.0 (mean ± SD) for stable ward-managed COVID-19 suspect patients; 11.9 ± 3.8 for stable ward-managed confirmed COVID-19 patients; and 30.0 ± 5.3 for stable, mechanically ventilated, ICU-managed COVID-19 patients. This data can be used in PPE demand simulation modelling for COVID-19 and potentially other respiratory illnesses. Conclusion Data on the average number of staff-to-patient interactions needed for the care of COVID-19 patients is presented. This data can be used for PPE demand simulation modelling.

Background: Professional support in childbearing has beneficial effects on childbirth experience, interactions within the family, breastfeeding and medical outcomes. However, more knowledge is needed about prerequisites for professional support to be valuable and satisfactory during childbearing. Aim: The aim of this discourse paper is to describe and explore prerequisites for professional support that are of value for women and their families during childbearing as well as how healthcare organizations can be formed to facilitate these prerequisites. Design: Discourse paper. Methods: This discourse paper is based on our own experiences and is supported by literature and theory. Results: Well-functioning structures and processes facilitate professional support that leads to safe, secure, calm and prepared parents with the ability to handle the challenges of childbearing and parenting. When organizing care in childbearing, prerequisites for support needs must also be considered. CC BY 4.0© 2021 The Authors. Nursing Open published by John Wiley & Sons Ltd.First published: 06 November 2021CorrespondenceAnette Ekström-Bergström, Department of Health Sciences, University West, SE-461 86 Trollhättan, Sweden.Email: anette.ekstrom-bergstrom@hv.se

This paper utilizes a hybrid Debye model to accurately simulate the relaxation response process of the oil‐paper insulation of a transformer to explore the application of frequency domain dielectric spectroscopy (FDS) in nondestructive diagnosis of the aging condition of oil‐paper insulation. Via FDS test data, the model parameters can be identified, and the influence laws of FDS can be obtained through the variation of model parameters. To explore the effects of insulating paper moisture content, insulating paper layers, and test temperature on FDS characteristics, an FDS experimental platform is established. The results show that the hybrid Debye model can effectively reflect the relaxation response process of oil‐paper insulation under different conditions, as well as that a physical relationship between the model parameters and oil‐paper dielectric polarization exists. In addition, the parameters of the hybrid Debye model can be used as the characteristic quantities for the non‐destructive evaluation of the oil‐paper insulation state, providing new ideas for the non‐destructive evaluation of the oil‐paper insulation state.

Patient safety and quality of care are a priority for hospital pharmacists all across Europe. The European Association of Hospital Pharmacists (EAHP) has manifested the importance of patient safety for hospital pharmacy practice in a dedicated section of its European Statements of Hospital Pharmacy.1 As stewards of patients’ medication safety, hospital pharmacists are the key stakeholders ensuring the safe, effective and rational use of medicines by upholding the ‘rights’ of patients. This includes improving the safety of using medications, especially high-risk medication and look-alike and sound-alike (LASA) medications, through their close surveillance as well as advising on the most appropriate use of medicines. While some prescribing, dispensing and administration may not cause harm, it may not be cost-effective or beneficial for the patient. The abovementioned phrase 'appropriate use' encompasses a multitude of situations. Patient safety, which lies at the heart of all representations made by EAHP and its members, covers many aspects. EAHP’s position on patient safety specifically focuses on medication safety. In particular, medication errors, which occur when a medicine has been inappropriately prescribed, prepared, dispensed or administered to a patient, are a key concern for hospital pharmacists. Throughout the medication use process specific measures must be taken by healthcare professionals (figure 1). For hospital pharmacists these include improving medication safety by reducing available harm through using risk assessment procedures. Figure 1 The medication use process from a patient perspective. Even before a patient is treated for a specific disease, hospital pharmacists ensure the safety of the patient throughout the care pathway. These include actions linked to the hospital formulary, such as selecting narrow-spectrum antibiotics to prevent resistance, and implementation of the decision of the Drug and Therapeutics Committee, the proper selection and procurement as well as the application of appropriate quality assurance strategies for the medication use processes to …

Hemostatic abnormalities and thrombotic risk associated with coronavirus disease 2019 (COVID-19) are among the most discussed topics in the management of this disease. The aim of this position paper is to provide the opinion of Brazilian experts on the thromboprophylaxis and management of thrombotic events in patients with suspected COVID-19, in the sphere of healthcare in Brazil. To do so, the Brazilian Society of Thrombosis and Hemostasis (BSTH) and the Thrombosis and Hemostasis Committee of the Brazilian Association of Hematology, Hemotherapy and Cellular Therapy (ABHH) have constituted a panel of experts to carefully review and discuss the available evidence about this topic. The data discussed in this document was reviewed by May 9, 2020. Recommendations and suggestions reflect the opinion of the panel and should be reviewed periodically as new evidence emerges.

Paper-based surface-enhanced Raman spectroscopy (SERS) sensors can be fabricated easily by dropcasting or inkjet printing colloidal Au nanoparticles onto cellulose-based filter papers. They are flexible, economical, and sensitive and provide the crucial advantage of point-of-need sampling for application in the field. In this study, paper-based SERS sensors are fabricated through inkjet printing of a colloidal Au sol onto a filter paper substrate. We have characterized their SERS performances with benzenethiol and pyridine molecules using a handheld Raman analyzer. Due to the heterogeneous loading of the Au nanoclusters on the paper substrate, we introduce the concept of receiver operating characteristic as an alternate measurand to quantify the performance of these sensors. With their inherent filtration sampling capability, we demonstrate the use of paper SERS sensors for the detection of chemical aerosols. Lastly, we present the use of a precision materials printer to deposit quantifiable amounts of analyte (fentanyl) uniformly across the active sensing area of a paper SERS sensor. This will allow for analyte-loaded certified references to be prepared and used in the field as standards for comparison.

The progress in the fabrication of carbon-nanotube-based structures has made it possible to use Raman spectroscopy to measure the deformation states of carbon nanotubes and abutting materials. In this work, we investigate the effects of laser power and surrounding materials on the Raman shift of carbon-nanotube (CNT) papers for the laser intensity in a range of 0.071 to 1.415 kW/mm2 without action of mechanical loading. Two different configurations of the CNT papers are used in the Raman measurement; one uses a suspended CNT paper, and the other places a CNT paper on a glass or aluminum substrate. The experimental results reveal that there exist combinational effects of the laser power and abutting materials on the changes of the wavenumbers of the D, G and G′ bands of the CNT papers. We derive an analytical relation between the strain components, temperature and the change of the wavenumber of the Raman peak, which yields a proportional relationship between the change of the wavenumber of the Raman peak and the laser power. Such a relationship is supported by the experimental results.

Perioperative immediate hypersensitivity reactions are rare. Subsequent allergy investigation is complicated by multiple simultaneous drug exposures, the use of drugs with potent effects and the many differential diagnoses to hypersensitivity in the perioperative setting. The approach to the investigation of these complex reactions is not standardized, and it is becoming increasingly apparent that collaboration between experts in the field of allergy/immunology/dermatology and anaesthesiology is needed to provide the best possible care for these patients. The EAACI task force behind this position paper has therefore combined the expertise of allergists, immunologists and anaesthesiologists. The aims of this position paper were to provide recommendations for the investigation of immediate-type perioperative hypersensitivity reactions and to provide practical information that can assist clinicians in planning and carrying out investigations.

Poly(3,4-ethylenedioxythiophene) doped with the polymer anion poly(styrenesulfonate), PEDOT:PSS, is a common electrochromic material used in the preparation of electrochromic devices (ECDs). In this paper, the PEDOT:PSS doped with a solvent was used both as the electrode and the electrochromic functional layer for fabrication of ECDs on absorptive paper surfaces. The doped PEDOT:PSS dispersion was assessed for the film-forming evenness, sheet resistance and conductivity, and the performance of prepared ECDs for their color contrast and switching dynamics. The ECD performance is discussed in relation to the absorptive characteristics of the substrates. The results indicate that it is feasible to prepare ECDs onto absorptive substrates, despite the partial polymer material imbibition into them. The extent of polymer absorption influences the ECD performance: an increased absorption reduces the color contrast but speeds up the color switching. The electrochemical properties of the used solid electrolyte were found to be crucial for functioning of the ECDs. Insufficient ion transport and associated high resistance led to failure of the devices.

During the early stages of the COVID-19 pandemic, EASL and ESCMID published a position paper to provide guidance for physicians involved in the care of patients with chronic liver disease. In the meantime, many countries and healthcare systems have been, or are still overwhelmed by the pandemic, significantly impacting on the care of this group of patients, whilst others have started to return towards their usual routine. In addition, many studies have been published focusing on how COVID-19 may affect the liver and how pre-existing liver diseases might influence the clinical course of COVID-19. While many aspects remain poorly understood, it has become increasingly evident that pre-existing liver diseases and liver injury during the course of the disease have to be kept in mind when caring for patients with COVID-19. Thus, this review should serve as an update on the previous position paper summarizing the evidence for liver disease involvement during COVID-19 and also provid, PNN was supported by the National Institute of Health Research (NIHR) Birmingham Biomedical Research Centre (BRC). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.

This article presents the use of flexible carbon substrates for the growth of III-nitride nanowire light emitters. A dense packing of gallium nitride nanowires were grown on a carbon paper substrate. The nanowires grew predominantly along the a-plane direction, normal to the local surface of the carbon paper. Strong photo- and electro-luminescence was observed from InGaN quantum well light emitting diode nanowires.

Halide perovskite quantum dots (PQDs) are promising materials for diverse applications including displays, light‐emitting diodes, and solar cells due to their intriguing properties such as tunable bandgap, high photoluminescence quantum yield, high absorbance, and narrow emission peaks. Despite the prosperous achievements over the past several years, PQDs face severe challenges in terms of stability under different circumstances. Currently, researchers have overcome part of the stability problem, making PQDs sustainable in water, oxygen, and polar solvents for long‐term use. However, halide PQDs are easily degraded under continuous irradiation, which significantly limits their potential for conventional applications. In this study, an oleic acid/oleylamine (traditional surface ligands)‐free method to fabricate perovskite quantum dot papers (PQDP) is developed by adding cellulose nanocrystals as long‐chain binding ligands that stabilize the PQD structure. As a result, the relative photoluminescence intensity of PQDP remains over ≈90% under continuous ultraviolet (UV, 16 W) irradiation for 2 months, showing negligible photodegradation. This proposed method paves the way for the fabrication of ultrastable PQDs and the future development of related applications., Solid‐state perovskite quantum dot papers are fabricated using a unique vacuum filtration growth method without a purification process. The bonding between cellulose nanocrystals and perovskite quantum dots makes the hybrid structure stable, and record high UV stability and thermal stability are achieved for perovskite quantum dot papers.

In this study, the effects of the mixing conditions of waste paper sludge ash (WPSA) on the strength and bearing capacity of controlled low-strength material (CLSM) were evaluated, and the optimal mixing conditions were used to evaluate the strength characteristics of CLSM with recyclable WPSA. The strength and bearing capacity of CLSM with WPSA were evaluated using unconfined compressive strength tests and plate bearing tests, respectively. The unconfined compressive strength test results show that the optimal mixing conditions for securing 0.8&ndash, 1.2 MPa of target strength under 5% of cement content conditions can be obtained when both WPSA and fly ash are used. This is because WPSA and fly ash, which act as binders, have a significant impact on overall strength when the cement content is low. The bearing capacity of weathered soil increased from 550 to 575 kPa over time, and CLSM with WPSA increased significantly, from 560 to 730 kPa. This means that the bearing capacity of CLSM with WPSA was 2.0% higher than that of weathered soil immediately after construction, furthermore, it was 27% higher at 60 days of age. In addition, the allowable bearing capacity of CLSM corresponding to the optimal mixing conditions was evaluated, and it was found that this value increased by 30.4% until 60 days of age. This increase rate was 6.7 times larger than that of weathered soil (4.5%). Therefore, based on the allowable bearing capacity calculation results, CLSM with WPSA was applied as a sewage pipe backfill material. It was found that CLSM with WPSA performed better as backfill and was more stable than soil immediately after construction. The results of this study confirm that CLSM with WPSA can be utilized as sewage pipe backfill material.

Cardiovascular disease is one of the main causes of morbidity and sick leave in Belgium, imposing a great socio-economic burden on the contemporary healthcare system and society. Cardiac rehabilitation is an evidence-based treatment strategy that not only improves the cardiac patients' health state but also holds promise so as to facilitate vocational reintegration in the society. This position paper was developed and endorsed by the Belgian Working Group of Cardiovascular Prevention and Rehabilitation. It provides an overview of the currently available Belgian data with regard to the role of cardiac rehabilitation in return to work after an initial cardiac event. It identifies the relevant barriers and facilitators of vocational integration of cardiac patients and summarises the contemporary Belgian legal and medical framework in this regard. Cardiac rehabilitation remains a primordial component of the post-acute event management of the cardiac patient, facilitating vocational reintegrating and thereby decreasing the pressure on social security. Despite the availability of a relevant legislative framework, there is a need for well-defined algorithms to assess readiness for return to work that can be used in daily clinical practice. ispartof: ACTA CARDIOLOGICA vol:75 issue:5 pages:388-397 ispartof: location:England status: published

Contains fulltext : 225338.pdf (Publisher’s version ) (Open Access) OBJECTIVES: The number of older people dying in long-term care facilities (LTCFs) is increasing globally, but care quality may be variable. A framework was developed drawing on empirical research findings from the Palliative Care for Older People (PACE) study and a scoping review of literature on the implementation of palliative care interventions in LTCFs. The PACE study mapped palliative care in LTCFs in Europe, evaluated quality of end-of-life care and quality of dying in a cross-sectional study of deceased residents of LTCFs in 6 countries, and undertook a cluster-randomized control trial that evaluated the impact of the PACE Steps to Success intervention in 7 countries. Working with the European Association for Palliative Care, a white paper was written that outlined recommendations for the implementation of interventions to improve palliative and end-of-life care for all older adults with serious illness, regardless of diagnosis, living in LTCFs. The goal of the article is to present these key domains and recommendations. DESIGN: Transparent expert consultation. SETTING: International experts in LTCFs. PARTICIPANTS: Eighteen (of 20 invited) international experts from 15 countries participated in a 1-day face-to-face Transparent Expert Consultation (TEC) workshop in Bern, Switzerland, and 21 (of 28 invited) completed a follow-up online survey. METHODS: The TEC study used (1) a face-to-face workshop to discuss a scoping review and initial recommendations and (2) an online survey. RESULTS: Thirty recommendations about implementing palliative care for older people in LTCFs were refined during the TEC workshop and, of these, 20 were selected following the survey. These 20 recommendations cover domains at micro (within organizations), meso (across organizations), and macro (at national or regional) levels addressed in 3 phases: establishing conditions for action, embedding in everyday practice, and sustaining ongoing change. CONCLUSIONS AND IMPLICATIONS: We developed a framework of 20 recommendations to guide implementation of improvements in palliative care in LTCFs.

Summary: The International Osteoporosis Foundation (IOF) Capture the Fracture® Campaign with the Fragility Fracture Network (FFN) and National Osteoporosis Foundation (NOF) has developed eleven patient-level key performance indicators (KPIs) for fracture liaison services (FLSs) to guide quality improvement. Introduction: Fracture Liaison Services (FLSs) are recommended worldwide to reduce fracture risk after a sentinel fracture. Given not every FLS is automatically effective, the IOF Capture the Fracture working group has developed and implemented the Best Practice Framework to assess the organisational components of an FLS. We have now developed a complimentary KPI set that extends this assessment of performance to the patient level. Methods: The Capture the Fracture working group in collaboration with the Fragility Fracture Network Secondary Fragility Fracture Special Interest Group and National Osteoporosis Foundation adapted existing metrics from the UK-based Fracture Liaison Service Database Audit to develop a patient-level KPI set for FLSs. Results: Eleven KPIs were selected. The proportion of patients: with non-spinal fractures; with spine fractures (detected clinically and radiologically); assessed for fracture risk within 12 weeks of sentinel fracture; having DXA assessment within 12 weeks of sentinel fracture; having falls risk assessment; recommended anti-osteoporosis medication; commenced of strength and balance exercise intervention within 16 weeks of sentinel fracture; monitored within 16 weeks of sentinel fracture; started anti-osteoporosis medication within 16 weeks of sentinel fracture; prescribed anti-osteoporosis medication 52 weeks after sentinel fracture. The final KPI measures data completeness for each of the other KPIs. For these indicators, levels of achievement were set at the < 50%, 50–80% and > 80% levels except for treatment recommendation where a level of 50% was used. Conclusion: This KPI set compliments the existing Best Practice Framework to support FLSs to examine their own performance using patient-level data. By using this KPI set for local quality improvement cycles, FLSs will be able to efficiently realise the full potential of secondary fracture prevention and improved clinical outcomes for their local populations.

International audience; AIM: The families of hospitalised preterm infants risk depression and post-traumatic stress and the preterm infants risk re-hospitalisation. The French neonatal society's aim was to review the literature on how the transition from hospital to home could limit these risks and to produce a position paper.METHODS: A systematic literature review was performed covering 1 January 2000 to 1 January 2018, and multidisciplinary experts examined the scientific evidence.RESULTS: We identified 939 English and French papers and 169 are quoted in the position paper. Most studies stressed the importance of early, personalised and progressive involvement of the family. Healthcare staff and families should assess discharge preparations jointly. This evaluation should assess the capacities of the newborn infant, with regard to its physiological maturity. It should also assess the family's ability to supply the medical, psychological and social assistance required before and after discharge. There should be a structured follow-up process that includes effective communication, various tools, interventions, networks, health and social professionals.CONCLUSION: Discharge preparations may improve the transition from hospital to home and the outcomes for the parents and newborn preterm infant. This early family-centred approach should be structured, coordinated and based on individual needs and circumstances.

A colorimetric polydiacetylene (PDA) paper strip sensor that can specifically recognize Bacillus thuringiensis (BT) HD-73 spores is described in this work. The target-specific aptamer was combined with PDA, and the aptamer-conjugated PDA vesicles were then coated on polyvinylidene fluoride (PVDF) paper strips by a simple solvent evaporation method. The PDA-aptamer paper strips can be used to detect the target without any pre-treatment. Using the paper strip, the presence of BT spores is directly observable by the naked eye based on the unique blue-to-red color transition of the PDA. Quantitative studies using the paper strip were also carried out by analyzing the color transitions of the PDA. The specificity of this PDA sensor was verified with a high concentration of Escherichia coli, and no discernable change was observed. The observable color change in the paper strip occurs in less than 1 h, and the limit of detection is 3 &times, 107 CFU/mL, much below the level harmful to humans. The PDA-based paper sensor, developed in this work, does not require a separate power or detection device, making the sensor strip highly transportable and suitable for spore analysis anytime and anywhere. Moreover, this paper sensor platform is easily fabricated, can be adapted to other targets, is highly portable, and is highly specific for the detection of BT spores.

Bacterial remediation of heavy metal polluted soil and effluent from paper mill was investigated using standard analytical methods. The paper mill was visited for 6 months at interval of 30 days to collect soil and effluent samples for the analysis. The pH of soil was slightly alkaline while effluent was acidic. There was a significant increase (P < 0.05) in total organic carbon (TOC) of soil; and turbidity, biochemical oxygen demand (BOD), chemical oxygen demand (COD) and TOC of effluent when compared to control. Bacteria isolated from the samples were grouped into two and used to remediate eight heavy metals. The remediation experiment consists of three treatments; Treatment 1 (treated with proteobacteria), Treatment 2 (treated with non-proteobacteria) and Treatment 3 (without bacteria) (control experiment). Result of the remediation study showed that there was a significant decrease (P < 0.05) in Treatment 1 and Treatment 2 of all the heavy metals in soil and effluent samples from day 30-180 when compared to day 0. The rate of removal of heavy metals in soil was highest in Treatment 1 for chromium (Cr; 0.00846 day-1) and lowest in Treatment 1 for cadmium (Cd; 0.00403 day-1) while the rate of removal in effluent was highest in Treatment 1 for zinc (Zn; 0.01207 day-1) and lowest in Treatment 1 for Cd (0.00391 day-1). It was concluded that bacteria isolated from soil and effluent samples were capable of remediating the concentration of Pb, arsenic (As), Cr, Zn and nickel (Ni) heavy metals.

International audience; The population of patients with congenital heart disease (CHD) is continuously increasing, and a significant proportion of these patients will experience arrhythmias because of the underlying congenital heart defect itself or as a consequence of interventional or surgical treatment. Arrhythmias are a leading cause of mortality, morbidity and impaired quality of life in adults with CHD. Arrhythmias may also occur in children with or without CHD. In light of the unique issues, challenges and considerations involved in managing arrhythmias in this growing, ageing and heterogeneous patient population and in children, it appears both timely and essential to critically appraise and synthesize optimal treatment strategies. The introduction of catheter ablation techniques has greatly improved the treatment of cardiac arrhythmias. However, catheter ablation in adults or children with CHD and in children without CHD is more technically demanding, potentially causing various complications, and thus requires a high level of expertise to maximize success rates and minimize complication rates. As French recommendations regarding required technical competence and equipment are lacking in this situation, the Working Group of Pacing and Electrophysiology of the French Society of Cardiology and the Affiliate Group of Paediatric and Adult Congenital Cardiology have decided to produce a common position paper compiled from expert opinions from cardiac electrophysiology and paediatric cardiology. The paper details the features of an interventional cardiac electrophysiology centre that are required for ablation procedures in adults with CHD and in children, the importance of being able to diagnose, monitor and manage complications associated with ablations in these patients and the supplemental hospital-based resources required, such as anaesthesia, surgical back-up, intensive care, haemodynamic assistance and imaging. Lastly, the need for quality evaluations and French registries of ablations in these populations is discussed. The purpose of this consensus statement is therefore to define optimal conditions for the delivery of invasive care regarding ablation of arrhythmias in adults with CHD and in children, and to provide expert and - when possible - evidence-based recommendations on best practice for catheter-based ablation procedures in these specific populations.

More than 10,000 preterm infants have participated in randomised controlled trials on probiotics worldwide, suggesting that probiotics in general could reduce rates of necrotising enterocolitis (NEC), sepsis, and mortality. Answers to relevant clinical questions as to which strain to use, at what dosage, and how long to supplement are, however, not available. On the other hand, an increasing number of commercial products containing probiotics are available from sometimes suboptimal quality. Also, a large number of units around the world are routinely offering probiotic supplementation as the standard of care despite lacking solid evidence. Our recent network meta-analysis identified probiotic strains with greatest efficacy regarding relevant clinical outcomes for preterm neonates. Efficacy in reducing mortality and morbidity was found for only a minority of the studied strains or combinations. In the present position paper, we aim to provide advice, which specific strains might potentially be used and which strains should not be used. In addition, we aim to address safety issues of probiotic supplementation to preterm infants, who have reduced immunological capacities and occasional indwelling catheters. For example, quality reassurance of the probiotic product is essential, probiotic strains should be devoid of transferable antibiotic resistance genes, and local microbiologists should be able to routinely detect probiotic sepsis. Provided all safety issues are met, there is currently a conditional recommendation (with low certainty of evidence) to provide either Lactobacillus rhamnosus GG ATCC53103 or the combination of Bifidobacterium infantis Bb-02, Bifidobacterium lactis Bb-12, and Streptococcus thermophilus TH-4 in order to reduce NEC rates.

Highly cited papers in the Essential Science Indicators database refer to papers with citations in the top 1% of all papers in a research field, and they are considered to be symbols of scientific excellence and top performance of the past ten years. This study provided an informetric analysis of 7791 highly cited papers in the environmental sciences category during 2009&ndash, 2019. Informetric indicators and visualization tools were applied to evaluate and present the performances of journals, countries/territories, institutions, top cited papers, and research hotspots. The results showed that the cumulative number of publications has increased exponentially, suggesting strong development of the environmental sciences category. There were 211 journals publishing highly cited papers, with Energy &amp, Environmental Science as the leading journal. The USA ranked first with the highest number of publications and occupied the core position in the collaboration network, while Mainland China took the first place in independent research output. Review articles have an obvious advantage in terms of achieving high citations. &ldquo, Adsorption&rdquo, &ldquo, climate change&rdquo, and &ldquo, heavy metal&rdquo, were the most frequent keywords, with &ldquo, microplastic&rdquo, rising rapidly as a new research frontier in recent years. Five research hotspots were visualized from highly cited papers via cluster analysis.

Coronavirus Disease 2019 (COVID‐19) has infected more than 3.0 million people worldwide and killed more than 200,000 as of April 27, 2020. In this White Paper, we address the cardiovascular co‐morbidities of COVID‐19 infection; the diagnosis and treatment of standard cardiovascular conditions during the pandemic; and the diagnosis and treatment of the cardiovascular consequences of COVID‐19 infection. In addition, we will also address various issues related to the safety of healthcare workers and the ethical issues related to patient care in this pandemic.

Scientific journals are the main form of recording and disseminating results of scientific research. After the advancement of digital media, their search, access, and navigation became easier and faster. This changes the way readers interact with the content. In this sense, the configuration of typography, an essential component of text-based publications, should facilitate the reading and understanding of the information presented. Thus, this research aimed to formalize an analysis process for the application of typography in papers on electronic scientific journals. Based on the literature review, an analysis structure was formulated. The analysis identified the fundamental principles of application of typography as: legibility, readability, spacing and font size and information hierarchy. Subsequently, four electronic papers from Brazilian scientific journals with different areas of knowledge were selected as objects of study. As a result, a potential application of typography for digital media was identified, but this potential is not fully explored by the editors of scientific journals nor by the literature dealing with the topic.

Made available in DSpace on 2020-12-10T19:54:25Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-03-04 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) We present a capacitive smart sensor based on printed circuit board (PCB) technology to measure the amount of water content in a paper pulp at the wet end of a paper machine. The developed sensor incorporates in the same PCB the signal processing circuits. It is a handheld portable device, and its output is sent to the reading equipment using a Bluetooth wireless connection, providing to the sensor's operator ease of mobility around the wet end of a paper machine. The prototype was tested in a laboratory, using a wire mesh to emulate the end of a paper machine, and we were able to measure and easily detect when it reaches the water content in the range of 90% to 92%, as required in the paper fabrication process. Standard deviation of the capacitance measurements at various moisture levels is four orders of magnitude smaller than the mean. The smart sensor was tested in the 20 degrees C to 40 degrees C temperature range, in a paper pulp with a gravimetric water content of 91%. Since the variation of capacitance with temperature is practically linear, we propose a simple linear compensation equation to correct the observed sensitivity with the temperature. To keep the signal processing circuits small, low cost, simple, and robust, a novel direct interface sensor to microcontroller circuit technique was used to make the capacitive measurement, allowing for measuring small capacitance deviations without high-frequency oscillators. It was shown that it is possible to integrate the signal processing circuits in the top layer of the PCB interdigitated sensor without adding noise or degrading the performance of the capacitive sensor. Sao Paulo State Univ Julio de Mesquita Filho, Fac Sci & Engn, Tupa, SP, Brazil Parana Fed Univ Technol UTFPR, Cornelio Procopio, PR, Brazil FEEC UNICAMP, Dept Semicond Instrumentat & Photon, Campinas, SP, Brazil Uninove Campus Vergueiro, Sao Paulo, SP, Brazil Sao Paulo State Univ Julio de Mesquita Filho, Fac Sci & Engn, Tupa, SP, Brazil CAPES: 001

Objectives:The purpose of this position paper is two-fold: first, to describe the state of extracorporeal membrane oxygenation education worldwide, noting current limitations and challenges; and second, to put forth an educational agenda regarding opportunities for an international collaborative approach toward standardization.Design:Relevant medical literature was reviewed through literature search, and materials from national organizations were accessed through the Internet. Taskforce members generated a consensus statement using an iterative consensus process through teleconferences and electronic communication.Setting:In 2018, the Extracorporeal Life Support Organization convened the ECMOed Taskforce at two structured, face-to-face meetings of 40 healthcare practitioners and educators with expertise in caring for the extracorporeal membrane oxygenation patient and in extracorporeal membrane oxygenation education.Patients:None.Interventions:None.Measurements and Main Results:The ECMOed Taskforce identified seven educational domains that would benefit from international collaborative efforts. Of primary importance, the Taskforce outlined actionable items regarding 1) the creation of a standardized extracorporeal membrane oxygenation curriculum; 2) defining criteria for an extracorporeal membrane oxygenation course as a vehicle for delivering the curriculum; 3) outlining a mechanism for evaluating the quality of educational offerings; 4) utilizing validated assessment tools in the development of extracorporeal membrane oxygenation practitioner certification; and 5) promoting high-quality educational research to guide ongoing educational and competency assessment development.Conclusions:Significant variability and limitations in global extracorporeal membrane oxygenation education exist. In this position paper, we outline a road map for standardizing international extracorporeal membrane oxygenation education and practitioner certification. Ongoing high-quality educational research is needed to evaluate the impact of these initiatives.

© 2020 John Wiley & Sons, Ltd. Drug misuse in prisons contributes to increased disruption and violence and negatively impacts prisoner safety, rehabilitation, and recovery. Synthetic cannabinoid receptor agonists (SCRAs), colloquially known as “spice”, are infused into papers and are of particular concern in a prison setting where they are commonly vaped. Methods for the qualitative and quantitative analysis of SCRA infused papers, including impurity profiling, were developed using gas chromatography–mass spectrometry (GC–MS) with qualitative confirmation by ultra high pressure liquid chromatography with photodiode array and quadrupole time of flight mass spectrometry detection (UPLC-PDA-QToF-MS) and applied to 354 individual seized paper samples originating from 168 seizures from three Scottish prisons. Of these samples, 41% (146 samples from 101 seizures) contained at least one SCRA and multiple SCRAs were detected on 23% of these papers. Concentrations ranged from < 0.05–1.17 mg/cm2 paper, representing the first reported quantitative data for SCRA infused papers. An evolution in the SCRAs detected was demonstrated; 5F-MDMB-PINACA (5F-ADB) predominated until late 2018, after which time 5F-MDMB-PICA and 4F-MDMB-BINACA became increasingly more prevalent, followed by the arrival of MDMB-4en-PINACA in June 2019. Concentration mapping data from two seized paper samples demonstrated that SCRA concentrations across larger papers were highly variable (0.47–2.38 mg/cm2 paper) making consistent dosing by users, and representative sampling by laboratory analysts, difficult. Near real-time qualitative and quantitative information on SCRAs circulating in prisons acts as an early warning system for SCRAs emerging on the wider illicit market, inform the methods used to detect them and limit supply, and provide information to support harm reduction measures.

For a suspected forgery that involves the falsification of a document or its contents, the investigator will primarily analyze the document&rsquo, s paper and ink in order to establish the authenticity of the subject under investigation. As a non-destructive and contactless technique, Hyperspectral Imaging (HSI) is gaining popularity in the field of forensic document analysis. HSI returns more information compared to conventional three channel imaging systems due to the vast number of narrowband images recorded across the electromagnetic spectrum. As a result, HSI can provide better classification results. In this publication, we present results of an approach known as the t-Distributed Stochastic Neighbor Embedding (t-SNE) algorithm, which we have applied to HSI paper data analysis. Even though t-SNE has been widely accepted as a method for dimensionality reduction and visualization of high dimensional data, its usefulness has not yet been evaluated for the classification of paper data. In this research, we present a hyperspectral dataset of paper samples, and evaluate the clustering quality of the proposed method both visually and quantitatively. The t-SNE algorithm shows exceptional discrimination power when compared to traditional PCA with k-means clustering, in both visual and quantitative evaluations.

Renal denervation is a device-based procedure for hypertension for which safety and efficacy has been demonstrated. At present, its clinical use is still matter of debate, despite the most recent clinical trials have shown promising results with new-generation devices in various hypertensive populations. This position paper was deemed necessary by the Italian Society of Arterial Hypertension, in order to provide indications about the applications of renal denervation in the clinical setting. A state-of-the art review of the literature, focusing on safety and efficacy data, is provided. Furthermore, based on current evidence and expert consensus, clinical profiles of possible candidates for renal denervation are proposed. The selection process should take into account not only blood pressure values, global cardiovascular risk profile, but also drug adherence and tolerability and patient preferences. This position paper also defines minimum requirements for renal denervation selection centers and a flowchart for the difficult-to-treat hypertensive patient. Further studies are needed to support these preliminary indications, which are based on expert-consensus only.

In the last decades, the increase in global industrialization and the consequent technological progress have damaged the quality of the environment. As a consequence, the high levels of hazardous compounds such as metals and gases released in the atmosphere and water, have raised several concerns about the health of living organisms. Today, many analytical techniques are available with the aim to detect pollutant chemical species. However, a lot of them are not affordable due to the expensive instrumentations, time-consuming processes and high reagents volumes. Last but not least, their use is exclusive to trained operators. Contrarily, colorimetric sensing devices, including paper-based devices, are easy to use, providing results in a short time, without particular specializations to interpret the results. In addition, the colorimetric response is suitable for fast detection, especially in resource-limited environments or underdeveloped countries. Among different chemical species, transition and heavy metals such as iron Fe(II) and copper Cu(II) as well as volatile compounds, such as ammonia (NH3) and acetaldehyde (C2H4O) are widespread mainly in industrialized geographical areas. In this work, we developed a colorimetric paper-based analytical device (PAD) to detect different contaminants, including Fe2+ and Cu2+ ions in water, and NH3 and C2H4O in air at low concentrations. This study is a &ldquo, proof of concept&rdquo, of a new paper sensor in which the intensity of the colorimetric response is proportional to the concentration of a detected pollutant species. The sensor model could be further implemented in other technologies, such as drones, individual protection devices or wearable apparatus to monitor the exposure to toxic species in both indoor and outdoor environments.

The analysis of complex systems requires an integrated application of different assessment methods also taking into account different scales and points of view to gain a systemic understanding of the investigated case study. Life Cycle Assessment (LCA) and Emergy Accounting (EMA) are both environmental assessment methods, showing many similarities in the way they are performed, especially with respect to the inventory construction and to the interpretation of results. They also show great differences, the main residing in the different perspectives they give. LCA applies a consumer side perspective, and its space and time scales are set at a boundary capable to include all the process phases in terms of location and durability and their direct impacts on the investigated areas. On the other hand, throughout its donor side perspective, EMA expands the boundaries of the system over the entire biosphere space and time scales. Differences and similarities between LCA and EMA may gain added value by their implementation within a procedural framework which exploits the characteristics of the two methods. The present work proposes a methodological procedure based on the sequential and integrated application of LCA and EMA methods, called LEAF (LCA & EMA Applied Framework). The traditional Amalfi paper production is used as a test case study. The procedure stems include: (i) an ex-ante LCA analysis, to identify the hotspots of the investigated case study; (ii) the assessment of the environmental performance of the system through the development of different EMA-based improvement scenarios built around the chosen hotspots; and (iii) an ex-post LCA application built on each scenario results in order to detect the different environmental burdens. The application of LEAF to the traditional Amalfi paper production shows that the use of a more sustainable energy source is an effective solution (among the set of proposed options) to increase the sustainability of the investigated system.

Acute and chronic physical exercises may enhance the development of statin-related myopathy. In this context, the recent (2019) guidelines of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS) for the management of dyslipidemias recommend that, although individuals with dyslipidemia should be advised to engage in regular moderate physical exercise (for at least 30 min daily), physicians should be alerted with regard to myopathy and creatine kinase (CK) elevation in statin-treated sport athletes. However it is worth emphasizing that abovementioned guidelines, previous and recent ESC/EAS consensus papers on adverse effects of statin therapy as well as other previous attempts on this issue, including the ones from the International Lipid Expert Panel (ILEP), give only general recommendations on how to manage patients requiring statin therapy on regular exercises. Therefore, these guidelines in the form of the Position Paper are the first such an attempt to summary existing, often scarce knowledge, and to present this important issue in the form of step-by-step practical recommendations. It is critically important as we might observe more and more individuals on regular exercises/athletes requiring statin therapy due to their cardiovascular risk.

Assessment of vitamin and trace element status (VTE) is important in the clinical management of the sick child. In this position paper, we present the various assessment methods available to the clinical practitioner, and critically discuss pitfalls with interpretation of their results. There are 4 main approaches to assess the VTE body status of an individual patient including clinical examination, dietary assessment, and measurement of direct and indirect biomarkers of VTE in biological samples. Clinical signs of VTE deficiencies usually present only when body stores are substantially depleted and are often difficult to detect or differentiate from other nonnutrient-related causes. In isolation, dietary assessment of micronutrients can be inaccurate and imprecise, in disease and in individual patient assessment but may be useful to complement findings from other VTE assessment methods. Use of biomarkers is the most common approach to assess VTE status in routine practice but in the presence of systemic inflammatory response and in the absence of appropriate paediatric reference intervals, interpretation of biomarker results might be challenging and potentially mislead clinical practice. The use of a multimodal approach, including clinical examination, dietary assessment, and laboratory biomarkers is proposed as the optimal way to ascertain the VTE status of individual patients. In the presence of acute inflammatory conditions, VTE measurements in plasma should be replaced by biomarkers not affected by systemic inflammatory response or delayed until inflammatory state is resolved.

International audience; The hemp plant Cannabis sativa Linn, referring to industrial hemp, is a high-yielding annual industrial crop grown providing fibers from hemp stalk and oil from hemp seeds. Although hemp is a niche crop, hemp production is currently undergoing a renaissance. More than 30 countries grow hemp, with China being the largest hemp producing and exporting country. Europe and Canada are also important actors in the global hemp market. Traditionally, hemp as a fiber plant has been used for the production of apparels, fabrics, papers, cordages and building materials. The hurds, as waste by-product of fiber production, were used for bedding of animals, the seeds for human nutrition, e.g., as flour, and the oil for a wide range of purposes, from cooking to cosmetics. Hemp has also been an important crop throughout human history for medicine. Other more recent applications include materials for insulation and furniture, automotive composites for interior applications and motor vehicle parts, bioplastics, jewelry and fashion sectors, animal feed, animal bedding, and energy and fuel production. Foods containing hemp seed and oil are currently marketed worldwide for both animal and human nutrition. They also find applications in beverages and in neutraceutical products. Hemp oil is also used for cosmetics and personal care items, paints, printing inks, detergents and solvents. It is estimated that the global market for hemp consists of more than 25,000 products. Currently, the construction and insulation sector, paper and textile industries, and food and nutrition domains are the main markets while the cosmetics and automotive sector are growing markets. Innovative applications, e.g., in the medical and therapeutic domains, cosmeceuticals, phytoremediation, acoustic domain, wastewater treatment, biofuels, biopesticides and biotechnology, open new challenges. Hemp is also the object of numerous fundamental studies. This review presents and discusses the traditional and new uses of industrial hemp.

Marked mix-nets were introduced by Pereira and Rivest as a mechanism to allow very efficient mixing that ensures privacy but at the cost of not guaranteeing integrity. This is useful in a number of e-voting schemes such as STAR-Vote and Selene. However, the proposed marked mix-net construction comes with no proof of security and, as we show in this paper, does not provide privacy even in the presence of a single corrupt authority. Fortunately, the attack that we present is easy to prevent and we show several possible ways to address it. Finally while the original marked mix-net paper worked with ElGamal, we identify conditions that the adopted encryption scheme should satisfy in order to be appropriate for a marked mix-net. This opens the possibility of building marked mix-nets based on intractability assumptions which are believed to hold in the presence of a quantum computer.

As the treatment landscape continues to evolve towards the application of precision medicine in multiple myeloma (MM), there is a clear need to identify those patients who are at risk of not achieving the maximum benefit whilst exposed to the highest level of toxicity. This group of patients, defined as frail, is an unmet clinical need. However, how we define such a vulnerable group of patients with MM remains to be clarified. An integral aspect of this is to define the physiological age and capacity of patients with MM to deal with the burden of their disease and it’s treatment. Such assessments may include not only functional and clinical assessments but also laboratory-based biomarkers of frailty, aging and senescent cellular burden. A need to develop, test and validate clinical screening scores before their adoption into clinical practice is mandated. This position paper from the European Myeloma Network aims to review what is known about defining frailty in MM, and how we can advance this knowledge for the design of clinical trials and ultimately how we deliver treatment in the clinic.