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The COVID-19 pandemic represents an unprecedented event that has brought deep changes in hospital facilities with reshaping of the health system organization, revealing inadequacies of current hospital and local health systems. When the COVID-19 emergency will end, further evaluation of the national health system, new organization of acute wards, and a further evolution of the entire health system will be needed to improve care during the chronic phase of disease. Therefore, new standards for healthcare personnel, more efficient organization of hospital facilities for patients with acute illnesses, improvement of technological approaches, and better integration between hospital and territorial services should be pursued. With experience derived from the COVID-19 pandemic,new models, paradigms, interventional approaches, values and priorities should be suggested and implemented.

Since the first statement of the German Society of Oto-Rhino-Laryngology, hypoglossal nerve stimulation (HNS) is meanwhile an established treatment option for obstructive sleep apnea (OSA). There are three HNS systems available in Germany which differ in their technical details of the underlying comparable basic principle. For the unilateral HNS with respiratory sensing, several comparative studies, high-volume register analysis and long-term reports exist. The continuous HNS without respiratory sensing does not require a sleep endoscopy for indication. For the bilateral continuous HNS as the single partially implantable device, a feasibility study exists. For indication, the assessment of positive airway pressure failure by sleep medicine is crucial, and the decision for HNS should be made in discussion of other treatment options for at least moderate OSA. The implantation center holds primarily responsibility among the interdisciplinary sleep team and is primary contact for the patient in problems. This depicts why structural processes are required to secure outcome quality and minimize the complications. The aftercare of HNS patients can be provided interdisciplinary and by different medical institutions, whereat, minimal reporting standards to document outcome and usage are recommended.

Allergo journal international 30(5), 155-168 (2021). doi:10.1007/s40629-021-00178-2, Published by Urban & Vogel, München

Rearrangements in the anaplastic lymphoma kinase (ALK) and proto-oncogene tyrosine-protein kinase ROS (ROS1) genes characterise two distinct molecular subsets of non-small cell lung cancer (NSCLC) tumours. Lorlatinib is a third-generation ALK/ROS1 tyrosine kinase inhibitor (TKI) shown to have systemic and intracranial activity in treatment-naive patients and in those who progressed on first- and second-generation TKIs. Despite being generally well tolerated, lorlatinib has a unique and challenging safety profile that includes hyperlipidaemia and central and peripheral nervous system adverse events (AEs). This article summarises a set of strategies designed to monitor and manage lorlatinib-related AEs that were agreed upon by a multidisciplinary panel of specialists in a meeting held in July 2020. Among the recommendations hereby described, special emphasis was placed on communication: prescribing physicians should inform patients and their families/caregivers about the likelihood and nature of lorlatinib AEs, encouraging them to report any symptoms, while at the same time reassuring them that most events are manageable and resolve spontaneously and have little to no interference with cancer treatment. Importantly, all patients should undergo a set of baseline assessments, including biochemical analysis, evaluation of cardiovascular risk, electrocardiogram (ECG), neurological evaluation and contrast-enhanced magnetic resonance imaging of the brain, which should be repeated regularly during lorlatinib treatment. Supportive medications to treat or relieve lorlatinib AEs were also discussed, as were the conditions requiring specialist consultations and/or adjustments in lorlatinib therapy. The overall goal of this article is to serve as a practical guide for oncologists to systematically and effectively approach lorlatinib AEs.

In this study, we developed a microfluidic paper analysis device (μPAD) for distance-based detection of Ag+ in water. The μPAD was manufactured by wax printing method on filter paper. Then, a layer of gold nanoparticles (AuNPs) was deposited and ascorbic acid was printed on the channel. In the detection, Ag+ was reduced by ascorbic acid and coated on the surface of the AuNPs on the channel, forming Au@Ag core/shell nanoparticles. Based on the capillary flow principle, different concentrations of Ag+ formed different distances of color ribbons. Thus, quantitative detection of Ag+ can be achieved by measuring the distance of the color ribbon. The detection limit of this method was as low as 1 mg·L−1 within 15 min and the interference of common metal ions in water can be eliminated. In conclusion, this method had successfully realized the leap from colorimetry to direct reading, realizing fast read and easy manipulation with low-cost.

The American Society for Parenteral and Enteral Nutrition (ASPEN) Position Paper focus is on applying the 4 ethical principles for clinician's decision-making in the use of artificially administered nutrition and hydration (AANH) for adult and pediatric patients. These basic principles are (1) autonomy, respect the patient's healthcare preferences; (2) beneficence, provide healthcare in the best interest of the patient; (3) nonmaleficence, do no harm; and (4) justice, provide all individuals a fair and appropriate distribution of healthcare resources. Preventing and resolving ethical dilemmas is addressed, with an emphasis on a collaborative, interdisciplinary approach. Optimizing early communication and promoting advance care planning, involving completion of an advance directive, including designation of a surrogate decision-maker, are encouraged. Clinicians achieve respect for autonomy when they incorporate the patient, family, community, country, geographical, and presumed cultural values and religious belief considerations into ethical decision-making for adults and children with a shared decision-making process. These discussions should be guided by the 4 ethical principles. Hospital committees and teams, limited-time trials, clinician obligation with conflicts, and forgoing of AANH are addressed. Specific patient conditions are addressed because of the concern for potential ethical issues: coma, decreased consciousness, and dementia; advanced dementia; cancer; eating disorders; and end-stage disease/terminal illness. Incorporated in the Position Paper are ethical decisions during a pandemic and a legal summary involving ethical issues. International authors presented the similarities and differences within their own country or region and compared them with the US perspective.

The pulp and paper industry is a highly energy-intensive and water-consuming industry. This industry is known for the utilization of a wide range of raw materials, containing cellulose fibers (generally wood, recycled paper, and agricultural residues), for the production of various grades of paper. There are several processes involved in the conversion of raw materials to the paper product such as raw material preparation, pulping, pulp washing and screening, bleaching, stock preparation, papermaking and chemical recovery. All the processes are facing issues regarding process efficiency, product quality, energy & water consumption, and cost and environment. There is a need for further improvement and upgrading the technologies but the scale of operations, technological obsolesce and cost of implementing new technologies are some of the major issues. The main thrust areas of pulp and paper processing require major interventions in the adoption of green and clean technologies.

Our dependency towards wood has reduced the number of forests especially in Indonesia. Hence, many people tried to use another material as a replacement of wood. One of them is composite. Department of Industrial Engineering Universitas Sebelas Maret has developed paper-based composite using newspaper waste in Praktikum Perancangan Teknik Industri (PPTI) II. Unfortunately, the quality of composite is not so good. This paper tried to understand the effect of factors to responses and discover the best combination of factors to obtain the best responses. The responses of this experiment are tensile strength, bending strength and impact value. The factors of this experiment are paper pulp, PVAc glue and water. Taguchi method is used to find the appropriate orthogonal array and Particle Swarm Optimization method to find the optimum combination of the factors. Orthogonal array used in this experiment is L9 (34). Through analysis, all of the factors are significant to tensile and bending strength, but they are not significant to impact value. The best combination of factors is 175 grams paper pulp, 130 grams PVAc glue and 175 ml water. Optimum results obtained for tensile strength is 0.7595 N/mm2, bending strength is 4.873 N/mm2 and impact value is 0.0138 J/mm2.

The present study illustrates the electrocoagulation remediation of paper mill wastewater for multiple response optimization. Multiple response optimization can be combined into one desirability function. All variables and responses varied for a unique global solution. The effect of basic electrocoagulation process variables pH (3–10), conductivity (3.15–10 mS/cm), electrode distance (1–2.5 cm) and current density (5–20 mA/cm2) on four response parameters such as chemical oxygen demand, color, total dissolved solids and total organic carbon has been analyzed experimentally and statistically. The global solution for these variables and responses obtained by software over a hundred design points. For unit desirability function variables conditions were pH 7.49, Conductivity 8.34 mS/cm, electrode distance 2.06 cm and current density 9.32 mA/cm2. In these global variable conditions, responses were observed to be COD 70.19%, Color 75.03%, TDS 70.69% and TOC 71.93%, respectively.

Flexible paper-based sensors may be applied in numerous fields, but this requires addressing their limitations related to poor thermal and water resistance, which results in low service life. Herein, we report a paper-based composite sensor composed of carboxylic carbon nanotubes (CCNTs) and poly-m-phenyleneisophthalamide (PMIA), fabricated by a facile papermaking process. The CCNT/PMIA composite sensor exhibits an ability to detect pressures generated by various human movements, attributed to the sensor's conductive network and the characteristic "mud-brick" microstructure. The sensor exhibits the capability to monitor human motions, such as bending of finger joints and elbow joints, speaking, blinking, and smiling, as well as temperature variations in the range of 30-90 °C. Such a capability to sensitively detect pressure can be realized at different applied frequencies, gradient sagittas, and multiple twists with a short response time (104 ms) even after being soaked in water, acid, and alkali solutions. Moreover, the sensor demonstrates excellent mechanical properties and hence can be folded up to 6000 times without failure, can bear 5 kg of load without breaking, and can be cycled 2000 times without energy loss, providing a great possibility for a long sensing life. Additionally, the composite sensor shows exceptional Joule heating performance, which can reach 242 °C in less than 15 s even when powered by a low input voltage (25 V). From the perspective of industrialization, low-cost and large-scale roll-to-roll production of the paper-based sensor can be achieved, with a formed length of thousands of meters, showing great potential for future industrial applications as a wearable smart sensor for detecting pressure and temperature, with the capability of electric heating.

Background: Rickettsial diseases are difficult to diagnose in Bangladesh due to low index of suspicion and lack of diagnostic facilities in most laboratories especially in rural areas. Immunofluorescence assay (IFA) is the gold standard serological test for diagnosis of Rickettsial diseases. For serological diagnosis of rickettsial diseases, use of filter paper is an inexpensive and convenient method for collecting, storing, and transporting of blood samples with little space without refrigeration. Current study shows that the rickettsial diseases were present in febrile patients in Bangladesh. The study also compared the results of direct serum by IFA and filter paper serum spot followed by IFA as an alternative way of testing frozen samples. Materials and Methods: This observational study for evaluation of rickettsial diseases from direct serum by IFA and sera dried on blotting paper followed by IFA at the department of Virology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. A total of 152 patients’ sera were selected by systemic random sampling of every 3rd sera of 556 febrile patients who were tested negative for dengue and or Chikungunya virus infection. Forty cases were confirmed by IFA from direct sera. In addition, 60 samples were selected from 152 sera by systemic random sampling of every 3rd sera for blotting on filter paper for further IFA test. Out of 60 sera, 35 were confirmed by IFA from direct sera and of the 35 confirmed positive cases, 31(88.6%) were positive by IFA after blotting paper assay. Taking the IFA of direct sera as gold standard test, the sensitivity, specificity, positive predictive value and negative predictive value of IFA from blotting paper eluted sera were 88%, 100%, 100% and 86% respectively. Conclusion: The study showed the use of filter paper is an inexpensive and convenient method for storing and transporting samples for serological tests like IFA in diagnosis of rickettsial diseases. J Dhaka Medical College, Vol. 28, No.2, October, 2019, Page 153-158

The solid waste dumpsites of pulp and paper industries are prone to be turned into degraded lands due to the loss of vegetation cover. Such sites often possess drought, salinity and pH stresses as well as heavy metal contamination. Restoration of top soil by creating vegetation cover has proved to be the most sustainable approach to check land degradation. Therefore, to find some stress-tolerant species capable of creating vegetation cover in paper mill dumpsites, a vegetation composition study was conducted in a paper mill dumpsite. A total of seven plant species viz., Calotropis gigantea (L.) Dryand., Chromolaena odorata (L.) R.M. King & H. Rob, Mikania scandens (L.) Willd., R. communis L., Rotheca serrata (L.) Steane & Mabb., Senna sophera (L.) Roxb. and Solanum myriacanthum Dunal were found. To correlate the existence of these plants with stress condition of soil, the level of phytotoxicity in the dumpsite was assessed by studying seed germination status, proline accumulation, leaf relative water content (RWC), leaf pH, total chlorophyll content and ascorbic acid level of Ricinus communis as bioassay indices. The significantly lower percentage of seed germination in dumpsite soil, compared to control, revealed the phytotoxic nature of the soil of the dumpsite. The significantly higher level of proline, RWC, total chlorophyll and ascorbic acid in plant leaves from dumpsites than from the control soils indicated considerable stress in the dumpsite. Soil physicochemical and nutrient status analyses substantiated with the bioassay results. Despite apparent phytotoxicity, the presence of certain plant species in the dumpsite indicated their inherent stress tolerance capability to be prospected.

Edible oils form an integral component in the human diet as well as in the industrial preparations. Any adulteration in oil is concerning from nutritional as well as economical perspective. Although analytical techniques exist for detection of adulterants in oil, most of them require sophisticated instruments, and trained professionals. Microfluidic based lab-on-a-chip technologies have rapidly progressed over the recent years and offer promising alternatives in this regard. In this work, we report development of a paper-based microfluidic lab-on-a-chip for detection of palm oil contamination in sunflower oil. We use the paper-based microfluidic colorimetric detection approach that indicates the presence of adulteration in a visual manner. The data is analyzed using digitally acquired images along with ultraviolet–visible spectrophotometry. The paper-based microfluidic device is fabricated and tested for 10–50% (v/v) palm oil adulteration in sunflower oil. Further, we employ the device for free fatty acid content tests in oil samples. Visual signal acquired from the device is optimized by varying phenolphthalein proportions. The stability of visual colorimetric signal is examined over time and is found to remain steady over the trial period of six days considered in this work. The integration of the detection device with smartphone imaging can prove to be useful for onsite data collection. We believe the approach presented here can be extended to food quality monitoring portable platforms.

Tacrolimus is one of the most effective and prevalent drugs used to combat vascularized composite allotransplantation rejection. We have fabricated a rapid and easy-to-use six-layer paper based microfluidic device using the principles of competitive immunoassays and vertical flow microfluidics for colorimetric detection of tacrolimus in a small volume of blood.

Introduction We developed low-cost, portable paper-based diagnostic devices for detection of human immunoglobulin M (IgM) and immunoglobulin G (IgG) in serum without any sample preparation. These devices can be used to help identify presence of diseases, used to provide rapid results ( Materials and Methods We successfully accomplished colorimetric detection of human IgG and human IgM using a sandwich-style assay within the microfluidic paper device via vertical flow immunoassay configuration. The reaction zone in the wax printed paper layer is a small circular pattern. Gold nanoparticles conjugated with anti-human IgG and IgM antibodies have been used for colorimetric detection of IgG or IgM by naked eye. Colorimetric signal can be precisely quantified through implementation of image analysis software which can be developed as an app for a smartphone. The size of the device is 2 cm × 2 cm × 1 mm. Results Colorimetric detection of human IgG was accomplished at 100 fg/mL concentration using a gold nanoparticle–conjugated anti-human IgG antibody. The developed platform has a dynamic range of IgM and IgG concentrations between 0.1 pg/mL and 100 μg/mL. These devices provided a color readout in Conclusions Because of the inherent simplicity of the device operation and their ease of use, there is no variation between samples and users of the device. This low-cost approach enables multiplexing with >1 measurement performed in parallel at the same time. We anticipate that because of the sensitivity, specificity, ease of use, and overall reliability, this approach will become a standard for diagnosis of diseases and health conditions.

Lab-on-paper, or microfluidic paper-based analytical devices (μPADs), use paper as a substrate material, and are patterned with a system of microchannels, reaction zones and sensing elements to perform analysis and detection. The sample transfer in such devices is performed by capillary action. As a result, external driving forces are not required, and hence the size and cost of the device are significantly reduced. Lab-on-paper devices have thus attracted significant attention for point-of-care medical diagnostic purposes in recent years, particularly in less-developed regions of the world lacking medical resources and infrastructures. This review discusses the major advances in lab-on-paper technology for blood analysis and diagnosis in the past five years. The review focuses particularly on the many clinical applications of lab-on-paper devices, including diabetes diagnosis, acute myocardial infarction (AMI) detection, kidney function diagnosis, liver function diagnosis, cholesterol and triglyceride (TG) analysis, sickle-cell disease (SCD) and phenylketonuria (PKU) analysis, virus analysis, C-reactive protein (CRP) analysis, blood ion analysis, cancer factor analysis, and drug analysis. The review commences by introducing the basic transmission principles, fabrication methods, structural characteristics, detection techniques, and sample pretreatment process of modern lab-on-paper devices. A comprehensive review of the most recent applications of lab-on-paper devices to the diagnosis of common human diseases using blood samples is then presented. The review concludes with a brief summary of the main challenges and opportunities facing the lab-on-paper technology field in the coming years.

Cocaine (COC) is one of the most widely consumed illegal drugs around the world. Street COC is commonly adulterated with pharmaceutical compounds that mimic or intensify the COC's sensory effect. Adulteration is performed to increase the profit of criminal organizations and each one has their own way of doing it. Therefore, determining the composition of seized COC samples (chemical profile) provides evidence for the police to track criminal organization networks and their activity patterns. Using filter paper as a substrate, we developed a multiple detection paper-based analytical device (PAD) that combines colorimetric and electrochemical measurements to discriminate COC samples according to adulterant's content. A regular graphite lead modified with a gold film made from Au leaf (graphite/Au) to improve electron transfer was used as a working electrode. Silver and Ag/AgCl were used as auxiliary and reference electrodes, respectively. The colorimetric device was patterned using a laser cutter and coupled to the electrochemical device using a double-sided tape, allowing simultaneous analysis to gather more analytical information about COC samples. Graphite/Au was characterized by scanning and transmission electron microscopies and electrochemical assays. The simultaneous colorimetric and electrochemical analyses combined to principal component analysis improved the analytical characterization of COC trial samples and provided a fast discrimination based on the assembled database.

This study presents a paper-based thin-layer optical cuvette for absorption spectroscopy with a pneumatically driven pump for the introduction of an aqueous sample. The three major components, a sample reservoir, an open-channel as an optical path and a pneumatic pump, are patterned in polypropylene paper using an electronic cutting machine. When sealed with transparent tape, the patterned paper serves as the side walls of the paper-based cuvette with an integrated pneumatic pump. Due to the reduced pressure inside the open-channel caused by the depression of the pump with a finger, aqueous samples spotted onto the reservoir are introduced into the open-channel of the paper-based cuvette. We demonstrated that the paper-based cuvettes are compatible with conventional spectrophotometers for absorption spectroscopic measurements and capable of quantifying the concentrations of various colored dyes in aqueous samples.

The waste of paper or the paper dump is a serious problem and its occurrence is widespread in various institutions. Wastepaper can be recycled to produce some important and usable products that are ecological and biodegradable. For example, it is used to extract new paper from the old by chemical decomposition. Other products such as paper plates, paper cups, paper spoons, tiles, toys, crafts, etc. can be formed from the slurry. This project also initiates a mould that makes cups and plates from the wastepaper management circuit. With learning institutions being the main consumers, most paper are usually eliminated after its use. The waste remains undeveloped and unused, although is a valuable resource. Studying the design of a manual, economical and efficient paper recycling machine, it can be surmised that the design uses the integration of the knowledge gained about the recycling technology that exists manually from the paper recycling machines used to form a cheap but effective paper recycling system. The advantages of the machine are not only of recycled paper, but also the advantages of the interaction of the manual drive system, which will also reduce the high cost. As the design is not 100% effective, the transmission, belt and chain transmission correspond to the estimated 90% efficiency using the 90% for the design. The power consumption for the design is 450 W and since an average user can produce 100 W constant, it takes 5 people to drive the machine.

Feedback is beneficial to students’ learning process and overall achievement, but one of the common complaints from students about college education is regarding feedback. So, this study aimed to examine whether digital written feedback positively influences students’ learning experience and attitude toward learning. Digital written feedback refers to feedback provided through a learning management system as handwritten feedback added to a scanned copy of the student’s paper-based assessment using a smart pad and smart pencil. The study surveyed a diverse set of college students’ (n = 175) perceptions regarding feedback satisfaction, learning satisfaction, the usefulness of digital written feedback, and perceived achievement via an online survey. A one-way analysis of variance found a significant difference between feedback satisfaction and learning satisfaction according to the feedback method. A multiple regression analysis indicated the satisfaction and perceived usefulness of digital written feedback predicted perceived achievement. From the students’ open responses regarding the benefits of digital written feedback, five themes emerged, namely usability, psychological relief, accessibility, self-regulation, and acceptance. The implications for digital written feedback are discussed.

We report a paper-based photodetector made from mixed cation organic perovskite halide MA1–xFAxPbI3 (MA = methylammonium (CH3NH3); FA = formamidium CH(NH2)2). The detector shows a substantial photo...

Social aggression is a pervasive feature of insect societies. In eusocial Hymenoptera, aggression among females can affect task performance and competition over direct reproduction (egg laying); in most species males participate in social interactions relatively rarely. Males of the independent-founding paper wasp Mischocyttarus mastigophorus are exceptional: they are aggressive toward female nestmates, leading us to explore the function of this unusual behavior. We applied social network analyses to data on M. mastigophorus social aggression to quantify sex differences in giving and receiving social aggression. The network analyses supported the pattern of biased male aggression toward female nestmates; females are relatively rarely aggressive to males. We then asked whether male aggression toward females was biased by females’ relative ovary development. Males were more aggressive toward females with better-developed ovaries, opposite to patterns of aggression among females. Because food brought to the colonies is often monopolized by dominant females, we suggest that males direct aggression toward socially dominant females with better-developed ovaries to obtain food. The implications of biased male aggression for female task performance and physiology are unknown.

This research presents a solar-blind (UVC) office paper-based photodetector that is self-biased, superflexible, nonwettable, high-performance, and high-voltage stable. In contrast to the traditiona...

The pulp and paper industry has significant sustainability implications and necessarily requires a careful consideration of direct and lower-tier suppliers for effective sustainable supply chain ma...

This paper introduces a novel potential-resolved paper-based biosensor for simultaneous detection of multiple microRNAs (miRNAs) (taking miRNA-155 and miRNA-126 as examples) based on the bipolar electrode (BPE) electrochemiluminescence (ECL) strategy. The proposed multiple-channel paper-based sensing microfluidic platform was prepared by wax-printing technology, screen-printing method, and in situ Au nanoparticles (AuNPs) growth to form hydrophilic areas, hydrophobic boundaries, waterproof electronic bridge, driving electrode regions, and parallel bipolar electrode regions. CdTe quantum dots (QDs)-H2 and Au@g-C3N4 nanosheets (NSs)-DNA1 were used as dual electrochemiluminescence signal probes, and carboxylated Fe3O4 magnetic nanoparticles existed as carriers. CdTe QDs-H2/S2O82- and Au@g-C3N4 NSs-DNA1/S2O82- could exhibit two strong and stable ECL emissions at a drive voltage of 9 and 12 V, respectively, which can be used as effective potential-resolved signal tags. In addition, the proposed three-dimensional (3D) DNA nanomachine model and the target miRNA cycle strategy were used to achieve double amplification of electrochemiluminescence intensity. More importantly, the combination of the bipolar electrode system and the potential-resolved multitarget electrochemiluminescence method can greatly reduce the spatial interference between substances. The prepared ECL biosensor showed a favorable linear response for the detection of miRNA-155 and miRNA-126 with relatively low detection limits of 5.7 and 4.2 fM, respectively. With excellent sensitivity, the strategy may provide an efficient method for clinical application, especially in detection of trace multiple targets.

In 2018, the position paper ‘Imaging the adult with congenital heart disease: a multimodality imaging approach’ was published. The paper highlights, in the first part, the different imaging modalities applied in adult congenital heart disease patients. In the second part, these modalities are discussed more detailed for moderate to complex anatomical defects. Because of the length of the paper, simple lesions were not touched on. However, imaging modalities to use for simple shunt lesions are still poorly known. One is looking for structured recommendations on which they can rely when dealing with an (undiscovered) shunt lesion. This information is lacking for the initial diagnostic process, during repair and at follow-up. Therefore, this paper will focus on atrial septal defect, ventricular septal defect, and persistent arterial duct. Pre-, intra-, and post-procedural imaging techniques will be systematically discussed. This position paper will offer algorithms that might help at a glance. The document is prepared for general cardiologists, trainees, medical students, imagers/technicians to select the most appropriate imaging modality and to detect the requested information for each specific lesion. It might serve as reference to which researchers could refer when setting up a (imaging) study.

Declining carbon (C) content in agricultural soils threatens soil fertility and makes soil prone to erosion, which could be rectified with organic soil amendments. In a 4‐yr field trial, we made a single application of three different organic sludges from the pulp and paper industry and studied their effects on cereal yield, soil C content, and fungal and bacterial composition. In laboratory rainfall simulations, we also studied the effects of the soil amendments on susceptibility to erosion and nutrient mobilization of a clay‐textured soil by measuring the quality of percolation water passing through 40‐cm intact soil monoliths during 2‐d rainfall simulations over four consecutive years after application. A nutrient‐poor fiber sludge reduced wheat yield in the first growing season, but there were no other significant effects on cereal yield or grain quality. An input of ∼8 Mg ha−1 C with the soil amendments had only minor effects on soil C content after 4 yr, likely because of fast microbe‐mediated turnover. The amendments clearly changed the fungal and bacterial community composition. All amendments significantly reduced suspended solids (SS) and total phosphorus (TP) concentrations in percolation water. The effect declined with time, but the reduction in SS and TP was still >25% 4 yr after application. We attributed the lower tendency for particle detachment in rain simulations to direct interactions of soil minerals with the added particulate organic matter and microbe‐derived compounds that stabilize soil aggregates. In soils with low organic matter content, pulp and paper industry by‐products can be a viable measure for erosion mitigation.

Food safety is always one of the most important issues for human being. With the variety of food, it is required to develop rapid, low-cost and convenient detection techniques for food safety. As a representative, paper-based detection techniques have developed rapidly from simple test papers to various microfluidic paper-based devices. The paper-based analytical devices combining paper platform with a variety of advanced analytical methods have shown great application prospects for rapid testing of food safety. In this review, the surface functionalization and modification of paper are introduced. Then, the construction and development of various detection techniques are discussed, including colorimetric analysis, fluorescent analysis, electrochemical analysis, surface enhanced Raman spectroscopic analysis, and multimethods on paper-based platforms for the application in rapid detection for food safety. Finally, the prospects and future challenges of rapid detection techniques in food safety are also discussed.

Background/Aims: The incidence of disease outbreaks in clinical settings arising from ultrasound examinations is well documented, and is a source of worry. The ultrasound transducers and the coupling gel are potential sources of these infections since they come in direct contact with the patient’s skin. In this study, we examine the efficacy of the widespread practice of the use of plain non-sterile tissue paper in some low-cost private ultrasound centres in our locality as a method of disinfecting ultrasound transducers after each use. Its potential impact on nosocomial infection management in clinical practice is also examined. Methods: Swab samples from convex ultrasound transducers before and after transabdominal scanning of three consecutive patients were obtained from 10 different ultrasound centres in urban and rural areas of Enugu state. Ultrasound coupling gel samples were equally obtained, and all samples cultured for bacteria growth which was quantified in colony-forming units per ml (CFU/ml) and reported in 1000/ml. Paired sampled t-test was used to check for significance in a reduction in a bacterial load before and after the transducer was cleaned. Results: Nine different bacterial strains were isolated. Staphylococcus aureus and Klebsiella spp had the highest percentage of occurrence in all centres. Significant bacteria growth was recorded in the morning before the examination, and plain tissue paper significantly reduced the bacteria load in the ultrasound transducer. Conclusion: Even though disinfecting ultrasound transducers with non-sterile plain tissue paper alone is statistically effective and has the potential to minimize nosocomial infection, it is however not clinically effective and hence not advised.

Cleaner production of sugars and pulp from renewable feedstocks has captured significant scientific attention in the recent past because they can be used for various end applications. In the papermaking industry, a major fraction of hemicellulosic sugars is lost during the pulping. The present study aims at retrieving these hemicellulosic sugars through alkali-, hot-water-, and acid-mediated extraction prior to pulping, which otherwise would have been lost during pulping and washing of pulp. These retrieved sugars can be used as feedstocks for renewable energy and value-added products. Different pretreatments were applied, aided with varying temperature, chemical concentrations, and time. Substantial amounts of total reducing sugars (TRSs) up to 21.98, 13.2, and 15.01% were extracted prior to pulping by acid, alkali, and hot-water pretreatments. Compositions of mono sugars present in the treated liquor were also characterized and confirmed by high-performance liquid chromatography analysis. The morphological changes in the wheat straw after pre-extraction were studied using the field emission gun scanning electron microscopy technique. Pulping of untreated and pretreated wheat straw was carried out at different alkali charges (12, 14, and 16% NaOH). Among all, acid-pretreated straw showed an increase in pulp yield by 10.9% at a 16% alkali charge. Physical strength properties of different pulps were further examined. Alkali- and hot-water-pretreated straw pulp retained 94.26 and 83.16% tensile indices and 92.43 and 87.02% burst indices, respectively. An increase in tear index up to 4.32, 2.01, and 2.30% for alkali-, hot-water-, and acid-pretreated straw pulp was achieved, respectively. Hot-water- and alkali-pretreated wheat straw was observed to be conducive for paper production. The integrated use of wheat straw for extraction of underutilized sugars and pulp production in this way may serve as a key stepping stone for future biorefinery designs in pulp and paper mills.

Process-monitoring laboratories in the pulp and paper industry generally use a combination of wet chemical analyses and physical measurements to certify the fitness of a production pulp for a specific end-use. These laboratory tests require time and the effort of trained personnel, limiting their utility for real-time process control. Here we show that Raman probes of unrefined cellulosic pulps, well-suited to the online measurement of in-process materials, can predict the quality attributes of manufactured papers. The accuracy of prediction improves when the covariance is modelled in a reduced measurement space selected by a data-driven, feature-selection technique referred to as a Template Oriented Genetic Algorithm (TOGA). TOGA, combined with discrete wavelet transform (DWT), isolates functional-group features that correlate best with mechanical properties paper derived from refined pulp. Paper makers refine market pulps to build sheet strength using a beating process that decreases freeness as it increases fibre-fibre bonding. Methods demonstrated here predict manufactured sheet properties obtainable after any specified degree of refining from the Raman spectrum of an unrefined pulp. This analysis capacity will enable both vendors of market pulp and makers of sheet paper to specify in advance the amount of beating required to produce a desired product, thereby saving cost and conserving resources.

The pulp and paper industry has a great impact in the world. It has been manufactured for ages and ages, it is still booming up as industry in small scale and large scale levels. Despite the fact that they produce printing and writing papers, paper rolls, packaging material etc. they also produce large amount of waste materials from their Industry by Manufacturing. This when left untreated leads to environmental pollution, harsh contamination and so on. As every industry has its own waste water treatment methods to recycle, reuse and reduce pollution. This Industry also has its own criteria to carry out the process of waste water treatment, yet it lags in being efficient in it. By the sources collected and compared with other kinds of industries it is listed that pulp and paper manufacturing industry is one of the top most industries to produce large volumes of waste water which has degradable organics at higher level. Hence this paper aims to study the manufacturing process, waste water components released and its effect on environment, the treatment methods carried out and how it can be improvised efficiently in forthcoming days

The paper industry wastewater even after bio-treatment at industrial scale is a major source of aquatic and soil pollution due to various unknown compounds. Hence, the study has focused on the detection of residual organic pollutants from the bleached and unbleached paper mill wastewater and both sources showed endocrine-disrupting compounds. The toxicity test with Phaseolus aureus seed germination showed inhibition of seed germination and alpha-amylase activity >25% in bleached and unbleached paper mill wastewater. The LC50 of Tubifex tubifex was noted of >50% after 48 hours incubation test. This revealed that the wastewater discharged from bleached paper mill is more toxic than unbleached paper mill waste this might be due to the use of more chemicals during bleaching and pulping process. This study has revealed that there is need to treat both paper mill wastewaters adequately prior to discharge.

In this study, a microfluidic paper-based analytical device (mu PAD) was integrated with a smartphone app capable of offline (without internet access) image processing and analysis for the rapid colorimetric detection of glucose. A self-inking stamp was used to form hydrophobic channels on a piece of paper-towel due to its superior water absorption efficiency. As demonstrated, the developed sensor was employed for the colorimetric detection of glucose in artificial saliva in the linear scope of 0 - 1 mM with a calculated detection limit of 29.65 mu M. The experimental results show that the quantitative analysis of glucose with the proposed smartphone platform could be completed in less than one minute. The app developed for the smartphone platform is capable of extracting the color-changing area with an embedded image processing tool which could address the problem of color uniformity in the detection zones of mu PAD. The integrated platform has great potential to be used for non-invasive measurements of glucose in body fluids, like tears, sweat and saliva.

The use of machine perfusion (MP) in liver transplantation (LT) is spreading worldwide. However, its efficacy has not been demonstrated, and its proper clinical use has far to go to be widely implemented. The Società Italiana Trapianti d’Organo (SITO) promoted the development of an evidence-based position paper. A 3-step approach has been adopted to develop this position paper. First, SITO appointed a chair and a cochair who then assembled a working group with specific experience of MP in LT. The Guideline Development Group framed the clinical questions into a patient, intervention, control, and outcome (PICO) format, extracted and analyzed the available literature, ranked the quality of the evidence, and prepared and graded the recommendations. Recommendations were then discussed by all the members of the SITO and were voted on via the Delphi method by an institutional review board. Finally, they were evaluated and scored by a panel of external reviewers. All available literature was analyzed, and its quality was ranked. A total of 18 recommendations regarding the use and the efficacy of ex situ hypothermic and normothermic machine perfusion and sequential normothermic regional perfusion and ex situ MP were prepared and graded according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) method. A critical and scientific approach is required for the safe implementation of this new technology.

Tissue paper conversion consists of the transformation of base tissue papers into finished tissue products to meet specific demands. When base tissue paper arrives at the converting line, it already holds different requirements that were met during its manufacture in the paper machine (e.g., grammage, bulk, tensile index, etc.). However, what happens during converting can still influence the performance and quality of the finished products. The current work addresses this topic and aims to evaluate the influence of converting conditions on the final softness. For that, two 5-ply finished tissue products were analyzed using different methodologies for their proper characterization in terms of softness and surface analysis. The analyzed products are composed by the same base tissue papers, but some changes were applied on their settings in the converting line. In particular, the base tissue papers arrangement and the embossing pressure affected the finished products, resulting in one of them being softer and more pleasant to touch, with a global handfeel (HF) value of 75.3 units, and the other revealed to be rougher and less pleasant, with a global handfeel (HF) value of 68.0 units.

This is a pre-copyedited, author-produced version of an article accepted for publication in European Journal of Preventive Cardiology following peer review. The version of record Kavousi, Pisinger, Barthelemy, Smedt, Koskinas, Marques-Vidal, Panagiotakos, Prescott, Tiberi, Vassiliou, Løchen. Electronic cigarettes and health with special focus on cardiovascular effects: position paper of the European Association of Preventive Cardiology (EAPC). European Journal of Preventive Cardiology (EJPC). 2020:2047487320941993, is available online at: https://doi.org/10.1177/2047487320941993. Background - Tobacco use is the single largest preventable risk factor for premature death of non-communicable diseases and the second leading cause of cardiovascular disease. In response to the harmful effects of tobacco smoking, the use of electronic cigarettes (e-cigarettes) has emerged and gained significant popularity over the past 15 years. E-cigarettes are promoted as safe alternatives for traditional tobacco smoking and are often suggested as a way to reduce or quit smoking. However, evidence suggests they are not harmless. Discussion - The rapid evolution of the e-cigarette market has outpaced the legislator’s regulatory capacity, leading to mixed regulations. The increasing use of e-cigarettes in adolescents and young individuals is of concern. While the long-term direct cardiovascular effects of e-cigarettes remain largely unknown, the existing evidence suggests that the e-cigarette should not be regarded as a cardiovascular safe product. The contribution of e-cigarette use to reducing conventional cigarette use and smoking cessation is complex, and the impact of e-cigarette use on long-term cessation lacks sufficient evidence. Conclusion - This position paper describes the evidence regarding the prevalence of e-cigarette smoking, uptake of e-cigarettes in the young, related legislations, cardiovascular effects of e-cigarettes and the impact of e-cigarettes on smoking cessation. Knowledge gaps in the field are also highlighted. The recommendations from the population science and public health section of the European Association of Preventive Cardiology are presented.

Background Cutaneous leishmaniasis (CL) is generally diagnosed by molecular methods, including PCR, using biopsy samples, skin scrapings and clinical exudates. In this study, we assessed the PCR performance for diagnosis of CL using skin of biopsy samples vs PCR of skin lesion exudate samples on filter paper and compared the diagnostic concordance of PCR using both sampling methods. Methods We assessed the PCR performance using 80 skin biopsy samples and 80 filter paper samples containing exudates from skin lesions obtained from 74 patients with clinical suspicion of CL in Cusco, Peru. Results : PCR using skin biopsy samples had superior diagnostic accuracy compared with filter paper PCR (62.5% [50/80] vs 38.7% [31/80], respectively; p˂0.005) and the diagnostic concordance between both sampling methods was ‘moderate’ (kappa coefficient=0.50, 95% CI 0.98 to 1.0). Conclusions PCR using biopsy samples remains the standard for diagnosis of CL.

The present study was undertaken to know the effect of common mixed pulp and paper mill effluent discharge released from century pulp and paper mill Lalkuan, Nainital Uttarakhand on the blood morphology of Heteropneustes fossilis (Singhi). The various morphological changes were observed in the specimen, randomly collected with the help of cast net from (3 sites) different locations. The maximum changes were observed in the specimen collected from site 3 in compare to site 1 and 2 respectively. The formation of inclusion bodies, sickle cells, Cabot rings and ovalocytes were recorded along with nuclear fusion, membrane disruption and cell clumping of blood cells in the specimen collected from the site 3 (i.e. nearer to source of discharge) while in the specimen collected from site 2, the formation of tear drop cell, target cells, spherocytes and bi-nucleated cells were recorded along with the activity of cell clumping. The changes were found less in the specimen collected from site 1 in compare to the specimen of site 2 and 3 i.e. formation of ovalocytes, spherocytes and microcytes with the activity of membrane degeneration and agglutination in blood cells.

Workers in a print shop are exposed to photocopier toner dust and paper dust over a prolonged period of time. However, there are only rare case reports of toner and paper dust induced lung damage in humans. We reviewed our consultation files for a period of 30 years from 1987 to 2018 to look for cases with a diagnosis of giant cell interstitial pneumonia (GIP), printer toner exposure and paper dust exposure resulting in lung disease. There were two cases which met our inclusion criteria. Slides, clinical histories and imaging were reviewed. Both the patients had worked in print shops, and had no history of exposure to hard metals. Patient 1 presented with shortness of breath and cough over several months, while patient 2 was asymptomatic at presentation. Both the patients underwent surgical lung biopsies. Histopathologic examination from both the cases showed a spectrum of pathology, including features of GIP, desquamative interstitial pneumonia, chronic bronchiolitis with lymphoid hyperplasia, and particulate matter consistent with toner. Energy dispersive spectroscopy was performed on one case, and it revealed no cobalt or tungsten particles. The unusual combination of findings is very suggestive that toner particles with or without paper dust exposure were responsible for the pathologic changes in the lungs of these patients. This possibility should be explored further with additional patients who work in print shops where they are exposed to paper dust and paper toner and have signs or symptoms of diffuse lung disease.

Objectives: The objective of the study was to study the compressive strength of the partially replaced paper mill waste in cement. Methods/ Statistical analysis: The concrete cube specimen were prepared for compressive strength test. In this study, the cement has been replaced with 20%, 30%, 40% and 50% of hypo sludge. The specimens were cured for two different ages (7 days and 28 days) and tested for compressive strength. The quadratic polynomial prediction equation was proposed using Response Surface Methodology (RSM). The prediction model was developed using the experimental output results. Thus, the prediction model facilitates the further research work to be conducted by researchers on paper mill waste replacement. The rate analysis was also further carried out to show the cost effectiveness of using the waste replacement in cement. Findings: The test was conducted on the compressive strength (7 days and 28 days) of control specimen (0%) and partial replacement of 20%, 30%, 40% and 50% of cement using the hypo sludge. Thus, 20% replacement of cement using hypo sludge has shown good compressive strength than the control specimen. The cost of 20% paper mill waste was less when compared to the cost of control specimen. Novelty/ Applications: The compressive strength of 20% partial replacement of paper mill waste in cement can be used in further construction. The prediction model can be used to predict the future compressive strength of partially replaced paper mill waste concrete. Keywords: Ordinary Portland cement; Paper mill waste; Hypo sludge; Partial replacement; RSM

Directed evolution has become an important method to unleash the latent potential of enzymes to make them uniquely suited for human purposes. However, the need for a large reagent volume and sophisticated instrumentation hampers its broad implementation. In an attempt to address this problem, here we report a paper-based high-throughput screening approach that should find broad application in generating desired enzymes. As an example case, the dehalogenation reaction of the halohydrin dehalogenase was adopted for assay development. In addition to visual detection, quantitative measurements were performed by measuring the color intensity of an image that was photographed by a smartphone and processed using ImageJ free software. The proposed method was first validated using a gold standard method and then applied to mutagenesis library screening with reduced consumption of reagents (i.e., ≤ 10 μl per assay) and a shorter assay time. We identified two active mutants (P135A and G137A) with improved activities toward four tested substrates. The assay not only consumes less reagents but also eliminates the need for expensive instrumentation. The proposed method demonstrates the potential of paper-based whole-cell screening coupled with digital image colorimetry as a promising approach for the discovery of industrially important enzymes.Key Points• A frugal method was developed for directed enzyme evolution.• Mutagenesis libraries were successfully screened on a paper platform.• Smartphone imaging was efficiently used to measure enzyme activities.

We demonstrate a versatile and easily fabricated paper-based CO2 sensor. The sensor consists of a specially designed fluorescent color-shift chromophore infused into standard filter paper. The emission color of the resulting fluorescent paper changes upon exposure to CO2 due to the formation of carbonic acid, which underlies the sensing mechanism. By using a ratiometric method, the undesirable effects of photobleaching can be eliminated, leading to a stable and repeatable sensor performance. These multiuse sensors have a response time on the order of 1 min and feature low detection limits for a paper-based CO2 gas sensor, suggesting possible low-cost applications in smart buildings or other facilities in which CO2 levels are required to be continuously monitored.

Anaerobic-oxic (AO) systems have been extensively adopted for the biological treatment of wastewater from recycled paper mills, which is characterized by high chemical oxygen demand (COD) concentrations and contains hundreds of organic compounds. In this study, an up-flow anaerobic sludge blanket (UASB) served as the anaerobic treatment of recycled paper mill wastewater. Then, either a sequential batch reactor (SBR) or a sequential batch biofilm reactor (SBBR) were adopted as aerobic treatment to treat the UASB effluent respectively. Parameters such as COD, BOD5, and TSS were measured to compare the treatment performance of SBR and the SBBR. After 80 days’ operation, COD removal efficiency of SBR and SBBR were 21.79 ± 3.4% and 38.38 ± 2.69% respectively; TSS removal efficiencies were 20.84 ± 5.15% and 47.02 ± 5.84% respectively. The results indicated that SBR was effective for removing residual organic matter in UASB effluent. However, SBBR showed significant advantages for the removal of COD and total suspended solids (TSS), which are ascribed to the effective biomass retention and biofiltration of SBBR.