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The pursuit for sustainability in the papermaking industry calls for the elimination or reduction of synthetic additives and the exploration of renewable and biodegradable alternatives. Cellulose nanofibrils (CNFs), due to their inherent morphological and biochemical properties, are an excellent alternative to synthetic additives. These properties enable CNFs to improve the mechanical, functional, and barrier properties of different types of paper. The nanosize diameter, micrometre length, semicrystalline structure, high strength, and modulus of CNFs have a direct influence on the mechanical properties of paper, such as tensile index, burst index, Scott index, breaking length, tear index, Z-strength, E-modulus, strain at break, and tensile stiffness. This review details the role played by CNFs as an additive to improve strength properties of paper and the factors affecting the improvement in paper quality when CNFs are added as additives. The paper also includes techno-economic aspects of the process and identifies areas that need further research.

Infections caused by resistant microorganisms are a complex global public health challenge, and the way to combat the increase of resistance is the development of more modern and faster techniques for resistance detection. This study aimed to evaluate the transport of inactivated bacteria impregnated in a filter paper disk to detect carbapenem resistance genes by multiplex real-time PCR (qPCR) using high-resolution melting (HRM). A total of 88 isolates of 10 different species of Enterobacterales harboring well-characterized carbapenem resistance genes were evaluated. A full 10-µL loop of fresh growth of bacteria were impregnated in a filter paper disk, which was left at room temperature for 2 days in order to simulate the time spent in transportation. Bacterial inactivation was performed with 70% ethanol at 15 min. Afterwards, the DNA was extracted from the paper disks for further analysis by qPCR HRM. The time of 15 min in 70% ethanol was enough to inactivate all the isolates tested. It was possible to correctly identify the presence of the carbapenem resistance gene by HRM qPCR in 87 isolates (98.87%) that were transported in the filter paper disks. Our results indicated that it is possible to use filter paper to transport inactivated bacteria and to identify carbapenem resistance genes by qPCR HRM. This alternative tends to facilitate the access to this technology by many laboratories which do not have the qPCR equipment.

Malnutrition, muscle loss, and cachexia are prevalent in cancer and remain key challenges in oncology today. These conditions are frequently underrecognized and undertreated and have devastating consequences for patients. Early nutrition screening/assessment and intervention are associated with improved patient outcomes. As a multifaceted disease, cancer requires multimodal care that integrates supportive interventions, specifically nutrition and exercise, to improve nutrient intake, muscle mass, physical functioning, quality of life, and treatment outcomes. An integrated team of healthcare providers that incorporates societies’ recommendations into clinical practice can help achieve the best possible outcomes. A multidisciplinary panel of experts in oncology, nutrition, exercise, and medicine participated in a 2-day virtual roundtable in October 2020 to discuss gaps and opportunities in oncology nutrition, alone and in combination with exercise, relative to current evidence and international societies’ recommendations. The panel recommended five principles to optimize clinical oncology practice: (1) position oncology nutrition at the center of multidisciplinary care; (2) partner with colleagues and administrators to integrate a nutrition care process into the multidisciplinary cancer care approach; (3) screen all patients for malnutrition risk at diagnosis and regularly throughout treatment; (4) combine exercise and nutrition interventions before (e.g., prehabilitation), during, and after treatment as oncology standard of care to optimize nutrition status and muscle mass; and (5) incorporate a patient-centered approach into multidisciplinary care.

In this research work, we present a synthesis of silver and cobalt bimetal nanoparticles stabilized by a carboxymethyl cellulose biopolymer (CMC-AgCo) and its coating on a cellulose filter paper (CFP) to prepare the dip-catalyst. All the prepared samples were subjected to characterization by scanning electron microscopy for surface morphology, EDX, XRD and thermogravimetric analysis. The catalytic properties of the CFP/CMC-AgCo as dip-catalysts were evaluated in the reduction of organic nitroaromatic pollutants of 2,6-dinitrophenol to 2,6-diaminophenol as well as the 4-nitrophenol to 4-aminophenol. It was found that the reduction reaction advanced with the pseudo-first-order kinetics. The CFP/CMC-AgCo catalyzed the 2,6-diaminophenol and 4-nitrophenol with a reaction rate constant of 0.1244 and 0.177 min− 1, respectively. The separation of the CFP/CMC-AgCo was easy as it required a simple pulling of the strip from the reaction medium. Importantly, the catalytic reaction rates and conversion percentages of the two nitroaromatics were well-maintained for multiple times during recycling experiments.

The study aimed at the use of char produced during pyrolysis of mix plastic waste. It further focused on producing activated carbon from char and also found its efficacy as efficient adsorbent for treatment of pulp and paper mill wastewater. The activated carbon was characterized in comparison with raw char for their physical, surface and adsorptive properties. Batch type adsorption experiments were carried out using 100 ml wastewater to observe the individual effectiveness using five different variables such as adsorbent dose (0.25–2.0 g), pH (6–10), time (5–24 h), agitation speed (100–200 rpm) and temperature (30–50 °C) by keeping other variables constant which helped to find out the effective range of all the variables. The competency was evaluated on the basis of colour and lignin content of pulp and paper industry wastewater. Once the effective range of different variables was identified, the statistical analysis was conducted to monitor the mutual impact on the reduction in colour and lignin contents in wastewater. From the statistical design applied, the best result was obtained at activated carbon dose (1.25 g), pH (8.0), contact time (7 h), agitation speed (184 rpm) and temperature (40 °C). The study resulted in reduction of 96.48% in colour and 94.25% in lignin at optimized condition in comparison with 87.37 and 80.44%, respectively, at unoptimized conditions. A potential increase in reduction of 9.0% in colour and 14.0% in lignin content was achieved after optimization through statistical design that confirmed its usefulness.

This study focused on the applying endo-xylanases to reduce the use of bleaching agent, coupled with the production of xylooligosaccharides (XOs), in mulberry paper making. Paper mulberry pulp (PMP) was consecutively prepared from paper mulberry bark by traditional NaOH-treatment, and two types of thermostable endo-xylanase from Streptomyces thermovulgaris TISTR1948 (wild-type and recombinant endo-xylanases) were employed in the biobleaching of PMP. This process was optimized to achieve maximum XOs yields and the highest PMP quality. The optimal condition was an enzyme dosage of 125 U/g PMP at 12 h of reaction time, both in a 500 mL laboratory bottle and a 150 L reactor. The mixture obtained from the reactor was separated as liquid of XOs derived from PMP (PMP-XOs) and solid biobleached PMP. The PMP-XOs from wild-type endo-xylanase were composed of 31.6% xylopentaose (X5), 30.9% xylohexaose and higher-degree XOs (X ≥ 6), and 11.7% xylobiose (X2), whereas 76.6% of X5 and 8.6% of X2 were the main products from recombinant endo-xylanase. The PMP-XOs derived from both endo-xylanase types exhibited high antioxidant activities, reducing power, phenolic contents, and prebiotic efficacy. In addition, the application of both endo-xylanases enhanced the brightness of PMP by 5.1% and 3.5%, and reduced the kappa number by 9.1% and 3.6%, respectively. Biobleached PMP was subsequently subjected to the NaOCl bleaching step to produce the mulberry paper. This approach could reduce NaOCl consumption by 20–25%, making it an environmentally friendly alternative. The production of valuable prebiotics, such as PMP-XOs, further enhances the economic viability of this approach.

Background Coronavirus Disease 2019 (COVID-19), firstly reported in China last November 2019, became a global pandemic. It has been shown that periods of isolation may induce a spike in alcohol use disorder (AUD). In addition, alcohol-related liver disease (ALD) is the most common consequence of excessive alcohol consumption worldwide. Moreover, liver impairment has also been reported as a common manifestation of COVID-19. Aims The aim of our position paper was to consider some critical issues regarding the management of ALD in patients with AUD in the era of COVID-19. Methods A panel of experts of the Italian Society of Alcohology (SIA) met via “conference calls” during the lockdown period to draft the SIA’s criteria for the management of ALD in patients with COVID-19 as follows: (a) liver injury in patients with ALD and COVID-19 infection; (b) toxicity to the liver of the drugs currently tested to treat COVID-19 and the pharmacological interaction between medications used to treat AUD and to treat COVID-19; (c) reorganization of the management of compensated and decompensated ALD and liver transplantation in the COVID-19 era. Results and Conclusions The COVID-19 pandemic has rapidly carried us toward a new governance scenario of AUD and ALD which necessarily requires an in-depth review of the management of these diseases with a new safe approach (management of out-patients and in-patients following new rules of safety, telemedicine, telehealth, call meetings with clinicians, nurses, patients, and caregivers) without losing the therapeutic efficacy of multidisciplinary treatment.

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.

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.

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.

Many studies have been conducted on measuring avian influenza viruses and their hemagglutinin (HA) antigens via electrochemical principles; most of these studies have used gold electrodes on ceramic, glass, or silicon substrates, and/or labeling for signal enhancement. Herein, we present a paper-based immunosensor for label-free measurement of multiple avian influenza virus (H5N1, H7N9, and H9N2) antigens using flexible screen-printed carbon nanotube-polydimethylsiloxane electrodes. These flexible electrodes on a paper substrate can complement the physical weakness of the paper-based sensors when wetted, without affecting flexibility. The relative standard deviation of the peak currents was 1.88% when the electrodes were repeatedly bent and unfolded twenty times with deionized water provided each cycle, showing the stability of the electrodes. For the detection of HA antigens, approximately 10-μl samples (concentration: 100 pg/ml–100 ng/ml) were needed to form the antigen–antibody complexes during 20–30 min incubation, and the immune responses were measured via differential pulse voltammetry. The limits of detections were 55.7 pg/ml (0.95 pM) for H5N1 HA, 99.6 pg/ml (1.69 pM) for H7N9 HA, and 54.0 pg/ml (0.72 pM) for H9N2 HA antigens in phosphate buffered saline, and the sensors showed good selectivity and reproducibility. Such paper-based sensors are economical, flexible, robust, and easy-to-manufacture, with the ability to detect several avian influenza viruses.

Bone mineral abnormalities (defined as Chronic Kidney Disease Mineral Bone Disorder; CKD-MBD) are prevalent and associated with a substantial risk burden and poor prognosis in CKD population. Several lines of evidence support the notion that a large proportion of patients receiving maintenance dialysis experience a suboptimal biochemical control of CKD-MBD. Although no study has ever demonstrated conclusively that CKD-MBD control is associated with improved survival, an expanding therapeutic armamentarium is available to correct bone mineral abnormalities. In this position paper of Lombardy Nephrologists, a summary of the state of art of CKD-MBD as well as a summary of the unmet clinical needs will be provided. Furthermore, this position paper will focus on the potential and drawbacks of a new injectable calcimimetic, etelcalcetide, a drug available in Italy since few months ago.

In order for enterprise imaging to be successful across a multitude of specialties, systems, and sites, standards are essential to categorize and classify imaging data. The HIMSS-SIIM Enterprise Imaging Community believes that the Digital Imaging Communications in Medicine (DICOM) Anatomic Region Sequence, or its equivalent in other data standards, is a vital data element for this role, when populated with standard coded values. We believe that labeling images with standard Anatomic Region Sequence codes will enhance the user’s ability to consume data, facilitate interoperability, and allow greater control of privacy. Image consumption—when a user views a patient’s images, he or she often wants to see relevant comparison images of the same lesion or anatomic region for the same patient automatically presented. Relevant comparison images may have been acquired from a variety of modalities and specialties. The Anatomic Region Sequence data element provides a basis to allow for efficient comparison in both instances. Interoperability—as patients move between health care systems, it is important to minimize friction for data transfer. Health care providers and facilities need to be able to consume and review the increasingly large and complex volume of data efficiently. The use of Anatomic Region Sequence, or its equivalent, populated with standard values enables seamless interoperability of imaging data regardless of whether images are used within a site or across different sites and systems. Privacy—as more visible light photographs are integrated into electronic systems, it becomes apparent that some images may need to be sequestered. Although additional work is needed to protect sensitive images, standard coded values in Anatomic Region Sequence support the identification of potentially sensitive images, enable facilities to create access control policies, and can be used as an interim surrogate for more sophisticated rule-based or attribute-based access control mechanisms. To satisfy such use cases, the HIMSS-SIIM Enterprise Imaging Community encourages the use of a pre-existing body part ontology. Through this white paper, we will identify potential challenges in employing this standard and provide potential solutions for these challenges.

A method for treating cellulose paper using the ionic liquid 1-butyl-3-methylimidazolium chloride ([BMIM]Cl) was developed. The treatment was intended to reform the paper structure. Filter paper was immersed in 20 g of molten [BMIM]Cl at 80 °C for 20–80 s and then washed with ethanol and distilled water. The treated paper was then immersed in tert-butyl alcohol before drying in a freeze dryer for 30 min. Next, polyethylene glycol (PG) and trichloromethylsilane were fixed to freeze-dried paper. The paper treated with [BMIM]Cl had a higher specific surface area than that not treated with [BMIM]Cl, and the specific surface area increased as the treatment time increased. The amount of PG fixed to the paper increased as the specific surface area of the paper increased, and PG improved moisture retention. The degree to which the moisture retention was improved was therefore related to the increase in the specific surface area caused by [BMIM]Cl treatment. Addition of trichloromethylsilane to the paper treated with [BMIM]Cl improved the hydrophobicity, and this was caused by the [BMIM]Cl treatment. Overall, [BMIM]Cl treatment was effective for reforming the paper structure and this improved the amount of functional material that could be fixed to the paper.

In the present analysis, a new experimental pilot plant system for exploring resin-impregnated paper (RIP) bushing technology was conducted. Experimental and numerical studies were carried out on the resin infusion and impregnation processes in the paper condenser core of a RIP bushing. An innovative approach for the molding process (named molding method B) of a commercial RIP bushing was implemented. For this method, the homogeneity of the paper winding process was controlled precisely. The filling process was conducted by gravity due to the difference of heights between two vacuumed chambers and from bottom to top in the mold. The flow front position and infusion time were measured experimentally and used to obtain the axial permeability of the paper condenser core analytically and numerically. The results indicate that the molding methods have a significant effect on the RIP bushing quality, homogeneous filling, and impregnating process time. Also, it was found that homogeneity of the paper winding process and, consequently, uniform axial velocity of resin flow in the radial direction is the most effective factor to eject the air. Finally, it was recognized that the determination of axial permeability in the case of transient flow is novel in comparison with conventional procedures such as Darcy relation of steady flows. By decreasing the paper thickness from 0.3 to 0.2 mm, the permeability decreased from 8.84 × 10−10 to 4.52 × 10−10 m2. The microstructure of the core illustrates that the axial permeability of the crepe paper condenser core is considerably affected by the variation of the paper thickness.

A novel paper-based capacitance mast cell sensor has been designed and developed for real-time monitoring of the major peanut allergen Ara h 2. In this study, we created the 3D paper chip printed with carbon electrodes as a non-contact capacitance sensing platform. To improve the conductivity and biocompatibility of the cellulose paper, a polyvinyl alcohol (PVA)-gelatin methacryloyl (GelMA)-nano-hydroxyapatite (nHAP) composite hydrogel (PGHAP gel) was employed to fabricate the prepared paper chip. When rat basophilic leukemia mast cells (RBL-2H3) are immobilized and cultured in the 3D culture system consisting of PGHAP gel and paper fibers, identification signals of Ara h 2 could be specifically monitored non-contact and real-time by capacitance change measurement. This 3D structure combined with time-lapse monitoring completes the capacitance cell sensor. Results indicate that Ara h 2 has given a remarkable decrease to the capacitance in dose-dependent range from 0.1 to 100 ng/mL. Therefore, the real-time cell allergic response could be accurately monitored by this low-cost, disposable cell sensor, which supplies a novel and effective pathway for the rapid and accurate evaluation for food allergens.

The diagnosis of dengue infection is still a critical factor determining success in the clinical management and treatment of patients. Here, the development of microfluidic paper-based analytical devices (μPADs) utilizing a sandwich immunoassay on wax patterned paper functionalized with anti-dengue NS1 monoclonal antibodies for point-of-care detection of dengue NS1 (DEN-NS1-PAD) is reported. Various assay conditions, including the length of the channel and diluent, were optimized, and the response detected by the naked eye and digitized images within 20–30 min. The DEN-NS1-PAD was successfully tested in the field for detecting dengue NS1 in buffer, cell culture media, and human serum. The limit of detection (LoD) of the DEN-NS1-PAD obtained with the naked eye, scanner, and a smartphone camera was 200, 46.7, and 74.8 ng mL−1, respectively. The repeatability, reproducibility, and stability of the DEN-NS1-PAD were also evaluated. High true specificity and sensitivity in the serum of pediatric patients were observed. These evaluation results confirm that the DEN-NS1-PAD can potentially be used in point-of-care dengue diagnostics, which can significantly impact on the spreading of mosquito-borne diseases, which are likely to become more prevalent with the effects of global warming.

Chronic kidney disease (CKD) represents a major public health issue worldwide and entails a high burden of cardiovascular events and mortality. Dyslipidaemia is common in patients with CKD and it is characterized by a highly atherogenic profile with relatively low levels of HDL-cholesterol and high levels of triglyceride and oxidized LDL-cholesterol. Overall, current literature indicates that lowering LDL-cholesterol is beneficial for preventing major atherosclerotic events in patients with CKD and in kidney transplant recipients while the evidence is less clear in patients on dialysis. Lipid lowering treatment is recommended in all patients with stage 3 CKD or worse, independently of baseline LDL-cholesterol levels. Statin and ezetimibe are the cornerstones in the management of dyslipidaemia in patients with CKD, however alternative and emerging lipid-lowering therapies may acquire a central role in near future. This position paper endorsed by the Italian Society of Nephrology aims at providing useful information on the topic of dyslipidaemia in CKD and at assisting decision making in the management of these patients.

In recent years, the paper industry is developing strongly and plays an important role in the industry of our country. Most of the factories have their own wastewater treatment systems. In general, wastewater in paper mill is very difficult to treat and to handle, especially color (Pt–Co) index. In this research, activated carbon with a high surface area and high adsorption capacity was prepared from corn stalks, an agricultural by-products. The suitable conditions of pyrolysis were investigated to prepare activated bio-char from corn stalk. Then, as-obtained carbon material was applied for color treatment of effluent from paper mill. The activated carbon showed high efficiency and capability in color removal of waste water, with the color reduction of 77%.

The present study investigated the adsorption efficiency of laboratory-produced activated carbon (AC) from pyrolysis of mix waste plastic (MWP) for treating paper mill effluent. In the present work, adsorbent was prepared from MWP and was characterized in comparison to commercial adsorbents. A lab scale adsorption study was performed in 100 mL batch experiments to get the optimized condition of different variables by eliminating the pollutants from EOP wastewater and was found as AC dose 10.0 g/100 mL, temperature 35 °C, agitation rate 150 rpm, contact time 7 h, and pH 9.0. The EOP wastewater was analyzed for different quality parameters after treating with prepared AC (PW-AC) and two commercial ACs (SC-AC and M-AC) at optimized conditions. The efficiency of ACs was found to be in order as M-AC>PW-AC>SC-AC. The optimized conditions were applied for the removal of chlorophenols using different ACs in comparison to control EOP wastewater. The study revealed that elimination of chlorophenolic compounds from EOP wastewater (7824 ng/L) was the highest in M-AC treatment followed by PW-AC and SC-AC, i.e., 1426 ng/L, 1759 ng/L, and 2200 ng/L, respectively. PW-AC had major impacts on reduction of chloroguaiacols (82%) as well as chlorophenols (80.7%) that were present in chief amount in EOP wastewater. PW-AC was found to be a capable adsorbent for the removal of chlorophenolic compounds from the most toxic bleaching effluents of pulp and paper industry.

Propofol is a widely used intravenous anesthetic agent in sedation and general anesthesia. To improve the safety and maintain the depth of anesthesia, it is important to develop a rapid, sensitive, and reliable method to monitor the concentration of propofol in blood during anesthesia continuously. Here, we present a novel strategy based on paper spray ionization-mass spectrometry (PSI-MS) to detect propofol. Samples (in 10 μL) were mixed with methanol as protein precipitation solvent and 2,6-dimethylphenol as internal standard. Protein micro-precipitation was achieved with methanol by vortexing and centrifuging for 5 s each, and propofol was extracted to the supernatant. PSI-MS was performed in negative ionization mode, and MS signal lasted for 1 min. The analysis of a single sample was completed within 2 min. The area ratios of propofol to internal standard were calculated for quantification. Limit of detection of 5.5 ng mL−1 and limit of quantification of 18.2 ng mL−1 were achieved for propofol in whole blood. Calibration curve was linear in the range of 0.02–10 μg mL−1. The developed method was used successfully in monitoring the propofol concentration in 3 patients’ whole blood during anesthesia, showing its further application in controlling and feeding-back target concentration infusion.

Direct oral anticoagulants (DOAC) are mostly prescribed to prevent cardioembolic stroke in patients with non-valvular atrial fibrillation (AF). An increasing number of guidelines recommend DOAC in AF patients with preserved renal function for the prevention of thromboembolism and an increased use of DOAC in daily practice is recorded also in elderly patients. Aging is associated with a reduction of glomerular filtration rate and impaired renal function, regardless of the cause, increases the risk of bleeding. Multiple medication use (polypharmacy) for treating superimposed co-morbidities is common in both elderly and chronic kidney disease (CKD) patients and drug-drug interaction may cause accumulation of DOAC, thereby increasing the risk of bleeding. There is uncertainty on the safety profile of DOAC in patients with CKD, particularly in those with severely impaired renal function or end stage renal disease, due to the heterogeneity of studies and the relative paucity of data. This document reports the position of three Italian scientific societies engaged in the management of patients with atrial fibrillation who are treated with DOAC and present with CKD.

Infections caused by foodborne microorganisms are a great threat to the global environment and public healthcare today. Thus, rapid, portable and sensitive assays that can realize the identification of foodborne bacteria are highly desired. In this study, a smart fluorescent and colorimetric dual-readout sensing system has been established for simple and rapid E. coli determination by utilizing the Cu2+-triggered oxidation of o-phenylenediamine (OPD). Initially, Cu2+ can oxidize OPD to OPDox, resulting in an orange-yellow fluorescence and visible pale-yellow color. However, E. coli can effectively reduce Cu2+ into Cu+, inhibiting the Cu2+-triggered oxidation of OPD to OPDox. Consequently, the introduction of E. coli can turn off both the fluorescence and the UV-vis absorbance signals of the OPD-Cu2+ system, illustrating an original mechanism for fluorescent and colorimetric dual-channel detection of E. coli. Moreover, a filter paper-based visual sensor was built and coupled with OPD-Cu2+ solution under the assistance of a UV lamp. The as-prepared sensor can detect E. coli quantitatively with the help of a typical smartphone color-scanning application (APP). Thus, this study offers a valid dual-mode assay for sensitive and on-site visible detection of E. coli, guaranteeing the reliability of the results and is more attractive for practical use. Graphical Abstract Schematic illustration of the smartphone-integrated sensing system for fluorescent and colorimetric dual-channel detection of E. coli based on the Cu2+-OPD system.

Contains fulltext : 220920.pdf (Publisher’s version ) (Open Access) Patients with myocardial infarction and non-obstructive coronary arteries (MINOCA), defined as angiographic stenosis

Background The study tests the effects of data collection modes on patient responses associated with the multi-item measures such as Patient-Reported Outcomes Measurement System (PROMIS®), and single-item measures such as Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE), and Numerical Rating Scale (NRS) measures. Methods Adult cancer patients were recruited from five cancer centers and administered measures of anxiety, depression, fatigue, sleep disturbance, pain intensity, pain interference, ability to participate in social roles and activities, global mental and physical health, and physical function. Patients were randomized to complete the measures on paper (595), interactive voice response (IVR, 596) system, or tablet computer (589). We evaluated differential item functioning (DIF) by method of data collection using the R software package, lordif. For constructs that showed no DIF, we concluded equivalence across modes if the equivalence margin, defined as ± 0.20 × pooled SD, completely surrounds 95% confidence intervals (CI's) for difference in mean score. If the 95% CI fell totally outside the equivalence margin, we concluded systematic score difference by modes. If the 95% CI partly overlaps the equivalence margin, we concluded neither equivalence nor difference. Results For all constructs, no DIF of any kind was found for the three modes. The scores on paper and tablet were more comparable than between IVR and other modes but none of the 95% CI’s were completely outside the equivalence margins, in which we established neither equivalence nor difference. Percentages of missing values were comparable for paper and tablet modes. Percentages of missing values were higher for IVR (2.3% to 6.5% depending on measures) compared to paper and tablet modes (0.7% to 3.3% depending on measures and modes), which was attributed to random technical difficulties experienced in some centers. Conclusion Across all mode comparisons, there were some measures with CI’s not completely contained within the margin of small effect. Two visual modes agreed more than visual-auditory pairs. IVR may induce differences in scores unrelated to constructs being measured in comparison with paper and tablet. The users of the surveys should consider using IVR only when paper and computer administration is not feasible.

Oily water contamination has been sighted as one of the most global environmental pollution. Herein, copper hydroxide nanorods layer was constructed onto cellulosic filter paper surface cured with polydopamine, Ag nanoparticles, and Cu NPs through immersion method. This work has been aimed to produce a superhydrophobic and superoleophilic cellulosic filter paper. The structure, crystalline, and morphological properties of these modified cellulosic filter paper were investigated. Scanning electron microscope images confirmed that the modified surface was rougher compared with the pristine surface. The contact angle measurement confirmed the hydrophobic nature of these modified surfaces with a water contact angle of 169.7°. The absorption capacity was 8.2 g/g for diesel oil and the separation efficiency was higher than 99%. It was noted that the flux in the case of low viscosity solvent as n-hexane was 9663.5 Lm−2 h−1, while for the viscous oil as diesel was 1452.7 Lm−2 h−1.

Purpose To study respiratory effects of exposure to soft paper dust exposure, a relationship that is rarely studied. Methods Soft tissue paper mill workers at a Swedish paper mill were investigated using a questionnaire and lung function and atopy screening. Spirometry without bronchodilation was performed with a dry wedge spirometer, and forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) were obtained and expressed as percent predicted. Exposure to soft paper dust was assessed from historical stationary and personal measurements of total dust, in addition to historical information about the work, department, and production. The impact of high exposure to soft paper dust (> 5 mg/m3) vs. lower exposure ≤ 5 mg/m3, as well as cumulative exposure, was analyzed using multiple linear regression models. Multivariate models were adjusted for smoking, atopy, gender, and body mass index. Results One hundred ninety-eight current workers (124 male and 74 female) were included. There were significant associations between both cumulative exposure and years of high exposure to soft paper dust and impaired lung function. Each year of high exposure to soft paper dust was associated with a 0.87% decrease in FEV1 [95% confidence interval (CI) − 1.39 to − 0.35] and decreased FVC (− 0.54%, 95% CI − 1.00 to − 0.08) compared to the lower exposed workers. Conclusions The present study shows that occupational exposure to soft paper dust (years exceeding 5 mg/m3 total dust) is associated with lung function impairment and increased prevalence of obstructive lung function impairment.

Background Microfluidic chip detection technology is considered a potent tool for many bioanalytic applications. Rapid detection of foodborne pathogens in the early stages is imperative to prevent the outbreak of foodborne diseases, known as a severe threat to human health. Conventional bacterial culture methods for detecting foodborne pathogens are time-consuming, laborious, and lacking in pathogen diagnosis. To overcome this problem, we have created an embedded paper-based microchip based on isothermal loop amplification (LAMP), which can rapidly and sensitively detect foodborne pathogens. Results We embed paper impregnated with LAMP reagent and specific primers in multiple reaction chambers of the microchip. The solution containing the target pathogen was injected into the center chamber and uniformly distributed into the reaction chamber by centrifugal force. The purified DNA of Escherichia coli O157:H7, Salmonella spp., Staphylococcus aureus, and Vibrio parahaemolyticus has been successfully amplified and directly detected on the microchip. The E. coli O157:H7 DNA was identified as low as 0.0134 ng μL− 1. Besides, the potential of this microchip in point-of-care testing was further tested by combining the on-chip sample purification module and using milk spiked with Salmonella spp.. The pyrolyzed milk sample was filtered through a polydopamine-coated paper embedded in the inside of the sample chamber. It was transported to the reaction chamber by centrifugal force for LAMP amplification. Then direct chip detection was performed in the reaction chamber embedded with calcein-soaked paper. The detection limit of Salmonella spp. in the sample measured by the microchip was approximately 12 CFU mL− 1. Conclusion The paper embedded LAMP microchip offers inexpensive, user-friendly, and highly selective pathogen detection capabilities. It is expected to have great potential as a quick, efficient, and cost-effective solution for future foodborne pathogen detection.

The coronavirus disease 2019 (COVID-19) pandemic has led to preventive measures worldwide. With the decline of infection rates, less stringent restrictions for sports and exercise are being implemented. COVID-19 is associated with significant cardiovascular complications; however there are limited data on cardiovascular complications and long-term outcomes in both competitive (elite) athletes and highly active individuals. Based on different categories of disease severity (asymptomatic, regional/systemic symptoms, hospitalisation, myocardial damage, and/or myocarditis), in this point-of-view article we offer the (sports) cardiologist or sports physician in the Netherlands a practical guide to pre-participation screening, and diagnostic and management strategies in all athletes >16 years of age after COVID-19 infection.

Cerebellar reserve refers to the capacity of the cerebellum to compensate for tissue damage or loss of function resulting from many different etiologies. When the inciting event produces acute focal damage (e.g., stroke, trauma), impaired cerebellar function may be compensated for by other cerebellar areas or by extracerebellar structures (i.e., structural cerebellar reserve). In contrast, when pathological changes compromise cerebellar neuronal integrity gradually leading to cell death (e.g., metabolic and immune-mediated cerebellar ataxias, neurodegenerative ataxias), it is possible that the affected area itself can compensate for the slowly evolving cerebellar lesion (i.e., functional cerebellar reserve). Here, we examine cerebellar reserve from the perspective of the three cornerstones of clinical ataxiology: control of ocular movements, coordination of voluntary axial and appendicular movements, and cognitive functions. Current evidence indicates that cerebellar reserve is potentiated by environmental enrichment through the mechanisms of autophagy and synaptogenesis, suggesting that cerebellar reserve is not rigid or fixed, but exhibits plasticity potentiated by experience. These conclusions have therapeutic implications. During the period when cerebellar reserve is preserved, treatments should be directed at stopping disease progression and/or limiting the pathological process. Simultaneously, cerebellar reserve may be potentiated using multiple approaches. Potentiation of cerebellar reserve may lead to compensation and restoration of function in the setting of cerebellar diseases, and also in disorders primarily of the cerebral hemispheres by enhancing cerebellar mechanisms of action. It therefore appears that cerebellar reserve, and the underlying plasticity of cerebellar microcircuitry that enables it, may be of critical neurobiological importance to a wide range of neurological/neuropsychiatric conditions.

Recycled paper and some hardwood paper often display poorer mechanical properties, which hinder its practical applications and need to be addressed. In this work, cellulose nanofibrils (CNFs) obtained by a combined process of enzymatic hydrolysis and grinding (EG-CNFs), grinding and microfluidization (GH-CNFs) or TEMPO-mediated oxidation and grinding (TE-CNFs) were characterized by scanning electron microscopy (SEM) and atomic force microscopy (AFM). Moreover, CNFs were made into films on which some characterizations including X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), and UV–Vis transmittance spectroscopy were implemented. Results showed that CNF fibrillation was promoted as times of passes increased in microfluidization, and CNFs pretreated by enzyme possessed shorter length. Crystallinity of CNFs was related to CNF manufacturing methods, while CNF films’ transparency was correlated to CNF diameter distributions. Moreover, CNFs were applied with different dosages on recycled and hardwood paper. Lengths of CNFs, strength of CNF network, and pulp properties were critical factors affecting the mechanical strength of CNFs-enhanced paper. GH-CNFs showed better strengthened effect on tensile strength of paper than TE-CNFs and EG-CNFs. The best overall improvement was achieved at GH-CNF10 dosage of 5.0 wt% on hardwood paper. The increment of tensile index, burst index, and folding endurance were 108.32%, 104.65%, and 600%, respectively. This work aims to find out the relationship between production methods and morphologies of CNFs and how the morphological characteristics of CNFs affecting the mechanical performance of paper when they are added as strength additives.

Information on industrial paper obtained from special purpose heat-resistant and fire-resistant fibers by the method of fiber swelling is presented. Results of a study of the effect of fiber cutting length on the mechanical properties the paper are presented. Corresponding dependencies are established.

Microfluidic paper-based devices (μPADs) and wearable devices have been highly studied to be used as diagnostic tools due to their advantages such as simplicity and ability to provide instrument-free fast results. Diseases such as periodontitis and diabetes mellitus can potentially be detected through these devices by the detection of important biomarkers. This study describes the development of μPADs through craft cutter printing for glucose and nitrite salivary diagnostics. In addition, the use of μPADs integrated into a mouthguard as a wearable sensor for glucose monitoring is also presented. μPADs were designed to contain two detection zones for glucose and nitrite assays and a sampling zone interconnected by microfluidic channels. Initially, the analytical performance of the proposed μPADs was investigated and it provided linear behavior (r2 ≥ 0.994) in the concentration ranges between 0 to 2.0 mmol L−1 and 0 to 400 μmol L−1 for glucose and nitrite, respectively. Under the optimized conditions, the limits of detection achieved for glucose and nitrite were 27 μmol L−1 and 7 μmol L−1, respectively. Human saliva samples were collected from healthy individuals and patients previously diagnosed with periodontitis or diabetes and then analyzed on the proposed μPADs. The results found using μPADs revealed higher glucose concentration values in saliva collected from patients diagnosed with diabetes mellitus and greater nitrite concentrations in saliva collected from patients diagnosed with periodontitis, as expected. The results obtained on μPADs did not differ statistically from those measured by spectrophotometry. With the aim of developing paper-based wearable sensors, μPADs were integrated, for the first time, into a silicone mouthguard using a 3D-printed holder. The proof of concept was successfully demonstrated through the monitoring of the glucose concentration in saliva after the ingestion of chocolate. According to the results reported herein, paper-based microfluidic devices offer great potential for salivary diagnostics, making their integration into a silicone mouthguard possible, generating simple, low-cost, instrument-free, and powerful wearable sensors.

In this work, nanokaolin (K) and nanometakaolin (MK) were synthesized from waste paper via planetary ball milling and characterized by means of X-ray diffraction (XRD), Fourier transform infrared vibrational spectroscopy (FTIR), and scanning electron microscopy (SEM). Suspensions of carboxymethyl cellulose (CMC) and the synthesized nanominerals at 1.5, 3, 6, and 9% led to nanocomposites 30, 60, 90, and 120 μm thick. Nanocomposites coated papers were analyzed by means of XRD, FTIR, SEM, tensile index, strain rate, burst index, and air passage resistance. The highest tensile index, burst index, and air permeability resistance values of 80.78 $$\frac{N.m}{g}$$ , 5.24 $$\frac{kPa.{m}^{2}}{g}$$ , and 286.66 $$ml/min$$ , respectively, were obtained for CMC-9%MK-120. These results indicated that paper coated with CMC nanometakaolin composite is suitable for packaging.

Xylanases are widely used enzymes in the food, textile, and paper industries. Most efficient xylanases have been identified from lignocellulose-degrading microbiota, such as the microbiota of the cow rumen and the termite hindgut. Xylanase genes from efficient pulp and paper wastewater treatment (PPWT) microbiota have been previously recovered by metagenomics, assigning most of the xylanase genes to the GH10 family. In this study, a total of 40 GH10 family xylanase genes derived from a certain PPWT microbiota were cloned and expressed in Escherichia coli BL21 (DE3). Among these xylanase genes, 14 showed xylanase activity on beechwood substrate. Two of these, PW-xyl9 and PW-xyl37, showed high activities, and were purified to evaluate their xylanase properties. Values of optimal pH and temperature for PW-xyl9 were pH 7 and 60 ℃, respectively, while those for PW-xyl37 were pH 7 and 55 ℃, respectively; their specific xylanase activities under optimal conditions were 470.1 U/mg protein and 113.7 U/mg protein, respectively. Furthermore, the Km values of PW-xyl9 and PW-xyl37 were determined as 8.02 and 18.8 g/L, respectively. The characterization of these two xylanases paves the way for potential application in future pulp and paper production and other industries, indicating that PPWT microbiota has been an undiscovered reservoir of efficient lignocellulase genes. This study demonstrates that a metagenomic approach has the potential to screen efficient xylanases of uncultured microorganisms from lignocellulose-degrading microbiota. In a similar way, other efficient lignocellulase genes might be identified from PPWT treatment microbiota in the future.

“Hot papers” (HPs) are papers which received a boost of citations shortly after publication. Papers with “delayed recognition” (DRs) received scarcely impact over a long time period, before a considerable citation boost started. DRs have attracted a lot of attention in scientometrics and beyond. Based on a comprehensive dataset with more than 5,000,000 papers published between 1980 and 1990, we identified HPs and DRs. In contrast to many other studies on DRs, which are based on raw citation counts, we calculated dynamically field-normalized impact scores for the search of HPs and DRs. This study is intended to investigate the differences between HPs (n = 323) and DRs (n = 315). The investigation of the journals which have published HPs and DRs revealed that some journals (e.g. Physical Review Letters and PNAS) were able to publish significantly more HPs than other journals. This pattern did not appear in DRs. Many HPs and DRs have been published by authors from the USA; however, in contrast to other countries, authors from the USA have published statistically significantly more HPs than DRs. Whereas “Biochemistry & Molecular Biology,” “Immunology,” and “Cell Biology” have published significantly more HPs than DRs, the opposite result arrived for “Surgery” and “Orthopedics.” The results of the analysis of certain properties of HPs and DRs (e.g. number of pages) suggest that the emergence of DRs is an unpredictable process.

Refining (i.e., mechanical beating of pulp) is a common procedure that is used in paper-making to improve the mechanical properties of the final product. The improvements caused by refining are mainly attributed to increased density and to a better bonding between fibers. In this work, we study how various mechanisms that can be triggered by refining affect the tensile behavior of the sheets. Consequently, we use direct numerical simulations of fiber networks. We relate our finding to the experimental measurements that we conducted on handsheets. We have found that fibrillar fines with size distributions below the resolution of modern state-of-the art pulp characterization tools have a substantial contribution to the increased strength and stiffness of the sheets.

Most high-voltage transformers are fluid filled machines whose insulation system is constituted of dielectric oil–solid combination. The insulation oil generally used is mineral oil, however, this fluid has started to be substituted by natural and synthetic esters due to their higher biodegradability and flash point in comparison with mineral oil. The introduction of a new fluid in the insulation system of power transformers requires kinetic models which can estimate the degradation rate of insulation solids, taking into account the properties of the new materials. The aim of this work is to go further in demonstrating that a kinetic model based on damage parameter can be used as a cellulose degradation model for Kraft paper, which is one of the solid materials used in the insulation system of oil-filled transformers. The ageing study has been extended to Kraft specimens immersed in two different oils (mineral and natural ester). The kinetic model that best tracks the ageing patterns was shown to be a function of damage parameter estimated through the energy consumed per unit volume of the failure zone (ER) in comparison with other mechanical properties such as rupture strength (σR) or strain under ultimate strength (ecm). Finally, an assessment of the effect of end-of-life criteria on correlation coefficient was carried out, providing further evidence that this criteria established until now (25% retained tensile strength) should be discussed in order to obtain more accurate kinetic models.

Recent advances in telecommunication technology and video conferencing systems have opened a new avenue for surgical instruction called “surgical telementoring.” This report from the Technology Working Group of the SAGES Project 6 Summit reviews the telementoring technology that currently exists and proposes recommendations for minimum technology requirements and future technology development. While also providing insight in regulatory considerations, this review offers what prospective surgical telementoring participants need to know about the underlying technology with a specific focus on safety, reliability, transmission quality, ease of use, and cost. Content experts from around the world, in minimally invasive surgery, surgical mentoring and telementoring, surgical education, business development, healthcare innovation, and regulation were invited to attend a 2-day summit in Los Angeles, USA to outline the current state of surgical telementoring and chart the challenges and opportunities going forward. This article summarizes the discussion, conclusions, and recommendation of the technology group with regard to telementoring technology. This article reviews the technical requirements which can be divided into the following categories: (1) safety, (2) reliability, (3) transmission quality, (4) ease of use, and (5) cost. Telementoring applications are technology driven. Given the pace of change of technology, guiding principles in technology design and selection are warranted (Table 4). Telementoring technologies require two basic components, video capturing and display devices at the transmitting and receiving end, and a telecommunication link between them. Many additional features can be added to this basic setup including multiple cameras or video sources, remote camera zoom and pan, recording and storage of videos and images, and telestration capabilities to mention just a few. In general, the cost of these technologies is feature driven. The education framework for each specific application should determine the need for these features (Schlachta in Surg Endosc https://doi.org/10.1007/s00464-016-4988-5 ).

Polyethylene laminated disposable paper cups are commonly used as a container for hot drinks, yet there is limited knowledge on the transfer of contaminants from the cup to the drink. Here we poured 95◦C hot water in 14 cups, to simulate the preparation of hot beverage for daily use. We studied the water composition after 15 min by inductively coupled plasma mass spectrometry (ICP-MS) and ion chromatography. Results show the presence of metals such as vanadium, chromium, copper, cobalt and arsenic at concentration ranging from 0.04 to 1.80 µg/L. Nitrate, nitrite, chloride, bromate, fluoride and sulfate ions were also detected at concentration from 0.003 to 49.21 mg/L. All concentrations are below the WHO maximum permissible limits in drinking water. However, the levels of vanadium at 1.24 µg/L and fluoride ions at 1.03 mg/L are likely to induce a health risk by bioaccumulation after long-term water ingestion. Therefore paper cups composition should be modified to avoid the release of contaminants in hot drinks.

Suitability of lignin–phenol–formaldehyde (LPF) resoles was investigated for manufacturing paper-based high-pressure laminates. As lignin source, pine kraft lignin and spruce sodium lignosulfonate were compared, substituting 40 wt% of phenol by lignin in each case. The synthesized resins were characterized for their viscosity development, solid content, pH, free formaldehyde as well as free phenol content and B-time. Paper-based high-pressure laminates were manufactured using the two different resins. The laminates were exposed to different test climates and were compared for boiling water resistance, thickness swelling, bending properties and impact energy. The results indicate that pine kraft lignin performs superior to spruce sodium lignosulfonate for utilization in paper based laminates for outdoor usage due to a lower affinity of the pine kraft LPF laminates to water.

Purpose: Some universal accessibility practitioners have voiced that they experience a mismatch in the research focus and the need for knowledge within specialized problem domains. This study thus set out to identify the balance of research into the main areas of accessibility, the impact of this research, and how the research profile varies over time and across geographical regions. Method: All UAIS papers indexed in Scopus were analysed using bibliometric methods. The WCAG taxonomy of accessibility was used for the analysis, namely perceivable, operable, and understandable. Results: The results confirm the expectation that research into visual impairment has received more attention than papers addressing operable and understandable. Although papers focussing on understandable made up the smallest group, papers in this group attracted more citations. Funded research attracted fewer citations than research without funding. The breakdown of research efforts appears consistent over time and across different geographical regions. Researchers in Europe and North America have been active throughout the last two decades, while Southeast Asia, Latin America, and Middle East became active in during the last five years. There is also seemingly a growing trend of out-of-scope papers. Conclusions: Based on the findings, several recommendations are proposed to the UAIS editorial board.

A colorimetric paper-based sensor is proposed for the rapid monitoring of six major organophosphate and carbamate pesticides. The assay was constructed by dropping gold and silver nanoparticles on the hydrophilic zones of a paper substrate. The nanoparticles were modified by L-arginine, quercetin, and polyglutamic acid. The mechanism of sensing is based on the interaction between the pesticide and the nanoparticles. The color of nanoparticles changed during the interactions. A digital camera recorded these changes. The assay provided a unique response for each studied pesticide. This method can determine six individual pesticides including carbaryl, paraoxon, parathion, malathion, diazinon, and chlorpyrifos. The limit of detection for these pesticides were 29.0, 22.0, 32.0, 17.0, 45.0, and 36.0 ng mL−1, respectively. The assay was applied to simultaneously determine the six studied pesticides in a mixture using the partial least square method (PLS). The root mean square errors of prediction were 11, 8.7, 9.2, 10, 12, and 11 for carbaryl, paraoxon, parathion, malathion, diazinon, and chlorpyrifos, respectively. The paper-based device can differentiate two types of studied pesticide (organophosphate and carbamate) as well as two types of organophosphate structures (oxon and thion). Furthermore, this sensor showed high selectivity to the pesticides in the presence of other potential species (e.g., metal ions, anions, amino acids, sugar, and vitamins). This assay is capable of determining the pesticide compounds in tap water, apple juice, and rice samples. Graphical abstract

To develop and evaluate methods for assembling radiopaque printed paper sheets to realistic patient phantoms for CT dose and image quality testing. CT images of two patients were radiopaque printed with aqueous potassium iodide solution (0.6 g/ml) on paper. Two methods were developed for assembling the paper sheets to head and neck phantoms. (1) Printed sheets were fed to a paper-based 3D printer along with corresponding 3D printable STL files. (2) Paper stacks of 5-mm thickness were glued with toner, cut to the patient shape and assembled to a phantom. In a sample application study, both phantoms were examined with five different tube current settings. Images were reconstructed using filtered-back projection (FBP) and iterative reconstruction (AIDR 3D) with three strength levels. Dose length product (DLP), signal-to-noise ratios (SNR) and contrast-to-noise ratios (CNRs) were analysed. Data were analysed using 2-way analysis of variance (ANOVA). Both methods achieved anthropomorphic phantoms with detailed patient anatomy. The 3D printer yielded a precise reproduction of the external patient shape, but caused visible glue artefacts. Gluing with toner avoided these artefacts and yielded more flexibility with regard to phantom size. In the sample application study, non-inferior SNR and CNR and up to 83.7% lower DLP were achieved on the phantoms with AIDR 3D compared with FBP. Two methods for assembling radiopaque printed paper sheets to phantoms of individual patients are presented. The sample application demonstrates potential for simulation of patient imaging and systematic CT dose and image quality assessment. • Two methods were developed to create realistic CT phantoms of individual patients from radiopaque printed paper sheets. • Analysis of five tube current and four reconstruction settings on two radiopaque 3D printed patient phantoms yielded non-inferior SNR and CNR and up to 83.7% lower dose with iterative reconstruction in comparison with filtered back projection. • Radiopaque 3D printed phantoms can simulate patients and allow systematic analysis of CT dose and image quality parameters.

The governing international standard for the development of prosthetic heart valves is International Organization for Standardization (ISO) 5840. This standard requires the assessment of the thrombus potential of transcatheter heart valve substitutes using an integrated thrombus evaluation. Besides experimental flow field assessment and ex vivo flow testing, computational fluid dynamics is a critical component of this integrated approach. This position paper is intended to provide and discuss best practices for the setup of a computational model, numerical solving, post-processing, data evaluation and reporting, as it relates to transcatheter heart valve substitutes. This paper is not intended to be a review of current computational technology; instead, it represents the position of the ISO working group consisting of experts from academia and industry with regards to considerations for computational fluid dynamic assessment of transcatheter heart valve substitutes.

The incidence of flavivirus infections has increased dramatically in recent decades in tropical and sub-tropical areas worldwide, affecting hundreds of millions of people each year. Dengue viruses are typically transmitted by mosquitoes and can cause a wide range of symptoms from flu-like fever to organ impairment and death. Although conventional diagnostic tests can provide early diagnosis of acute dengue infections, access to these tests is often limited in developing countries. Consequently, there is an urgent need to develop affordable, simple, rapid, and robust diagnostic tools that can be used at 'Point of Care' settings. Early diagnosis is crucial to improve patient management and reduce the risk of complications. In the present study, a novel laser-cut device made of glass-fiber paper was designed and tested for the detection of the dengue Non Structural 1 (NS1) viral protein and specific IgM in blood and plasma. The device, called PAD, was able to detect around 25 ng/mL of NS1 protein in various sample types in 8 minutes, following a few simple steps. The PAD was also able to detect specific IgM in human plasmas in less than 10 minutes. The PAD appears to have all the potential to assist health workers in early diagnosis of dengue fever or other tropical fevers caused by flaviviruses.

Switching between metabolically active and dormant states provides bacteria with protection from environmental stresses and allows rapid growth under favorable conditions. This rapid growth can be detrimental to the environment, e.g., pathogens in recreational lakes, or to industrial processes, e.g., fermentation, making it useful to quickly determine when the ratio of dormant to metabolically active bacteria changes. While a rapid increase in metabolically active bacteria can cause complications, a high number of dormant bacteria can also be problematic, since they can be more virulent and antibiotic-resistant. To determine the metabolic state of Escherichia coli and Salmonella Typhimurium, we developed two paper-based colorimetric assays. The color changes were based on oxidoreductases reducing tetrazolium salts to formazans, and alkaline phosphatases cleaving phosphates from nitrophenyl phosphate salt. Specifically, we added iodophenyl-nitrophenyl-phenyl tetrazolium salt (INT) and methylphenazinium methyl sulfate to metabolically active bacteria on paper and INT and para-nitrophenyl phosphate salt to dormant bacteria on paper. The color changed in less than 60 min and was generally visible at 103 CFU and quantifiable at 106 CFU. The color changes occurred in both bacteria, since oxidoreductases and alkaline phosphatases are common bacterial enzymes. On one hand, this feature makes the assays suitable to a wide range of applications, on the other, it requires specific capture, if only one type of bacterium is of interest. We captured Salmonella or E. coli with immobilized P22 or T4 bacteriophages on the paper, before detecting them at levels of 102 or 104 CFU, respectively. Determining the ratio of the metabolic state of bacteria or a specific bacterium at low cost and in a short time, makes this methodology useful in environmental, industrial and health care settings.