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The integration of telecommunications and information systems in health care first began 4 decades ago with 500 patient consultations performed via interactive television. The use of telemedicine services and technology to deliver health care at a distance is increasing exponentially. Concomitant with this rapid expansion is the exciting ability to provide enhancements in quality and safety of care. Telemedicine enables increased access to care, improvement in health outcomes, reduction in medical costs, better resource use, expanded educational opportunities, and enhanced collaboration between patients and physicians. These potential benefits should be weighed against the risks and challenges of using telemedicine. The American College of Allergy, Asthma, and Immunology advocates for incorporation of meaningful and sustained use of telemedicine in allergy and immunology practice. This article serves to offer policy and position statements of the use of telemedicine pertinent to the allergy and immunology subspecialty.

Paper mill sludge biochar (PMSB) was produced via pyrolysis in a muffle furnace at 750 °C. Subsequently, PMSB was soaked in the HCl solution and washed by deionized water to obtain minerals and organic materials. The organics were named as demineralized paper mill sludge biochar (DPMSB). It was found that PMSB and minerals had larger pore diameters than DPMSB. Also, the removal efficiencies of Cu, Zn and As were above 95.00% by using PMSB and minerals because of the large pores, abundant carbonates and OH groups, while the removal efficiencies of Cu, Zn and As by using DPMSB were 40.92%, 87.93% and 94.99%, respectively, owing to the H + competition to Cu and Zn adsorption but more micropores to enhance As adsorption. The adsorption behavior of PMSB showed that the adsorption isotherms of Cu, Zn and As could be well simulated by the Freundlich model, and the pseudo-second-order model fitted the adsorption kinetics of Zn and As, and the Elovich model fitted the adsorption kinetics of Cu. Moreover, the optimal dosages of PMSB to adsorb Cu, Zn and As were 0.3, 0.3 and 0.1 g/L, respectively. And the pH values of the solution for the efficient adsorption of Cu, Zn and As were 4.00, 6.00 and 2.00, respectively. This work provided basic data for the potential commercial application of PMSB for heavy metals removal from wastewater.

The design of a cheap, simple, and handy sensing system for rapid quantitation of pharmaceuticals becomes mandatory to ease drug development procedures, quality control, health care, etc. This work describes a simple, innovative, and easily manufactured paper-based device using a correction pen as a plotter for hydrophobic/lipophobic barriers and graphene quantum dots for recognition and quantification of the hemostatic drug carbazochrome, via fluorescence turn-off mechanism mediated by the inner filter effect. A smartphone-based all-in-one device fitted with an inexpensive 365 nm flashlight as a UV light source and a free image processing software was developed for rapid and reliable interpretation of the fluorescence change from the paper-based device upon introduction of the drug. The simple and convenient steps permit the analysis of many samples in a very short time. The smartphone-based all-in-one device featured excellent sensitivity for carbazochrome with a limit of detection equals to 12 ng/detection zone and good %recovery (100.0 ± 0.4). The reliability of the device was ascertained by favorable statistical comparison with the analogous optimized conventional fluorimetry method and a reference HPLC method. The device has been successfully applied for versatile quantitation of carbazochrome in tablets and on manufacturing equipment surfaces with excellent recoveries. The device offers many green aspects that definitely assist the implementation of the sustainability concept to analytical laboratories. The cost-efficiency, reliability, and ease of fabrication as well as the greenness and user friendship qualify the device for wide application in low-income communities.

The present study has aimed to evaluate the role of vermitechnology in the qualitative enrichment of compost during the valorization process of solid paper mill wastes. A maximum mass reduction of 77% (primary sludge) and 76% (secondary sludge) were noticed through thermogravimetric (TG) analysis. The biodegradation of complex xenobiotics such as lignin, cellulose, etc. were found in spectral bands of FTIR spectroscopy which had attributed to extent of mineralization among compost samples. A significant correlation between the decrease of the C/N ratio and the rise of the 2921/1633 peak ratio of FTIR had conferred the maturity among vermicompost samples. Furthermore, the presence of different macromolecular humic acid-like substances such as benzene dicarboxylic acid, propanedioic acid, glutaric acid, etc. was found in the vermicompost samples through GC–MS analysis. In addition to such qualitative enrichment, microbial diversity was manifested using PLFA biomarkers which had revealed a huge bottleneck in terms of microbial populaces designating ecological succession upon vermicomposting. Therefore, the present study can be considered as a comprehensive eco-biochemical approach which will open up a new vista the importance in context to paper mill solid waste management.

Summary Skin-interfaced wearable electronics can find a broad spectrum of applications in healthcare, human-machine interface, robotics, and others. The state-of-the-art wearable electronics usually suffer from costly and complex fabrication procedures and nonbiodegradable polymer substrates. Paper, comprising entangled micro- or nano-scale cellulose fibers, is compatible with scalable fabrication techniques and emerges as a sustainable, inexpensive, disposable, and biocompatible substrate for wearable electronics. Given various attractive properties (e.g., breathability, flexibility, biocompatibility, and biodegradability) and rich tunability of surface chemistry and porous structures, paper offers many exciting opportunities for wearable electronics. In this review, we first introduce the intriguing properties of paper-based wearable electronics and strategies for cellulose modifications to satisfy specific demands. We then overview the applications of paper-based devices in biosensing, energy storage and generation, optoelectronics, soft actuators, and several others. Finally, we discuss some challenges that need to be addressed before practical uses and wide implementation of paper-based wearable electronics., Graphical abstract, Biodevices; Bioelectronics; Electronic materials

Green Energy efficiency is becoming more important because of the resulting cost reduction and image of green society which helps to enhance competitiveness in a globalized green market. Pulp and paper manufacturing is a large-scale industry which is generally regarded as important for national development. The Pulp and Paper industry consumes approximately 2.5% of total industrial energy consumption in Thailand by 44 factories distributed throughout the country. Therefore, energy efficiency improvement can play a significant role in the industry. Investigations of the cost effectiveness of energy efficiency measures and technologies using bottom-up Conservation Supply Curve (CSC) in the pulp and paper mill process are required. This study examines the concept, methodology, and the usefulness of the energy conservation supply curve, and the potential to create the appropriate energy policies to the Thai Pulp and Paper Industry.

The objective of this study was to determine the effect of electrical conductivity, pH and temperature which were kept constant during treatment via an advanced control strategy on chemical oxygen demand, color, turbidity and total suspended solids removal and energy consumption. Central Composite Design matrices were formed for aluminum and iron electrode systems separately with different combinations of 5 independent variables (electrical conductivity, pH, temperature, current intensity and electrolysis time). Obtained results revealed that aluminum electrode system was found to be more effective than iron electrode system under controlled conditions. Comparison of uncontrolled and controlled studies at optimum values of aluminum electrode system showed an increase by 31.67% in chemical oxygen demand removal and a decrease by 48.30% in energy consumption under controlled case. Results indicated that constant electrical conductivity, pH and temperature during electrocoagulation process of pulp and paper mill wastewater by means of a controller enhanced treatment efficiency.

Large-sized graphene sheets (LG) and doping strategy were employed to fabricate lightweight and flexible graphene paper with exceptional electromagnetic interference (EMI) shielding performance. Compared with the smaller sized ones, LG with fewer defects and more conjugated carbon domain size as well as better alignment result in higher electrical conductivity and strength of graphene paper. The iodine doping further improves the carrier density of LG by formation of triiodide ( I 3 − ) and pentaiodide ( I 5 − ) through charge transfer process without deteriorating the mechanical property, thus leading to superior EMI shielding effectiveness (SE). The EMI SE of iodine doped LG film with thickness of 12.5 μm is up to ∼52.2 dB at 8.2 GHz, which is much higher than that of undoped LG with the same thickness (∼47.0 dB). More important, the improvements in EMI SE is contributed to the SE absorption, while the SE reflection is almost unchanged. The mechanisms of improved EMI shielding performance as well as mechanical property were investigated and discussed. The present study provides a facile way to fully develop graphene in lightweight and flexible EMI shielding materials and devices.

Recycled paper mill sludge (RPMS) was hydrothermally treated by subcritical water (SBW) in two modes of operation, namely semi-continuous and batch, at temperatures in the range 150–250 °C, and 100 bar. The performance of both systems was analyzed in terms of degree of hydrolysis, product yield and formation of degradation products. The highest degree of RMPS hydrolysis was achieved using the batch reactor configuration, while in the semi-continuous system higher yields of water soluble compounds (WSC) and monosaccharides were achieved. By using the semi-continuous system at 100 bar, 250 °C and a water flow rate of 5 mL/min, 40% of the organic carbon content of RPMS was recovered in the form of soluble compounds. Additionally 20% of total carbohydrates and 75% of total lignin of RPMS were recovered as soluble material. Detailed mass balances performed for both operational modes revealed that under batch mode, the naturally occurring compounds found in RPMS underwent significant transformation, generating derivatives referred to as degradation products. An analysis of the severity factor was performed for both operational modes. It was concluded that significant values of WSC were only obtained for severity factors higher than four.

This study aimed at the quantification of thermochemical behaviors of textile dye sludge (TDS), paper mill sludge (PMS), and their various blend ratios during (co-)combustion. Changes in mass loss percentage (MLP) and rate (MLR) were estimated as a function of temperature, heating rate, and blend ratio. Our results pointed to a direct influence of blend ratios on mass loss percentage. Stochastic uncertainties and sensitivities associated with best-fit predictions of MLP and MLR responses were detected using all-at-once versus one-at-a-time Monte Carlo simulations. Co-combustion of TDS and PMS provided more flame stability owing to their volatile matter contents than did the combustion of pure TDS or PMS. The high C and H contents of TDS relative to those of PMS led to high lower heating value (higher energy). Effect of increased temperature on the co-combustion manifested itself in the breakdown of (hemi-)cellulose initially and lignin progressively in TDS and PMS. The increasing TDS of the blend ratio increased both MLP and MLR. Stochastic uncertainty analysis of the deterministic empirical models pinpointed overestimation by 15.6% in mean MLP and by 50% in mean MLR. Sensitivity analysis pointed to blend ratio as the most influential predictor on both MLP and MLR.

• Hydrophobicity of LB- and TB-EPS extracted from anaerobic granular sludge treating paper mill effluent are characterized.

The aim of this study was to evaluate some physical and mechanical properties of the paper mill (PMS) and spruce planer shaving added cement boards. Also the effect of sludge type in consequence of waste water treatment technique on properties of wood-cement boards (WCB) was investigated. The wood/cement ratios were used as 1/3, based on the oven dry weight for the WCB manufacture. PMS was used up to 20% wt of total composite based on organic (wood) and inorganic (cement) amounts. Black sludge has shown more improvement than grey sludge on properties of WCBs, which indicates the anaerobic waste treatment technique is more effective for additive in WCB. The modulus of rupture and elasticity values of the WCBs with 5% of grey sludge, 5% and 10% of mixture of grey and black sludge were acceptable limits according to EN 634-2 standard. The mechanical strengths of all WCBs with black sludge were found above the specified EN standard. This suggests that PMS depending on sludge type may be used up to 20% wt of total composite weight for the commercial production of WCBs, which could expand the raw material base for this panel product.

The state-of-art is a mesophilic treatment of wastewater in paper mills without reuse due to the high water quality requirements. Thermophilic biological treatment could save a large amount of thermal energy, but the major obstacle of a reuse are the poor sludge settling properties under thermophile conditions, leading to insufficient water quality if conventional gravimetric phase separation is applied. MBR technology is a promising alternative which allows a recirculation of treated water for improving the water and energy footprint. So far, there is only limited experience with thermophilic MBR at the time. In this study, a thermophilic MBR with a submerged membrane (TSMBR) was operated to treat wastewater from a paper mill with a COD concentration of 25–30 g L −1 . The TSMBR was integrated into the operational process of the paper mill. Research questions were the influence of suspended solids, food to microorganism ratio (F/M ratio), cross-flow-aeration and filtration flux to the fouling of the membrane. Applying the critical flux concept, optimal operating conditions and costs for a future economic full-scale implementation could be derived. Key results are inter alia a sub-critical flux of below 10 L m −2 h −1 is recommended for long-time durability of the membrane for minimizing the irreversible fouling and the permeability decrease. A chemical cleaning does not change the critical flux, but improves the permeability of the membrane significantly. The TSMBR suffered from increasing fouling at a cross-flow-aeration of below 0.6 m 3 m −2 h −1 and a concentration of suspended solids of above 14 g L −1 . A stable process and cleaning could only be ensured by a F/M ratio of below 0.4 g COD g MLSS −1 d −1 . Higher values result in an increased cake layer formation and intensive foaming.

An integrated platform consisting of a microfluidic paper-based/PMMA (Polymethyl-Methacrylate) chip and a small battery-operated detection system is proposed for the concentration detection of sulfur dioxide (SO 2 ). In the proposed method, a small strip of filter paper is coated with acid-base indicator and then inserted into a PMMA microchip. The SO 2 sample is then injected into the reservoir of the chip; prompting a reaction with the acid-base indicator. The chip is transferred to the detection system, where the reaction-induced color change is captured by a CMOS (Complementary Metal-Oxide Semiconductor) camera. Finally, the CMOS image is transferred to a cell phone via a USB (Universal Serial Bus) connector and the SO 2 concentration is derived using self-written RGB color analysis software. The experimental results obtained for 10 control samples show that the correlation coefficient for the variation of the R(ed) signal intensity with the SO 2 concentration is equal to R 2 = 0.9971 in the low-concentration range (20 ∼ 600 ppm) and R 2 = 0.9920 in the high-concentration range (600 ∼ 5000 ppm). The real-world applicability of the proposed platform is demonstrated by measuring the SO 2 concentrations of fifteen commercial food samples. The concentration measurements deviate by no more than 4.29% from those obtained using a standard macroscale technique. Overall, the results presented in this study show that the proposed integrated microfluidic paper-based system provides a cheap, compact and reliable method for SO 2 concentration measurement purposes.

The removal of Tricaine Methanesulfonate from water in a fixed-bed column packed with pyrolysed paper mill sludge was evaluated for application in Recirculating Aquaculture Systems. Breakthrough adsorption curves were determined for this pharmaceutical, under different operating conditions. In a laboratory-scale approach, with synthetic effluent, a bed adsorption capacity of 125 mg g −1 was obtained under a flux of 56 L min −1 m −2 , with 400 mg L −1 of MS-222 with 4.5 cm bed depth. The performance of the continuous adsorption in a column packed with biological paper mill sludge-based carbon, using real aquaculture wastewater as matrix, was not significantly affected. Then, scale-up was carried out and the bed depth service time model was applied and provided good predictions. Finally, the thermal regeneration of the exhausted adsorbent was assessed, which revealed satisfactory results for one cycle reusability after saturation; however, considering the nature of its precursor, the use of new adsorbent could be more profitable than its regeneration, functioning also as an additional option for the management of such wastes.

International audience; An energy audit is a primary step toward improving energy efficiency at the facility level and ensuring a clean production. The pulp and paper sector is one of the most energy-intensive industries in Morocco. This article aimed at identifying energy conservation opportunities at a Small and Medium-sized paper industry. The audit results together with their financial viability are presented regarding the analysis of energy consumption and electrical quality issues. The paper introduces an action plan for a more efficient energy use of some specific applications such as furnaces and compressed-air installations as well. The recommended energy efficiency measures have the potential of saving about 347.85 MWh of electrical energy and 101.78 MWh of thermal energy corresponding to reductions of 11.48% and 2.22%, respectively. The total investments related to the application of the action plan is approximately 290.53 kMAD and the global payback period does not exceed one year. It was also shown that a total quantity of 283.39 t of CO2 emissions can be saved annually.

Pulp and paper production is a highly energy intensive process and improvement of energy efficiency in this process is considered as promising measures for reducing industrial greenhouse gases emissions (GHG). This study focuses the Pakistan's pulp and paper industry which consumes around 7% of the country's industrial energy and contributes to over 317,269 tonnes of CO 2 emissions. With rising demands for fuels and consequently as harp increase in CO 2 emissions due to the growth of the paper sector in Pakistan, this article aims to analyse the energy efficiency and carbon dioxide emissions reductions potential through the incorporation of cogeneration technologies. The cogeneration technologies studied are agas turbine, steam turbine and combined cycle and are evaluated from the energetic and economic point of view to propose a best suitable technology for each paper mill. The proposed cogeneration technologies are selected on the basis of high energy utilisation factor, as implepayback period of five years or less with least Annualised life cycle cost. The result shows that a theoretical energy saving potential equivalent to 16.9% of the actual thermal energy requirement of mills can be achieved through cogeneration which will lead to 14.3% reduction of the present carbon emissions levels in Pakistan's paper sector.

China's paper production accounted for nearly a quarter of the world's total paper production in 2010. In this study, 23 energy saving technologies applicable to the pulping and papermaking process in China are identified and analyzed. The conservation supply curve (CSC) method is employed to assess the technical and economic aspects of energy conservation. The fuel CSC for Chinese pulp and paper industry shows the cost-effective and technical fuel conservation potential is 180 PJ and 254 PJ, accounting for 27% and 38% of total fuel used in 2010, respectively. The CO 2 mitigation potential related to the cost-effective fuel efficiency is 17 Mt CO 2 and the technical potential is 24 Mt CO 2 . The electricity CSC shows the technical electricity conservation potential is 2316 GWh, representing 4% of total electricity consumption. All of the electricity efficiency measures are shown to be cost-effective in this study. The CO 2 mitigation resulted from electricity efficiency is around 2 Mt CO 2 . In addition, sensitivity analyses for the parameters of penetration rate, discount rate, and energy price are conducted to assess their influence on the final results.

The application of anaerobic digestion is mounting worldwide because of its economic and environmental benefits. As a concern, the rate and extent of the anaerobic digestion of pulp and paper mill sludge was tested using the biochemical methane potential (BMP) with different food/microorganisms (F/M) ratio. The study was evaluated at five different F/M ratios (i.e. 0.5, 1.0, 1.5, 2.0, 2.5). In addition to that reaction kinetics and the influence of biodegradability were also evaluated for the biomethane potential of substrates. The highest cumulative methane yield was obtained in F/M ratio 2.0 with 3.4 L followed by F/M ratio 1.5 and 2.5 with 3.3 L and 2.9 L, respectively. The maximum methane production rate 3.66 L CH4 was perceived as per kinetics. The biomass activity may be affected due to the high substrate concentration during BMP test of lower F/M ratios. On the other hand, F/M ratio greater than 2.0, methane yield was decreased due to increased volatile fatty acid production reduces the reactor pH and inhibits methanogens activity.

CdSe/ZnS quantum dots (QDs) and 3,3,5,5-tetramethylbenzidine (TMB) were incorporated into a filter paper to produce a paper-based colorimetric device for Hg2+ detection. Under visible light, the CdSe/ZnS QDs acted as a photocatalyst to oxidize TMB, resulting in blue colorization on the paper. Moreover, Hg2+ could enhance the photocatalytic activity of CdSe/ZnS QDs and consequently caused an increase in the color intensity of the paper. The color change of the paper-based device can be directly identified by naked-eye observation or captured by a smartphone and analyzed using image processing software for quantitative analysis. Under optimal conditions, a low detection limit of 0.09 µM was achieved. This device was applied for real samples, including tap water and cosmetics, and achieved satisfying results.

As a kind of industrial hazardous solid waste, paper mill sludge (PMS) was hard to treated by conventional process because of its high moisture, high organic content and and high environmental risk. The hydrothermal liquefaction (HTL) shows excellent potential for the conversion to a wide variety of organic matter with high water contents including various kinds sludge into fuels or value-added chemicals. In this paper, the liquefaction potential for PMS under different reaction temperatures were investigated, and the products were classified into several main components based on the results of GC-MS. The results showed that the highest yield of bio-oil was 44 % (wt/wt dry PMS without ash) at 340 °C with simply compound composition. And the bio-oil product has above 26 % long chain hydrocarbon and 22 % cycloketones. It has potential for conversion to biomass platform compounds. It can be used as bio-fuel for heat recovery of alkali recovery system of paper mill. So, adjusting different reaction temperatures of HTL, the properties of products can meet the different requirements for platform chemical and/or bio-oil fuel.

In the present study, life estimation of accelerated aged insulating papers used in rotating machines is estimated by Arrhenius model. Various types of insulating papers used in rotating machines such as Mylar, Nomex-Mylar-Nomex(NMN), Leatheroid, Dacron-Mylar-Dacron(DMD), Mica Tape, and Kapton are thermally aged at 90°C, 130°C and 170°C with 300hrs duration of each sample. These insulating materials wrapped on copper conductor with single and double layer. Then, breakdown voltage test is performed at each temperature for both single and double layer papers to determine their dielectric strength. Further, correlation analysis between breakdown voltage and different applied temperatures is performed for all paper samples. Popular Arrhenius plot is drawn by short term test data on breakdown voltage for an extrapolation to long term performance of various types of insulating paper used in rotating machines. The results showed that the performance of double layer insulation is almost twice than single layer performance. The aging analysis and testing of insulating papers was performed in TIFAC-Core centre of NIT Hamirpur, H.P., India.

Paper has recently attracted increasing attention as a substrate for various biomedical applications. By modifying its physical and chemical properties, paper can be used as an alternative to conventional cell culture substrates. Because it can be stacked into a three-dimensional (3D) structure, which can better mimic the in vivo cell microenvironment. Paper has shown great potential as a 3D cell culture platform for developing normal and diseased models. This platform gives precise control over extracellular matrix (ECM) composition as well as cell distribution and precise analysis of the interactions between cells. Paper-based platforms have been applied for pathophysiological studies and therapeutic intervention studies. In this paper, we first discuss the modifications of the physical and chemical properties of paper to develop various 2D and 3D cell culture platforms. We then review the applications of paper-based cell culture platforms for the construction of in vitro disease models, drug screening, and cell cryopreservation applications. Because of its advantages such as biocompatibility, eco-friendliness, cost efficiency, and ease of large-scale production, we believe that paper-based cell culture platforms would play an important role in the fields of biomedicine.

Paper manufacture is a very energy-intensive industry and generates a large amount of waste such as paper mill sludge (PMS). Given that the current PMS disposal ways (e.g., incineration and landfilling) are not eco-friendly and costly, establishing an appropriate PMS disposal platform including energy recovery is crucial to making more environmentally benign and economically viable industrial paper manufacturing process. In this respect, this study places a great emphasis on investigating the influence of CO2 on pyrolysis of PMS by systematical analysis of major three-phase pyrolytic products, such as gases and tar, under N2 and CO2 atmospheres. It was validated that using CO2 as a reaction medium in pyrolysis of PMS not only increased the production of CO (a major constituent of syngas) by ∼1000% but also decreased the amount of tar by 23%. The increase in CO production and decrease in tar formation likely resulted from reactions between CO2 and volatile organic compounds (VOCs) generated from thermal decomposition of PMS, which could be expedited by catalytic effects of minerals contained in PMS. The results shown in this paper could be applied to design green paper manufacturing processes efficiently utilizing a potent greenhouse gas, CO2.

Eco-design initiatives are gaining importance due to changing environmental conditions and the industry is developing different solutions. The purpose of this paper is the identification and evaluation of barriers related to the implementation of eco-design initiatives in pulp and paper industry. This study identifies the key barriers through literature research and provides information flow dependencies using design structure matrix through a case study of a company in Finland. This method differs from traditional management tools because it focuses on representing information flow rather than workflow. The findings provide policy recommendations to policy makers for managing eco-design implementation.

The results of physico-chemical analysis of pulp and paper mill effluent sedimented sludge revealed the presence of heavy metals (mg l−1) Fe (67.53), Zn (13.90), Cu (2.15), Cr (2.30), Cd (0.255), Mn (11.0), Ni (3.30), and Pb (1.05) along with persistent chlorolignin. The major persistent organic pollutants detected by GC–MS were ethane, 1,1-diethoxy; tetradecanoic acid; furane 2,5-dimethyl; n-hexadecanoic acid; nonacosane, trimethylenebis-1,3-dioxolane; 1,3-dioxolane, 2-(phynylmethyl). Twelve representative native plants were noted based on their population number growing on pulp and paper sludge and evaluated for their phytoextraction potential of heavy metals. The result revealed that Triticum aestivum was found as root accumulator for all metals except Cu. Similarly, the Brassica campestris accumulated all metals maximum in root except Ni, Fe and Pb. While, Eclipta alba accumulated majority of metals in their shoot and leaves, But Solanum nigrum, Rumex dentatus accumulated metals in root and shoot both. Rananculus scleratus accumulated all the tested metals in their aerial parts except Cd and Pb. Cammelina benghalensis accumulated metals in root except Cd, Pd. Similarly the Phragmites cummunis and Ricinus cummunis accumulated majority of metals in their shoot and leaves. It was also noted that several evaluated plant showed bioconcentration factor (BCF) greater than one for accumulated metals i.e. Pb in T. aestivum (1.285), C. benghalensis (5.142), Cannabis sativa (3.466), P. cummunis (7.180), R. cummunis (66.80) was also noted. Furthermore, greater than one translocation factor (TF) for all these plants showed strong evidence for phytoextraction and in situ remediation potential of these plants. The overall order of phytoextraction potential of native wetland plants were C. sativa > P. cummunis > C. benghalensis > T. aestivum > B. campestris > E. alba.

The thermal characteristics and kinetics of municipal solid waste (MSW) and paper mill sludge (PMS) and their blends were evaluated under pyrolysis condition with different additives, MgO and activated carbon (AC) which were the two common chemical reagents and different content (5% and 10%). The PMS was blended with MSW of 10%, 30%, 50%, 70% and 90%, which were named as 90M10P, 70M30P, 50M50P and 10M90P. The initial temperature, characteristic index, interaction and activation energy were studied in this paper. The initial temperature became higher with the increasing of PMS proportion and became lower when added the additives. The value of the comprehensive pyrolysis characteristic index of the blends indicated that 90M10P and70M30P were the suitable ratios for co-pyrolysis. There was significant interaction between MSW and PMS in high temperature. The average activated energy which calculated in the proportion of 90M10P showed that the MgO(5%) and AC(5%) were the preferable additives.

A simple anodization technique has been adopted for the synthesis of Au doped TiO2 nanotubes (Au/TiO2NTs) electrode. The physicochemical properties of Au/TiO2NTs electrodes have been studied using FE-SEM, Raman spectroscopy, FTIR, XRD, and UV–vis DRS analysis techniques and, compared with un-doped TiO2NTs electrodes. The optimization of process parameters has been carried out for the photoelectrocatalytic (PEC) degradation of 4-CG (4-Chloroguaiacol) under batch-mode experiments. Au/TiO2 nanotube electrodes showed 84% degradation efficiency in 6 h under optimized conditions viz. 0.15 mM Au loading, 0.08 g L−1 electrolyte concentration, 0.03 A current and pH 3 under UV light irradiations. The degradation of 4-CG was validated with the quantification of generated •OH and degradation intermediates/by-products during the batch-mode PEC treatment. The PEC process was observed to be more efficient for degrading and mineralizing 4-CG when compared to PC and EC processes, individually. PEC degradation of 4-CG has also been assessed in recirculation mode to study the feasibility of synthesized Au/TiO2NTs electrodes to treat large volume of contaminant polluted wastewater. For the feasibility of industrial scale applications, pulp and paper mill effluent was subjected to the PEC degradation under recirculation mode using Au/TiO2NTs electrodes and significant reduction in COD and TOC values were observed. Overall, the cost of electrical energy consumption was computed for all the batch and recirculation-mode PEC treatment of 4-CG as well as real pulp and paper mill effluent.

Summary Background & aims Nutrition education is necessary in the training of healthcare professionals, including medical students. However, recent surveys showed that there is a high variability within Medical Schools in different countries. The aim of this ESPEN position paper is to identify a minimum curriculum knowledge in nutrition that serves to improve the training of the future doctors and how to solve the main barriers of its implementation in university centres. Methods In 2017, the ESPEN Executive Committee launched the Nutrition Education in Medical Schools (NEMS) Project and formed a core working group including members of the ESPEN Nutrition Education Study Group (NESG) and representatives of several European Medical Schools. This group met in Brussels, on 19th July 2018 and decided to prepare a position paper on this topic. Results Five main learning objectives and twenty-one topics on human nutrition, within its three domains (basic, applied and clinical nutrition) were identified to be fulfilled at the end of training in all Medical Schools. The experts showed the following key factors for its implementation: establish a nutrition curriculum committee, use different models of integration of the contents in the curriculum (vertical and horizontal), have a multidisciplinary and experienced faculty, incorporate a variety of teaching models, and evaluate the programme periodically. Conclusions Nutrition Education is necessary and should be mandatory in all Medical Schools. This position paper aims at improving this gap knowledge and gives some clues for a successful implementation of the changes in the medical curriculum at university centres.

Multiple myeloma is the second most common hematological malignancy in the USA and Europe. Despite improvements in the 5-year and overall survival rates over the past decade, older adults (aged ≥65 years) with multiple myeloma continue to experience disproportionately worse outcomes than their younger counterparts. These differences in outcomes arise from the increased prevalence of vulnerabilities such as medical comorbidities and frailty seen with advancing age that can influence treatment-delivery and tolerance and impact survival. In general, geriatric assessments can help identify those patients more likely to benefit from enhanced toxicity risk-prediction and aid treatment decision-making. Despite the observed benefits of geriatric assessments and other screening frailty tools, provider and systems-level barriers continue to influence the overall perception of the feasibility of geriatric assessments in clinical practice settings. Clinical trials are underway evaluating the efficacy and safety of various multiple myeloma therapies in less fit/frail older adults, with a minority examining fitness-based/risk-adapted approaches. Thus, significant gaps exist in knowing which myeloma therapies are most appropriate for older and more vulnerable adults with multiple myeloma. The purpose of this Review is to discuss how geriatric assessments can be used to guide the management of transplant-ineligible patients; and to highlight frontline therapies for standard-risk and high-risk cytogenetic abnormalities [i.e., t(4;14), t(14;16), and del(17p)] associated with multiple myeloma. We also discuss the current shortcomings of the existing clinical approaches to care and highlight ongoing clinical trials evaluating newer fitness-based approaches to managing transplant-ineligible patients.

The rapid development of the portable and wearable devices has inspired the ever-growing pursuit of flexible energy storage equipment which can power these devices. Here, rice paper (RP) was integrated with a homemade LGS-polypyrrole (LGS-PPy) ink and commercial pen ink in order to construct a flexible electrode of a supercapacitor via a facial dip-coating method. The obtained RP/LGS-PPy ink/Pen ink composites showed a high areal specific capacitance of 1568 mF/cm2 at 0.2 mA/cm2, owing to the uniform deposition of a LGS-PPy layer which was covered by the pen ink coating. Furthermore, the assembled symmetric supercapacitor fabricated from the RP/LGS-PPy ink/Pen ink electrode exhibited impressive electrochemical performances in terms of specific capacitance (317.5 mF/cm2 at 2 mA/cm2), power density (846 μW/cm2 at the energy density of 23.5 μWh/cm2), and life times (82.1% capacitance retention after 5000 cycles). In addition, the capacitance of the as-prepared device remained essentially unchanged even after bending at 180°, thus demonstrating this device's outstanding flexibility. The low cost of raw materials, robust fabrication strategy as well as the moderate performances make the RP-based supercapacitor a promising candidate for future flexible energy storage devices.

Scaphoid fractures are commonly seen following a fall on an outstretched hand and often missed on initial presentation. An untreated scaphoid fracture may result in avascular necrosis of the scaphoid due to its retrograde blood supply. Published articles guide our investigation and management of these injuries. A citation analysis was performed on the top 30 articles relating to scaphoid fractures ranked by citation number. The 30 articles have been cited a total of 4595 times originating from 9 different countries. The leading article was cited 443 times with an average of 12.66 citations/year. Although this may not directly correlate with study quality, it does provide an insight to the influence which a paper has had on the scientific community. This list may prove invaluable to clinicians involved in the treatment of patients with scaphoid fractures and those actively furthering the development of the field.

This work examines the feasibility of co-gasification of sewage sludge and paper-mill sludge in a commercial scale plant and its application for sludge-to-energy conversion. The results indicated that the thermal reaction activity is increased with an increase in the amount of sewage sludge. This is due to the sewage sludge contains less fixed carbon content could decrease the activation energy, resulting in a thermal reaction is significantly enhanced. The synthetic gas (syngas) composition, that includes H 2 and CO, ranged from percentages of 2.59%–4.13% and 3.2%–6.91%, respectively. The heating value of the produced gas ranged from 1.67 MJ/Nm 3 to 2.56 MJ/Nm 3 , which was coupled with cold gas efficiency (CGE) that ranged from 46.6% to 77%. In the case of two tons of wet tested sludge with 67% moisture content, it could produce one ton of dry tested sludge with 30% moisture content after a drying process, and produce approximately 2.2 tons of syngas in gasification. After using a boiler and heat exchanger for energy recovery, it is possible to recover 4.46 tons of steam. This steam could provide energy for the dryer, and constitutes a positive sum on the energy balance in a commercial scale gasification plant.

The pulp and paper industry is a high energy consuming and polluting sector, and carbon emissions emitted from this sector are worthy of attention. This article, based upon an analysis of China’s Pulp and Paper Industry (CPPI), provides estimates of each of the following: carbon emissions from energy consumption, pre-treatment sector, combustion of condensed black liquor, and methane emitted from incomplete aerobic digestion during sewage treatment of CPPI. During the study period (2005–2012), total CO2 emissions ranged from 126.0 Mt to 155.4 Mt. Energy consumption was estimated to be the largest source of carbon emissions, however, due to the application of the local emission inventory rather than the IPCC inventory, energy consumption decreased by 4.7%, a lower percentage than was calculated in a previous study. According to this study’s estimation, the emissions caused by the recovery of biomass energy contributed 26–29% of the total CO2 emissions. CH4 generated from sewage treatment accounted for 9–11% of the total carbon emissions. The CO2 intensity dropped during the study period, which reflected the improvement of energy efficiency in the pulp and paper industry. The outcome of this study provides not only detailed information about CPPI’s carbon emissions, but also a calculation framework for studying carbon emissions from pulp and paper sector in the other regions. It suggests that the local carbon emissions inventory should be used for estimating carbon emissions and to reduce the fossil fuel energy, increase energy recovery from biomass, and that promoting cleaner production is essential to achieve a low carbon development of the pulp and paper industry.

Introduction The disruption score is a new bibliometric tool that has recently been utilized to identify studies that are innovative and shift paradigms. We sought to identify and characterize the top 100 most disruptive publications in pediatric surgery. Methods The 100 most disruptive and cited publications in 17 pediatric surgery journals were identified from a validated dataset and linked with the iCite NIH tool. The top 100 most disruptive publications were reviewed to determine study design, clinical focus, and perceived contribution. Results The publications included in the top 100 list were more disruptive than 99.5% of the entire PubMed universe. Journal of Pediatric Surgery (n = 45) had the most articles included. There was a weak correlation between citation count and disruption score (r = 0.27). Retrospective cohort studies (38%), contributions in clinical outcomes (39%), technical/technological innovations (31%), clinical focus in trauma (18%), and disorders of the gastrointestinal tract (18%) were the most represented. The disruption score identified a unique subset of literature that has created new paradigms with long lasting influence and may be further applied as another tool to measure scientific impact. This wide array of literature highlights both technical and technological innovations as well as key moments in the history of pediatric surgery. Level of evidence V

Bladder duplication is a rare anomaly classified as sagittal or coronal, depending on the axis of the septum. VACTER association involves congenital anomalies affecting the vertebrae, anus, heart, trachea, esophagus, kidney and genitourinary system. This is the first description of a case of coronal bladder duplication in a patient that also presented with anomalies on the foregut and other organs that correspond to VACTER association. Pertinent literature is systematically reviewed and compared with our case.

In April 2019, the U.K. released a white paper about Online Harms. The White Paper proposes to take Internet censorship to a new height, essentially unmatched by any other Western democracy. It’s a sign of how comprehensive censorship has moved beyond repressive regimes to become trendy even in leading republican democracies. To redress a wide range of anti-social online activity, the White Paper seeks to tightly circumscribe user-generated content — so tightly that only a small number Internet giants will be able to profitably publish user-generated content. Other Internet publishers will be pushed towards licensing professional content and cover those costs by charging subscriber fees to consumers. Thus, the White Paper will produce a reconfigured Internet 3.0 that will resemble the cable TV industry, not the current Internet we know and love. This essay addresses three main points. It first deconstructs the some of the “facts” the White Paper uses to justify its censorious ideas. Then it highlights some of the proposals’ worst policy aspects. The essay concludes by explaining how the White Paper will reshape the Internet and kill off most user-generated content.

We examine voluntary disclosures made by issuers of initial coin offerings (ICOs) in their “white papers” and use them to rate the blockchain technology being developed by the ICO issuers. First, we find that most ICOs receive a low rating. In fact, over 80% of the ICOs do not need to use a blockchain. Second, ICO projects with a higher rating raised more funds than their counterparts, after controlling for other project-, issuer-, and token-related features. Third, ICOs with a high rating are more likely to have their digital coins/tokens listed on a cryptocurrency exchange within 180 days after their ICO end dates. Finally, results indicate that providing technical details in the white paper can be an effective way to signal the quality of an ICO project. Overall, these results are consistent with ICO token buyers/investors taking into consideration the underlying blockchain technology of the ICO projects when making their purchasing/investing decisions. Since the white paper is the main source of ICO information, our findings imply that the credibility of this information is important to protect the interests of ICO buyers/investors and to ensure the long-term viability of the ICO as a capital-raising tool for blockchain-based ventures.

This White Paper provides a summary of the insights gathered at the Oxford Impact Roundtables (OIR) in 2018 and 2019 and proposes a structured frame for the evaluation of the most popular sustainability accounting, reporting and valuation approaches and their relation to one another. Through this we hope to identify synergies and complementarities of different frameworks and enable a better understanding of these by internal and external audiences. Specifically, this paper considers the following frameworks: Sustainability Reporting, Triple Bottom Line, Integrated Reporting, Impact Valuation, Integrated Profit and Loss accounting (Integrated P+L) and the Mutual Profit and Loss statement (Mutual P+L). Recognizing that a multitude of frameworks exist and are in use, we have focused our analysis on those that are most frequently used and relevant for the context of the OIR participants.

This document seeks to respond to the questions raised by the Australian Human Rights Commission and World Economic Forum in their ‘Artificial Intelligence: governance and leadership’ White Paper consultation. It draws upon some of the research conducted at the Allens Hub to make suggestions about if and how systems involving some component of artificial intelligence or automation should be regulated. It also seeks to create further clarity regarding the potential structure and functions of the proposed Responsible Innovation Organisation. We note that our research does not relate to all the questions asked in the White Paper consultation, and so we only set out answers in relation to those matters where our research may be relevant. We are otherwise grateful for the opportunity to present our views and hope this submission will help the Australian Human Rights Commission and World Economic Forum in their consideration.

In this work, urea and diammonium phosphate (DAP) was replaced with paper mill sludge (PMSP) and sewage sludge powders (SWSP) individually as the source of nitrogen and phosphorous and treated by using a consortium isolated from i) sediment of final discharge (ii) sediment of secondary sludge (iii) sediment of equalization tank and named as Bacillus sp. IITRDVM-5, Pseudomonas sp. IITRDVM-10, and Pseudomonas stutzeri IITRDVM-16. The optimum conditions for treatment of the sequence batch biological process were: 48 h reaction time, temperature 37 °C, 150 rpm, and pH 7.0 ± 0.2 using 8% consortium inoculum. The maximum reductions in total organic carbon (TOC), chemical oxygen demand (COD), biochemical oxygen demand (BOD5day), and color at PMSP 3.16 g/500 mL were 79.7, 78.3, 83.2, and 73.9% whereas at SWSP 1.392 g/500 mL were 72.6, 71.4, 76.1 and 69.3% respectively compared to their respective controls. Both PMSP and SWSP individually showed a higher reduction in TOC, COD, BOD5day, lignin, total phenol, adsorbable organic halids (AOX), nitrogen, phosphate, and color compared to the final discharge of paper industry wastewater. Besides, a 74.2% reduction was observed in Kraft lignin (2000 ppm) prepared with MSM at a reaction time of 48 h. Fourier transforms infrared spectrophotometry (FTIR) was done to observe the significant changes in the functional groups of organic pollutants after the treatment of the wastewater samples. Finally, phytotoxicity analysis of the final discharge of the paper industry, untreated and treated wastewater sample was studied on seed (Vigna radiata) germination in which treated effluent showed lesser phytotoxicity.

The development of microfluidic devices for point-of-care (POC) testing has been widely applied for food quality control, environmental monitoring, and clinical diagnoses. Regarding the latter, microfluidic paper-based analytical devices (µPADs) have a great potential in developing portable and disposable platforms for fast disease-relevant biomarker detection in remote areas. In this work, k-nearest neighbors (k-NN) classifiers were applied to demonstrate the reliability of using chemical data obtained from µPADs for diagnosis of diseases like diabetes mellitus and hyperuricemia. Predictors based on glucose, lactate, and uric acid biomarkers were evaluated to reach this goal. Healthy adults were differentiated from the diagnosed patients with a perfect success rate. Metabolic disorders were suitably predicted with 95.0% overall accuracy. This model also showed sensitivities and specificities in the ranges 75–100% and 93–100%, respectively, indicating that the classification protocol is robust. The k-NN modeling proved the potential of the µPADs to be applied in telemedicine for reliable off-site diagnoses.

The main objective of this project was to assess an inkless method to collect reference (exemplar) fingerprints as a low-cost, portable, and hygienic technique; for temporary storage and as an alternative to the conventional black ink method. The tested inkless approach requires alcohol-based hand sanitizer gel as the medium and thermal paper as the substrate. The final quality and clarity of fingerprints were examined and compared between the two methods, especially on the basis of medium/substrate and biological sex effects. Two different evaluation systems of visual quality (clarity) were conducted to provide more reliable results: a quality score scheme (QS) and metrics from the FBI's Universal Latent Workstation (ULW). Fingerprints were obtained from 20 individuals (11 males and 9 females) between the ages of 20 and 40; a total of 240 impressions were evaluated. The results provide evidence that the inkless method produces identifiable fingerprints of equivalent quality to the standard ink method, although significantly better for males. The potential of the proposed technique as an alternative to the conventional ink method is proven and corroborated by the two independent systems of visual quality assessments.

Worldwide, the release of toxic organics with liquid and solid waste from the paper industry has become a serious concern. Papermill effluent was treated by the activated sludge process using urea-diammonium phosphate (DAP) as the sources of nitrogen and phosphorous, which caused bleaching of phytoplankton and eutrophication. Aiming this, urea-DAP was replaced with paper mill sludge powder (PMSP) and sewage sludge powder (SWSP) individually for the treatment of effluent using Bacillus sp. IITRDVM-5. The use of PMSP and SWSP individually showed maximum reduction in total organic carbon, chemical oxygen demand, biochemical oxygen demand, lignin, total phenol, adsorbable organic halides, total Kjeldahl nitrogen, phosphate, and color than the final discharge of paper industry effluent at optimum conditions. IITRDVM-5 also showed a 75.0 to 82.5% reduction in different concentrations of phenol. Gas chromatography analysis of effluent treated mixing with PMSP showed complete removal of 2,5-dichlorophenol; 2-methyl-4, 6-dinitrophenol, and 94% pentachlorophenol. Finally, the effect of untreated, treated, and final discharge of effluent was studied on seed germination of Vigna radiata and effluent treated with IITRDVM-5 showed good seed-growth and lesser phytotoxicity.

The ongoing pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused unprecedented damage to the global economy. Diagnostic testing is a key factor in limiting virus transmission and safeguarding public health. We present the fabrication process of a paper-based device that uses reverse-transcription loop-mediated isothermal amplification (RT-LAMP) to detect SARS-CoV-2 in complex matrices by providing a colorimetric response apparent to the naked eye. Because of LAMP's functionality, this device just requires a simple heat source (e.g., water bath, incubator), it can be deployed in resource-constrained areas and can be used as a supplement to current point-of-care (POC) and community testing procedures. Since the test is based on nucleic acids, the testing platform itself lends to further applications including food safety monitoring, animal diagnostics, etc. simply by changing the specific primers.•We developed a platform capable of on-paper detection of SARS-CoV-2 using colorimetric reporters that produce responses visible to the naked eye.•The platform is easily reconfigurable to target different pathogens by changing the primer sets, and multiplexing is possible by adding additional reaction sites to the device., Graphical abstract Image, graphical abstract

Pulp and paper is considered to be the fourth most energy-intensive industry (EII) worldwide. However, as most of the CO2 emissions are of biomass origin, this sector has the potential to become a carbon-negative industry. This study proposes a new concept for conversion of the pulp and paper industry to carbon negative that relies on the inherent CO2 capture capability of the Kraft process. The techno-economic performance of the proposed carbon-negative system, based on calcium looping (CaL) retrofitted to a pulp and paper plant, was evaluated. The effect of CaL design specifications and cost assumptions on the thermodynamic and economic performance were evaluated. Under the initial design assumptions, the reference pulp and paper plant was shown to turn from electricity importer to electricity exporter with the cost of CO2 avoided equal to 39.0 €/tCO2. The parametric study showed that an increase in the fresh limestone make-up rate resulted in a linear increase of the specific primary energy consumption for CO2 avoided (SPECCA) and a reduction in the amount of electricity exported to the electric grid. This translates into an increase in the price of pulp and newsprint, and the cost of CO2 avoided. This study has also demonstrated that the pulp and paper industry has high potential to become carbon negative. It has been shown that carbon capture and storage would become economically viable in this industry if the negative CO2 emissions are recognised and a negative CO2 emissions credit of at least 41.8 €/tCO2 is implemented.

The aims of the study was the evaluation of phytoremediation potential by Eclipta alba (L) and Alternanthera philoxeroide (L) of pulp and paper mill waste after secondary treatment which a source of aquatic and soil pollution due to huge discharge of organometallic compounds per tone of paper production. The result revealed 50% reduction of pollution parameters after in-situ phytoremediation. The comparative analysis of metal and metalloids showed the highest accumulation of Fe (2251.24 ± 64.74) in both plants. The antioxidant activity, chlorophyll and carotenoid content were increased in E. alba (L.) and A. philoxeroide (L.) respectively. From the results, it was concluded that E. alba (L.) and A. philoxeroide (L.) could be effectively used for the removal of metals and metalloids from effluent and sludge of pulp and paper mill waste that may help to reduce adverse health effects of metal accumulation in humans and animals via their food chain.

The ACR Committee on Incidental Findings presents recommendations for managing liver lesions that are incidentally detected on CT. These recommendations represent an update from the liver component of the ACR 2010 white paper on managing incidental findings in the pancreas, adrenal glands, kidneys, and liver. The Liver Subcommittee-which included five abdominal radiologists, one hepatologist, and one hepatobiliary surgeon-developed this algorithm. The recommendations draw from published evidence and expert opinion and were finalized by informal iterative consensus. Algorithm branches categorize liver lesions on the basis of patient characteristics and imaging features. They terminate with an assessment of benignity or a specific follow-up recommendation. The algorithm addresses most, but not all, pathologies and clinical scenarios. The goal is to improve the quality of care by providing guidance on how to manage incidentally detected liver lesions.