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Gas flotation for oily wastewater treatment is based on the attachment of gas bubbles to oil droplets to produce lighter aggregates that rise to the wastewater surface. It is a feasible, promising, and effective method for oily wastewater treatment due to its high separation efficiency with no secondary contamination, cost-effectiveness, and simple operation. This review focuses on separating oil from emulsions by gas flotation using microbubbles (MBs) and nanobubbles (NBs), which offer the advantages of small bubble size, large specific surface area, and slow rising velocity. The properties of different types of gas bubbles and their generation methods were discussed. Different gas flotation system designs and operational parameters were summarized for dissolved gas flotation, induced gas flotation, and electrolytic flotation (EF). The review illustrated that oil removal efficiency in MB- and NB-based gas flotation was affected by various factors including initial oil concentration, pH, temperature, flotation time, and oil droplet size. Key words: gas flotation, microbubble, nanobubble, oil-in-water emulsion, oily wastewater treatment La flottation gazeuse pour le traitement des eaux usées contaminées par les hydrocarbures est basée sur la fixation des bulles de gaz aux gouttelettes d'hydrocarbures pour produire des agrégats plus légers qui remontent àla surface des eaux usées. Il s'agit d'une méthode réalisable, prometteuse et efficace pour le traitement des eaux usées contaminées par les hydrocarbures en raison de sa grande efficacité de séparation sans contamination secondaire, de sa rentabilité et de sa simplicité d'utilisation. Cette synthèse se concentre sur la séparation des hydrocarbures des émulsions par flottation gazeuse en utilisant des microbulles et des nanobulles qui offrent les avantages d'une petite taille de bulle, d'une grande surface spécifique et d'une vitesse d'ascension lente. Les propriétés des différents types de bulles de gaz et leurs méthodes de génération ont été discutées. Les différentes conceptions de systèmes de flottation gazeuse et les paramètres opérationnels ont été résumés pour la flottation par gaz dissous, la flottation par gaz induit et la flottation électrolytique. La synthèse a montré que l'efficacité de l'élimination des hydrocarbures par la flottation gazeuse àbase de microbulles et de nanobulles était affectée par divers facteurs, notamment la concentration initiale d'hydrocarbures, le pH, la température, le temps de flottation et la taille des gouttelettes d'hydrocarbures. [Traduit par la Rédaction] Mots-clés : flottation gazeuse, microbulles, nanobulles, émulsion d'huile dans l'eau, traitement des eaux usées contaminées aux hydrocarbures, 1 Introduction Oily wastewater is generated from oil spill incidents and many other sources, such as food processing, oil refining, textile and leather industries, metal rolling and finishing, paper deinking, [...]

Background: Chronic nonspecific neck pain (CNSNP) is a common musculoskeletal disorder, particularly in the elderly, leading to reduced cervical muscle strength, impaired functional balance, and decreased postural stability. This study investigated the correlation between cervical muscle strength, functional balance, and limits of stability (LOS) in elderly individuals with CNSNP. Additionally, it assessed the moderating effect of pain severity on the relationship between cervical muscle strength and these balance outcomes. Methods: A prospective study included a total of 186 participants, including 93 with CNSNP and 93 asymptomatic individuals, were recruited. Cervical flexor and extensor muscle strength were assessed using an ergoFET hand-held dynamometer. Functional balance was measured using the Berg Balance Scale (BBS) and Timed Up and Go (TUG) test, while LOS were evaluated using the Iso-Free machine. Results: Individuals with CNSNP exhibited significantly lower cervical flexor strength (32.45 ± 5.67 N vs. 40.75 ± 5.20 N, p < 0.001) and extensor strength (28.30 ± 6.05 N vs. 36.90 ± 5.90 N, p < 0.001) compared to asymptomatic individuals. Functional balance was also poorer in the CNSNP group, with lower BBS scores (47.85 ± 4.20 vs. 53.65 ± 3.85, p < 0.001) and slower TUG times (11.30 ± 2.05 s vs. 8.45 ± 1.80 s, p < 0.001). Cervical muscle strength showed moderate to strong positive correlations with LOS (r = 0.56 to 0.62, p < 0.001) and BBS (r = 0.48 to 0.53, p < 0.001). Pain severity significantly moderated the relationship between cervical muscle strength and functional balance (β = 0.20, p = 0.045) as well as LOS (β = 0.22, p = 0.038), suggesting that higher pain levels diminish the positive effects of muscle strength on balance. Conclusion: Cervical muscle strength plays a crucial role in maintaining functional balance and postural stability in elderly individuals with CNSNP. Pain severity moderates the relationship between cervical muscle strength and balance outcomes, emphasizing the importance of integrating muscle strengthening and pain management in rehabilitation programs for elderly individuals with CNSNP to optimize postural control and minimize fall risk. [ABSTRACT FROM AUTHOR]

Background: Type 2 diabetes mellitus (T2DM) is a prevalent metabolic disorder with systemic implications, potentially affecting musculoskeletal health. This study aimed to assess shoulder muscle strength and joint repositioning accuracy in individuals with T2DM, exploring potential correlations and shedding light on the musculoskeletal consequences of the condition. The objectives were two-fold: (1) to assess and compare shoulder strength and joint repositioning accuracy between individuals with T2DM and asymptomatic counterparts, and (2) to examine the correlation between shoulder strength and joint repositioning accuracy in individuals with T2DM. Methods: A cross-sectional study enrolled 172 participants using the convenience sampling method, including 86 individuals with T2DM and an age-matched asymptomatic group (n = 86). Shoulder strength was assessed using a handheld dynamometer, while joint repositioning accuracy was evaluated with an electronic digital inclinometer. Results: Individuals with T2DM exhibited reduced shoulder muscle strength compared to asymptomatic individuals (p < 0.001). Additionally, joint repositioning accuracy was significantly lower in the T2DM group (p < 0.001). Negative correlations were observed between shoulder strength and joint repositioning accuracy in various directions (ranging from −0.29 to −0.46, p < 0.001), indicating that higher muscle strength was associated with improved joint repositioning accuracy in individuals with T2DM. Conclusion: This study highlights the significant impact of T2DM on shoulder muscle strength and joint repositioning accuracy. Reduced strength and impaired accuracy are evident in individuals with T2DM, emphasizing the importance of addressing musculoskeletal aspects in diabetes management. The negative correlations suggest that enhancing shoulder muscle strength may lead to improved joint repositioning accuracy, potentially contributing to enhanced physical functioning in this population. [ABSTRACT FROM AUTHOR]

The article focuses on the need for clinical ethics fellowship programs to adopt anti-racist practices and address racial inequities in their recruitment and mentorship processes. Topics include the establishment of diversity standards for recruitment; the development of culturally responsive mentorship practices; and the integration of structural competency into fellows' training to enhance their understanding of systemic racism in healthcare.

Objective: Pediatric clinicians caring for children with acquired brain injury have noted that many individuals requiring assistive technology (AD go unserved or face delays until devices are obtained, with potential adverse implications for recovery and development. In this article we map the pathways by which AT is prescribed and assess delays and barriers to access. Methods: We conducted a retrospective chart review of patients with moderate to severe brain injury admitted to Blythedale Children's Hospital over a 2-year period using a database drawn from the medical record. Results: We identified 72 children diagnosed with brain injury requiring at least 1 device. Devices were used to improve mobility and positioning, self-care, safety, and communication, and enable access to other technologies and foster social integration. We found that 550/0 of devices were delivered, with most deliveries to home or the hospital's outpatient department for fitting, training, and instruction. Time to delivery ranged from 12 to 250 days with an average of 69.4 days. Twenty percent of nondeliveries were attributable to change in medical status, transfer to a skilled nursing facility, or continued inpatient status, while 31% were canceled by the family. Other nondeliveries were attributed to insurance coverage. We also found that the medical record is not designed for the longit·udinal tracking of devices, indicating the need for a prospective process to document the AT trajectory. Conclusion: Instead of tolerating delays and denials, there should be a normative expectation that children have a right to medically necessary devices, consistent with disability law. This analysis was undertaken as a step toward formulating a prospective means of tracking AT recommendations, approvals, denials, and/or deliveries. Our findings should be understood as a promissory note toward structural reforms that are reflective of society's responsibility to better meet the needs of vulnerable children and their farnmes. [ABSTRACT FROM AUTHOR]

This article explores the ethical considerations involved in making discharge decisions in healthcare settings. It emphasizes the complexity of these decisions and the need for healthcare professionals to consider various factors, including the patient's ability to manage medications, independence, living situation, and access to necessary services. The article also highlights the impact of social inequities on discharge decisions, such as housing and food insecurity. It emphasizes the importance of effective communication and understanding between healthcare providers and patients/families to ensure safe and appropriate discharge decisions. The text discusses the challenges and complexities of making discharge recommendations, the differences in perspectives between clinicians and patients, and the need for clinicians to uncover the deeper meanings behind patients' desires. It introduces an alternative to the binary system of discharge recommendations and emphasizes the importance of collaboration between patients, care partners, and clinicians. The second part of the text focuses on the challenges and ethical dilemmas faced by healthcare professionals in making discharge decisions for patients with cognitive impairments. It highlights the lack of expertise and knowledge about patients' living environments and resources, as well as the limited options and structural barriers in the healthcare system. The text emphasizes the need for better long-term home and community-based services and supports, as well as shared decision-making and realistic discussions about the risks and benefits of different discharge options. The author shares a personal story to underscore the importance of advocating for better options and approaching discharge decisions with empathy and respect for patients' core values. The authors argue for embracing uncertainty and exploring ambiguous spaces to find more effective solutions [Extracted from the article]

Chronic ankle instability (CAI) is characterized by impaired ankle joint position sense (JPS) and compromised balance. Despite previous studies investigating the correlation between ankle JPS and balance in individuals with CAI, the potential mediating effect of pain in this relationship remains unclear. Understanding the role of pain as a mediator between ankle JPS and balance could provide valuable insights into the complex interplay among these variables in individuals with CAI. Therefore, further research is needed to elucidate the mediating effect of pain and its implications in assessing and managing ankle JPS and balance deficits in individuals with CAI. This cross-sectional study aimed to investigate the mediating role of pain in the association between ankle JPS and balance in individuals with unilateral CAI. Methods: Fifty-five individuals diagnosed with CAI participated in this study. Ankle JPS was assessed using a digital inclinometer, whereas the balance was measured using a computerized dynamic posturography device. Results: Participants with CAI showed impaired ankle JPS in the affected leg compared to that in the asymptomatic leg (p < 0.001). Ankle JPS errors were greater in both dorsiflexion and plantarflexion directions in the CAI. Balance was compromised in the CAI leg (p < 0.001). Moderate correlations (p < 0.001, r = 0.31 to 0.48) were found between the balance variables. Pain significantly mediated the ankle JPS-balance relationship in the CAI (p < 0.05, Sobel test). The findings suggest that individuals with CAI exhibit impaired ankle JPS and compromised balance. Pain plays a mediating role in the association between ankle JPS and balance in individuals with CAI. These results highlight the importance of considering pain as a potential mediator when assessing and treating balance issues in individuals with CAI. Healthcare professionals should incorporate assessments of ankle JPS and pain into the management of interventions that address these factors and improve balance and functional ability. [ABSTRACT FROM AUTHOR]

Aphasia is a language disorder caused by damage to the language areas and networks in the brain, and conservative estimates indicate there are currently more than 2.5 million people living with aphasia in the United States.[5] Aphasia can affect any of the four language modalities (speaking, understanding, reading, and writing) to varying degrees depending on the type and extent of a person's injury. From a disability rights perspective, people with communication disabilities like aphasia experience issues of communication access. While it is true that people with communication disabilities may be more susceptible to the risk of non- or limited comprehension of complex concepts, both the literature and my own direct experiences as a clinical researcher show that appropriate communication accommodations allow people with varied communication disabilities to communicate effectively and participate meaningfully as research participants. Why communication access is critical to ethical clinical research B Elissa Larkin MS, CCC SLP b Shirley Ryan Ability Lab As a clinician and rehabilitation researcher, I have had many humbling and enlightening experiences during which individuals with communication disabilities have educated me about the inequities they face. [Extracted from the article]

The authors comment on the urgency of the decision when the patient has indications for dialysis. Topics discussed include actions that should be taken by the team during this situation, different options that should be told to the patient for him to make an informed decision, and common theme that arose in a study of advanced kidney disease patients who decided to forgo dialysis.

Percutaneous endoscopic gastrostomy tubes, or PEG tubes, look innocuous enough--narrow, plastic, pliable tubes, that when inserted into the stomach protrude approximately 3 to 5 inches and can be attached to [...]

In the clinical domain, ethical analyses involve examination of complex individual responses, psychological processes, and social context. Psychological aspects of stroke adaptation include the risk for depression and anxiety, changes [...]