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Specialized medical Control over COVID-19: A Review of Medicinal Treatments.
The challenge of reducing the grey footprint is not in technology development, but rather in the proper maintenance and monitoring of treatment systems.The biodegradability and safety of the bioflocculants make them a potential alternative to non-biodegradable chemical flocculants for wastewater treatment. However, low yield and production cost has been reported to be the limiting factor for large scale bioflocculant production. Although the utilization of cheap nutrient sources is generally appealing for large scale bioproduct production, exploration to meet the demand for them is still low. Although much progress has been achieved at laboratory scale, Industrial production and application of bioflocculant is yet to be viable due to cost of the production medium and low yield. Thus, the prospects of bioflocculant application as an alternative to chemical flocculants is linked to evaluation and utilization of cheap alternative and renewable nutrient sources. selleck kinase inhibitor This review evaluates the latest literature on the utilization of waste/wastewater as an alternative substitute for conventional expensive nutrient sources. It focuses on the mechanisms and metabolic pathways involved in microbial flocculant synthesis, culture conditions and nutrient requirements for bioflocculant production, pre-treatment, and also optimization of waste substrate for bioflocculant synthesis and bioflocculant production from waste and their efficiencies. Utilization of wastes as a microbial nutrient source drastically reduces the cost of bioflocculant production and increases the appeal of bioflocculant as a cost-effective alternative to chemical flocculants.BACKGROUND It is unclear whether individual-level and area-level socioeconomic status (SES) is associated with hearing impairment (HI). This study determines an association of individual SES, area SES and their interaction with HI among working-aged adults. METHODS Data were obtained from the large, population-based sample of the Second China National Sample Survey on Disability, a cross-sectional study conducted in China. A total of 1 333 528 participants aged 25-59 years were included. HI was measured by pure-tone audiometry (PTA) and audiologists further ascertained for a final diagnosis. Individual SES was defined as a summed of z-scored of education level and household income per capita, and area SES was calculated as a summed of z-scored of county-level income per capita, high school rate, poverty rate and rate of upper-class occupation. Multilevel logistic regression was used. RESULTS Individual and area SES were associated with HI among Chinese working-aged adults. A 1-SD increase in individual SES was associated with decreased risk of HI (OR=0.3, 95% CI 0.3 to 0.3). Area SES was positively related to HI (OR=1.2, 95%CI 1.2 to 1.3). The cross-level interaction on individual and area SES was significantly associated with HI, indicating that among those who lived in higher SES areas, participants with lower SES had a greater likelihood to develop HI. CONCLUSIONS Significant individual and area socioeconomic inequalities were observed in HI among Chinese working-aged adults. Lower SES adults who resided in prosperous areas may face more deprivation on hearing health than those with higher SES. © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.BACKGROUND Cardiovascular disease (CVD) risk prediction equations are being used to guide risk management among increasingly older individuals. We examined the performance of recent equations, derived from a 2006 cohort including almost all New Zealanders aged 30-74 years, among older people. METHODS All New Zealanders aged 75-89 years in contact with state-funded health services in 2006 without prior CVD or heart failure and with complete predictor data were identified by anonymised individual-level linkage of eight national administrative health datasets. Baseline 5-year CVD risk was estimated using sex-specific New Zealand risk equations, and CVD hospitalisations or deaths occurring between 2007 and 2011 inclusive were ascertained. Performance was assessed with calibration plots and standard metrics. RESULTS Among 124 358 New Zealanders aged 75-89 years old, 30 152 CVD events were recorded during follow-up. Sex-specific equations derived from 30-74 year olds slightly underestimated CVD risk among women and slightly overestimated risk among men aged 75-89 years. Discrimination metrics were poor in both sexes and the risk equations explained only 9.4% of the variation in time to CVD event among women and 6.0% for men. In the 5-year age bands, progressively worsening underprediction in women, overprediction in men and poorer performance metrics were observed with increasing age. CONCLUSION Entire-population CVD risk equations developed among 30-74 year olds do not perform well among older people. Existing risk algorithms developed from primarily middle-aged or early-retirement cohorts should be used with caution in those aged ≥75 years until carefully validated in narrow age bands to avoid masking poorer performance in older age groups. © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.The studyHewlett S, Almeida C, Ambler N, et al. Reducing arthritis fatigue impact two-year randomised controlled trial of cognitive behavioural approaches by rheumatology teams (RAFT). Ann Rheum Dis 2019;78465-72.Hewlett S, Almeida C, Ambler N, et al. Group cognitive behavioural programme to reduce the impact of rheumatoid arthritis fatigue the RAFT RCT with economic and qualitative evaluations. Health Technol Assess 2019;2357.This project was funded by the NIHR Health Technology Assessment Programme (project number 11/112/01).To read the full NIHR Signal, go to https//discover.dc.nihr.ac.uk/content/signal-000860/group-cognitive-behavioural-courses-may-reduce-fatigue-from-rheumatoid-arthritis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http//group.bmj.com/group/rights-licensing/permissions.
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