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Pre-hospital transfusion regarding post-traumatic hemorrhage: Medical and regulating elements.
A crucial role in the external postmortem examination system of the Netherlands is that of the attending physicians, who are either general practitioners or physicians in hospitals. They perform 85% of all external postmortem examinations and must immediately report to forensic physicians all unnatural deaths and deaths that they are not convinced to be natural. These attending physicians need therefore to be properly qualified and need to be competent, by acting consistently and by having knowledge of the appropriate laws surrounding external postmortem examination. The aim of this study is to analyse the competence of the attending physicians in hospital settings. This research studied whether they regard themselves as competent, whether they had knowledge of and acted according to the appropriate laws, and whether they acted consistently in following the procedures around external postmortem examinations. A survey was conducted among clinicians. After discarding 23 questionnaires for various reasons, 326 datasets remained on which the research was based. There was no significant difference between the medical specialists (79%) and the residents and fellows (86%) in their feeling of being competent in undertaking external postmortem examinations. The answers of the respondents showed at least one inconsistency in 54%. Of the respondents 34% were considered as to have knowledge of relevant laws. Of the respondents 21% felt competent, was consistent in all their answers and scored a 100% on legal knowledge. The study showed that though a physician might feel competent, this does not mean he actually is competent in performing an external postmortem examination. Furthermore, the extent of a respondents' ignorance of the appropriate laws and the inconsistency in acts and thoughts is undermining the system of postmortem examination.Three continuously stirred-tank reactors fed with manure operating under high ammonia levels (5.0 g NH3-N L-1) and with increased organic loading rate (OLR), (2.09 R1, 3.02 R2 and 4.0 R3 g VS L-1 d-1), achieved through glucose amendment in R2 and R3, were inoculated with an ammonia-acclimatized microbial culture. Successful bioaugmentation was endured only in R2 and R3, both reactors characterized by high OLR, resulting in 19.6 and 24.5% increase in methane production, respectively. The high OLRs in these reactors favored the co-occurrence of the hydrogenotrophic (Methanobacteriaceae), methylotrophic (Methanomethylophilaceae) and aceticlastic methanogenic pathways. The latter was supported by the successful establishment of ammonium-tolerant Methanosarcina, prevailing in the inoculum. Oppositely in R1, the low OLR prevented the establishment of Methanosarcina, leading to an exclusive hydrogenotrophic methanogenesis and reduced methane production. HRT shortening resulted in limited effect on biomethane performance, indicating a well establishment of the introduced bioaugmentation culture in the reactors.Gutter oil is strictly prohibited from being reprocessed back to the catering and food industry. Extensive attention has been paid to rapid screening of gutter oil to guarantee the safety of edible oil. Capsaicin, a special component of condiments, has been adopted as the marker of gutter oil. The time-resolved fluorescent microspheres are utilized for labeling of antibody to capsaicin, which are further applied for the construction of fluorescent lateral-flow-strip (LFS). By simple extraction of capsaicin with ethanol (or liquor) from the edible oil, the capsaicin can be rapid determined with the fluorescent LFS in less than 10 min. As low as 20 ng/mL capsaicin can be visually judged and 2.3 ng/mL is achieved as the detection limit by ImageJ analysis. The illegal gutter oil is also well screened with this time-resolved LFS. This method can be a useful candidate for routine quality monitoring of edible oil and a powerful tool for self-inspection at home.
Intercultural sensitivity is accepting the existence of cultural differences and similarities between individuals without attributing a value to them. In order to provide individualized nursing care, it is required to train nurses who can respond to cultural needs of society, have cultural knowledge and skills regarding society and show a high intercultural sensitivity.

The purpose of this study is to examine the correlation between intercultural sensitivity and individualized care perception of nursing students, who will become a member of professional health discipline.

The population of this study consisted of nursing students receiving education in a state university in Ağrı. The sample of the study consisted of 2nd, 3rd, and 4th year students who agreed to participate in the study and were not absent during the data collection process. In the study, the "Student Information Form", "Intercultural Sensitivity Scale" and "Individualized Care Scale" were used. The study was completed with 90 individualIt was found that as nursing students' intercultural sensitivity level increased, their individualized care perception also increased.Inhibitory effects of phosphate on zero-valent iron (ZVI) dissolution have been studied mainly focusing on a single chemical system. Little is known about inhibitory effects and the mechanism of phosphate on ZVI dissolution within a bioreactor during long-term operation. This study demonstrates the feasibility of achieving energy recovery from phosphate-containing domestic sewage using an efficient anaerobic reactor with micro-sized or nano-sized ZVI addition. The results indicate that the chemical oxygen demand (COD) removal and methane production are enhanced by ZVI addition. A maximum COD removal efficiency of 89% and methane content of 60% was achieved. However, the strengthening effect of ZVI on methane production is weakened by the presence of phosphate in domestic sewage. Analyzing the variations of Fe2+ ions and phosphate concentrations and characterizing the micro-morphology of corroded ZVI proved that the generated Fe2+ ions reacts with phosphate and forms a passivation layer on the ZVI surface, inhibiting further dissolution of ZVI. As an improved alternative, we chose the double layered core-shell structured ZVI@carbon composite as an excellent candidate to reduce the inhibitory effects of phosphate on ZVI dissolution. In this way, the direct formation of precipitates on the ZVI surface can be avoided due to the protective carbon layer which adjusts the ion transfer. Adding ZVI@carbon composites accelerate the methane content by 16%. To our knowledge, this is the first report on adding ZVI@carbon composites to promote the anaerobic metabolism in studies, which are focusing on reducing the inhibition of ZVI by phosphate.The disposal and resource utilization of waste activated sludge (WAS) is a big challenge for its high moisture content. Ionic liquid (IL), 1-ethyl-3-methylimidazolium trifluoromethanesulfonate ([EMIM][OTf]), was innovatively used as a conditioner to improve the dewatering performance of WAS. The WAS was characterized by flocs size, three-dimensional excitation-emission matrix (3D-EEM), zeta potential, Fourier transform infrared spectroscopy (FT-IR) and scanning electron microscope (SEM) for the investigation of intensification mechanism. The results showed that the dewatering performance of WAS conditioned by [EMIM][OTf] was significantly improved. selleck compound The moisture content was successfully decreased to 64.99±0.92 %, and the intensification mechanism was investigated. The results showed that the structures of extracellular polymeric substance (EPS) were destroyed by [EMIM][OTf]. It brought a sharp decrease of the contents of polysaccharides (PS), proteins (PN), humic acid (HA) and fulvic acid (FA) in tightly bound extracellular polymeric substance (TB-EPS) structure. The inactivation of microbial cells promoted the disintegration of flocs. Large flocs were converted into unstable small particles and biopolymers. In addition, the negative charges of WAS were also neutralized for dissolution of biopolymers in [EMIM][OTf], and the electrostatic repulsion between flocs was weakened. [EMIM][OTf] was easily recycled five times. The research results indicate that specific IL, such as [EMIM][OTf], is a potential conditioner to improve the dewatering performance of WAS.Due to the growing and diverse demands on water supply, exploitation of non-conventional sources of water has received much attention. Since water consumption for irrigation is the major contributor to total water withdrawal, the utilization of non-conventional sources of water for the purpose of irrigation is critical to assuring the sustainability of water resources. Although numerous studies have been conducted to evaluate and manage non-conventional water sources, little research has reviewed the suitability of available water technologies for improving water quality, so that water reclaimed from non-conventional supplies could be an alternative water resource for irrigation. This article provides a systematic overview of all aspects of regulation, technology and management to enable the innovative technology, thereby promoting and facilitating the reuse of non-conventional water. The study first reviews the requirements for water quantity and quality (i.e., physical, chemical, and biological parameters) for agricultural irrigation. Five candidate sources of non-conventional water were evaluated in terms of quantity and quality, namely rainfall/stormwater runoff, industrial cooling water, hydraulic fracturing wastewater, process wastewater, and domestic sewage. Water quality issues, such as suspended solids, biochemical/chemical oxygen demand, total dissolved solids, total nitrogen, bacteria, and emerging contaminates, were assessed. Available technologies for improving the quality of non-conventional water were comprehensively investigated. The potential risks to plants, human health, and the environment posed by non-conventional water reuse for irrigation are also discussed. Lastly, three priority research directions, including efficient collection of non-conventional water, design of fit-for-purpose treatment, and deployment of energy-efficient processes, were proposed to provide guidance on the potential for future research.
To train and validate a predictive model of mortality for hospitalized COVID-19 patients based on lung densitometry.

Two-hundred-fifty-one patients with respiratory symptoms underwent CT few days after hospitalization. "Aerated" (AV), "consolidated" (CV) and "intermediate" (IV) lung sub-volumes were quantified by an operator-independent method based on individual HU maximum gradient recognition. AV, CV, IV, CV/AV, IV/AV, and HU of the first peak position were extracted. Relevant clinical parameters were prospectively collected. The population was composed by training (n=166) and validation (n=85) consecutive cohorts, and backward multi-variate logistic regression was applied on the training group to build a CT_model. Similarly, models including only clinical parameters (CLIN_model) and both CT/clinical parameters (COMB_model) were developed. Model's performances were assessed by goodness-of-fit (H&L-test), calibration and discrimination. Model's performances were tested in the validation group.

Forty-three patients died (25/18 in training/validation).
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