Start-up

BACKGROUND: Diabetes distress (DD) affects at least 36% of T2DM patients and is often associated with insufficient support and care. This study examines an intervention that targets DD through enhanced cross-sectoral collaboration and treatment during the first 3 months following diagnosis. The intervention aims to improve care and self-management and to reduce DD. METHODS AND INTERVENTION: The study is designed as a cluster-randomized trial with the intervention focusing on four key elements of diabetes care: effective cross-sectoral communication and information sharing, systematic care, a "one-stop-shop" health screening and start-up conversation at the municipality, and improving patient insights into own care...

The use of routinely collected electronic healthcare records (EHR) for outcome assessment in clinical trials has been described as a 'disruptive' new technique more than a decade ago. Despite this potential, significant methodological issues and regulatory barriers have hampered the progress in this area.This article discusses the key considerations that trialists should take into account when incorporating EHR into their trials. These include considerations of the clinical relevance of the outcome, data timeliness and quality, ethical and regulatory issues, and some practical considerations for clinical trials units...

Advanced in situ analyses are indispensable for comprehending the catalyst aging mechanisms of Pt-based PEM fuel cell cathode materials, particularly during accelerated stress tests (AST). In this study, a combination of in situ small-angle and wide-angle X-ray scattering (SAXS & WAXS) techniques were employed to establish correlations between structural parameters (crystal phase, quantity, and size) of a highly active skeleton-PtCo (sk-PtCo) catalyst and their degradation cycles within the potential range of the start-up/shut-down (SUSD) conditions...

High-quality biofilm carriers are crucial for the formation of biofilm, but problems such as slow biofilm growth on the carrier surface have been troubling a large number of researchers. The addition of a carrier changes the flow state in the reactor, which in turn affects the microbial attachment and the quantity of microorganisms. Also, aerobic microorganisms need to use dissolved oxygen in the water to remove water pollutants. In this paper, a novel recirculating flow carrier with a hollow cylinder structure is proposed, with a certain number of hollow inverted circular plates placed at equal distances inside...

For better understanding the mechanism of microbial strains promoting methane production, four strains Hungatella xylanolytica A5, Bacillus licheniformis B1, Paraclostridium benzoelyticum C2 and Advenella faeciporci E1 were inoculated into anaerobic digestion systems. After bioaugmentation, the cumulative methane production of A5, B1, C2 and E1 groups elevated by 11.68%, 8.20%, 18.21% and 15.67% compared to CK group, respectively. The metagenomic analysis revealed that the species diversity and uniformity of the experimental groups was improved, and hydrolytic acidifying bacteria, represented by Clostridiaceae, Anaerolineaceae and Oscillospiraceae, and methanogens, such as Methanotrichaceae and Methanobacteriaceae, were enriched...

BACKGROUND: Partial nitritation-anammox (PNA) is a biological nitrogen removal process commonly used in wastewater treatment plants for the treatment of warm and nitrogen-rich sludge liquor from anaerobic digestion, often referred to as sidestream wastewater. In these systems, biofilms are frequently used to retain biomass with aerobic ammonia-oxidizing bacteria (AOB) and anammox bacteria, which together convert ammonium to nitrogen gas. Little is known about how these biofilm communities develop, and whether knowledge about the assembly of biofilms in natural communities can be applied to PNA biofilms...

BACKGROUND: Despite encouraging developments after its initial founding in Indonesia more than seven decades ago, inequity in access and availability of neurosurgical services throughout the country continues to pose a challenge. We aimed to elaborate on the start-up of a previously inactive neurosurgical service in North Maluku, an archipelagic province in East Indonesia, and describe cases managed within the first two years of service. METHODS: In the North Maluku Database in the Neurosurgery register, demographic and clinical information of neurosurgical patients admitted to Chasan Boesoirie General Hospital, Ternate, from January 2021 to December 2022, were analyzed...

The aim of this study was to evaluate two moving bed biofilm reactors (MBBR) without nitrifying bacteria inoculation. Biofilms and viable bacterial colonies were evaluated after 124 days. MBBR bioreactors received water from Oreochromis niloticus fish farming and water quality parameters were monitored daily. Four distinct phases with different fish stocking density were established.: phase 1 (2.40 kg m-3 ), phase 2 (4.95 kg m-3 ), phase 3 (8.71 kg m-3 ) and phase 4 (12...

The enhancement of nitrate reduction in microbial fuel cells (MFCs) by acclimating biocathode potential was studied. An MFC system was started up, and measured by cyclic voltammetry to determine a suitable potential region for acclimating biocathode. The experimental results revealed that potential acclimation could efficiently improve denitrification performance by relieving the phenomenon of nitrite accumulation, and optimum performance was obtained at -0.4 V with a total nitrogen removal efficiency of 87...

BACKGROUND: Unemployment and restricted work opportunities for youth are enduring social challenges that affect health, well-being, and quality of life, especially in low- to middle-income countries. When considering the advantages associated with work as a determinant of health, unemployment is understood to contribute to occupational injustice. However, self-employment, hailed the solution to youth unemployment, is often necessity-driven, precarious in nature and restricted by the low success rate of business start-ups...

Oral Immunotherapy (OIT) is an accessible procedure for practicing allergy/immunology providers, yet rigorous safety standards are limited in the clinical setting. By exploring the transition from research to clinical practice OIT, we review relevant safety considerations necessary for the clinical provider. We offer perspective on clinical benefits and considerations at the individual, collaboration, and policy level from the vantage of a large academic OIT program, and we offer several practical start-up checklists and clerical considerations for practicing providers...

As a clean, sustainable and efficient technology of wastewater treatment, ultrasonic irradiation has gained special attention in wastewater treatment. It has been widely studied for degrading pollutants and enhancing biological treatment processes for wastewater treatment. This review focuses on the mechanism and updated information of ultrasonic technology to enhance biological treatment of wastewater. The mechanism involved in improving biological treatment by ultrasonic includes: 1) degradation of refractory substances and release carbon from sludges, 2) promotion of mass transfer and change of cell permeability, 3) facilitation of enzyme-catalyzed reactions and 4) influence of cell growth...

Carbon nanotube (CNT)-based field emission X-ray source with the advantage of fast start-up response offers the chance to achieve high-frequency X-ray emission. In this study, a high-frequency random pulse X-ray source of CNT cold cathode combined with a channel electron multiplier (CEM) was built, and its direct current (DC) and pulse emission characteristics were tested. The DC measurement results were used for parameter selection for performing pulse experiments. During the DC test, with the conditions of 2...

With the increasing use of renewable energy resources for the power grid, the need for long-term storage technologies, such as power-to-gas systems, is growing. Biomethanation provides the opportunity to store energy in the form of the natural gas-equivalent biomethane. This study investigates a novel plug flow reactor that employs a helical static mixer for the biological methanation of hydrogen and carbon dioxide. In tests, the reactor achieved an average methane production rate of 2.5 LCH4LR∗d (methane production [LCH4 ] per liter of reactor volume [LR ] per day [d]) with a maximum methane content of 94%...

The COVID-19 pandemic dictated rapid reform in outpatient paediatric services. To reduce ward footfall and its associated infection risk, a trainee-led outpatient clinic was established with the aim to provide children with continuity of care following discharge from hospital. The service was created as a safe alternative to the long-standing practice of ward attenders while reducing mounting pressures on appointments at consultant-led clinics. Several issues arose in its implementation. A retrospective analysis with insights from service users found significant communication issues at various stages in referral, booking and follow-up management...

Untreated stormwater is a major source of microplastics, organic pollutants, metals, and nutrients in urban water courses. The aim of this study was to improve the knowledge about the start-up periods of bioretention filters. A rain garden pilot facility with 13 bioretention filters was constructed and stormwater from a highway and adjacent impervious surfaces was used for irrigation for ∼12 weeks. Selected plants (Armeria maritima, Hippophae rhamnoides, Juncus effusus, and Festuca rubra) was planted in ten filters...

BACKGROUND: Many emerging adults (EAs) are prone to making unhealthy choices, which increase their risk of premature cancer morbidity and mortality. In the era of social media, rigorous research on interventions to promote health behaviors for cancer risk reduction among EAs delivered over social media is limited. Cancer prevention information and recommendations may reach EAs more effectively over social media than in settings such as health care, schools, and workplaces, particularly for EAs residing in rural areas...

BACKGROUND: The prognosis of advanced melanoma patients has significantly improved over the years. We aimed to evaluate the survival per year of diagnosis. METHODS: All systemically treated patients diagnosed with advanced melanoma from 2013 to 2021 were included from the Dutch Melanoma Treatment Registry. Baseline characteristics and overall survival (OS) were compared between the different years of diagnosis. A multivariable Cox proportional hazards model was used to estimate the association between year of diagnosis and OS...

A horizontal biotrickling filter (HBTF) was designed to understand the toluene removal process and microbial community structures. The start-up time of the HBTF, immobilized by the dominant fungi was only about 6 days and the toluene removal efficiency was found to be more than 95% when the inlet toluene concentration remained at around 1560.0 mg/m3 . In the stable operation stage of the HBTF, based on not greatly reducing the removal efficiency, a simple and convenient periodic commutation was adopted to reduce the pressure drop (△P) and regulate the distribution of microorganisms in the packing area of the HBTF...

OBJECTIVES: We aimed to investigate the value of adding a video monitoring (VM) system with falls and costs for patients at high risk. METHODS: We conducted a retrospective, historically controlled study of adults (≥18 y old) at high risk of fall admitted at the University of Miami Hospital and Clinics from January 1 to November 30, 2020 (pre-VM) and January 1 to November 30, 2021 (post-VM); in-person sitters were available in both periods. Fall risk assessment was conducted on admission and at every nursing shift; we defined patients as high risk if their Morse Fall Scale was ≥60...