Wash Period Research Articles

Maximizing efficiency in emergency care: triple interventions to minimize left without being seen: An observational study

Left without being seen (LWBS) is a quality care metric associated with patient-centered outcomes. The risks affecting LWBS are complex and interventions targeting certain risks have diverse effects. We aimed to use different artificial intelligence and machine learning (AI/ML) algorithms to identify the risks affecting LWBS, implement triple interventions specifically targeted at such risks, and compare daily LWBS rate changes before and after the intervention. This is a retrospective observational study. Single urban Emergency Department (ED) daily throughput data from March 1, 2019, to February 28, 2023, were used for AI/ML model prediction. Model performance including accuracy, recall, precision, F1 score, and area under the receiver operating characteristics (AUC) were reported. The top risks affecting the LWBS were identified using the important function of the AI/ML feature. Triple interventions were implemented. The average daily LWBS rate was compared before (March 1, 2019, to February 28, 2023) and after (June 1, 2023, to May 31, 2024). A total of 1919 daily throughput metrics were analyzed, including 1461 daily metrics before the intervention, 92 daily metrics during the wash period, and 366 daily metrics after the intervention. Using data before the intervention, the Extreme Gradient Boosting (XGBoost) and Random Forest AI/ML algorithms predicted LWBS with a similar favorable performance. The 3 common factors influencing the increased daily LWBS rate were triage-to-bed (wait time), boarding time, and door-to-triage in the ED. Rapid triage, direct bedding, and boarding reduction (triple intervention) were implemented on March 1, 2023. We found 4.82% of daily LWBS before the triple intervention compared to 1.93% of daily LWBS after the triple intervention (P < .001). AI/ML approaches can identify common factors that are highly related to LWBS with favorable performance. Triple interventions targeting these factors can reduce the daily LWBS rate by approximately 60%, indicating the efficiency of the ED operational management.

The effectiveness of hyperoxygenation in preventing oxygen desaturation in intubated infants treated with endotracheal suctioning

Endotracheal suctioning is an effective nursing intervention for intubated infants undergoing invasive mechanical ventilation. However, this intervention has the potential to cause side effects, such as hypoxemia, which typically requires hyperoxygenation. Despite the widespread use of hyperoxygenation in clinical practice, there are limited reports on its effectiveness in infants. This study aims to determine the effect of hyperoxygenation on oxygen saturation of intubated infants.The study procedures were carried out using a quasi-experimental method with a cross-over approach. In addition, the sample population comprised 22 intubated infants who were treated at the perinatology unit of Dr. Cipto Mangunkusumo Hospital in Jakarta from March to April 2018. The participants were then divided into 2 groups based on their condition, and oxygen saturation level was assessed. The intervention comprised endotracheal suctioning with and without hyperoxygenation, with a 3-hour washing period. Data collection was performed at different measurement intervals, namely before, during, and after suctioning, followed by statistical analysis.The paired-sample t-tests and Wilcoxon test showed that there was a significant difference in oxygen saturation at certain measurement intervals (p=0.006; p=0.010; p=0.001; p=0.001; p=0.001). In addition, Friedman test also showed the presence of a significant difference in the reduction of oxygen saturation between the control and intervention groups (p=0.001).In conclusion, hyperoxygenation had the potential to prevent the reduction of oxygen saturation during endotracheal suctioning in intubated infants. However, individual assessment of the need for suctioning and hyperoxygenation was necessary for a safe and effective procedure.

The effect of bioelectric and manual impressions on quality of complete dentures and quality of life: A cross over pilot study

The effect of bioelectric and manual impressions on quality of complete dentures and quality of life: A cross over pilot study

#1182 Arterial hypertension and chronic obstructive pulmonary disease—problems of choice of therapy

Abstract Background and Aims The development of hypertension in COPD is based on the early formation of endothelial dysfunction in the small and large circulatory circles, increased sympathetic activity with an imbalance in the synthesis of catecholamines, a violation of the role of the lungs in the metabolism of vasoactive substances, oxidative stress, chronic systemic inflammation, an imbalance in the renin-angiotensin-aldosterone system (RAAS). There are few studies confirming the role of RAAS components in the pathogenesis of cardiovascular changes in patients COPD. The activity of angiotensin converting enzyme (ACE) increases with hypoxia, which may play an important role in increasing the degree of systemic hypertension. An increase in the function of the RAAS is possible both under the direct influence of hypoxia and indirectly through activation of the sympathoadrenal system. To evaluate the efficacy and tolerability of the angiotensin II receptor antagonist valsartan (Nortivan) at a dose 80-160 mg per day in patients with hypertension of 1-2 degrees and COPD of stage II-IV. Method The study design is a local, open, incomparable study on the efficacy and safety of the drug Nortivan in patients with hypertension in combination with COPD. We examined 18 patients with stage II-IV in remission, suffering from grade I and II hypertension, determined in accordance with the generally accepted classification of blood pressure levels (VNOK, 2010). Results The criteria for exclusion from the study were the presence in patients of complications of hypertension, coronary heart disease, decompensated chronic pulmonary heart, endocrine diseases requiring drug correction, kidney pathology, chronic heart failure, oral steroid therapy. 10 days in the last 6 months before inclusion in the study, oncological diseases and any other conditions that could interfere with the interpretation and evaluation of the results of the study. Patients who had not previously received antihypertensive treatment were included in the study immediately, and the rest underwent a washing period for 2 weeks. Patients received Nortivan as antihypertensive therapy for 24 weeks. The effectiveness of therapy was controlled by daily monitoring blood pressure. The choice of quality criteria for the effectiveness of therapy parameters SMAD is associated with literature data and own observations on the prevalence of diurnal blood pressure profiles in patients with hypertension and COPD with no decrease or increase in blood pressure at night, when office blood pressure figures are to a lesser extent reflect the effectiveness of antihypertensive therapy. The initial dosage was 80 mg/day. With insufficient hypotensive effect, the dose of the drug was doubled at the 4th week of treatment. The basic COPD therapy did not change throughout the study period and included anticholinergic drugs (ipratropium bromide, tiotropium bromide), beta2-adrenomimetic (fe-noterol) or a combination thereof. Initially and after 24 weeks of treatment, a complete laboratory examination was performed: a clinical blood test, a biochemical blood test. The thickness of the intima-media complex of the carotid arteries and ECG was also studied. The criterion The safety of the therapy was assessed by the indicators of respiratory function, daily pulse oximetry. Conclusion The use of the drug Nortivan has shown high efficacy and safety in patients Grade I–II hypertension in combination with stage II-IV COPD. A statistically and clinically significant normalization of SMAD indicators with correction of pathological types of daily curves due to a decrease in the number of patients with an increase in or the absence of a decrease in blood pressure during the night period. The safety of using the drug in the clinical group with bronchial obstruction syndrome was confirmed by the dynamics of ventilation indicators according to spirometry and the results of daily pulse oximetry, which showed the absence of exacerbation of hypoxia during therapy.

Dose adjustment of paroxetine based on CYP2D6 activity score inferred metabolizer status in Chinese Han patients with depressive or anxiety disorders: a prospective study and cross-ethnic meta-analysis

Understanding the impact of CYP2D6 metabolism on paroxetine, a widely used antidepressant, is essential for precision dosing. We conducted an 8-week, multi-center, single-drug, 2-week wash period prospective cohort study in 921 Chinese Han patients with depressive or anxiety disorders (ChiCTR2000038462). We performed CYP2D6 genotyping (single nucleotide variant and copy number variant) to derive the CYP2D6 activity score and evaluated paroxetine treatment outcomes including steady-state concentration, treatment efficacy, and adverse reaction. CYP2D6 metabolizer status was categorized into poor metabolizers (PMs), intermediate metabolizers (IMs), extensive metabolizers (EMs), and ultrarapid metabolizers (UMs). The influence of CYP2D6 metabolic phenotype onparoxetine treatment outcomes was examined using multiple regression analysis and cross-ethnic meta-analysis. The therapeutic reference range of paroxetine was estimated by receiver operating characteristic (ROC) analyses. After adjusting for demographic factors, the steady-state concentrations of paroxetine in PMs, IMs, and UMs were 2.50, 1.12, and 0.39 times that of EMs, with PM and UM effects being statistically significant (multiple linear regression, P=0.03 and P=0.04). Sex and ethnicity influenced the comparison between IMs and EMs. Moreover, poor efficacy of paroxetine was associated with UM, and a higher risk of developing adverse reactions was associated with lower CYP2D6 activity score. Lastly, cross-ethnic meta-analysis suggested dose adjustments for PMs, IMs, EMs, and UMs in the East Asian population to be 35%, 40%, 143%, and 241% of the manufacturer's recommended dose, and 62%, 68%, 131%, and 159% in the non-East Asian population. Our findings advocate for precision dosing based on the CYP2D6 metabolic phenotype, with sex and ethnicity being crucial considerations in this approach. National Natural Science Foundation of China; Academy of Medical Sciences Research Unit.

Reasonable multi-functionality of cotton fabric with superior flame retardancy and antibacterial ability using ammonium diphosphate as cross-linker

Reasonable multi-functionality of cotton fabric with superior flame retardancy and antibacterial ability using ammonium diphosphate as cross-linker

Immune endotyping and gene expression profile of patients with chronic rhinosinusitis with nasal polyps in the aspirin-exacerbated respiratory disease (AERD) and the non-AERD subgroups

BackgroundChronic Rhinosinusitis (CRS) is a paranasal sinus inflammatory disease and is divided into two subgroups defined as CRS with nasal polyps (CRSwNP) and CRS without nasal polyps (CRSsNP). CRSwNP displays a T helper (Th)2 biased phenotype, and based on sensitivity or tolerance to aspirin or non-steroidal anti-inflammatory drugs (NSAID), is further subdivided into Aspirin-exacerbated respiratory disease (AERD) and non-AERD groups. Considering the challenge of diagnosis and treatment in patients with CRSwNP, particularly the AERD subtype, and the significance of endotyping in these patients, we examined the immune profile and endotyping based on gene expression analysis in the AERD and the non-AERD groups of patients with CRSwNP.Material and methodIn this study, 21 patients were enrolled and were categorized into AERD (N = 10) and non-AERD (N = 11) groups based on their sensitivity to aspirin. After the special washing period, nasal polyps were biopsied in both groups, and the infiltration of eosinophils, neutrophils, plasma cells, and lymphocytes was compared between the AERD and the non-AERD groups. Also, gene expression levels of transcription factors including Tbet, GATA3, RoRγt, and FoxP3 and inflammatory cytokines including interleukin (IL)1β, IL1RAP (IL1 receptor accessory protein), IL2, IL4, IL5, IL10, IL13, IL17, TNFα, and IFNγ were investigated by quantitative Real-time PCR (qRT-PCR). Statistical analyses were performed using analytical tests including Kolmogorov–Smirnov, Mann-Whitney, and T-test. A P value less than 0.05 was considered statistically significant.ResultsThe mean ± SD age of the studied groups was 37 ± 8.7 years old (21–50) for the AERD, and 40.4 ± 7.7 years old (31–52) for the non-AERD. LMS/EPOS/SNOT scores and pulmonary function tests showed no difference between the two groups. Serum immunoglobulin E (IgE) levels were found to be higher in patients with AERD (p = 0.04), however, the peripheral blood counts of eosinophils were comparable in the two groups. In the histopathologic analysis, the AERD group showed higher percentages of eosinophils (p = 0.04), neutrophils (p = 0.04), and plasma cells (p = 0.04) than the non-AERD group. Additionally, the gene expression levels of GATA3 (p = 0.001), IL4 (p = 0.04), IL5 (p = 0.007), and IL17 (p = 0.03) were significantly higher in the AERD than the non-AERD groups.ConclusionHigher gene expression levels of GATA3, IL4, IL5, and IL17 were observed in the AERD group compared with the non-AERD group. These findings point to distinct patterns of inflammation in patients with AERD, with a predominance of Th2 inflammation.

Single Ultrasonic-Assisted Washing for Eco-Efficient Production of Mackerel (Auxis thazard) Surimi.

This study highlights a promising single washing method for producing dark-fleshed mackerel surimi aided by ultrasonication in conjunction with cold carbonated water containing 0.6% NaCl and mixed antioxidants (0.5% EDTA/0.2% sodium erythorbate/0.2% sodium tripolyphosphate) (CSA). Different washing periods (5, 10, and 15 min) with and without ultrasound were tested. Unwashed mince (A1) and conventional water-washed surimi (10 min/cycle, 3 cycles) (A2) were used as controls. A3, A4, and A5 were subjected to ultrasound-assisted washing for 5, 10, and 15 min, respectively, whereas A6, A7, and A8 had non-ultrasound-assisted washing for 5, 10, and 15 min. Results showed that the surimi yield decreased as the ultrasonic treatment time increased from 5 to 15 min (p < 0.05). Increased ultrasonic time resulted in greater protein denaturation, protein oxidation, myoglobin removal, and lipid oxidation in surimi (p < 0.05). Surimi produced by CSA ultrasonication for 5 min (A3), on the other hand, had a comparable overall quality to A2 surimi (p > 0.05). The correspondence gel (A3) outperformed the control gel (A2) in terms of gel strength, whiteness, and water-holding capacity (p < 0.05). The formation of regularly continuous, more organized, and smooth network structures in surimi gel was observed in A2 and A3 gels, whereas sparse and larger pore sizes were noticed in surimi gels produced by longer ultrasonic treatment. All of the surimi gels had identical FTIR spectra, indicating that the functional groups of the protein gel were consistent throughout. As a result, a single 5 min CSA-ultrasonic washing could potentially yield surimi of comparable quality to conventional washing. This could pave the way for the development of dark-fleshed fish surimi, which would require less washing time and produce less waste water.

Unraveling the Potential of Household Electrolytes on Extricating Imidacloprid Residues from Tomatoes: Toxicity Assessment

Farmers that cultivate tomatoes use imidacloprid to combat sucking bugs even while the fruits are being harvested so that they can maintain a five- to six-time harvest. Decontaminating tomato fruits before eating is absolutely necessary due to the insecticide's slow dissipation rate and the fact that residues last in vegetables for 15–25 days. The quality of fruit has been compromised and cannot be used in salads, despite the fact that various heat procedures are effective in removing imidacloprid residue. Therefore, a study was conducted to assess the effectiveness of common electrolytes, namely NaCl and NaHCO3, and their combinations, on imidacloprid removal from tomato fruits. Fruits and washing solutions were extracted for imidacloprid residue and determined using the UFLC-PDA besides optimizing the concentration and period of decontamination or washing without dietary risk. Results indicates that the washing of the fruits with NaCl @ 1, 2 and 3% solutions for 10 minutes are efficient (98-100% removal) in decontaminating to below hazard quotient when sprayed with recommended 20 g ai/ha. Whereas, the NaHCO3 or its combination with NaCl 1% for 10 minutes was found to be efficient (92-100%) in decontaminating the fruits when sprayed with 40 g ai/ha. Increasing the decontamination period beyond 10 minutes increased the residue load on fruits to above hazard quotient and was above 1.0 when NaCl was used. Study suggests the washing of tomato fruits with 2%NaHCO3 or 1%NaCl+2% NaHCO3 for 10 minutes is the efficient decontamination way and to ensure safety to the consumers.

Studying the Transmission Behavior of Two-Phase Flow Oil-Water Mixing Using a Laboratory Multiple Porous Media Model

The formation and flow of emulsions in porous media are common to all technologies used to extract or process oil. In most cases, oil and water emulsions are formed in a porous medium due to oil spills near watery areas or soils containing water. This emulsion leads to a reaction between oil and water, which finds its way to the porous medium. The detailed flow mechanisms of emulsions through porous media are not well understood. In this study, the soil’s oil percentage variation was studied when sand was introduced or an emulsion, i.e., mixed with water, and two porous media, different in composition and physical properties, were used to find out their effect on oil transmission. The percentage of oil and water was calculated at several points at different distances and times. It was noted that the results differed in both mediums due to the difference in permeability, porosity, arrangement of soil particles, compaction process, and other physical properties. Liquids’ viscosity, density, and chemical composition clearly and significantly affect the results. The time for the oil to reach the last point in the pipe differed for both soils. If the time period in the experiment of pumping oil only in sandy soil took 6 hours and the washing process took 3 hours. In organic soil, the time period for the pollutant pumping stage took about 7 hours and the washing stage about 4 hours because the oil is transmitted in sandy soil is faster, but in the experiment of pumping oil and water together, the time period in the process of pumping oil and water together in sandy soil took 4 hours and the washing process 3 hours In organic soil, the period of pumping oil and water together took 5 hours, and the washing period 3 hours, because the percentage of oil was less than in the experiment of pumping oil only. In the soil, that is, if the period of pumping the pollutant increased for more than 15 hours, the oil may reach a distance of more than 4 meters in the soil. As for the washing process, when the oil is mixed with water, it gives better results when washing it than if the oil enters alone into the soil because the proportions of oil when it enters the soil together with the water, it is little and does not rise much, so it is easy to wash.

Anoxic Treatment of Agricultural Drainage Water in a Venturi-Integrated Membrane Bioreactor.

Due to low sludge production and being a clean source without residuals, hydrogen-based autotrophic denitrification appears to be a promising choice for nitrate removal from agricultural drainage waters or water/wastewater with a similar composition. Although the incorporation of hydrogen-based autotrophic denitrification with membrane bioreactors (MBRs) enabled almost 100% utilization of hydrogen, the technology still needs to be improved to better utilize its advantages. This study investigated the anoxic treatment of both synthetic and real drainage waters using hydrogen gas in a recently developed membrane bioreactor configuration, a venturi-integrated submerged membrane bioreactor, for the first time. The study examined the effects of the inflow nitrate concentration, and the use of a venturi device on the removal efficiency, as well as the effects of the presence of headspace gas circulation and circulation rate on membrane fouling. The study found that using the headspace gas circulation through a venturi device did not significantly affect the treatment efficiency, and in both cases, a removal efficiency of over 90% was achieved. When the inlet NO3--N concentration was increased from 50 mg/L to 100 mg/L, the maximum removal efficiency decreased from 98% to 92%. It was observed that the most significant effect of the headspace gas circulation was on the membrane fouling. When the headspace gas was not circulated, the average membrane chemical washing period was 5 days. However, with headspace gas circulation, the membrane washing period increased to an average of 12 days. The study found that the headspace gas circulation method significantly affected membrane fouling. When the upper phase was circulated with a peristaltic pump instead of a venturi device, the membrane washing period decreased to one day. The study calculated the maximum hydrogen utilization efficiency to be approximately 96%.

Identification of endogenous biomarkers of renal organic cation transporters in rats by global metabolomics analysis

<b>Abstract ID 18183</b> <b>Poster Board 577</b> Kidney is one of the major drug-elimination organs. The total renal excretion of a compound is the net result of glomerular filtration, tubular secretion, and reabsorption. Tubular secretion is a transporter-mediated process, which is often mediated by organic cation transporters (OCT/Oct) that facilitate the active secretion of several cationic substrates including drugs such as metformin as well as endogenous cations¹. Endogenous biomarkers of OCTs can help in the early assessment of drug-drug interaction without the administration of exogenous OCT probe substrates². We hypothesize that administration of cimetidine, an OCT/Oct inhibitor, will lead to increased plasma levels and decreased renal clearance (CL_R) of endogenous OCT/Oct substrates. Such substrates can potentially act as OCT/Oct biomarkers. We carried out a rat pharmacokinetic (PK) study where metformin (5 mg/kg, IV) was administered as an exogenous substrate of OCT (positive control) to four Sprague-Dawley rats with and without cimetidine (100mg/kg, IP) in a cross-over study design with one week washing period. Blood samples were collected from the tail vein at different time points, i.e, pre-dose, 0.17, 0.5, 1, 2, 4, 6, and 8 h, and urine samples were collected at 0-4 and 4-8 h intervals. Rat blood and urine samples were analyzed for metformin and cimetidine levels by a validated method using liquid chromatography with tandem mass spectrometry (LC-MS/MS) (Waters Xevo-TQ-XS MS; Waters, Milford, MA). Metformin area under the blood concentration-time curve (AUC_(0-8h)) was significantly increased by 3.2 folds when co-administered with cimetidine (<i>p-value</i>, 0.003). Similarly, metformin CL_R(0-8h) was significantly decreased in cimetidine arm by 3.7 folds (<i>p-value</i>, 0.029). Further, to investigate the effect of cimetidine on endogenous metabolites, we carried out untargeted metabolomics for rat blood and urine samples using Easy Spray 1200 series nanoLC coupled Q-Exactive HF MS (Thermo Fisher Scientific, Waltham, MA). The rat blood samples were analyzed in three groups, i.e., pooled (0.5, 1, and 2h), 0.5 h, and 1 h samples, while rat urine samples were analyzed at 0-4 h interval samples. The generated data were analyzed by open-access XCMS Online software (xcmsonline.scripps.edu). Greater than 18,000 features were detected in the blood which were shortlisted using optimized selection criteria, i.e., fold differences (with versus without cimetidine) of 1.9-10 fold, <i>p-value</i> &lt;0.05, reproducible retention time, and quality of chromatogram peak. Out of the 85 shortlisted hits, 52 were detected by METLIN software, and 30 were common in blood and urine. Among several potential compounds predicted by METLIN for each mass-to-charge ratio (m/z) value, only compounds containing nitrogen atoms with mass error (ppm) less than 4 were selected. Two significant hits (m/z, 134.06, and 233.09 corresponding to putative oxindole and robustine, respectively) were consistently found in pooled, 0.5 h, and 1h samples (Figure 1). Other putative metabolites were oxyquinoline (m/z, 146.09), deoxyadenosine (m/z, 252.11), 1-naphthylamine (m/z, 182.04), and 2-methylquinoline-3,4-diol (m/z, 176.07). A clinical study is currently being conducted to further validate these preliminary data. This work was supported by NIH/NICHD R01HD081299

Selamerex: regional real-world practice and perspective of therapy optimisation

Перенести в английский вариант BACKGROUND. Hyperphosphatemia in CKD is spread widely, represents as independent factor of mortality at all stages of CKD, after transplantation, reduces the effectiveness of nephroprotection, leads to vascular calcification, stimulates hyperparathyroidism. Achieving the phosphatemia target is a difficult task and is based on a combination of a hypophosphate diet, effective dialysis, the antihyperparathyroidic measures and the phosphate-binders (PBs). THE AIM. The aim is to evaluate the effectiveness of sevelamertherapy in real clinical practice as part of a hypophosphatemic strategy with clarification of the conditions and measures under which it is optimal. PATIENTS AND METHODS. In an eight-month study in a region where there are no restrictions on access to calcium-free PBs, 127 patients were included in the study after the "washing period ": the of sevelamer doses were titrated until phosphatemia reaches below 1.58 mmol/l in parallel with individual measures of four-component hypophosphatemic strategy. RESULTS. From the starting dose of 3-6 tablets/day, 38 patients experienced either dose increase (+ 1016 ± 760 mg) or in 28 patients– decrease (- 1427 ± 1059 mg). By the third month of therapy, the proportion of patients with phosphatemia &lt; 1.58 mmol/l reached 70 %, &lt; 1.78 mmol/l – 90 %. The decrease magnitude depended on the initial phosphatemia, the level of PTH (maximum in the range of 150-600 pg/ml), occurs more slowly in men. During therapy, there was a decrease in the need for antihyperparathyroid therapy in the absence of dynamics in the parathyroid hormone level. In multiple regression analysis models, the independent factors associated with phosphatemia during treatment were sevelamer dose, dialysis dose, baseline phosphate and parathyroid hormone levels; the magnitude of phosphatemia reduction was independently associated with sevelamer dose, dialysis dose, baseline parathyroid hormone level, and assessment of treatment compliance. CONCLUSION. Sevelamer in a moderate well–tolerated doses as part of an individualized hyperphosphatemia correction strategy is able to achieve target phosphatemia (&lt; 1.58 mmol/L) in 70 % of cases, and relatively safe level (&lt; 1.78 mmol/L) – in 90 %.

Irritant potential of different washing procedures used for heavy-duty soiling: Short and intense or longer and mild?

To prevent irritant contact eczema even in occupational fields with heavy-duty soiling, it is generally recommended to use 'mild' hand cleansers (mild detergent without grits, MC). On the other hand, since grit-containing cleansers (GC) show a higher washing power that minimizes washing time, their usage is generally preferred in specific occupational fields. To compare whether a shorter, intense washing period might cause less skin damage than a longer washing period with an MC. Differences in cleaning time were first verified in a pilot study using standardized model dirt. In the main study, the forearms of 35 healthy volunteers were washed with three standardized procedures over a period of 3 days, either using 2 min of MC with/without hand brush or 1-min GC. Clinical scoring, transepidermal water loss (TEWL), corneometry, colourimetry and scaliness/roughness (Visioscan) were used to evaluate the epidermal barrier, topography and irritation. The pre-study showed that washing time doubled when using MC vs. GC. Using GC resulted in stronger barrier disruption, even after a shorter washing period - median ΔT4-T1 TEWL 0.96 g/m2 /h vs. 4.91 g/m2 /h respectively, p < 0.0001. The most harmful procedure for the skin was the additional application of a hand brush (18.86 g/m2 /h). Short-time washing with GC damages the skin barrier more significantly in comparison to a longer application of an MC. When washing with MC, the strongest irritant reaction occurred when accompanied with hand brushing.

Water washing and acid washing of gasification fly ash from municipal solid waste: Heavy metal behavior and characterization of residues

Gasification fly ash (GFA) is a hazardous solid residue generated in the slagging-gasification of municipal solid waste (MSW). GFA contains higher amounts of heavy metals such as Pb and Zn than incineration fly ash (IFA), which increases the difficulty of heavy metal immobilization but simultaneously makes it a potential feedstock for metal recovery. Water washing and acid washing are conventional and economic methods to treat wastes with high heavy metal and chloride contents. However, the research on the effects of such methods in treating GFA is still blank. Hence, in this study, water washing and acid washing of GFA were investigated in detail. Heavy metal behaviors at different time points during the washing processes were studied in a wide pH range and comprehensive characterizations of washed GFAs were also conducted. The results show that different re-precipitates could be identified in washed GFAs depending on different pH conditions. After water washing for 24h, more than 60% of Zn in GFA would dissolve and re-precipitate into calcium zincate. It is also revealed that the precipitation effect could in turn influence the pH during the washing process. After acid washing with a low-concentration acid, heavy metal leachabilities were found reduced due to the pH and precipitation effect. High-concentration acid washing could effectively extract Zn and Cd with extraction ratios exceeding 90%. Applying 1.2M-HCl washing, a short washing period of 15min could realize a Pb extraction ratio of 81.2%, much higher than 53.2% when extending the washing period to 24h.

Differential diagnosis of immune reconstitution inflammatory syndrome and progressive multifocal leukoencephalopathy after natalizumab withdrawal

The appearance of new foci on MRI, the increase in neurological deficits, including the appearance of cognitive disorders and disturbances in the level of consciousness in patients with multiple sclerosis during the «washing period» when transferring from natalizumab (NZ) to another drug, may be due to both progressive multifocal leukoencephalopathy (PML) and exacerbation of the disease in the absence of therapy. Discontinuation of NS is fraught not only with a resumption, but with an increase in disease activity, the development of an immune reconstitution inflammatory syndrome (IRIS) due to the opening of the blood-brain barrier. Often, the processes of differential diagnosis of IRIS and natalizumab-associated PML are complex and require the use of additional methods of examination and monitoring of the dynamics of the patient's condition. However, the severity of the condition and the severity of the consequences caused by incorrect therapeutic tactics significantly reduce the time for diagnosis and require an immediate decision. The difficulties of differential diagnosis of IRIS and PML are reflected in the clinical case.

Ex vivo evaluation of adhesive strength and barrier effect of a novel treatment for esophagitis

To investigate the mucoadhesive strength and barrier effect of Esophacare® (Atika Pharma SL, Las Palmas de Gran Canaria) in an ex vivo model of gastro-oesophageal reflux. An ex vivo evaluation through the Falling Liquide Film Technique with porcine esophagi was performed, compared to a positive control (Ziverel®; Norgine, Amsterdam), after different washing periods with saline, acidified saline (pH 1.2) and acidified saline with pepsin (2000U/mL). The adhesive mean strength on the oesophageal mucosa of Esophacare was 94.7 (6.0)%, compared to 27.6 (19.1)% of the positive control (p<0.05). These results were homogeneous across the different washes and throughout the tissue. The area covered by 1mL of Esophacare, and its respective persistence after washing was also assessed, yielding a mean global persistence of 74.29 (19.7)% vs. 18.9 (12.3)% for the control (p<0.05). In addition, after 30min exposure to acidified saline with pepsin, Esophacare shows a protective effect on the oesophageal mucosa, detectable histologically: preserved integrity and structure of the apical layers was observed, as well as reduced permeability to the washing solution. Esophacare shows an adhesive strength close to 100%, irrespective of the washing solution applied or the oesophageal region studied. Histologically, it reduces the abrasive effects of the acidic solution on the oesophageal epithelium, reducing permeability to the washing solution. The results in this ex vivo model of gastro-oesophageal reflux disease (GERD) support its therapeutic potential.

Effects of skin washing frequency on the epidermal barrier function and inflammatory processes of the epidermis: An experimental study.

Increased hand hygiene measures during the COVID-19 pandemic have led to an increased quantum of hand eczema (HE). To examine the effects of varying washing frequencies using current mild cleansing agents-alongside with the effect of a rehydrating cream-on the epidermal barrier function and inflammatory processes of the stratum corneum(SC). Standardized skin washings on the volar aspects of the lower arms of skin-healthy volunteers were performed using the automated cleansing device either 5 or 11 times within 4h for 60 s each with a standard cleanser, a lipid-containing syndet, or a lipid-containing syndet followed by one-time application of a rehydrating cream. Skin bioengineering parameters (transepidermal water loss, SC hydration, erythema, and SC pH) and biochemical/immunological parameters (interleukin-1α, interleukin-1α receptor antagonist and natural moisturizing factor) of SCsamples collected by tape stripping were assessed. All applied washing procedures provided comparable, mild effects on the epidermal barrier function and skin inflammation. Occupational skin cleansers seem to have improved regarding skin barrier damaging effects. To further corroborate this, a study design, modified on the basis of our findings, applying longer washing periods for consecutive days seems desirable.

K-4 Impact on Dehydration Process of Red Mud Settling

The article represents the results of a study on the red mud dehydration process (thickening, filtration, filtration washing) obtained in the alumina production during the processing of the low-silica bauxites. The synthetic flocculant K-4 has been used in order to intensify the red mud dehydration process. The main washing periods have been studied in the process of the filtration washing analysis. The expendable module impact on the effectiveness of aluminate solution cleaning (mother liquor) obtained from the mud settling has been represented. The settling washing, treated by the flocculant, has been established to allow increasing the quantity of the specific effective moisture at the cost of the mutual volume of the standing pores and the grow of free moisture volume.

Optimization of extraction conditions and determination of the Chlorpyrifos, Diazinon, and malathion residues in environment samples: Fruit (Apple, Orange, and Tomato)

Organophosphate (OP) insecticide, such as diazinon is found in the environments like water which is still approved for agricultural uses. When diazinon residues enter the human body, it functions as an acetylcholinesterase (AChE) inhibitor. This research aims to measure of chlorpyrifos (CPF), diazinon, and malathion residues in fruit such as apple, orange, and tomato after optimizing extraction conditions. Pesticide residues are measured by gas chromatography (GC) technique. Effective variables on pesticide residues are studied including pesticides kind, sampling station, and fruit kind. Results show that average concentration CPF, diazinon, and malathion residues in orange water are 7.05±0.01mgL-1, 6.66±0.03mgL-1, and 12.38±0.02µgL-1, respectively. The average concentration CPF, diazinon, and malathion residues in apple water are 0.74±0.02mgL-1, 0.70±0.01mgL-1, and 1.10±0.01µgL-1, respectively. The average concentration CPF, diazinon, and malathion residues in tomato water are 0.60±0.02mgL-1, 0.57±0.02mgL-1, and 0.89±0.01µgL-1, respectively. The highest CPF concentration is observed in the orange fruit from station 20. Due to an appropriate storage condition and presenting organic fruits in the supermarket, the least mean concentration of pesticides is obtained in studied fruits from station 2. The manner of washing, peeling, and storage period before consuming fruits lead to decreasing studied pesticides concentration about 15-35, 40-50, and 50-60%, respectively. Increasing the fruit shelf-life led to decreasing studied pesticides concentration. Between pesticide concentration and variables: pesticides kind, sampling station, fruit kind, are not seen meaningful statistic relationship (P>0.05). This study showed that pesticide residues in fruits can be decreased by washing, refrigerating, peeling procedures and increase in public surveillance.