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Removal of nutrients in water is crucial to control eutrophication. Fly ash has been increasingly used to synthesize zeolite to remove nutrients, but it is still poorly understood about the removal capacity of zeolite synthesized from coal gasification slag (CGS), which has not been well recycled in many countries. In this study, the CGS was acid leached, alkali dissolved, and synthesized to carbon/zeolite composite (C/ZC) under induction by medical stone. After being modified by ferric sulfate, the composite was analyzed for the adsorption of NH4+ and PO43-. Results showed that the maximum adsorption capacity by C/ZC is 5.17 mg/g, but C/ZC has no adsorption capacity of PO43-. The ferric sulfate was used to modify C/ZC to obtain carbon/zeolite composite modified by iron (M-C/ZC). M-C/ZC has a higher specific surface area (348.3 m2/g), and the negatively charge of M-C/ZC can adsorb NH4+ and form Fe-O-P between PO43- and Fe-OH bonds. The maximum adsorption capacity of NH4+ and PO43- by M-C/ZC are 7.44 mg/g and 6.94 mg/g, respectively. The removal efficiency of NH4+ and PO43- are up to 88% and 99% under initial NH4+ (5 mg/L) and PO43- (10 mg/L) concentration. The regeneration capacity of M-C/ZC of NH4+ was stronger than that of PO43-. After three cycles, the regeneration rate of M-C/ZC of NH4+ was still up to 76.96%. Our findings suggest the good application potential of M-C/ZC for removing NH4+ and PO43- from wastewater.This study was focused on an assessment of the agronomic efficiency of organo-mineral fertilizers based on sewage sludge and possible accumulation of heavy metals in plant biomass. Fertilizers optimized for industrial crops (rape, maize, sunflower) were used in the study. The impact of fertilizers based on sewage sludge on early stage plant growth was assessed using germination tests, and the impact on further growth and development was assessed using pot trials. The germination index of cress, sorghum and mustard was in the range of 50-92% depending on the type and dose of fertilizer and on the plant tested, which corresponded to moderate to zero toxicity. The results of pot trials showed a significant impact of fertilizers based on sewage sludge on the biomass growth of selected plants. The use of fertilizers caused an increase in fresh mass of 75-138% for rape, 96-138% for maize and 23-54% for sunflower with respect to the control sample. An increase in the dose of fertilizers for rape did not significantly affect the heavy metal content in plants, except for the content of Ni. In the case of fertilizers optimized for maize and sunflower, an increase in the dose caused an accumulation of Cd, Ni, Pb and Cr in the biomass of the tested plants. However, it should be noted that the pollution level of plant biomass for all treatments was zero to medium (1.00-1.66).Due to the drawbacks of using fossil fuels and the need to mitigate global warming caused by increasing greenhouse gas emissions, agricultural biomass for bioenergy production is gaining great interest around the world. This work presented a study at a biochemical plant in Lianyungang, Jiangsu Province, China to maximize methane production from cassava distiller wastewater. The plant's annual production of cassava distiller wastewater is more than 3 million tons and currently was treated using a series of 5000 m3 Internal Circulation (IC) reactors. Modification was applied at No.19 IC reactor by connecting it to two 1 m3 automatic biological incubators called Information Bio-Booster (IBB). The effluent of the IC reactor was fed into the IBBs and iron, cobalt and nickel were added directly in the IBBs. The function of the IBBs was to regulate the microbial community. Afterwards, the microorganisms in the IBBs were pumped back into the IC reactor to participate in the methane production reaction. Daily net increase of methane content and COD removal reached 8.02% and 33% respectively in No.19 IC reactor comparing to the unadjusted reactors. Preliminary lab experiments found that improvements of biogas production, enhanced COD removal and VS removal was closely related to the enhancement of anaerobic microbial communities' diversity and the promotion of enzyme activity through the addition of the metal salts. Daily economic value could be estimated to be $218 which indicated the application potential of using the proposed system to enhance anaerobic digestion at industrial plants for bioenergy production. To analyze and present the initial findings of provider perceptions regarding the impact of the implementation of a hospital-wide Tracheostomy Rounding Team (TRT) on the delivery of tracheostomy care at the Cleveland Clinic. Based on prior literature, a novel multidisciplinary TRT was designed and implemented at the Cleveland Clinic in December of 2018. After the TRT began clinical care, a previously validated RedCap survey was administered anonymously to 358 caregivers to assess provider experience, comfort, and prior education regarding tracheostomy management. Survey results were collected, and descriptive statistics were applied. Answers were compared between providers who interacted with the TRT clinically and those who did not. 42.9% of providers who interacted with the TRT clinically reported that the TRT improved hands-on assistance with tracheostomy care, and 36.7% reported that the TRT improved the identification of safety concerns. Similarly, 34.7% reported that the TRT improved the overall quality of tracheostomy care at the Cleveland Clinic. Providers with active exposure to the TRT additionally reported statistically higher comfort with multiple topics surrounding tracheostomy care. The implementation of this team improved provider comfort in managing patients with tracheostomies both qualitatively and quantifiably. This intervention offered a perceived benefit to patient care at our institution. Further study of the impact of this team on quantitative patient outcomes is forthcoming.The implementation of this team improved provider comfort in managing patients with tracheostomies both qualitatively and quantifiably. This intervention offered a perceived benefit to patient care at our institution. Further study of the impact of this team on quantitative patient outcomes is forthcoming. To investigate the incidence of synchronous malignancies identified during triple endoscopy in patients with head and neck squamous cell carcinoma. A retrospective chart review of patients from a tertiary academic medical center was performed. Patients with a primary head and neck squamous cell carcinoma who underwent triple endoscopy were included. Operative, radiographic, and pathology reports were reviewed to evaluate for the presence of synchronous malignancies in the aerodigestive tract diagnosed through endoscopy. Demographics, relevant medical history, including tobacco and alcohol use, and tumor characteristics were recorded. Univariate and multivariate regression analyses were conducted to assess for associations with synchronous malignancy on triple endoscopy. 215 patients were reviewed, 164 of which had a biopsy-positive head and neck squamous cell carcinoma and underwent triple endoscopy. Synchronous lesions were found in 8 patients (4.9%). Of the synchronous lesions, only two were identifiepy may be considered on a case-by-case basis. The purpose of the study was to assess outcomes of injection laryngoplasty (IL) for treating glottal insufficiency in elderly patients with presbyphonia or unilateral vocal fold paralysis (UVFP). A single-center retrospective study was performed. The study group consisted of 34 patients with glottal insufficiency aged between 60 and 82years who had been treated with injection laryngoplasty. Of them, 16 patients were diagnosed with presbyphonia and 18 with UVFP. After IL, glottal closure improved in both groups. The change was statistically significant in the patients with presbyphonia (marginal homogeneity test MH=3.80; p<0.001) and in the UVFP patients (MH=4.04; p<0.001). Voice quality improved after IL and 12months after surgical intervention remained significantly better compared to before augmentation (MH tests were statistically significant at p<0.05 for R, B, A, and S parameters). In the patients with UVFP, significant improvement was observed in 7 of 12 evaluated parameters (Jitt, RAP, PPQ, Shim, APQ, sAPQ, and NHR) but in the patients with presbyphonia only average fundamental frequency (F0) improved significantly. Comparison of the Voice Handicap Index outcomes before and 12months after surgery showed improvement of subjectively assessed voice quality in both groups; however, the change was statistically significant only in the UVFP patients. Injection laryngoplasty is a safe and effective treatment method for glottal insufficiency in the elderly. https://www.selleckchem.com/products/brd0539.html This study shows a significant and clinically relevant improvement to at least12 months, especially in patients with UVFP.Injection laryngoplasty is a safe and effective treatment method for glottal insufficiency in the elderly. This study shows a significant and clinically relevant improvement to at least12 months, especially in patients with UVFP. The test of glycated hemoglobin is used to assess the glycemic control of patients with diabetes mellitus, however is essential that the monitoring is carried out with adequate frequency. In this context, the objective of study is evaluate the frequency of A1C tests undertaken by patients assisted by pharmaceutical care services. Descriptive study that included patients with DM treated at pharmaceutical care services in Brazil. This service is provided by pharmacists, for optimizing of patient's drug therapy to achieve outcomes that improve a patient's quality of life. Frequency of A1C tests was collected, with a minimum interval of three and a maximum of six months being considered adequate. Tests performed with a minimum interval of less than three or greater than six months frequency were considered inadequate. The comparison of the mean time between the A1C tests between the groups was investigated by the Student's t-test. The significance level adopted was p<0.05. The study was conducted using data recorded from March 2018 to December 2019. The study included 66 patients and 67% of these underwent A1C test with inadequate frequency. The mean time between A1C tests was significantly higher (p<0.0001) in group with inadequate frequency. Only one third of DM patients treated by pharmaceutical care services are monitored with adequate A1C frequency. It is necessary to identify the causes of this underutilization and to develop tools to optimize the monitoring.Only one third of DM patients treated by pharmaceutical care services are monitored with adequate A1C frequency. It is necessary to identify the causes of this underutilization and to develop tools to optimize the monitoring. We hypothesized that spatio-temporal dynamics of interictal spikes reflect the extent and stability of epileptic sources and determine surgical outcome. We studied 30 consecutive patients (14 good outcome). Spikes were detected in prolonged stereo-electroencephalography recordings. We quantified the spatio-temporal dynamics of spikes using the variance of the spike rate, line length and skewness of the spike distribution, and related these features to outcome. We built a logistic regression model, and compared its performance to traditional markers. Good outcome patients had more dominant and stable sources than poor outcome patients as expressed by a higher variance of spike rates, a lower variance of line length, and a lower variance of positive skewness (ps<0.05). The outcome was correctly predicted in 80% of patients. This was better or non-inferior to predictions based on a focal lesion (p=0.016), focal seizure-onset zone, or complete resection (ps>0.05). In the five patients where traditional markers failed, spike distribution predicted the outcome correctly.
