ABSTRACT
Ammonia-nitrogen, a grave environmental concern, is a typical pollutant in deliming process due to the inclusion of ammonium salts as deliming agents in leather manufacture. In order to reduce the emission of ammonianitrogen and improve the biological treatment of mixed tannery wastewater, an ammonium-free deliming method was designed and optimized based on the synergistic effects of aromatic sulfonic acids and sodium dihydrogen phosphate. The results indicated that, the penetrating and buffering performance of the mixtures of p-Hydroxybenzene sulfonic acid (pHBSA) and sodium dihydrogen phosphate (SDHP) at weight ratio of 2:1 was good enough to fulfill the requirement of deliming. The organoleptic and mechanical properties of the crust leather produced by pHBSA-SDHP mixtures deliming were similar with the conventional ammonium sulfate deliming, and the grain pattern was found to be protected against the damage caused by enzymes during bating. The concentrations of ammonia-nitrogen and total nitrogen in pHBSA-SDHP deliming effluent were dramatically cut down by 99% and 94%. It is anticipated that the mixed tannery wastewater could be disposed of more easily by means of adjusting the total organic ratios of C:N:P to their natural ratio by introducing an additional carbon and phosphorus source to the tannery wastewater. This investigation provides an improved method of leather making with significant reduction of ammonia nitrogen emission in deliming operation and fulfills the integral requirements of the modern sustainable leather industry.
ABSTRACT
Background The COVID-19 pandemic highlighted the stark health inequities affecting minority ethnic populations in Europe. However, research on ethnic inequities and healthcare utilisation in children has seldom entered the policy discourse. A scoping review was conducted in the UK, summarising and appraising the quantitative evidence on ethnic differences (unequal) and inequities (unequal and unfair or disproportionate to healthcare needs) in paediatric healthcare utilisation. Methods Embase, Medline and grey literature sources were searched for studies published 2001-2021. Studies that found differences and inequities were mapped by ethnic group and healthcare utilisation outcome. They were appraised using the National Institute for Health and Care Excellence appraisal checklists. The distribution of studies was described across various methodological parameters. Results Of the 61 included studies, most found evidence of ethnic variations in healthcare utilisation (n = 54, 89%). Less than half attempted to distinguish between ethnic differences and inequities (n = 27, 44%). Studies were concentrated on primary and preventive care and hospitalisation, with minimal evidence on emergency and outpatient care. The quality of studies was often limited by a lack of theory underpinning analytical decisions, resulting in conflation of difference and inequity, and heterogeneity in ethnic classification. The majority of studies examined children's ethnicity but overlooked parent/caregiver ethnicity, and also didn't investigate patterns across age, year or location. Conclusions To improve the validity, generalisability and comparability of research on ethnicity and paediatric healthcare utilisation, findings from this scoping review were used to develop recommendations for future research. These lessons could be applied more broadly across the European context to improve evidence generation and evidence-based policy-making to reduce inequities in healthcare. Key messages • Quantitative studies of ethnicity and paediatric healthcare utilisation in the UK lack the use of sound theoretical frameworks, and often do not distinguish between ethnic differences and inequities. • The quality of future studies can be improved with greater attention to how ethnicity is classified and analysed, alongside specific considerations for examining healthcare utilisation in children.
ABSTRACT
Objective: To explore the implementation and management measures of drug clinical trials during the period of COVID-19 epidemic, protect the safety and rights of subjects, ensure the smooth implementation of clinical trials, and provide reference and suggestions for the management work of clinical trial institutions. Methods: According to the requirements of COVID-19 epidemic prevention and control policies and the national guiding principles for drug clinical trial management, combining the experience of our hospital, we optimized the working process and proposed management measures in four aspects including project and personnel management, subject follow-up management, drug distribution management, and communication between all parties involved in clinical trials. Results and conclusions: During the period of COVID-19 epidemic, our hospital has taken a series of measures which ensured the smooth implementation of more than 200 drug clinical trials and protected the safety and rights of subjects and researchers.
ABSTRACT
This study examines the impact of coronavirus disease 2019 (COVTD-19) test accuracy (i.e., sensitivity and specificity) on the progression of the pandemic under two scenarios of limited and unlimited test capacity. We extend the classic susceptible-exposed-infectious-recovered model to incorporate test accuracy and compare the progression of the pandemic under various sensitivities and specificities. We find that high-sensitivity tests effectively reduce the total number of infections only with sufficient testing capacity. Nevertheless, with limited test capacity and a relatively high cross-infection rate, the total number of infected cases may increase when sensitivity is above a certain threshold. Despite the potential for higher sensitivity tests to identify more infected individuals, more false positive cases occur, which wastes limited testing capacity, slowing down the detection of infected cases. Our findings reveal that improving test sensitivity alone does not always lead to effective pandemic control, indicating that policymakers should balance the trade-off between high sensitivity and high false positive rates when designing containment measures for infectious diseases, such as COVID-19, particularly when navigating limited test capacity.
ABSTRACT
Air quality is strongly influenced by both local emissions and regional transport. Atmospheric chemical transport models can distinguish between emissions and regional transport sources in air pollutant concentrations. However, quantifying model inventories is challenging due to emission changes caused by the recent strict control measures taken by the Chinese government. In this study, we use NO2 column observations from the Tropospheric Monitoring Instrument to retrieve top-down nitrogen oxide (NOX) emissions and quantify the contributions of local emissions and regional transport to NOx in Beijing (BJ), from 1 November 2018 to 28 February 2019 (W_2018) and 1 November 2019 to 29 February 2020 (W_2019). In W_2018 and W_2019, the BJ bottom-up NOX emissions from the multi-resolution emission inventory for China in 2017 were overestimated by 11.8% and 40.5%, respectively, and the input of NOX from other cities to BJ was overestimated by 10.9% and 51.6%, respectively. The simulation using our adjusted inventory exhibited a much higher spatial agreement (slope = 1.0, R-2 = 0.79) and reduced a mean relative error by 45% compared to those of bottom-up NOX emissions. The top-down inventory indicated that (1) city boundary transport contributes approximately 40% of the NOX concentration in BJ;(2) in W_2019, NOX emissions and transport in BJ decreased by 20.4% and 17.2%, respectively, compared to those of W_2018;(3) in W_2019, NOX influx substantially decreased (-699 g/s) in BJ compared to that of W_2018 despite negative meteorological conditions that should have increased NOx influx by +503 g/s. Overall, the contribution of intercity input to NOx in BJ has declined with decreasing emissions in the surrounding cities due to regional cooperative control measures, and the role of local emissions in BJ NOx levels was more prominent. Our findings indicate that local emissions may play vital roles in regional center city air quality.
ABSTRACT
BACKGROUND: Coronavirus disease 2019 (COVID-19) has emerged as a major global health threat with a great number of deaths worldwide. Despite abundant data on that many COVID-19 patients also displayed kidney disease, there is limited information available about the recovery of kidney disease after discharge. METHODS: Retrospective and prospective cohort study to patients with new-onset kidney disease during the COVID-19 hospitalization, admitted between January 28 to February 26, 2020. The median follow-up was 4 months after discharge. The follow-up patients were divided into the recovery group and non-recovery group. Descriptive statistics and between-groups comparison were used. RESULTS: In total, 143 discharged patients with new-onset kidney disease during the COVID-19 hospitalization were included. Patients had a median age was 64 (IQR, 51-70) years, and 59.4% of patients were men. During 4-months median follow-up, 91% (130 of 143) patients recovered from kidney disease, and 9% (13 of 143) patients haven't recovered. The median age of patients in the non-recovery group was 72 years, which was significantly higher than the median age of 62 years in the recovery group. Discharge serum creatinine was significantly higher in the non-recovery group than in the recovery group. CONCLUSIONS: Most of the new-onset kidney diseases during hospitalization of COVID-19 patients recovered 4 months after discharge. We recommend that COVID-19 patients with new-onset kidney disease be followed after discharge to assess kidney recovery, especially elderly patients or patients with high discharge creatinine.