Strategies for safe management of hospital wastewater during the COVID-19 pandemic.

Management of hospital wastewater is a challenging task, particularly during the situations like coronavirus 2019 (COVID-19) pandemic. The hospital effluent streams are likely to contain many known and unknown contaminants including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) along with a variety of pollutants arising from pharmaceuticals, life-style chemicals, drugs, radioactive species, and human excreta from the patients. The effluents are a mixed bag of contaminants with some of them capable of infecting through contact. Hence, it is essential to identify appropriate treatment strategies for hospital waste streams. In this work, various pollutants emerging in the context of COVID-19 are examined. A methodical review is conducted on the occurrence and disinfection methods of SARS-CoV-2 in wastewater. An emphasis is given to the necessity of addressing the challenges of handling hospital effluents dynamically involved during the pandemic scenario to ensure human and environmental safety. A comparative evaluation of disinfection strategies makes it evident that the non-contact methods like ultraviolet irradiation, hydrogen peroxide vapor, and preventive approaches such as the usage of antimicrobial surface coating offer promise in reducing the chance of disease transmission. These methods are also highly efficient in comparison with other strategies. Chemical disinfection strategies such as chlorination may lead to further disinfection byproducts, complicating the treatment processes. An overall analysis of various disinfection methods is presented here, including developing methods such as membrane technologies, highlighting the merits and demerits of each of these processes. Finally, the wastewater surveillance adopted during the COVID-19 outbreak is discussed. Supplementary Information: The online version contains supplementary material available at 10.1007/s13762-023-04803-1.

Patient-provider relationship and perceived provider weight bias among American Indians and Alaska Natives.

Objective: The objective of this study was to examine patient-provider relationships among American Indians and Alaska Native (AI/AN) patients by examining associations between patient activation, perceived provider weight bias and working alliance. Patient activation is generally defined as having the knowledge, skills and confidence to manage one's health. Methods: Among a sample of 87 AI/AN adults presenting for general medical care at an urban clinic in the north-west region of the USA, ordinary least squares regression analysis was completed to examine associations. Results: Better working alliance scores were associated with increased patient activation, while perceived provider weight bias was associated with reduced patient activation. In addition, those with class II obesity had decreased patient activation. Conclusion: These findings point to the importance of a positive patient-provider relationship in AI/ANs. Optimal patient engagement and subsequent health outcomes warrant additional consideration of patients' perceptions of provider weight bias within the context of health promotion and interventions.

Lingual thyroid.

Lingual thyroid is an abnormal mass of ectopic thyroid tissue seen in base of tongue caused due to embryological aberrancy in development of thyroid gland. Most of the ectopic tissue is seen in the tongue. Their identification and proper management is essential since they may be the only functioning thyroid tissue occurring in the body. We report a case of lingual thyroid in a 40 year old female patient who was hypothyroid with posterior swelling of tongue. Tc-99 scintigraphy confirmed the clinical diagnosis and surgical excision of entire tissue was done by midline mandibular split osteotomy and patient was placed under lifelong thyroxine replacement. Follow up showed excellent results with minimum patient discomfort.

On the uptake of ammonia by the water/vapor interface.

The passage of a single ammonia molecule from an infinitely dilute gas through the water/vapor interface is studied by constrained molecular dynamics simulations. The free energy of the system as a function of the distance between the ammonia and the interface has a minimum in the interfacial region. It is found that the preference of the ammonia for the interface is mainly due the disruption of the solvent structure caused by the ammonia in the bulk region, which results in an increase of the solvent internal energy.

Late scar recurrence in mucoepidermoid carcinoma of base of tongue.

Recurrence in mucoepidermoid carcinoma of the salivary gland after 15 years is rare and present difficult therapeutic decisions. A rare case of mucoepidermoid cancer of the base of the tongue that recurred loco-regionally after 20 years and was managed judiciously by a planned combined modality approach is presented.