Surface facet Fe2O3-based visible light photocatalytic activation of persulfate for the removal of RR120 dye: nonlinear modeling and optimization.

Photocatalytic activation of persulfate (PS) is recently emerged as an energy-efficient and environmentally sustainable approach for pollutants degradation, which enables to leverage the strengths of low-cost solar energy and heterogeneous catalysis. Herein, we investigated the photocatalytic decomposition of reactive red 120 (RR120) dye using PS-activated Fe2O3 nanoparticles and elucidated the effect of their facets, α-Fe2O3 (001), ß-Fe2O3 (100), and γ-Fe2O3 (111). ß-Fe2O3 not only boosted the charge carrier separation but also provided more active sites for PS activation resulting in 6- and 3.5-fold higher photocatalytic activities compared to α-Fe2O3 and γ-Fe2O3, respectively. Response surface methodology and artificial neural network coupled with genetic algorithm models were utilized to optimize and foresee Fe2O3/PS system under visible light. Almost 100% color removal and 82% organic removal were observed under the optimum conditions at 20 mg/L RR120, 22 mg/L ß-Fe2O3, 18 mg/L PS, and pH: 3. Scavenger test indicated that both sulfate and hydroxyl radicals are responsible for the observed RR120 removal. Although cell viability test indicated that cytotoxicity of wastewater is not significantly reduced after treatment. All the results proposed that ß-Fe2O3/PS at relatively low doses has a great potential to decompose and mineralize recalcitrant dyes in wastewater under invisible light.

Reliability of the Laboratory Risk Indicator in Necrotising Fasciitis (LRINEC) score.

BACKGROUND: The LRINEC score was introduced in 2004 but it has not yet been incorporated as a reliable diagnostic tool in the management of Necrotising Fasciitis. NF is uncommon and proportionately the evidence is limited, but the contradictory literature has resulted in varying individual concepts and clinical practices. This article is aimed to evaluate the reliability of the LRINEC score and determine its effectiveness based on the current available evidence. METHODS: Eighteen clinical studies published during 2004-2018 were identified after an extended literature search and critically appraised to determine the validity, reliability and applicability of the individual pieces of evidence. The recommendations for practice were formulated after summative analysis of the evidence. RESULTS: The systemic review and observational studies report the LRINEC score has a variable range of sensitivity (43.2-80%), positive predictive value (57-64%) and negative predictive value (42-86%) which is lower than the initial results by Wong et al. (2004). The LRINEC score ≥6 correlates well with diagnosis of NF but 7.1 was found to be statistically significant. Higher LRINEC score correlates with higher SOFA score, prolonged ICU and hospital stay, and mortality. It is not sensitive in immunocompromised patients. CONCLUSIONS: There is Level 3 evidence that LRINEC score is a reliable tool which can aid the clinical diagnosis of NF. It can stratify the high-risk patients and predict outcome; however, it should be correlated with the clinical assessment and radiological diagnostic modalities should be simultaneously used when doubt exists (grade C).

Patient's views of the consent process for groin hernia repair: Use of consent template improves compliance with best practice (Original research).

BACKGROUND: Informed consent obtained for day case surgery has been historically incomplete. An assessment of consenting practice for groin hernia was performed relative to existing gold standards and patient's perception of the consent process was evaluated with a questionnaire. The aim of the study was to identify areas of improvement to comply with best practice. METHODS: A retrospective audit of adult patients undergoing groin hernia repair (June-November 2016) at a tertiary care centre was performed. The same cohort of patients was surveyed with a self-administered questionnaire to identify their view on consenting practice. RESULTS: 113 patients were identified who underwent groin hernia repair during the study period. Pre-printed consent templates-stickers (as opposed to hand-written) were used in 53(47%) cases. In 75(66%) cases, there was complete documentation of the risks and benefits of surgery. 81(72%) patients received information about the full benefits of surgery. 27(23%) patients received partial information and 7(6%) patients had no mention of benefit recorded. Postoperative recovery was fully explained to 85(75%) patients. Use of pre-printed templates ensured 100% documentation compared to handwritten consent forms (risks 37%, benefits 47%, and recovery 53%). Preference for the timing of consent was in clinic (64%), day of surgery (25%). 34(56%) felt the choice for the technique and 22(36%) felt the choice for anaesthesia. Satisfaction was non-significantly better in those consented in clinic (87% versus 76% p = 0.74). 49(80%) felt happy with the overall consent process. 57(93%) felt that they received support and advice. 60(98%) responders felt confidence in the National Health Service and 59(97%) would recommend treatment to family and friends. CONCLUSIONS: The use of pre-printed consent and discharge summary templates improve compliance with best practice. Whilst patient preference favours consent in the outpatient clinic, satisfaction levels were high wherever consent was obtained. Patients should have more choice.