A data-driven QSPR model for screening organic corrosion inhibitors for carbon steel using machine learning techniques.

Machine learning (ML) techniques have shown great potential for screening corrosion inhibitors. In this study, a data-driven quantitative structure-property relationship (QSPR) model using the gradient boosting decision tree (GB) algorithm combined with the permutation feature importance (PFI) technique was developed to predict the corrosion inhibition efficiency (IE) of organic compounds on carbon steel. The results showed that the PFI method effectively selected the molecular descriptors most relevant to the IE. Using these important molecular descriptors, an IE predictive model was trained on a dataset encompassing various categories of organic corrosion inhibitors for carbon steel, achieving RMSE, MAE, and R2 of 6.40%, 4.80%, and 0.72, respectively. The integration of GB with PFI within the ML workflow demonstrated significantly enhanced IE predictive capability compared to previously reported ML models. Subsequent assessments involved the application of the trained model to drug-based corrosion inhibitors. The model demonstrates robust predictive capability when validated on available and our own experimental results. Furthermore, the model has been employed to predict IE for more than 1500 drug compounds, suggesting five novel drug compounds with the highest predicted IE on carbon steel. The developed ML workflow and associated model will be useful in accelerating the development of next-generation corrosion inhibitors for carbon steel.

Recovery of aluminum from plastic packages containing aluminum by gasification.

The standing pouch, a packaging material made of multiple layers of plastic and metal, presents a significant challenge for full recycling. Gasification shows promise as a method to recover aluminum from this type of waste and convert it into energy. This study aims to evaluate the efficiency of gasification in treating aluminum-containing plastic packages, and recovering aluminum while identifying the optimal combinations of temperature and equivalence ratio (ER) to achieve the best outcomes. The study achieved a conversion rate of 43.06 wt% to 69.42 wt% of the original waste mass into syngas, with aluminum recovery rates ranging from 35.2 % to 65.3 %. Temperature and ER alterations affected the product distribution, aluminum recovery rate, and aluminum partitioning in the products. The results indicated that the combination of 700 °C, ER = 0.4 would provide the largest amount of syngas about 69.42 %, which is the main product of the gasification process, and therefore, this combination is the most optimal for syngas-yielding purposes. Under the reclaiming aluminum is more prioritized, the combination of 800 °C, ER = 0.6 would be the most optimal condition, the majority of Al in fuel was found in char and fly ash were 67.5 % and 4.81 %, respectively. The study focused on the partitioning of aluminum during the gasification process, which was observed to mainly exist in the form of Al2O3(s), with gaseous species including AlCl3(g), AlH(g), and Al2O(g) due to their medium volatility. As the ER increased, the amount of O2 also increased, leading to more Al2O3(s) formation. In conclusion, this research provides a foundation for further exploration of gasification as a means of energy conversion and metal recovery.

9-1-1 Activations from Ambulatory Care Centers: A Sicker Pediatric Population.

BACKGROUND: Pediatric patients transferred by Emergency Medical Services (EMS) from urgent care (UC) and office-based physician practices to the emergency department (ED) following activation of the 9-1-1 EMS system are an under-studied population with scarce literature regarding outcomes for these children. The objectives of this study were to describe this population, explore EMS level-of-care transport decisions, and examine ED outcomes. METHODS: This was a retrospective review of patients zero to <15 years of age transported by EMS from UC and office-based physician practices to the ED of two pediatric receiving centers from January 2017 through December 2019. Variables included reason for transfer, level of transport, EMS interventions and medications, ED medications/labs/imaging ordered in the first hour, ED procedures, ED disposition, and demographics. Data were analyzed with descriptive statistics, X test, point biserial correlation, two-sample z test, Mann-Whitney U test, and 2-way ANOVA. RESULTS: A total of 450 EMS transports were included in this study: 382 Advanced Life Support (ALS) runs and 68 Basic Life Support (BLS) runs. The median patient age was 2.66 years, 60.9% were male, and 60.7% had private insurance. Overall, 48.9% of patients were transported from an office-based physician practice and 25.1% were transported from UC. Almost one-half (48.7%) of ALS patients received an EMS intervention or medication, as did 4.41% of BLS patients. Respiratory distress was the most common reason for transport (46.9%). Supplemental oxygen was the most common EMS intervention and albuterol was the most administered EMS medication. There was no significant association between level of transport and ED disposition (P = .23). The in-patient admission rate for transported patients was significantly higher than the general ED admission rate (P <.001). CONCLUSION: This study demonstrates that pediatric patients transferred via EMS after activation of the 9-1-1 system from UC and medical offices are more acutely ill than the general pediatric ED population and are likely sicker than the general pediatric EMS population. Paramedics appear to be making appropriate level-of-care transport decisions.

Encapsulation of Triphasia trifolia extracts by pH and thermal dual-sensitive chitosan hydrogels for controlled release.

Recent studies have developed varied delivery systems incorporating natural compounds to improve the limitations of plant extracts for clinical use while enabling their controlled release at treatment sites. For the first time, ethanolic limeberry extract (Triphasia trifolia) has been successfully encapsulated in thermo-sensitive chitosan hydrogels by a facile in situ loading. The extract-incorporated chitosan hydrogels have a pH value of nearly 7.00, gelation temperatures in the range of 37-38 °C, and exhibit an open-cell porous structure, thus allowing them to absorb and retain 756 % of their mass in water. The in vitro extract release from the hydrogels is driven by both temperature and pH, resulting in more than 70 % of the initial extract being released within the first 24 h. Although the release half-life of hydrogels at pH 7.4 is longer, their release capacity is higher than that at pH 6.5. Upon a 2 °C increase in temperature, the time to release 50 % initial extract is sharply reduced by 20-40 %. The release kinetics from the hydrogels mathematically demonstrated that diffusion is a prominent driving force over chitosan relaxation. Consequently, the developed hydrogels encapsulating the limeberry extract show their heat and pH sensitivity in controlled release for treating chronic wounds.

Negative Appendectomies: Evaluating Diagnostic Imaging Techniques at General versus Pediatric Emergency Departments.

BACKGROUND: Although appendicitis is the most common pediatric surgical emergency, the path to diagnosis remains equivocal, with utilization of imaging modalities largely institution dependent. OBJECTIVES: Our objective was to compare imaging practices and negative appendectomy rates between patients transferred from nonpediatric hospitals to our pediatric hospital and primary patients presenting directly to our institution. METHODS: We retrospectively reviewed all laparoscopic appendectomy cases performed at our pediatric hospital in 2017 for imaging and histopathologic results. Two-sample z-test was used to examine negative appendectomy rates between transfer and primary patients. The negative appendectomy rates of patients who received different imaging modalities were analyzed using the Fisher's exact test. RESULTS: Of 626 patients, 321 (51%) were transferred from nonpediatric hospitals. The negative appendectomy rate for transfer patients was 6.5% and 6.6% for primary patients (p = 0.99). Ultrasound (US) was the only imaging obtained in 31% of transfer and 82% of primary patients. The negative appendectomy rate of US performed at transfer hospitals compared with our pediatric institution was not significantly different (11% vs. 5%, p = 0.06). Computed tomography (CT) was the only imaging obtained in 34% of transfer and 5% of primary patients. Both US and CT were completed for 17% of transfer and 19% of primary patients. CONCLUSION: The negative appendectomy rates of transfer and primary patients were not significantly different despite more frequent CT use at nonpediatric facilities. It may be valuable to encourage US utilization at adult facilities given the potential to safely reduce CT use in the evaluation of suspected pediatric appendicitis.

A review of the extraction methods and advanced applications of lignin-silica hybrids derived from natural sources.

The global trend of increasing energy demand along the large volume of wastewater generated annually from the paper pulping and cellulose production industries are considered as serious dilemma that may need to be solved within these current decades. Within this discipline, lignin, silica or lignin-silica hybrids attained from biomass material have been considered as prospective candidates for the synthesis of advanced materials. In this study, the roles and linking mechanism between lignin and silica in plants were studied and evaluated. The effects of the extraction method on the quality of the obtained material were summarized to show that depending on the biomass feedstocks, different retrieval processes should be considered. The combination of alkaline treatment and acidic pH adjustment is proposed as an effective method to recover lignin-silica with high applicability for various types of raw materials. From considerations of the advanced applications of lignin and silica materials in environmental remediation, electronic devices and rubber fillers future valorizations hold potential in conductive materials and electrochemistry. Along with further studies, this research could not only contribute to the development of zero-waste manufacturing processes but also propose a solution for the fully exploiting of by-products from agricultural production.

A Mixed Methods Needs Assessment for a Debriefing Intervention Following Critical Cases.

OBJECTIVE: The emergency department (ED) is a demanding environment, and critical events have been identified as contributors to stress. Debriefing is a possible intervention for staff, but there is little information regarding formulation and implementation. A needs assessment was conducted to describe the emotions of pediatric ED (PED) staff following critical events and assess opinions regarding debriefing. METHOD: This mixed methods study used convergent design for triangulation. After critical cases, PED staff members were given the Peritraumatic Distress Inventory (PDI). Additionally, a questionnaire with 2 open-ended questions on debriefing was administered. Themes were extracted from the questionnaire using directed content analysis. RESULTS: A total of 719 responses were collected for 142 critical cases. Physical reactions were often endorsed in the PDI, and these reactions were mirrored in the qualitative data, which included physiological responses such as stress, adrenaline high, anxiety, fatigue, and overwhelm. Helplessness and grief were 2 of the emotional PDI items frequently endorsed, which were reflected in the qualitative strand by themes such as helplessness, sadness, disheartenment, and regret. There was considerable variability between critical cases such that not every critical case elicited a desire for a debrief. CONCLUSIONS: PED staff report measurable levels of stress after critical patient cases that warrant follow-up. Formal debriefing immediately after critical patient cases with specific caveats may be valuable for the reduction of stress. Any formal debriefing program will need to balance various goals with attention to the session length, setting, and timing.

Mental Health Revisits at US Pediatric Emergency Departments.

Importance: Pediatric emergency department (ED) visits for mental health crises are increasing. Patients who frequently use the ED are of particular concern, as pediatric mental health ED visits are commonly repeat visits. Better understanding of trends and factors associated with mental health ED revisits is needed for optimal resource allocation and targeting of prevention efforts. Objective: To describe trends in pediatric mental health ED visits and revisits and to determine factors associated with revisits. Design, Setting, and Participants: In this cohort study, data were obtained from 38 US children's hospital EDs in the Pediatric Health Information System between October 1, 2015, and February 29, 2020. The cohort included patients aged 3 to 17 years with a mental health ED visit. Exposures: Characteristics of patients, encounters, hospitals, and communities. Main Outcomes and Measures: The primary outcome was a mental health ED revisit within 6 months of the index visit. Trends were assessed using cosinor analysis and factors associated with time to revisit using mixed-effects Cox proportional hazards regression. Results: There were 308 264 mental health ED visits from 217 865 unique patients, and 13.2% of patients had a mental health revisit within 6 months. Mental health visits increased by 8.0% annually (95% CI, 4.5%-11.4%), whereas all other ED visits increased by 1.5% annually (95% CI, 0.1%-2.9%). Factors associated with mental health ED revisits included psychiatric comorbidities, chemical restraint use, public insurance, higher area measures of child opportunity, and presence of an inpatient psychiatric unit at the presenting hospital. Patients with psychotic disorders (hazard ratio [HR], 1.42; 95% CI, 1.29-1.57), disruptive or impulse control disorders (HR, 1.36; 95% CI, 1.30-1.42), and neurodevelopmental disorders (HR, 1.22; 95% CI, 1.14-1.30) were more likely to revisit. Patients with substance use disorders (HR, 0.60; 95% CI, 0.55-0.66) were less likely to revisit. Conclusions and Relevance: Markers of disease severity and health care access were associated with mental health revisits. Directing hospital and community interventions toward identified high-risk patients is needed to help mitigate recurrent mental health ED use and improve mental health care delivery.

Bayesian inference and calibration of magnetic diagnostics.

The magnetic diagnostics across TAE Technologies' compact toroid fusion device include 28 internal and 45 external flux loops that measure poloidal flux and axial field strength, 64 three-axis (radial, toroidal, and axial) Mirnov probes, and 22 internal and external, axial-only Mirnov probes. Imperfect construction, installation, and physical constraints required a Bayesian approach for the calibration process to best account for errors in signals. These errors included flux loops not fitted to a perfect circle due to spatial constraints, Mirnov probes not perfectly aligned against their respective axes, and flux pickup that occurred within the insert (feedthrough) of the Mirnov probes. Our model-based calibration is derived from magnetostatic theory and the circuitry of the sensors. These models predicted outputs that were compared against experimental data. Using a simple least-squares optimization, we were able to predict flux loop data within 1% of relative error. For the Mirnov probes, we utilized Bayesian inference to determine three rotation angles and three amplifier gains. The results of this work not only gave our diagnostic measurements physical meaning, but also act as a safeguard to spot when instruments have malfunctioned, or when there is an error in database maintenance. This paper will go into the details of our calibration procedure, our Bayesian modeling, and the accuracy of our results compared to experimental data.

Parental attitudes in the pediatric emergency department about the COVID-19 vaccine.

BACKGROUND: COVID-19 vaccinations are now recommended in the United States (U.S.) for children ≥ 6 months old. However, pediatric vaccination rates remain low, particularly in the Hispanic/Latinx population. OBJECTIVE: Using the 4C vaccine hesitancy framework (calculation, complacency, confidence, convenience), we examined parental attitudes in the emergency department (ED) towards COVID-19 vaccination, identified dimensions of parental vaccine hesitancy, and assessed parental willingness to have their child receive the COVID-19 vaccine. METHODS: As part of a larger multi-methods study examining influenza vaccine hesitancy, we conducted interviews that included questions about COVID-19 vaccine authorization for children. We used directed content analysis to extract qualitative themes from 3 groups of parents in the ED: Hispanic/Latinx Spanish speaking (HS), Hispanic/Latinx English speaking (HE), non-Hispanic/non-Latinx White English speaking (WE). Themes were triangulated with the Parent Attitudes about Childhood Vaccines (PACV) survey, where higher scores indicate increased vaccine hesitancy. RESULTS: Factors influencing vaccine hesitancy were mapped to the 4C framework from 58 sets of interviews and PACVs. HE and HS parents, compared to WE parents, had less knowledge about COVID-19 and its vaccine, and more beliefs in COVID-19 vaccine myths. However, both HS and HE parent groups were more inclined to endorse COVID-19 vaccine effectiveness as a reason to have their children vaccinated. HS parents felt that COVID-19 increased their fear of illnesses in general and were worried about confusing COVID-19 with other infections. Median PACV scores of HS (Mdn = 20) and HE (Mdn = 20) parent groups were higher than of WE parents (Mdn = 10), but parental willingness to have their child receive COVID-19 vaccination was similar across groups. CONCLUSIONS: Higher COVID-19 vaccine hesitancy among HS and HE parents compared to WE parents may be attributed to insufficient knowledge about COVID-19, its vaccine, along with COVID-19 vaccine myths. Efforts to provide targeted vaccine education to different populations is warranted.

Weighty Matters: A Real-World Comparison of the Handtevy and Broselow Methods of Prehospital Weight Estimation.

INTRODUCTION: The majority of pediatric medications are dosed according to weight and therefore accurate weight assessment is essential. However, this can be difficult in the unpredictable and peripatetic prehospital care setting, and medication errors are common. The Handtevy method and the Broselow tape are two systems designed to guide Emergency Medical Services (EMS) providers in both pediatric patient weight estimation and medication dosing. The accuracy of the Handtevy method of weight estimation as practiced in the field by EMS has not been previously examined. STUDY OBJECTIVE: The primary objective of this study was to examine the field performance of the Handtevy method and the Broselow tape with respect to prehospital patient weight estimation. METHODS: This was a retrospective chart review of trauma and non-trauma patients transported by EMS to the emergency department (ED) of a quaternary care children's hospital from January 1, 2021 through June 30, 2021. Demographic data, ED visit information, prehospital weight estimation, and medication dosing were collected and analyzed. Scale-based weight from the ED was used as the standard for comparison. RESULTS: A total of 509 patients <13 years of age were included in this study. The EMS providers using the Broselow method estimated patient weight to within +/-10% of ED scale weight in 51.3% of patients. When using the Handtevy method, the EMS providers estimated patient weight to within +/-10% of ED scale weight in 43.7% of patients. When comparing the Handtevy versus Broselow method of prehospital weight estimation, there was no significant association between method and categorized weight discrepancy (over, under, or accurate estimates - defined as within 10% of ED scale weight; P = .25) or percent weight discrepancy (P = .75). On average, prehospital weight estimation was 6.33% lower than ED weight with use of the Handtevy method and 6.94% lower with use of the Broselow method. CONCLUSION: This study demonstrated no statistically significant difference between the use of the Handtevy or Broselow methods with respect to prehospital weight estimation. While further research is necessary, these results suggest similar field performance of the Broselow and Handtevy methods.

Describing the Patient Population of a Pediatric Emergency Department Based on Visit Frequency.

OBJECTIVE: A small number of children in the United States use a disproportionate share of emergency healthcare services. Our study objective was to examine characteristics associated with frequent pediatric emergency department (PED) utilization. METHODS: A retrospective cohort-sequential study of patients seen in the PED of an urban children's hospital was conducted. Patients were categorized into 2 groups: infrequent users (<4 visits during index year 2017) and frequent users (≥4 visits in 2017). Frequent PED users were further divided into persistent frequent (≥4 visits in the year before and after 2017) and incidental frequent (≥4 visits in 2017). Patient- and visit-level characteristics were analyzed for associations with PED utilization. RESULTS: In 2017, there were 82,361 visits by 56,767 patients to our PED. Frequent users comprised 4% of the total patient volume but accounted for 13% of visits. Compared with infrequent users, frequent users were younger, more likely publicly insured, and English speaking. Frequent user visits were more likely to occur outside clinic hours, be triaged as emergent, and involve subspecialists. Compared with visits by incidental frequent users, visits by persistent frequent users were more likely to be emergent or urgent, and involve subspecialists, diagnostic imaging, laboratory testing, and medication administration. CONCLUSIONS: Although the percentage of frequent users to a PED in 2017 was low, they made up a disproportionate share of total visits. Differences between persistent and incidental frequent PED users suggest that these subgroups may benefit from tailored interventions to reduce frequent PED utilization.

Two new dimethylpyranoflavanones from the roots of Melodorum fruticosum.

Two previously unreported dimethylpyranoflavanones, pyronomelodorones A and B (1 and 2), along with five known compounds, 7-O-methyldihydrowogonin (3), 5,6,7-trimethoxyflavanone (4), 5,6-dihydroxy-7-methoxy-dihydroflavone (5), 5,7,8-trimethoxydihydroflavone (6), and pinostrobin (7), were isolated from the roots of Melodorum fruticosum. The structures of all isolates were fully characterized using spectroscopic data and comparison with the previous literature. All isolates were evaluated for their in vitro α-glucosidase inhibition and their cytotoxicity against KB, HepG2, and MCF7 cell lines. Among the isolates, compound 1 exhibited the most inhibitory activity against α-glucosidase and was superior to the positive control with an IC50 value of 1.32 µM. Compounds 1 and 2 showed weak cytotoxicity against the three human cancer cell lines, with IC50 values in the range of 53.3-79.0 µM.

Recent developments in chitosan hydrogels carrying natural bioactive compounds.

Chitosan hydrogel is a smart and highly applicable drug delivery carrier because of its nature, biocompatibility, biodegradability, and ability to encapsulate, carry and release the drug to the desired target flexibly depending on the conditions of the patient. Not only developing delivery systems but natural compounds are also increasingly being studied in supporting the treatment of diseases. However, the physicochemical and pharmacokinetic issues of the phytochemicals are remaining. This review summarizes the remarkable properties of chitosan hydrogel; approaches to loading natural extracts on the hydrogels to overcome the susceptibility of the phytochemicals to degradation; and their applications in biomedical fields. The drug loading efficiency, release profile, in vitro and in vivo results of the chitosan hydrogels carrying natural compounds are discussed to point out the remaining challenges of combining the extracts with chitosan hydrogels and controlling the release of the carried substances.

Depolymerization of Rice Straw Lignin into Value-Added Chemicals in Sub-Supercritical Ethanol.

Depolymerization of lignin is an important step to obtain a lignin monomer for the synthesis of functional chemicals. In the context of more lignin produced from biomass and pulp industry, converting real lignin with low purity is still required more studies. In this study, the influence of solvent composition and reaction parameters such as binary solvents ratio, time, and temperature, the solvent-to-lignin ratio on the depolymerization of rice straw lignin was investigated carefully. Essential lignin-degraded products including liquid product (LP), char (solid), and gas were obtained, and their yields were directly influenced by reaction conditions. Results show that the maximum lignin conversion rate of 92% and LP yield of 66% was under the condition of 275°C, 30 min, 75 : 1 (mL solvent/1 g lignin), and ethanol 50%. Gas chromatography-mass spectroscopy (GC-MS) analysis was used for the analysis of the depolymerization products and identified 11 compounds which are mainly phenolic compounds such as 2-ethylphenol, 3-ethylphenol, phenol, methyl 2,4,6-trimethylbenzoate. The structure changes of LP and char in various conditions were analyzed using Fourier-transform infrared (FTIR).

Social Emergency Medicine: Capitalizing on the Pediatric Emergency Department Visit to Screen and Connect Patients and Families to Community Resources.

OBJECTIVE: To describe the social needs of families screened by the Community Health Advocates Team (CHAT) Desk, situated within a pediatric emergency department (PED); and to evaluate the effectiveness of this help desk in connecting families to community resources. METHODS: Trained undergraduates, onsite in the PED 30 hours/week during daytime and evening hours, weekdays and weekends, screened a convenience sample of families of patients in the PED for social needs, and provided information on available community resources. Families were offered a follow-up phone call several weeks after their PED visit to assess program satisfaction and success, and identify remaining social needs. RESULTS: Between January 2019 and March 2020, CHAT Desk screened and assisted 682 families. CHAT routinely provided resources about free outdoor recreational activities for families, but after that, the most commonly provided informational resources pertained to: health care (n = 200), housing (n = 143), and food (n = 137). Of families who completed the follow-up phone call (n = 294), almost half (n = 134, 46%) reported being able to contact at least one of the resources; 100 reported that the resource was able to assist them, and 99 families planned to continue using the resource. When asked about satisfaction, 93% (n = 274) reported being very satisfied or somewhat satisfied with CHAT; 94% (n = 276) said they would recommend it to others. CONCLUSIONS: The PED of a busy tertiary care children's hospital is an opportune location to screen families for social needs, and provide them with information on requested community resources.

Recent Progresses in Eco-Friendly Fabrication and Applications of Sustainable Aerogels from Various Waste Materials.

Tons of waste from residential, commercial and manufacturing activities are generated due to the growing population, urbanization and economic development, prompting the need for sustainable measures. Numerous ways of converting waste to aerogels, a novel class of ultra-light and ultra-porous materials, have been researched to tackle the issues of waste. This review provides an overview of the status of aerogels made from agricultural waste, municipal solid, and industrial waste focusing on the fabrication, properties, and applications of such aerogels. The review first introduced common methods to synthesize the aerogels from waste, including dispersion and drying techniques. Following that, numerous works related to aerogels from waste are summarized and compared, mainly focusing on the sustainability aspect of the processes involved and their contributions for environmental applications such as thermal insulation and oil absorption. Next, advantages, and disadvantages of the current approaches are analyzed. Finally, some prospective waste aerogels and its applications are proposed.

Development of a paddy-based biorefinery approach toward improvement of biomass utilization for more bioproducts.

Improvement of biomass utilization productivity following cascading strategy is a priority for the biorefinery-based circular bioeconomy. In recent years, the field of energy research has seen an increasing interest in bio-products from paddy-based biorefinery, but the utilization of the entire value of paddy biomass to guide the commercial viability of its products has not been got feasible outcomes. Here we propose a potential pathway for a conceptual paddy biorefinery framework by addressing wastes for producing more products. The feasibility of the integrated biorefinery was demonstrated by the conversion of wastes into value-added products such as nano-silica and lignin. In particular, this is the first time that silica recovered from bioethanol system was continued to be reused to produce ZSM-5 and Ni/ZSM-5 as catalysts of rice straw lignin depolymerization achieving high conversion of lignin up to 95% and fair yield of phenolic products up to 41%. Material flow of an integrated biorefinery model was reported to give a future outlook for making most of the processing routes of rice residues. We also established a life cycle that follows the circular bioeconomy concept and discussed the relationship between each of potential bioproducts and their market opportunities.