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Our objective was to compare transition readiness assessment scores from adolescents with rheumatic disease with their parents and analyze their level of agreement. We found that adolescents and parents generally agree on the level of the transition readiness; however, there is occasional disagreement in specific domains.

Since advanced technologies were introduced into surgical education, a variety of new programs have been developed. However, a comprehensive review of digital education in general thoracic surgery has not been performed. This narrative review was conducted was to identify the current applications of digital education in general thoracic surgery.

A literature search was performed using keywords related to general thoracic surgery and digital education, including e-learning and virtual simulation, up to September 2021. Studies published in English investigating the effect of digital education in general thoracic surgery were included.

Thirteen studies met the criteria. The settings were in undergraduate (n= 6) and postgraduate education (residency) (n= 5) and mixed audience with other disciplines (n= 2). Theoretical knowledge (n= 5), technical skills (n= 4), and both knowledge and technical skills (n= 4) were the stated educational objectives for the studies. The didactic materials were transferred to hardware, software, or online platforms and delivered with multimedia materials. Technical skills training for bronchoscopy and chest tube insertion (n= 5) were offered using virtual reality and computer-based simulations. Subjective evaluation was done in 10 studies. Although after the digital education training there was observed improvement in knowledge or skills in 8 studies, studies were not designed to test for superiority compared with controls through randomized controlled studies.

This review summarizes the current applications of digital education in general thoracic surgery and helps establish the needs for future studies in this field.

This review summarizes the current applications of digital education in general thoracic surgery and helps establish the needs for future studies in this field.

Patient-reported outcomes (PROs) assessment is a necessary component of surgical outcome assessment and patient care. This study examined the success of routine PROs assessment in an academic-based thoracic surgery practice.

PROs, measuring pain intensity, physical function, and dyspnea, were routinely obtained using the National Institutes of Health-sponsored Patient-Reported Outcomes Measurement Information System (PROMIS) on all thoracic surgery patients beginning in April 2018 through January 2021. Questionnaires were administered electronically through a web-based platform at home or during the office visit. Bcl-2 inhibitor Completion rates and barriers were measured.

A total of 9725 thoracic surgery office visits occurred during this time frame. PROs data were obtained in 6899 visits from a total of 3551 patients. The mean number of questions answered per survey was 22.4 ± 2.2. Overall questionnaire completion rate was 65.7%. A significant decline in survey completion was noted in April 2020, after which adjustments were made to allow for questionnaire completion through a mobile health platform. Overall monthly questionnaire completion rates ranged from 20% (April 2020) to 90% (October 2018). Mean T scores were dyspnea, 41.6 ± 12.3; physical function, 42.7 ± 10.5; and pain intensity, 52.8 ± 10.3.

PROs can be assessed effectively in a thoracic surgery clinic setting, with minimal disruption of clinical activities. Future efforts should focus on facilitating PROs collection from disadvantaged patient populations and scaling implementation across programs.

PROs can be assessed effectively in a thoracic surgery clinic setting, with minimal disruption of clinical activities. Future efforts should focus on facilitating PROs collection from disadvantaged patient populations and scaling implementation across programs.Biodegradable cellulosic pulp foams with robustness and water resistance are urgently needed in nowadays to replace petroleum-based plastic foams for environmental sustainability. In this work, a facile protocol to fabricate robust poly-lactic acid (PLA) coated cellulose foams (PCCF) was developed through a combined water-based foaming and PLA melt-coating process using pulp as the raw material. In the synthesis, the so-called PLA coating was realized through melting PLA powders dispersed between fibers by an in-situ heating and post cooling process. Performance tests revealed that the incorporation of PLA coating significantly enhances mechanical strength, water stability, and biodegradability of the synthesized PCCF samples compared with conventional cellulosic foams. Specifically, the low-density PCCF were observed with mechanical strength up to 81.24 kPa, high water stability, and more than 95% degradation in 56 days. As the fabrication process is simple and pulp is highly cost competitive, our proposed synthesis strategy makes the PCCF a promising substitute for petroleum-based plastic foams at large-scale production.The social and ecological influence of Neonicotinoids (NEOs) usage in agriculture sector is progressively higher. There are seven NEOs insecticides widely used for the insects control. Among the NEOs, thiacloprid (THD) was extensively used for insect control during crop cultivation. This study targets to analyse the contamination levels of NEOs in agricultural soil and identify photo-biodegradation of THD degradation using pure isolates and mixed consortium. The photo degradation (PD), biodegradation (BD) and photo-biodegradation (PBD) of THD were compared. The corn field agricultural soils were polluted by four NEOs, among them THD had greater contamination level (surface soil 3901.2 ± 0.04 μg/g) and (sub-surface soil 3988.6 ± 0.05 μg/g). Three soil free enriched bacterial strains following Bacillus atrophaeus (PB-2), Priestia megaterium (PB-3) (formerly known as Bacillus megaterium), and Peribacillus simplex (PB-4) (formerly known as Bacillus simplex) were identified by microbiological and molecular 16s rRNA gene sequencing. The PD, BD and PBD of THD were conducted and degradation rate was detected by instrument UPLC-MS-MS. The PBD process with blue-LEDs showed better THD degradation efficiency than PD and BD, where the specific THD degradation rate was 85 ± 0.2%, 87 ± 0.5%, and 89 ± 0.3%, respectively for PB-2, PB-3 and PB-4. Then, the photo-biodegradation performance is greater at 150, 175, 200 rpm, pH 7.0-9.0, and temperature 30-35 °C. After the PBD system deliver four intermediate metabolites, the THD degradation process maybe through nitro reduction, hydroxylation and oxidative cleavage pathway.This study investigates the behavior of Tl in the Ría de Huelva (SW Spain), one of the most metal polluted estuaries in the world. Dissolved Tl concentration displayed a general decrease across the estuary during the dry season (DS); from 5.0 to 0.34 μg/L in the Tinto and Odiel estuaries, respectively, to 0.02 μg/L in the channel where the rivers join. A slighter decrease was observed during the wet season (WS) (from 0.72 to 0.14 μg/L to 0.02 μg/L) due to the dilution effect of rainfalls in the watersheds. These values are 3 orders of magnitude higher than those reported in other estuaries worldwide. Different increases in Tl concentrations with salinity were observed in the upper reaches of the Tinto and Odiel estuaries, attributed to desorption processes from particulate matter. Chemical and mineralogical evidences of particulate matter, point at Fe minerals (i.e., jarosite) as main drivers of Tl particulate transport in the estuary. Unlike other estuaries worldwide, where a fast sorption process onto particulate matter commonly takes place, Tl is mainly desorbed from particulate matter in the Tinto and Odiel estuaries. Thus, Tl may be released back from jarositic particulate matter across the salinity gradient due to the increasing proportion of unreactive TlCl0 and K+ ions, which compete for adsorption sites with Tl+ at increasing salinities. A mixing model based on conservative elements revealed a 6-fold increase in Tl concentrations related to desorption processes. However, mining spills like that occurred in May 2017 may contribute to enhance dissolved and particulate Tl concentrations in the estuary as well as to magnify these desorption processes (up to around 1100% of Tl release), highlighting the impact of the mine spill on the remobilization of Tl from the suspended matter to the water column.Clearfield® wheat (Triticum aestivum) have helped eliminate the toughest grasses and broadleaf weeds in Spain since 2005. This crop production system includes other tolerant cultivars to the application of imidazolinone (IMI) herbicides. However, the continuous use and off-label rates of IMI herbicides can contribute to the development of resistance in Lolium rigidum and other weed species. In this research, the main objectives were to study the resistance mechanisms to acetolactate synthase (ALS) and acetyl coenzyme A carboxylase (ACCase) inhibitors in a L. rigidum accession (LrR) from a Clearfield® wheat field, with a long history rotating these IMI-tolerant crops and compare them with those present in the IMI-tolerant wheat. The resistance to ACCase inhibitors in LrR was due to point mutations (Ile1781Leu plus Asp2078Gly) of the target site gene plus an enhanced herbicide metabolism (EHM), on the other hand, in wheat accessions was due only by EHM. Mechanisms involved in the resistance to ALS inhibitors were both point mutations of the target gene and EHM in the IMI-tolerant wheat, while only evidence of mutation (Trp574Leu) was found in the multiple herbicide resistant L. rigidum accession. This research demonstrates that if crop rotation is not accompanied by the use of alternative sites of action in herbicide-tolerant crops, resistant weeds to herbicide to which crops are tolerant, can easily be selected. Moreover, repeated and inappropriate use of Clearfield® crops and herbicide rotations can lead to the evolution of multiple resistant weeds, as shown in this study, and have also inestimable environmental impacts.Anthropogenic waste streams can be major sources of antibiotic resistant microbes within the environment, creating a potential risk to public health. We examined patterns in the occurrence of a suite of antibiotic resistance genes (ARGs) and their links to enteric bacteria at a popular swimming beach in Australia that experiences intermittent contamination by sewage, with potential points of input including stormwater drains and a coastal lagoon. Samples were collected throughout a significant rainfall event (40.8 mm over 3 days) and analysed using both qPCR and 16S rRNA amplicon sequencing. Before the rainfall event, low levels of faecal indicator bacteria and a microbial source tracking human faeces (sewage) marker (Lachno3) were observed. These levels increased over 10x following rainfall. Within lagoon, drain and seawater samples, levels of the ARGs sulI, dfrA1 and qnrS increased by between 1 and 2 orders of magnitude after 20.4 mm of rain, while levels of tetA increased by an order of magnitude after a total of 40.