Recent advances in applications of MXenes for desalination, water purification and as an antibacterial:a review

Membranes have become a basis in tackling the global challenge of freshwater scarcity, notably in the fields of desalination and water purification. MXenes, distinguished by their notable high aspect ratio, extensive surface area, robust mechanical strength, and enduring chemical resilience, have emerged as highly promising materials for membrane development. Recent progress in the research and application of MXene membranes, especially in the areas of water desalination and treatment, marks a significant leap forward in this domain. This study conducts an exhaustive analysis of the state-of-the-art developments in the creation and enhancement of MXene-based membranes. It delves into their application in various desalination processes, including membrane-based desalination and solar-driven interfacial steam generation, alongside their use in water purification. This analysis sheds light on their efficacy in desalination processes, in addition to evaluating their antimicrobial properties and salt rejection efficiency. Moreover, the review provides an in-depth examination of the mechanics behind MXene membranes and assesses their overall impact, pinpointing both the current opportunities they present and the challenges they face. The primary goal of this discussion is to enrich the collective understanding of MXene membrane technology and to drive continuous improvement and innovation in this area. By doing so, it aims to contribute to the advancement of sustainable solutions to water scarcity through the development of more efficient and effective membrane technologies.</p

Professional experiences on use of the mental health act in ethnically diverse populations:a photovoice study

Background: There are long-standing ethnic and racial inequalities in experiences and outcomes of severe mental illness, including compulsory admission and treatment (CAT). Aims: To gather professional experiences about (1) remedies for ethnic inequalities in the use of the Mental Health Act ((MHA) 1983 and 2007) and (2) recommendations for improving care experiences and for reducing ethnic inequalities. Method: We undertook a participatory research process using photovoice to gather experience data. Photographs were assembled and narrated by 17 professionals from a variety of disciplines. We undertook a thematic analysis. Results: Ineffective communications between inpatient and community services, insufficient staff capacity, a lack of continuity of care and language and cultural constraints meant MHA assessments were lacking information, leading to elevated perceptions of risk. Practitioners felt helpless at times of staff shortages and often felt CAT could have been prevented. They felt voiceless and powerless and unable to challenge stereotypes and poor practice, especially if they were from a similar demographic (ethnicity) as a patient. Interdisciplinary disagreements and mistrust led to more risk-aversive practices. The legislation created an inflexible, risk-averse and defensive process in care. Police involvement added to concerns about criminalisation and stigma. There were more risk-averse practices when team members and families disagreed on care plans. More rehabilitation and recovery-orientated care are needed. Legislative compliance in a crisis conflicted with supportive and recovery-orientated care. Conclusion: Clear standards are needed, including specific protocols for MHA assessment, police interactions, alternatives to admission, early intervention and continuity of care

A Bis‐Perylene Diimide Macrocycle Chiroptical Switch

Helical assemblies of organic dyes are ubiquitous chiral organic materials, with valuable properties including chiroptical switching due to the dynamic nature of supramolecular chirality. Herein, we report a novel chiral bis‐perylene diimide macrocycle, which acts as a discrete molecular model for a chiral supramolecular assembly. Point chirality is installed through amino acid‐derived imide groups which, upon macrocyclization, is translated into helical chirality in the perylene diimide dimer. In solution, the macrocycle's chiroptical properties are switchable, with both the sign (+/−) and amplitude (on/off) of the signal tuned using solvent and molecular recognition stimuli respectively. The chiral structure–property relationships identified from this macrocycle are important for the design of high fidelity supramolecular chiroptical switches

Knee osteoarthritis among adults in Al Madam city, Sharjah: unrevealing the prevalence and predisposing factors:a cross-sectional study

Background: Knee osteoarthritis (OA) is the most common joint disorder of the knee, and its progression, influenced by multifactorial predisposing factors such as age, BMI, and physical activity, often results in significant limitations in day-to-day activities and deterioration of quality of life. Although the prevalence and predisposing factors of OA are well-documented globally, this study is distinct in its focus on the semi-urban population of Al Madam City, Sharjah. The unique socio-cultural and occupational characteristics of this community provide an opportunity to identify localized risk factors and their impact on OA prevalence, offering insights that can inform tailored healthcare strategies. Objective: The present study was conducted to estimate the prevalence of OA and its associated predisposing factors among the population of Al Madam, Sharjah. Methods: A community-based cross-sectional study was conducted to estimate the prevalence of knee OA in the population of Al Madam City, Sharjah. This study was conducted in twelve villages. 1300 participants were recruited through convenience sampling using a screening questionnaire survey to identify individuals with knee OA. The Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire was used, with an additional questionnaire consisting of questions related to its predisposing factors. Results: The prevalence of knee OA was 12.9% in Al-Madam City, Sharjah. Predisposing factors, such as age (χ2:314.900), sex (χ2:13.581), nationality (χ2:76.657), BMI (χ2:86.174), physical activity levels (χ2:11.099), previous knee injury (χ2:657.715), level of education (χ2:259.906), and occupation with the sedentary job (χ2:193.911), were found to be associated with the prevalence of knee OA. Conclusions: This study highlights that the prevalence of knee OA in Al Madam City is 12.9%, with significant associations observed between knee OA and factors such as age, sex, BMI, physical activity levels, education, and previous knee trauma. The findings underline the impact of the city’s unique socio-cultural and occupational characteristics, such as high representation of labor-intensive jobs and limited leisure activity options, on the development of knee OA

Obligate diapause and its termination shape the life-cycle seasonality of an Antarctic insect

The Antarctic midge, Belgica antarctica, is a unique insect endemic to Antarctica. It has a 2-year life cycle, with larvae overwintering in two different instars and adults emerging the following summer. This seasonality is crucial for adaptation to Antarctica’s harsh climates and ephemeral growing seasons; however, the underlying mechanisms remain unclear. We found that, under summer-like conditions, larvae could develop from egg to the fourth-instar larval stage without interruption, but they never pupated. Spontaneous developmental arrest at this stage suggests that they overwinter in obligate diapause, a genetically determined period of dormancy. The winter cold can terminate this diapause, and long-term cold exposure is more effective. Although this species can utilise two alternative cold tolerance strategies with diapause for overwintering, freezing was more successful than cryoprotective dehydration in allowing survival and developmental resumption in our experimental conditions. In contrast, the first three larval instars continued their development under the same conditions as the fourth-instar larvae. Although we do not exclude the possibility of facultative diapause, they likely overwinter in a quiescent state, an immediate developmental arrest in response to adversity, to maximise exploitation of the short Antarctic summer. Diapause and quiescence ensure developmental and reproductive success in this extremophile insect

Effect of cyclic thermal loading on the behaviour of integral abutment bridges:a large-scale experimental study in a soil pit

We investigate abutment-backfill interaction in Integral Bridges (IBs) under thermal loading over a large number of cycles for a 120-year life span as specified by modern design codes. To better understand the associated mechanisms and assess the performance of IBs within their entire life cycle, a large-scale (1g) physical model, comprising a 3 m tall concrete wall retaining 35 m3 of dry uniform sand, was built and tested in the soil pit of the Soil-Foundation-Structure Interaction (SoFSI) laboratory, University of Bristol. The thermal load was modelled as a cyclic displacement history of 1.2 cm (constant) amplitude imposed via a hydraulic actuator, corresponding to a maximum drift of approximately 4 x 10-3. The maximum passive soil resistance increases monotonically, especially during the first 40 loading cycles, at a decreasing rate. Motivated by the inability of available design formulae to capture the pressure built-up over the entire life cycle of the bridge, an adaptive numerical spring model is developed, employed first for the design of the experiment and subsequently for the simulations; the model has shown to capture reasonably well the densification of the sand and successfully mimic the observed lateral earth pressure and bending moment distribution with number of cycles

Validation of a Single Item Measure for Financial Toxicity Screening in Patients With Breast Cancer

PurposeFinancial toxicity (FT) has been linked to higher symptom burden and poorer clinical outcomes for patients with cancer. Despite the availability of validated tools to measure FT, a simple screen remains an unmet need. We evaluated item 12 (“My illness has been a financial hardship to my family and me”) of the COmprehensive Score for Financial Toxicity (COST) measure as a single-item FT screening measure.MethodsIn this secondary analysis, 711 patients with cancer (690 with breast cancer) were recruited via a web-based survey from a philanthropic organization. COST items 1-11 were scored according to Functional Assessment of Chronic Illness Therapy scoring guidelines, with lower scores indicating worse FT. Analyses focused on establishing a correlation, examining item properties, and sensitivity/specificity of item 12 relative to the total COST score.ResultsItem 12 had a correlation of r = 0.53 with the COST-11 score, and an increase of one point on item 12 is associated with a decrease of approximately three total points on the full scale (b, 3.35; P &lt; .001; adjusted R2, 0.28). Item analysis with the graded-response item in response theory modeling showed very good discrimination (a, 2.096) for item 12, indicating that it can reliably distinguish between low and high FT in patients. Sensitivity ranged between 75.6% and 95.7% on all item 12 thresholds to screen positive for FT using two COST cutoffs as criteria. Maximizing both sensitivity and specificity was to be found for higher item 12 scores.ConclusionTo our knowledge, this is the first validation of a single-item screening measure for FT. Overall, these results illustrate that item 12 from the COST measure is a good candidate for a single-item screener. Clinicians can choose among item 12 screening thresholds depending on their tolerance for low specificity.<p/

Understanding the flexibility of working memory:Compositionality, generative processing, anchors and holistic representations

The typical conception of working memory is a mechanism to temporarily hold multiple discrete objects in service of other cognitive tasks in an item-based representation. In this paper, we expand the conventional idea that working memory represents objects into a more flexible framework that uses compositional and generative mechanisms to code and then re-code visual input according to task demands. Compositionality allows complex scenes or objects to be mentally decomposed into constituents that can be individually manipulated or recombined to form new representations. Generative processing allows purely conceptual information to be reconstructed in a format akin to visual sensory representations that can be manipulated and re-processed by perceptual mechanisms. Together, compositional and generative mechanisms would enable a wide range of cognitive functions including the basis of visual imagery. In our view, working memory items do not need to correspond to discrete objects, but could serve as pointers or anchors to clusters of features that form parts of objects, or alternatively, multiple objects could be encoded as one holistic item depending on the task. We conclude with a conceptual account of such a memory system that can build and re-use information by moving it between different levels of abstraction within a perceptual hierarchy. This model is linked to experimental results from the memory and visual imagery literatures that illustrate the flexibility of such a system for performing cognitive tasks.</p

Development of a consensus extension of the estimands framework for cluster randomised trials (CRT-estimands): results from an international Delphi study

BackgroundEstimands are increasingly used in randomised trials to clarify research objectives. The ICH E9(R1) addendum sets out five attributes necessary to describe a well-defined estimand. However, the addendum was primarily developed for individually randomised trials. There is growing recognition that estimand descriptions for cluster randomised trials, where groups of individuals are randomised, may require specification of additional considerations. We conducted a Delphi study to assess stakeholder views on additional items for inclusion in a consensus extension of the ICH E9(R1) for cluster randomised trials. MethodsWe invited experts in estimands and cluster randomised trials to participate in a modified Delphi process to identify critical items for describing estimands in cluster randomised trials. The research team generated an initial list of eight items and definitions. Across three Delphi rounds, panellists scored items, suggested additional items, and provided open-ended rationales for responses. The consensus threshold was set as &gt;70% of respondents rating an attribute as "essential" (i.e., score of &gt;7 on a 9-point Likert scale) and &lt; 15% of respondents rating the item as "not important" (i.e., a score of &lt; 3). ResultsSeventy-three (52%) invited individuals participated in Round 1. Response rates were 85% in Round 2 and 95% in Round 3. Panellists included largely statisticians (62, 85%) and clinical trialists (18, 25%). After Round 1, one additional item was added for Round 2 inclusion. After Round 3, five items met consensus criteria: how individuals and clusters are weighted, population of clusters, exposure time of clusters and individuals to the intervention, whether treatment effects are marginal or cluster-specific, and handling of cluster-level intercurrent events. ConclusionsThis Delphi identified expert consensus around the importance of several key items for defining estimands in cluster randomised trials. These results can inform the development of consensus guidance outlining the set of attributes to describe when defining estimands for cluster randomised trials

Optimisation before Crohn’s surgery using Exclusive Enteral Nutrition (OCEaN) Trial:a randomised controlled trial to determine whether preoperative exclusive enteral nutrition is more clinically and cost effective compared with standard care in patients undergoing surgery for Crohn’s disease

Background: Exclusive enteral nutrition (EEN) is commonly used in paediatric Crohn’s disease patients as a first-line therapy for inducing remission. However, there are currently no randomised controlled trials evaluating the effectiveness of EEN in adults compared to unrestricted diets. Despite advances in immunosuppressive and biologic treatments, 23-47% of patients with Crohn’s disease will require surgery, with approximately 22% needing repeat surgeries. Potential suggested benefits of EEN in the perioperative setting include reduced steroid usage, reduced operative complications, and reduced need for stoma formation.Methods: A multi-centre, two-arm, parallel group, open-label, pragmatic randomised controlled trial to assess the clinical and cost-effectiveness of EEN. The trial will be conducted in at least 40 UK-wide tertiary and district general NHS hospitals. Participants will be randomised to either six weeks of preoperative EEN or standard care as per local standard care. Primary outcomes will be quality of life and post-surgical complications at six weeks and 30 days post-surgery respectively.Discussion: The OCEaN Trial aims to determine whether preoperative EEN is more clinically and cost effective compared with standard care in patients undergoing surgery for Crohn’s disease.<br/