Characterizing the Urban Mine—Challenges of Simplified Chemical Analysis of Anthropogenic Mineral Residues

Anthropogenic mineral residues are characterized by their material complexity and heterogeneity, which pose challenges to the chemical analysis of multiple elements. However, creating an urban mine knowledge database requires data using affordable and simple chemical analysis methods, providing accurate and valid results. In this study, we assess the applicability of simplified multi-element chemical analysis methods for two anthropogenic mineral waste matrices: (1) lithium-ion battery ash that was obtained from thermal pre-treatment and (2) rare earth elements (REE)-bearing iron-apatite ore from a Swedish tailing dam. For both samples, simplified methods comprising ‘inhouse’ wet-chemical analysis and energy-dispersive Xray fluorescence (ED-XRF) spectrometry were compared to the results of the developed matrix-specific validated methods. Simplified wet-chemical analyses showed significant differences when compared to the validated method, despite proven internal quality assurance, such as verification of sample homogeneity, precision, and accuracy. Matrix-specific problems, such as incomplete digestion and overlapping spectra due to similar spectral lines (ICP-OES) or element masses (ICP-MS), can result in quadruple overestimations or underestimation by half when compared to the reference value. ED-XRF analysis proved to be applicable as semi-quantitative analysis for elements with mass fractions higher than 1000 ppm and an atomic number between Z 12 and Z 50. For elements with low mass fractions, ED-XRF analysis performed poorly and showed deviations of up to 90 times the validated value. Concerning all the results, we conclude that the characterization of anthropogenic mineral residues is prone to matrix-specific interferences, which have to be addressed with additional quality assurance measures.DFG, 414044773, Open Access Publizieren 2019 - 2020 / Technische Universität BerlinEC/H2020/641999/EU/ Prospecting Secondary raw materials in the Urban mine and Mining waste/ProSU

Emulator-based Bayesian calibration of the CISNET colorectal cancer models

PURPOSE: To calibrate Cancer Intervention and Surveillance Modeling Network (CISNET) 's SimCRC, MISCAN-Colon, and CRC-SPIN simulation models of the natural history colorectal cancer (CRC) with an emulator-based Bayesian algorithm and internally validate the model-predicted outcomes to calibration targets.METHODS: We used Latin hypercube sampling to sample up to 50,000 parameter sets for each CISNET-CRC model and generated the corresponding outputs. We trained multilayer perceptron artificial neural networks (ANN) as emulators using the input and output samples for each CISNET-CRC model. We selected ANN structures with corresponding hyperparameters (i.e., number of hidden layers, nodes, activation functions, epochs, and optimizer) that minimize the predicted mean square error on the validation sample. We implemented the ANN emulators in a probabilistic programming language and calibrated the input parameters with Hamiltonian Monte Carlo-based algorithms to obtain the joint posterior distributions of the CISNET-CRC models' parameters. We internally validated each calibrated emulator by comparing the model-predicted posterior outputs against the calibration targets.RESULTS: The optimal ANN for SimCRC had four hidden layers and 360 hidden nodes, MISCAN-Colon had 4 hidden layers and 114 hidden nodes, and CRC-SPIN had one hidden layer and 140 hidden nodes. The total time for training and calibrating the emulators was 7.3, 4.0, and 0.66 hours for SimCRC, MISCAN-Colon, and CRC-SPIN, respectively. The mean of the model-predicted outputs fell within the 95% confidence intervals of the calibration targets in 98 of 110 for SimCRC, 65 of 93 for MISCAN, and 31 of 41 targets for CRC-SPIN.CONCLUSIONS: Using ANN emulators is a practical solution to reduce the computational burden and complexity for Bayesian calibration of individual-level simulation models used for policy analysis, like the CISNET CRC models.</p

PRÁTICA EDUCATIVA COM ENFERMEIROS DA ATENÇÃO PRIMÁRIA: NÃO À LESÃO POR PRESSÃO

Objetivos: Analizar, partiendo de la visión de los enfermeros de Atención Primaria, las contribuciones de la práctica educativa en la prevención dela Lesión por Presión y promoción de salud. Método: Estudio Convergente Asistencia, con 20 enfermeros, realizado entre julio y agosto de 2014en Santa Catarina, desarrollado en dos etapas y cuatro reuniones, utilizándose cuestionario en la primera entrevista, realizándose luego tres talleres.Resultados: Datos analizados resultando en dos categorías: Dígale No a la Lesión por Presión y La práctica del enfermero en la prevención de laLP y la promoción de la salud en la APS, expresando adquisición y mejoramiento de conocimientos, construcción de nuevo saber, contribuyendoa acciones sanitarias. Conclusión: La práctica educativa consiguió su propósito, innovando y renovando el conocimiento de los enfermeros en elcuidado preventivo y promoción de salud. Resultan esenciales capacitaciones continuas, reflexionando sobre avances en la práctica asistencial ycientífica de Enfermería.Objectives: To analyze, from the views of Primary Care nurses, the contributions of educational practice in the prevention of Pressure Ulcer and healthpromotion. Method:. Convergent Care research with 20 nurses conducted between July and August 2014, in the State of Santa Catarina, developed intwo stages and including four meetings. First, the nurses were interviewed, through the use of a questionnaire, and subsequently participated in threeworkshops. Results: Data was submitted to analysis, and two categories emerged: Say no to Pressure Ulcer and The practices developed by nurses inthe prevention of PU and health promotion in PHC, which expressed acquisition and improvement of knowledge, construction of new knowledge,contributing to the promotion of health actions. Conclusion: The educational practice was successful, as it promoted innovation and the nurses gainedmore knowledge on preventive health care and health promotion. Continuous training is necessary, as it improves nursing care and scientific practice.Objetivos: Analisar, a partir da visão dos enfermeiros da Atenção Primária, as contribuições da prática educativa naprevenção da Lesão por Pressão e promoção da saúde. Método: Estudo Convergente Assistencial com 20 enfermeiros,realizado entre julho e agosto de 2014, no Estado de Santa Catarina, desenvolvido em duas etapas e quatro encontros,sendo a primeira entrevista com a utilização de questionário e, posteriormente, três oficinas. Resultados: Os dadosforam analisados e resultaram em duas categorias: Diga não à Lesão por Pressão e A prática do enfermeiro na prevençãoda LP e promoção da saúde na APS, que expressaram aquisição e aprimoramento de conhecimentos, construção donovo saber, contribuindo para ações de saúde. Conclusão: A prática educativa alcançou seu propósito, inovando erenovando o conhecimento dos enfermeiros no cuidado preventivo e promoção da saúde. São essenciais capacitaçõescontínuas, refletindo em ganhos na prática assistencial e científica da Enfermagem

Risk of Arterial and Venous Thrombotic Events Among Patients with COVID-19:A Multi-National Collaboration of Regulatory Agencies from Canada, Europe, and United States

Purpose: Few studies have examined how the absolute risk of thromboembolism with COVID-19 has evolved over time across different countries. Researchers from the European Medicines Agency, Health Canada, and the United States (US) Food and Drug Administration established a collaboration to evaluate the absolute risk of arterial (ATE) and venous thromboembolism (VTE) in the 90 days after diagnosis of COVID-19 in the ambulatory (eg, outpatient, emergency department, nursing facility) setting from seven countries across North America (Canada, US) and Europe (England, Germany, Italy, Netherlands, and Spain) within periods before and during COVID-19 vaccine availability. Patients and Methods: We conducted cohort studies of patients initially diagnosed with COVID-19 in the ambulatory setting from the seven specified countries. Patients were followed for 90 days after COVID-19 diagnosis. The primary outcomes were ATE and VTE over 90 days from diagnosis date. We measured country -level estimates of 90 -day absolute risk (with 95% confidence intervals) of ATE and VTE. Results: The seven cohorts included 1,061,565 patients initially diagnosed with COVID-19 in the ambulatory setting before COVID19 vaccines were available (through November 2020). The 90 -day absolute risk of ATE during this period ranged from 0.11% (0.09- 0.13%) in Canada to 1.01% (0.97-1.05%) in the US, and the 90 -day absolute risk of VTE ranged from 0.23% (0.21-0.26%) in Canada to 0.84% (0.80-0.89%) in England. The seven cohorts included 3,544,062 patients with COVID-19 during vaccine availability (beginning December 2020). The 90 -day absolute risk of ATE during this period ranged from 0.06% (0.06-0.07%) in England to 1.04% (1.01-1.06%) in the US, and the 90 -day absolute risk of VTE ranged from 0.25% (0.24-0.26%) in England to 1.02% (0.99- 1.04%) in the US. Conclusion: There was heterogeneity by country in 90 -day absolute risk of ATE and VTE after ambulatory COVID-19 diagnosis both before and during COVID-19 vaccine availability. Plain Language Summary: Cohort studies of patients diagnosed with COVID-19 in both the ambulatory and hospital settings have suggested that SARS-CoV-2 infection promotes hypercoagulability that could lead to arterial or venous thromboembolism. However, few studies have examined how the risk of thromboembolism with COVID-19 has evolved over time across different countries. A new collaboration was established among the regulatory authorities of Canada, Europe, and the US within the International Coalition of Medicines Regulatory Authorities to evaluate the 90 -day risk of both arterial and venous thromboembolism after initial diagnosis of COVID-19 in the ambulatory or hospital setting from seven countries across North America (Canada, US) and Europe (England, Germany, Italy, Netherlands, and Spain) within periods before and during COVID-19 vaccine availability. The study found that there was variability in the risk of both arterial and venous thromboembolism by month across the countries among patients initially diagnosed with COVID-19 in the ambulatory or hospital setting. Differences in the healthcare systems, prevalence of comorbidities in the study cohorts, and approaches to the case definitions of thromboembolism likely contributed to the variability in estimates of thromboembolism risk across the countries

Suitability of external controls for drug evaluation in Duchenne muscular dystrophy

OBJECTIVE: To evaluate the suitability of real-world data (RWD) and natural history data (NHD) for use as external controls in drug evaluations for ambulatory Duchenne muscular dystrophy (DMD). METHODS: The consistency of changes in the 6-minute walk distance (Δ6MWD) was assessed across multiple clinical trial placebo arms and sources of NHD/RWD. Six placebo arms reporting 48-week Δ6MWD were identified via literature review and represented 4 sets of inclusion/exclusion criteria (n = 383 patients in total). Five sources of RWD/NHD were contributed by Universitaire Ziekenhuizen Leuven, DMD Italian Group, The Cooperative International Neuromuscular Research Group, ImagingDMD, and the PRO-DMD-01 study (n = 430 patients, in total). Mean Δ6MWD was compared between each placebo arm and RWD/NHD source after subjecting the latter to the inclusion/exclusion criteria of the trial for baseline age, ambulatory function, and steroid use. Baseline covariate adjustment was investigated in a subset of patients with available data. RESULTS: Analyses included ∼1,200 patient-years of follow-up. Differences in mean Δ6MWD between trial placebo arms and RWD/NHD cohorts ranged from -19.4 m (i.e., better outcomes in RWD/NHD) to 19.5 m (i.e., worse outcomes in RWD/NHD) and were not statistically significant before or after covariate adjustment. CONCLUSIONS: We found that Δ6MWD was consistent between placebo arms and RWD/NHD subjected to equivalent inclusion/exclusion criteria. No evidence for systematic bias was detected. These findings are encouraging for the use of RWD/NHD to augment, or possibly replace, placebo controls in DMD trials. Multi-institution collaboration through the Collaborative Trajectory Analysis Project rendered this study feasible