Environmental performance of miscanthus-lime lightweight concrete using life cycle assessment:Application in external wall assemblies

This is the final version. Available from Elsevier via the DOI in this record. In the UK context, miscanthus is a potential alternative perennial crop for the development of bio-based building materials. This paper presents the environmental benefits of using miscanthus shives in lightweight blocks and their potential application in wall assemblies. A systemic life cycle assessment (LCA) is carried out for miscanthus-lime blocks, and the effects of binder type and binder content are discussed. The environmental performance-based analysis reveals that miscanthus blocks can capture 135 kg CO eq/m for an assumed 100-years life period. The impact analysis using the University of Leiden, institute of environmental science (CML) baseline (v4.4) method shows that 75% of the greenhouse gas emissions are attributable to the production of mineral binders. A reduction of binder to aggregate ratio from 2.0 to 1.5 reduces greenhouse gas emissions by 32.9%. The use of 10 wt% mineral additions can potentially stabilise blocks while having little effect on their overall environmental impacts. The environmental profiles of wall systems incorporating miscanthus-lime blocks have been evaluated in this this study. Combining miscanthus blocks with fired clay bricks enables a potential low carbon retrofitting technique for the current stock of residential buildings in the UK. Timber-framed system filled with miscanthus blocks enables a carbon storage of ~97.3 kg CO eq/m , which presents a potential carbon offsetting strategy in new-build dwellings. Consideration should be given to the potential negative impacts related to agricultural activities for the production of miscanthus shives. The largest negative environmental impact was ozone layer depletion, where a relative difference of 12.8% was recorded between miscanthus timber-framed wall and a typical solid wall insulated with mineral wool. It appears that miscanthus-lime composites can substantially improve the environmental profile of wall assemblies and sustainability be applied in existing uninsulated masonry walls or incorporated in timber- framed new-build houses.Engineering and Physical Sciences Research Council (EPSRC)Natural Environment Research Council (NERC)NERC GW4+ Doctoral Training Partnership studentshi

Pharmaceutical care in the neonatal intensive care unit: Perspectives of Polish medical and pharmacy students

© 2019 Elsevier Inc. Introduction: The concepts of ward-based pharmaceutical care as well as collaborative practice are still relatively novel in Poland, particularly in specialty areas of practice such as the neonatal intensive care unit (NICU). The purpose of this study was to identify the opinions and perceptions of Polish medical and pharmacy students towards the provision of pharmaceutical care services in the NICU as well as pharmacist integration into the ward-based multi-disciplinary NICU treating team. Methods: A cross-sectional, mixed-method survey was distributed among medical and pharmacy students at a large Polish medical university. Results: A total of 147 students completed the survey (74 pharmacy and 73 medical). Overall, there were statistically significant differences between the perspectives of medical and pharmacy students towards the provision of pharmaceutical care services in the NICU. For 11 out of 15 proposed clinical roles, a significantly lower proportion of medical students (M)agreed that pharmacists should perform these in the NICU compared to pharmacy students (P). These roles included participation in ward rounds (P = 82.4%, M = 38.4%, p < 0.001), therapeutic drug monitoring (P = 98.6%, M = 78.1%, p < 0.001), and monitoring total parenteral nutrition (P = 87.8%, M = 37%, p ≤ 0.001). Conclusions: Further investigation is needed to develop educational strategies directed at clinical, patient-centered, collaborative roles, particularly for specialty areas of practice such as the NICU, that have the potential to facilitate the provision of a more advanced and comprehensive level of pharmaceutical care

Salix

Willow (Salix L.) species have good qualities for becoming a biomass crop for production of biofuels. They grow on marginal soils, produce high yields of wood in a short period of time, and are easily propagated. Salix is one of the few genera that may be cryopreserved as dormant winter buds (DBs) instead of using tissue culture techniques. The objective of our study was to evaluate selected factors that affect cryotolerance of nine Salix germplasm accessions in the USDA‐ARS National Plant Germplasm System collection. One‐year‐old branches harvested in January over 3 yr were cut into either 6‐ to 7‐ or 10‐cm segments containing at least two DBs. Segments were treated with a slow‐cooling procedure and stored in vapor‐phase liquid N (LNV). Control segments were stored at −5 °C until planting. The LNV‐exposed and the −5 °C‐stored nodal segments were warmed and directly planted in a cold greenhouse. Six weeks later, the material was evaluated for shoot and root development. Segments that developed a shoot were considered viable. Average viability varied among years (0–35.1%) even for the same accession, species (4.2–51.4%), and segment length. Dormant buds on 10‐cm segments had higher average viability (82.2%) than did DBs on 6‐ to 7‐cm segments (43.9%), suggesting higher suitability for cryopreservation. In the material studied, Salix DB viability was correlated with branch diameter, DB density, and the ability to develop shoots and roots prior to cryopreservation

Performance of Eleven Simplified Methods for the Identification of Elevated Blood Pressure in Children and Adolescents.

The identification of elevated blood pressure (BP) in children and adolescents relies on complex percentile tables. The present study compares the performance of 11 simplified methods for assessing elevated or high BP in children and adolescents using individual-level data from 7 countries. Data on BP were available for a total of 58 899 children and adolescents aged 6 to 17 years from 7 national surveys in China, India, Iran, Korea, Poland, Tunisia, and the United States. Performance of the simplified methods for screening elevated or high BP was assessed with receiver operating characteristic curve (area under the curve), sensitivity, specificity, positive predictive value, and negative predictive value. When pooling individual data from the 7 countries, all 11 simplified methods performed well in screening high BP, with high area under the curve values (0.84-0.98), high sensitivity (0.69-1.00), high specificity (0.87-1.00), and high negative predictive values (≥0.98). However, positive predictive value was low for most simplified methods, but reached ≈0.90 for each of the 3 methods, including sex- and age-specific BP references (at the 95th percentile of height), the formula for BP references (at the 95th percentile of height), and the simplified method relying on a child's absolute height. These findings were found independently of sex, age, and geographical location. Similar results were found for simplified methods for screening elevated BP. In conclusion, all 11 simplified methods performed well for identifying high or elevated BP in children and adolescents, but 3 methods performed best and may be most useful for screening purposes

Establishing International Blood Pressure References Among Nonoverweight Children and Adolescents Aged 6 to 17 Years.

BACKGROUND: Several distributions of country-specific blood pressure (BP) percentiles by sex, age, and height for children and adolescents have been established worldwide. However, there are no globally unified BP references for defining elevated BP in children and adolescents, which limits international comparisons of the prevalence of pediatric elevated BP. We aimed to establish international BP references for children and adolescents by using 7 nationally representative data sets (China, India, Iran, Korea, Poland, Tunisia, and the United States). METHODS AND RESULTS: Data on BP for 52 636 nonoverweight children and adolescents aged 6 to 19 years were obtained from 7 large nationally representative cross-sectional surveys in China, India, Iran, Korea, Poland, Tunisia, and the United States. BP values were obtained with certified mercury sphygmomanometers in all 7 countries by using standard procedures for BP measurement. Smoothed BP percentiles (50th, 90th, 95th, and 99th) by age and height were estimated by using the Generalized Additive Model for Location Scale and Shape model. BP values were similar between males and females until the age of 13 years and were higher in males than females thereafter. In comparison with the BP levels of the 90th and 95th percentiles of the US Fourth Report at median height, systolic BP of the corresponding percentiles of these international references was lower, whereas diastolic BP was similar. CONCLUSIONS: These international BP references will be a useful tool for international comparison of the prevalence of elevated BP in children and adolescents and may help to identify hypertensive youths in diverse populations