Key physicochemical characteristics governing organic micropollutant adsorption and transport in ion-exchange membranes during reverse electrodialysis

The co-generation of electricity and electrodialysis of seawater in a hybrid system is a promising approach to overcome water scarcity. Reverse electrodialysis harvests energy from the salinity gradient, where seawater is used as a high salinity stream while secondary treated wastewater can be used as a sustainable low salinity stream. Treated wastewater contains organic micropollutants, which can be transported to the seawater stream. The current research establishes a connection between adsorption and transport of organic micropollutants in ion exchange membranes, using a cross-flow stack in adsorption and zero-current experiments. To mimic the composition of treated wastewater, a mixture of nineteen organic micropollutants of varied physicochemical characteristics (e.g. size, charge, polarity, hydrogen donor/acceptor count, hydrophobicity) at environmentally relevant concentrations was used. Depending on the charge, micropollutants develop different types of mechanisms responsible for short-distance interactions with ion-exchange membranes, which has a direct influence in their transport behavior. This study provides a rational basis for the optimization/design of next-generation ion-exchange membranes, in which the permeability toward organic micropollutants should be also included. This investigation highly contributes to understanding the potential hazard posed by organic micropollutants in reverse electrodialysis in seawater desalination systems, where treated wastewater is used as a low salinity stream

Principal–teacher relationships:Dimensionality and measurement invariance of a measure for primary and secondary school teachers

This study explored the dimensionality and measurement invariance of a multidimensional measure for evaluating teachers’ perceptions of the quality of their relationships with principals at the dyadic level. Participants were 630 teachers (85.9% female) from 220 primary and 204 secondary schools across the Netherlands. Teachers completed the 10-item Principal–Teacher Relationship Scale (PTRS) for their principals. Confirmatory factor analyses (CFA) provided evidence for a two-factor model, including a relational Closeness and Conflict dimension. Additionally, multigroup CFA results indicated strong invariance of the PTRS across school type, teacher gender, and teaching experience. Last, secondary school teachers and highly experienced teachers reported lower levels of Closeness and higher levels of Conflict in the relationship with their principal compared to primary school teachers and colleagues with less experience. Accordingly, the PTRS can be considered a valid and reliable measure that adds to the methodological repertoire of educational leadership research by focusing on both positive and negative aspects of dyadic principal–teacher relationships

Affective Student–Teacher Relationships and Students’ Engagement:A Cross–Cultural Comparison of China and The Netherlands

Ample evidence has been found for the association between affective, dyadic student–teacher relationships and students’ engagement with schoolwork in Western, individualistic countries. There are far fewer studies, however, examining this association in Eastern, collectivistic countries. As maintaining harmony in interpersonal relationships plays a crucial role in collectivistic countries, student–teacher relationships may even be more important in collectivistic countries than in individualistic countries. In the present study, we therefore investigated cross–cultural differences in the strength of associations between student–teacher relationship quality and students’ engagement based on data from the Netherlands (a Western country) and China (an Eastern country). The Dutch sample included 789 students (51.1% girls) and the Chinese sample included 588 students (52.9% girls) from grades 3 to 6 of elementary school. Students reported about the quality of their relationship with their teacher (closeness, conflict) and their behavioral and emotional engagement with schoolwork. Hierarchical linear modeling showed that the positive association between closeness and both behavioral and emotional engagement was stronger for the Chinese sample than for the Dutch sample. In contrast, the negative association between conflict and both behavioral and emotional engagement did not differ across countries. To conclude, closeness may be more relevant for Chinese students’ engagement than would be expected based on Western studies, whereas conflict seems to be equally harmful in both cultures. Therefore, developing relationship-focused interventions for Chinese teachers and students seems important, either by adapting Western programs or by developing new programs especially designed for Chinese schools

Prerequisites for Affective Signal Processing (ASP) - Part V: A response to comments and suggestions

In four papers, a set of eleven prerequisites for affective signal processing (ASP) were identified (van den Broek et al., 2010): validation, triangulation, a physiology-driven approach, contributions of the signal processing community, identification of users, theoretical specification, integration of biosignals, physical characteristics, historical perspective, temporal construction, and real-world baselines. Additionally, a review (in two parts) of affective computing was provided. Initiated by the reactions on these four papers, we now present: i) an extension of the review, ii) a post-hoc analysis based on the eleven prerequisites of Picard et al.(2001), and iii) a more detailed discussion and illustrations of temporal aspects with ASP

Low-Dose CT lung cancer screening:clinical evidence and implementation research

Lung cancer causes more deaths than breast, cervical, and colorectal cancer combined. Nevertheless, population-based lung cancer screening is still not considered standard practice in most countries worldwide. Early lung cancer detection leads to better survival outcomes: patients diagnosed with stage 1A lung cancer have a >75% 5-year survival rate, compared to < 5% at stage 4. LDCT thorax imaging for the secondary prevention of lung cancer has been studied at length, and has been shown to significantly reduce lung cancer mortality in high-risk populations. The US national lung screening trial reported 20% overall reduction in lung cancer mortality when comparing LDCT to chest x-ray, and the NELSON trial more recently reported 24% reduction when comparing LDCT to no screening. Hence, the focus has now shifted to implementation research. Consequently, the 4-IN-THE-LUNG-RUN consortium, based in 5 European countries, has set up a large-scale multi-center implementation trial. Successful implementation and accessibility of low-dose CT lung cancer screening are dependent on many factors, not limited to; population selection, recruitment strategy, CT-screening frequency, lung nodule management, participant compliance and cost-effectiveness. This review provides an overview of current evidence for LDCT lung cancer screening, and draws attention to major factors which need to be addressed to successfully implement standardized, effective, and accessible screening throughout Europe. Evidence shows that through the appropriate use of risk-prediction models and a more personalized approach to screening, efficacy could be improved. Further, extending the screening interval for low-risk individuals to reduce costs and associated harms is a possibility, and through the use of volumetric based measurement and follow-up, false positive results can be greatly reduced. Finally, smoking cessation programs could be a valuable addition to screening programs and artificial intelligence could offer the solution to the added workload pressures Radiologists are facing

Incorporating the patient experience into clinical guidelines: recommendations for researchers and guideline developers

Focusing on a specific example from community care, this article argues that clinical guidelines will be better and more usable if they incorporate the findings of high-quality, qualitative research. We suggest the development and adoption of guidelines which take a holistic approach to the individual and their circumstances. These should take account of the best available evidence in terms of which treatments, devices or lifestyle changes are most effective in a particular instance, and how these are affected by the day-to-day life of patients. In so doing, clinical guidelines will become representative of the patient population to whom they relate and thus truly evidence based. We offer below one particular example of where the incorporation of qualitative evidence will improve the usability of clinical guidelines

Wall-Fluid and Liquid-Gas Interfaces of Model Colloid-Polymer Mixtures by Simulation and Theory

We perform a study of the interfacial properties of a model suspension of hard sphere colloids with diameter $\sigma_c$ and non-adsorbing ideal polymer coils with diameter $\sigma_p$. For the mixture in contact with a planar hard wall, we obtain from simulations the wall-fluid interfacial free energy, $\gamma_{wf}$, for size ratios $q=\sigma_p/\sigma_c=0.6$ and 1, using thermodynamic integration, and study the (excess) adsorption of colloids, $\Gamma_c$, and of polymers, $\Gamma_p$, at the hard wall. The interfacial tension of the free liquid-gas interface, $\gamma_{lg}$, is obtained following three different routes in simulations: i) from studying the system size dependence of the interfacial width according to the predictions of capillary wave theory, ii) from the probability distribution of the colloid density at coexistence in the grand canonical ensemble, and iii) for statepoints where the colloidal liquid wets the wall completely, from Young's equation relating $\gamma_{lg}$ to the difference of wall-liquid and wall-gas interfacial tensions, $\gamma_{wl}-\gamma_{wg}$. In addition, we calculate $\gamma_{wf}, \Gamma_c$, and $\Gamma_p$ using density functional theory and a scaled particle theory based on free volume theory. Good agreement is found between the simulation results and those from density functional theory, while the results from scaled particle theory quantitatively deviate but reproduce some essential features. Simulation results for $\gamma_{lg}$ obtained from the three different routes are all in good agreement. Density functional theory predicts $\gamma_{lg}$ with good accuracy for high polymer reservoir packing fractions, but yields deviations from the simulation results close to the critical point.Comment: 23 pages, 10 figures, REVTEX. Fig 5a changed. Final versio

Persisting workarounds in Electronic Health Record System use:types, risks and benefts

Background Electronic Health Records (EHRs) are now widely used to create a single, shared, and reliable source of patient data throughout healthcare organizations. However, health professionals continue to experience mismatches between their working practices and what the EHR allows or directs them to do. Health professionals adopt working practices other than those imposed by the EHR to overcome such mismatches, known as workarounds. Our study aims to inductively develop a typology of enduring EHR workarounds and explore their consequences by answering the question: What types of EHR workarounds persist, and what are the user-perceived consequences? Methods This single case study was conducted within the Internal Medicine department of a Dutch hospital that had implemented an organization-wide, commercial EHR system over two years ago. Data were collected through observations of six EHR users (see Additional file 1, observation scheme) and 17 semi-structured interviews with physicians, nurses, administrators, and EHR support staff members. Documents were analyzed to contextualize these data (see Additional file 2, interview protocol). Results Through a qualitative analysis, 11 workarounds were identified, predominantly performed by physicians. These workarounds are categorized into three types either performed while working with the system (in-system workflow sequence workarounds and in-system data entry workarounds) or bypassing the system (out-system workarounds). While these workarounds seem to offer short-term benefits for the performer, they often create threats for the user, the patient, the overall healthcare organization, and the system. Conclusion: This study increases our understanding of the enduring phenomenon of working around Electronic Health Records by presenting a typology of those workarounds that persist after adoption and by reflecting on the user-perceived risks and benefits. The typology helps EHR users and their managers to identify enduring types of workarounds and differentiate between the harmful and less harmful ones. This distinction can inform their decisions to discourage or obviate the need for certain workarounds, while legitimating others