Ingenious use of autocatalytic hydrodeoxygenation for the separation and recovery of oil and iron from rolling oil sludge

This paper introduces a transformative hydrodeoxygenation process for the simultaneous recovery of oil and iron from hazardous rolling oil sludge (ROS). Leveraging the inherent catalytic capabilities of iron/iron oxide nanoparticles in the sludge, our process enables the conversion of fatty acids and esters into hydrocarbons under conditions of 4.5 MPa, 330 °C, and 500 rpm. This reaction triggers nanoparticle aggregation and subsequent separation from the oil phase, allowing for effective resource recovery. In contrast to conventional techniques, this method achieves a high recovery rate of 98.3% while dramatically reducing chemical reagent consumption. The reclaimed petroleum and iron-ready for high-value applications-are worth 3910 RMB/ton. Moreover, the process facilitates the retrieval of nanoscale magnetic Fe and Fe0 particles, and the oil, with an impressive hydrocarbon content of 87.8%, can be further refined. This energy-efficient approach offers a greener, more sustainable pathway for ROS valorization.

Prospects of microalgae in nutraceuticals production with nanotechnology applications

Nutraceutical supplements provide health benefits, such as fulfilling the lack of nutrients in the human body or being utilized to treat or cure certain diseases. As the world population is growing, certain countries are experiencing food crisis challenges, causing natural foods are not sustainable to be used for nutraceutical production because it will require large-scale of food supply to produce enriched nutraceutics. The high demand for abundant nutritional compounds has made microalgae a reliable source as they can synthesize high-value molecules through photosynthetic activities. However, some microalgae species are limited in growth and unable to accumulate a significant amount of biomass due to several factors related to environmental conditions. Therefore, adding nanoparticles (NPs) as a photocatalyst is considered to enhance the yield rate of microalgae in an energy-saving and economical way. This review focuses on the composition of microalgal biomass for nutraceutical production, the health perspectives of nutritional compounds on humans, and the application of nanotechnology on microalgae for improved production and harvesting. The results obtained show that microalgal-based compounds indeed have better nutrients content than natural foods. However, nanotechnology must be further comprehended to make them non-hazardous and sustainable.

Toward High-Value, Cost-Conscious Care - Supporting Future Doctors to Adopt a Role as Stewards of a Sustainable Healthcare System

PHENOMENON

In order to tackle the persistent rise of healthcare costs, physicians as "stewards of scarce resources" could be effective change agents, extending cost containment efforts from national policy to the micro level. Current programs focus on educating future doctors to deliver "high-value, cost-conscious care" (HVCCC). Although the importance of HVCCC education is increasingly recognized, there is a lag in implementation. Whereas recent efforts generated effective interventions that promote HVCCC in a local context, gaps persist in the examination of system factors that underlie broader successful and lasting implementation in educational and healthcare practices.

APPROACH

We conducted a realist evaluation of a program focused on embedding HVCCC in postgraduate education by encouraging and supporting residents to set up "HVCCC projects" to promote HVCCC delivery. We interviewed 39 medical residents and 10 attending physicians involved in such HVCCC projects to examine HVCCC implementation in different educational and healthcare contexts. We held six reflection sessions attended by the program commissioners and educationalists to validate and enrich the findings.

FINDINGS

A realist evaluation was used to unravel the facilitators and barriers that underlie the implementation of HVCCC in a variety of healthcare practices. Whereas research activities regularly stop after the identification of facilitators and barriers, we used these insights to formulate four high-value, cost-conscious care carriers: (1) continue to promote HVCCC awareness, (2) create an institutional structure that fosters HVCCC, (3) continue the focus on projects for embedding HVCCC in practice, (4) generate evidence. The carriers support residents, attendings and others involved in educating physicians in training to develop and implement innovative HVCCC projects.

INSIGHTS

Strategies to promote physician stewardship go beyond the formal curriculum and require a transformation in the informal educational system from one that almost exclusively focuses on medical discussions to one that also considers value and cost as part of medical decision-making. The HVCCC carriers propose a set of strategies and system adaptations that could aid the transformation toward a HVCCC supporting context.

A Comprehensive Monetary Analysis of Inpatient Total Hip and Knee Arthroplasties Billed to Medicare by Hospitals: 2011-2017

BACKGROUND

Total joint arthroplasty (TJA) has been a recent target of reimbursement reform. As such, the purpose of this study was to evaluate trends in Medicare reimbursement to hospitals for TJA patients from 2011 to 2017.

METHODS

The Inpatient Utilization and Payment Public Use File was queried for all primary total hip and knee arthroplasty episodes. This file includes all services billed to Medicare via the Inpatient Prospective Payment System. Extracted data included hospital charges and amount paid by Medicare. All data were adjusted for inflation to 2017 US dollars. Multiple linear mixed-model regression analyses were conducted to assess change over time, and geo-modelling was used to represent reimbursement by location.

RESULTS

A total of 3,368,924 primary TJA procedures were billed to Medicare by hospitals from 2011 to 2017 and included in the study. The mean inflation-adjusted Medicare payment to hospitals for DRG 469 decreased from $22,783.66 to $19,604.62 per procedure (-$3179.04; -14.0%; P < .001) and decreased from $13,290.79 to $11,771.54 for DRG 470 (-$1519.25; -11.4%, P = .011) from 2011 to 2017. Meanwhile, the mean charge submitted by hospitals increased by $6483.39 and $5115.60 for DRGs 469 and 470, respectively (+7.4% for 469, +9.3% for 470; P < .001). Medicare reimbursement to hospitals varied by state.

CONCLUSION

During the study period, the mean Medicare reimbursement to hospitals decreased for TJA from 2011 to 2017. Meanwhile, the average charge submitted by hospitals increased. As alternative payment models continue to undergo evaluation and development, these data are important for the advancement of more agreeable reimbursement models in arthroplasty care.

High-value chemicals from Botryococcus braunii and their current applications - A review

Botryococcus braunii is known for its high yield of extracellular hydrocarbons and polysaccharides. Hydrocarbons, especially botryococcenes and squalene can be used as not only fuels but also alternative feedstock for other fossil-based products. Exopolysaccharides excreted from B. braunii can be used as scaffolds for polyesters production, and have a notable potential for synthesis of nanoparticles. B. braunii is also a rich source of carotenoids, especially the unique secondary carotenoids such as botryoxanthins that have never been found in other microalgae. The morphology, physiology, and outer cell walls of B. braunii are complex. Understanding the colony structure shall provide insights into the mechanism of cell growth and chemicals secretion. It is possible to improve the production economics of the alga with advanced culture systems. Moreover, investigation of metabolic pathways for B. braunii may help us understand their regulation and provide valuable information for strain selection and optimal production of high-value chemicals.