US emergency departments are facing a number of operational challenges related to chronic shortages of registered nurses. Many of the tasks done by registered nurses can be safely and successfully delegated to the emergency department technician (EDT), particularly if a hospital's nursing and administrative leadership are affirmatively engaged in a process to professionalize and train their EDT workforce. This paper examines the state, Joint Commission on Accreditation of Healthcare Organizations, and Centers for Medicare & Medicaid Services regulatory landscape for the EDT, reviews the literature on how hospital's utilize EDT's, discusses approaches to skills training, and examines the need for profession standardization that enables job role expansion.
  Among patients with a known peanut allergy, previous studies suggest low carrying rates of epinephrine auto-injectors (EAIs) and hesitancy to self-administer epinephrine upon anaphylaxis onset. Given the high prescription rates of epinephrine and prevalence of peanut allergies, it is important to identify rates of on-scene EAI use and affecting factors.
 
  The electronic medical records of 217 patients-either with an ED diagnosis of peanut anaphylaxis or diagnosis of anaphylaxis with a known epinephrine prescription from 2010 through May 2020--were reviewed for physician notes and demographic factors.
 
  Epinephrine was administered on-scene by 25.3% of anaphylaxis patients. Of the 6 health care professionals identified, 100% administered epinephrine on-scene. Females (32.2%) were administered epinephrine on-scene more frequently than males (19.8%; p=0.04). Rate of epinephrine administration increased from 2010 through 2019 (p=0.005).
 
  This study selected for individuals diagnosed with anaphylaxis, meaning Edicates that comfort with EAIs facilitates willingness to administer on-scene. EAIs can range up to $900 in expense, thus physicians should employ EAI training devices and other training strategies.CoFe2O4 (Cobalt ferrite, CF) nanoparticles were prepared, well characterized and applied as efficient solid catalyst in catalytic ozonation, named CF/O3 process, for the removal of emerging organic contaminants (EOCs). The degradation and mineralization of clofibric acid (CA) in CF/O3 process were dramatically enhanced in comparison with those under the O3 system. Surface hydroxyl groups (HGs) were considered as an important factor for ozone decomposition and the reactive oxygen species (ROS) on the catalyst surface were mainly responsible for CA elimination. The contribution and formation of ROS, including hydroxyl radicals (•OH), especially superoxide radicals (O2•-), singlet oxygen (1O2), and hydrogen peroxide (H2O2) were evaluated, and a rational mechanism was elucidated accordingly. Probable degradation pathway of CA was proposed according to the organic intermediates identified. The acute toxicity of the treated solution increased during the first 15 min and then declined rapidly and nearly disappeared as the reaction proceeded. In addition, acceptable catalytic performance of CF/O3 can be obtained for the treatment of other EOCs and the treatment of natural surface water spiked with CA. This work presents an efficient and promising catalytic ozonation technique for the elimination of EOCs in complex water matrices.The coexistence of nanoplastics (NPs) and various pollutants in the environment has become a problem that cannot be ignored. In order to identify the microcystin-LR (MCLR) bioaccumulation and the potential impacts on the early growth of F1 zebrafish (Danio rerio) offspring in the presence of polystyrene nanoplastics (PSNPs), PSNPs and MCLR were used to expose adult zebrafish for 21days. The exposure groups divided into MCLR (0, 0.9, 4.5 and 22.5μgL-1) alone groups and PSNP (100μgL-1) and MCLR co-exposure groups.  https://www.selleckchem.com/products/paeoniflorin.html  F1 embryos were collected and developed to 120 h post-fertilization (hpf) in clear water. Compared with the exposure to MCLR only, the combined exposure increased the parental transfer of MCLR to the offspring and subsequently exacerbated the growth inhibition of F1 larvae. Further research clarified that combined exposure of PSNPs and MCLR could reduce the levels of thyroxine (T4) and 3, 5, 3'-triiodothyronine (T3) by altering the expression of hypothalamus-pituitary-thyroid (HPT) axis-related genes, eventually leading to growth inhibition of F1 larvae. Our results also exhibited combined exposure of PSNPs and MCLR could change the transcription of key genes of the GH/IGF axis compared with MCLR single exposure, suggesting the GH/IGF axis was a potential target for the growth inhibition of F1 larvae in PSNPs and MCLR co-exposure groups. The present study highlights the potential risks of coexistence of MCLR and PSNPs on development of fish offspring, and the environmental risks to aquatic ecosystems.Bayer red mud (RM) occupies a large amount of land, which excessive Na+ seriously damages groundwater resources. In this research, a RM based cementitious material (RMC) composed of RM and ordinary Portland cement (OPC) was developed. It is interesting to find that a binary reaction consisting of cement hydration and geopolymer reaction in RMC. The mechanical and Na+ consolidation rate of RMC were improved by the synergistic effect of binary reaction. The results indicated that the compressive strength of RMC is the highest and reaches 32.5R OPC when the mass ratio of CaO/(SiO2+Al2O3) is 1.37, and the Na+ leaching concentration is environmentally acceptable. The 7 days compressive strength of RM-based cementitious material No.2 (RMC2) can reach 93.80% of that of 28 days. As the predominant hydration products, cement hydration product (Ca5(SiO4)2(OH)2) and geopolymer (CaAl2Si2O8·2H2O and Na3Al3Si3O12·2H2O) were principally responsible for the strength development of RMC2 at 7 days. The optimal densification microstructure and [SiO4] polymerization structure was presented in RMC2. The supreme Na+ consolidation rate was 99.23% in RMC2 due to the cooperation of physical fixation and [Si(Al)O4] charge balance principle. This paper provides a fresh theoretical guidance for the utilization of RM and its Na+ in building materials.