RESUMEN
The presence of various organic and inorganic contaminants in wastewater leads to serious health effects on humans and ecosystems. Industrial effluents have been considered as noticeable sources of contaminating water streams. These effluents directly liberate the pollutants such as dye molecules and heavy metal ions into the environment. In the present study, three biowaste materials (groundnut shell powder, coconut coir powder and activated corn leaf carbon) were utilized and compared for the removal of acid blue dye 113 from aqueous solutions. The characterization study of newly prepared sorbent material (H3PO4-activated corn leaf carbon) and the other utilized sorbents was carried out by Scanning Electron Microscope (SEM) and Fourier Transform Infrared Spectrophotometer (FTIR), along with Energy Dispersive X-Ray (EDX) Analysis. The influence of experimental conditions such as pH, initial dye concentration, temperature, contact time, and sorbent dosage on the removal efficiency of the dye were appraised. The adsorption isotherm and kinetic result of acid blue dye 113 adsorption onto the sorbents best obeyed from Sips and pseudo-second-order kinetic model. Overall, the outcomes confirmed that the newly synthesized sorbent material (carbonized H3PO4-activated corn leaf) has superior adsorption capacity, rapid adsorption, and higher suitability for the removal of toxic dyes from the contaminated waters.
Asunto(s)
Contaminantes Químicos del Agua , Humanos , Contaminantes Químicos del Agua/análisis , Adsorción , Colorantes/química , Biomasa , Ecosistema , Polvos , Carbono , Cinética , Concentración de Iones de Hidrógeno , Espectroscopía Infrarroja por Transformada de FourierRESUMEN
OBJECTIVES: Randomized clinical trials frequently attract volunteer patients who were either non-compliant or seeking to switch therapies. Patients on active therapies often undergo a washout period after which a single medication is initiated. Observational research has the potential to compare alternative treatments under a wider range of clinical situations if care is taken to document each patient's treatment history. METHODS: This study used paid claims data from a large commercial insurer to investigate drug therapy outcomes in schizophrenia. Episodes of drug therapy were defined each time a patient initiated or restarted drug therapy using an antipsychotic, antidepressant or mood stabilizing medication. Episode definitions were based on calculations of continuous drug therapy using a 15-day gap definition. A total of 21,570 episodes of drug therapy were included in the analysis, some of which used two drugs as initial therapy. RESULTS: Most episodes were initiated using a mood stabilizing drug (27%) or an antidepressant (38%). Over 62% of all episodes were augmentation therapy in which a psychotropic drug was added to an existing psychotropic medication, followed by switching episodes (22%) and restart episodes (16%). Patient outcomes measured by either duration of uninterrupted therapy or one-year post-treatment cost varied significantly with patient treatment history, especially episode type. The comparative effectiveness of alternative therapies is sensitive to the extent to which treatment history is taken into account. CONCLUSIONS: Observational comparative effectiveness research should capture and evaluate patient outcomes across a wide range of patients taking into account the patient's treatment history.
Asunto(s)
Antidepresivos/uso terapéutico , Antipsicóticos/uso terapéutico , Investigación sobre la Eficacia Comparativa , Esquizofrenia/tratamiento farmacológico , Adolescente , Adulto , Afecto/efectos de los fármacos , Anciano , Antidepresivos/economía , Antipsicóticos/economía , Niño , Análisis Costo-Beneficio , Costos de los Medicamentos , Sustitución de Medicamentos , Quimioterapia Combinada , Femenino , Costos de la Atención en Salud , Humanos , Análisis de los Mínimos Cuadrados , Modelos Logísticos , Masculino , Persona de Mediana Edad , Modelos Económicos , Evaluación de Procesos y Resultados en Atención de Salud , Modelos de Riesgos Proporcionales , Esquizofrenia/diagnóstico , Esquizofrenia/economía , Psicología del Esquizofrénico , Factores de Tiempo , Resultado del Tratamiento , Estados Unidos , Adulto JovenRESUMEN
BACKGROUND: Randomized clinical trials [RCT] are the Gold Standard of medical evidence. However, observational comparative effectiveness research [CER] based on real-world data is receiving national attention. This paper demonstrates how observational CER can fill important gaps in clinical knowledge left behind by RCT approaches. An example of CER in bipolar disorders is presented. METHODS: Paid claims data from a large commercial insurer were used to identify episodes of drug therapy. Episodes were defined each time a patient initiated or restarted therapy using an antipsychotic, antidepressant or mood stabilizing medication. Episode definitions were based on calculations of continuous days of drug therapy using a 15 day gap definition. 105,440 episodes of drug therapy were included in the analysis. RESULTS: Most episodes were initiated using a mood stabilizing drug (40%) or an antidepressant (40%). Over 59% of all episodes were for augmentation therapy, followed by switching episodes (25%) and restart episodes (16%). Patient outcomes measured by either duration of uninterrupted therapy or one-year post-treatment cost varied significantly with patient treatment history, especially episode type. The comparative effectiveness of alternative therapies was sensitive to the extent to which treatment history is taken into account. CONCLUSIONS: Observational research can evaluate patient outcomes across a wide range of clinical presentations with regard to the patient's treatment history. Treatment history is a major determinant of patient compliance and future treatment costs. Failure to account for treatment history can introduce bias into comparative effectiveness results. Observational CER research can also uncover important questions that require future research.