Site-selective modification of complex peptides and the functionalization of their C–H bonds hold great promise for expanding their use in therapeutics and biomedical research. Herein, we leverage ...the power of late-stage chemoenzymatic catalysis using an indole prenyltransferase (IPT) enzyme and alkyl diphosphates to specifically modify the indole ring of tryptophan in clinically relevant peptides. Furthermore, the installed handle enables bioorthogonal click chemistry through an inverse electron-demand Diels–Alder (IEDDA) reaction with a biotin-conjugated tetrazine probe.
We aimed to assess whether a pharmacist-led intervention enhances knowledge, medication adherence and glycemic control in patients with type 2 diabetes mellitus (T2DM).
We conducted a single-blinded ...randomized controlled trial in Vietnam. Individuals with T2DM were recruited from a general hospital and randomly allocated to intervention and routine care. The intervention group received routine care plus counselling intervention by a pharmacist, including providing drug information and answering individual patients' queries relating to T2DM and medications, which had not been done in routine care. We assessed the outcomes: knowledge score as measured by the Diabetes Knowledge Questionnaire, self-reported adherence and fasting blood glucose (FBG) at the 1-month follow-up.
A total of 165 patients (83 intervention, 82 control) completed the study; their mean age was 63.33 years, and 49.1% were males. The baseline characteristics of the patients were similar between the groups. At 1-month follow-up, the pharmacist's intervention resulted in an improvement in all three outcomes: knowledge score B = 5.527; 95% confidence intervals (CI): 3.982 to 7.072; P < 0.001, adherence odds ratio (OR) = 9.813; 95% CI: 2.456 to 39.205; P = 0.001 and attainment of target FBG (OR = 1.979; 95% CI: 1.029 to 3.806; P = 0.041).
The pharmacist-led intervention enhanced disease knowledge, medication adherence and glycemic control in patients with T2DM. This study provides evidence of the benefits of pharmacist counselling in addition to routine care for T2DM outpatients in a Vietnam population.
Objectives
To determine the extent of physicians' adherence to prescribing guidelines for acute coronary syndrome in Vietnamese hospitals.
Methods
Retrospective cross‐sectional study of medical ...records of all patients with ACS admitted to two public hospitals in Ho Chi Minh City, Vietnam, from January to December 2013. Percentages of eligible patients receiving guideline‐recommended medications were determined. Factors associated with non‐adherence were identified using multivariate logistic regression.
Results
Overall, 711 medical records were reviewed and 284 patients fulfilled inclusion criteria (mean age 64 years; 69.4% male). Of those patients eligible for treatment, aspirin was prescribed for 97.9% at arrival and 96.3% at discharge; dual antiplatelet therapy was prescribed for 92.3% at arrival and 91.7% at discharge; loading doses were prescribed for 79.5% (aspirin) and 55.8% (clopidogrel); beta blockers were prescribed for 58.7% at arrival and 76.7% at discharge; angiotensin‐converting enzyme inhibitors or angiotensin receptor blockers (ACEI/ARB) were prescribed for 89.1% at arrival or discharge; and statins were prescribed for 94.1% at arrival and 90.7% at discharge. Patients undergoing an invasive procedure were more likely to receive guideline‐recommended medications at discharge: dual antiplatelet therapy (OR 3.77; 95% CI 1.23–11.52), beta blocker (OR 3.95; 95% CI 1.86–8.40) and ACEI/ARB (OR 4.01; 95% CI 1.30–12.41). Ninety of the excluded patients were discharged without completing treatment.
Conclusions
In general, physicians closely adhered to ACS prescribing guidelines in Vietnamese hospital practice. Prescribing of beta blockers and clopidogrel loading doses was probably suboptimal. Why patients do not complete treatment needs to be investigated.
Objectifs
Déterminer le degré d'adhésion des médecins aux directives sur les prescriptions pour le syndrome coronarien aigu (SCA) dans les hôpitaux vietnamiens.
Méthodes
Etude transversale rétrospective des dossiers médicaux de tous les patients atteints de SCA admis dans deux hôpitaux publics de Ho Chi Minh City, au Vietnam, de janvier à décembre 2013. Les pourcentages de patients éligibles recevant des médicaments recommandés par les directives ont été déterminés. Les facteurs associés à la non‐adhésion ont été identifiés par régression logistique multivariée.
Résultats
Au total, 711 dossiers médicaux ont été examinés et 284 patients répondaient aux critères d'inclusion (âge moyen: 64 ans; 69,4% d'hommes). Parmi les patients éligibles au traitement, l'aspirine a été prescrite pour 97,9% à l'arrivée et 96,3% à la sortie, la bithérapie antiplaquettaire a été prescrite pour 92,3% à l'arrivée et 91,7% à la sortie, des doses de charge ont été prescrites pour 79,5% (aspirine) et 55,8% (clopidogrel). Des bêtabloquants ont été prescrits pour 58,7% à l'arrivée et 76,7% à la sortie, des inhibiteurs de l'enzyme de conversion de l'angiotensine ou des antagonistes des récepteurs de l'angiotensine (IECA/ARA) ont été prescrits pour 89,1% à l'arrivée et à la sortie et des statines ont été prescrites pour 94,1% à l'arrivée et 90,7% à la sortie. Les patients subissant une procédure invasive étaient plus susceptibles de recevoir des médicaments recommandés par les directives à la sortie: la bithérapie antiplaquettaire (OR: 3,77; IC95%: 1,23 à 11,52), un bêtabloquant (OR: 3,95; IC95%: 1,86 à 8,40) et un IECA/ARA (OR: 4,01; IC95%: 1,30 à 12,41). Quatre‐vingt dix des patients exclus ont été libérés sans finir leur traitement.
Conclusions
En général, les médecins adhèrent rigoureusement aux directives de prescription pour le SCA dans la pratique hospitalière vietnamienne. La prescription de bêtabloquants et de doses de charge de clopidogrel était probablement sous‐optimale. Les raisons pour lesquelles des patients n'ont pas fini le traitement devraient être investiguées.
Objetivos
Determinar el nivel de adherencia de los médicos a las guías de prescripción para el síndrome coronario agudo (SCA) en hospitales de Vietnam.
Métodos
Estudio croseccional retrospectivo de historias médicas de pacientes con SCA admitidos en dos hospitales públicos en la Ciudad de Ho Chi Minh, Vietnam, entre Enero y Diciembre del 2013. Se determinaron los porcentajes de pacientes elegibles que recibían la medicación recomendada en las guías. Se identificaron los factores asociados con la no‐adherencia mediante una regresión logística multivariante.
Resultados
En total se revisaron 711 historias clínicas y se encontraron 284 pacientes que cumplían con los criterios de inclusión (edad media 64 años; 69.4% hombres). De entre los pacientes elegibles para recibir tratamiento, se prescribió aspirina al 97.9% al ser admitidos y a 96.3% al ser dados de alta; se prescribió terapia antiplaquetaria dual al 92.3% al ser admitidos y a un 91.7% al ser dados de alta; se prescribieron dosis de carga para un 79.5% en el caso de la aspirina y a un 55.8% con clopidogrel; se prescribieron beta‐bloqueantes a un 58.7% al ingresar y a un 76.7% al ser dados de alta; los inhibidores de la enzima convertidora de angiotensina o bloqueadores del receptor de la angiotensina (IECA/BRA) fueron prescritos en un 89.1% de los casos al ingreso y al ser dados de alta; y se prescribieron estatinas al 94.1% al ingreso y al 90.7% al ser dados de alta. Los pacientes con un procedimiento invasivo tenían mayor probabilidad de recibir un tratamiento acorde con el recomendado en las guías en el momento de ser dados de alta: terapia antiplaquetaria dual (OR 3.77; IC 95% 1.23‐11.52), beta bloqueantes (OR 3.95; IC 95% CI 1.86‐8.40), y IECA/BRA (OR 4.01; IC 95% 1.30‐12.41). Noventa de los pacientes excluidos fueron dados de alta sin completar el tratamiento.
Conclusiones
En general, los médicos se adherían a las guías de prescripción para SCA dentro de la práctica hospitalaria en Vietnam. La prescripción de las dosis de carga de betabloqueantes y clopidogrel era probablemente inadecuada. El porqué los pacientes no completaban el tratamiento requiere ser investigado.
Abstract
Objectives
To determine the extent of physicians' adherence to prescribing guidelines for acute coronary syndrome in
V
ietnamese hospitals.
Methods
Retrospective cross‐sectional study of ...medical records of all patients with
ACS
admitted to two public hospitals in
H
o
C
hi
M
inh
C
ity,
V
ietnam, from January to December 2013. Percentages of eligible patients receiving guideline‐recommended medications were determined. Factors associated with non‐adherence were identified using multivariate logistic regression.
Results
Overall, 711 medical records were reviewed and 284 patients fulfilled inclusion criteria (mean age 64 years; 69.4% male). Of those patients eligible for treatment, aspirin was prescribed for 97.9% at arrival and 96.3% at discharge; dual antiplatelet therapy was prescribed for 92.3% at arrival and 91.7% at discharge; loading doses were prescribed for 79.5% (aspirin) and 55.8% (clopidogrel); beta blockers were prescribed for 58.7% at arrival and 76.7% at discharge; angiotensin‐converting enzyme inhibitors or angiotensin receptor blockers (
ACEI
/
ARB
) were prescribed for 89.1% at arrival or discharge; and statins were prescribed for 94.1% at arrival and 90.7% at discharge. Patients undergoing an invasive procedure were more likely to receive guideline‐recommended medications at discharge: dual antiplatelet therapy (
OR
3.77; 95%
CI
1.23–11.52), beta blocker (
OR
3.95; 95%
CI
1.86–8.40) and
ACEI
/
ARB
(
OR
4.01; 95%
CI
1.30–12.41). Ninety of the excluded patients were discharged without completing treatment.
Conclusions
In general, physicians closely adhered to
ACS
prescribing guidelines in
V
ietnamese hospital practice. Prescribing of beta blockers and clopidogrel loading doses was probably suboptimal. Why patients do not complete treatment needs to be investigated.
Objectifs
Déterminer le degré d'adhésion des médecins aux directives sur les prescriptions pour le syndrome coronarien aigu (
SCA
) dans les hôpitaux vietnamiens.
Méthodes
Etude transversale rétrospective des dossiers médicaux de tous les patients atteints de
SCA
admis dans deux hôpitaux publics de Ho Chi Minh City, au Vietnam, de janvier à décembre 2013. Les pourcentages de patients éligibles recevant des médicaments recommandés par les directives ont été déterminés. Les facteurs associés à la non‐adhésion ont été identifiés par régression logistique multivariée.
Résultats
Au total, 711 dossiers médicaux ont été examinés et 284 patients répondaient aux critères d'inclusion (âge moyen: 64 ans; 69,4% d'hommes). Parmi les patients éligibles au traitement, l'aspirine a été prescrite pour 97,9% à l'arrivée et 96,3% à la sortie, la bithérapie antiplaquettaire a été prescrite pour 92,3% à l'arrivée et 91,7% à la sortie, des doses de charge ont été prescrites pour 79,5% (aspirine) et 55,8% (clopidogrel). Des bêtabloquants ont été prescrits pour 58,7% à l'arrivée et 76,7% à la sortie, des inhibiteurs de l'enzyme de conversion de l'angiotensine ou des antagonistes des récepteurs de l'angiotensine (
IECA
/
ARA
) ont été prescrits pour 89,1% à l'arrivée et à la sortie et des statines ont été prescrites pour 94,1% à l'arrivée et 90,7% à la sortie. Les patients subissant une procédure invasive étaient plus susceptibles de recevoir des médicaments recommandés par les directives à la sortie: la bithérapie antiplaquettaire (
OR
: 3,77;
IC
95%: 1,23 à 11,52), un bêtabloquant (
OR
: 3,95;
IC
95%: 1,86 à 8,40) et un
IECA
/
ARA
(
OR
: 4,01;
IC
95%: 1,30 à 12,41). Quatre‐vingt dix des patients exclus ont été libérés sans finir leur traitement.
Conclusions
En général, les médecins adhèrent rigoureusement aux directives de prescription pour le
SCA
dans la pratique hospitalière vietnamienne. La prescription de bêtabloquants et de doses de charge de clopidogrel était probablement sous‐optimale. Les raisons pour lesquelles des patients n'ont pas fini le traitement devraient être investiguées.
Objetivos
Determinar el nivel de adherencia de los médicos a las guías de prescripción para el síndrome coronario agudo (
SCA
) en hospitales de Vietnam.
Métodos
Estudio croseccional retrospectivo de historias médicas de pacientes con
SCA
admitidos en dos hospitales públicos en la Ciudad de Ho Chi Minh, Vietnam, entre Enero y Diciembre del 2013. Se determinaron los porcentajes de pacientes elegibles que recibían la medicación recomendada en las guías. Se identificaron los factores asociados con la no‐adherencia mediante una regresión logística multivariante.
Resultados
En total se revisaron 711 historias clínicas y se encontraron 284 pacientes que cumplían con los criterios de inclusión (edad media 64 años; 69.4% hombres). De entre los pacientes elegibles para recibir tratamiento, se prescribió aspirina al 97.9% al ser admitidos y a 96.3% al ser dados de alta; se prescribió terapia antiplaquetaria dual al 92.3% al ser admitidos y a un 91.7% al ser dados de alta; se prescribieron dosis de carga para un 79.5% en el caso de la aspirina y a un 55.8% con clopidogrel; se prescribieron beta‐bloqueantes a un 58.7% al ingresar y a un 76.7% al ser dados de alta; los inhibidores de la enzima convertidora de angiotensina o bloqueadores del receptor de la angiotensina (
IECA
/
BRA
) fueron prescritos en un 89.1% de los casos al ingreso y al ser dados de alta; y se prescribieron estatinas al 94.1% al ingreso y al 90.7% al ser dados de alta. Los pacientes con un procedimiento invasivo tenían mayor probabilidad de recibir un tratamiento acorde con el recomendado en las guías en el momento de ser dados de alta: terapia antiplaquetaria dual (
OR
3.77;
IC
95% 1.23‐11.52), beta bloqueantes (
OR
3.95;
IC
95%
CI
1.86‐8.40), y
IECA
/
BRA
(
OR
4.01;
IC
95% 1.30‐12.41). Noventa de los pacientes excluidos fueron dados de alta sin completar el tratamiento.
Conclusiones
En general, los médicos se adherían a las guías de prescripción para
SCA
dentro de la práctica hospitalaria en Vietnam. La prescripción de las dosis de carga de betabloqueantes y clopidogrel era probablemente inadecuada. El porqué los pacientes no completaban el tratamiento requiere ser investigado.
Mortality from dengue infection is mostly due to shock. Among dengue patients with shock, approximately 30% have recurrent shock that requires a treatment change. Here, we report development of a ...clinical rule for use during a patient's first shock episode to predict a recurrent shock episode.
The study was conducted in Center for Preventive Medicine in Vinh Long province and the Children's Hospital No. 2 in Ho Chi Minh City, Vietnam. We included 444 dengue patients with shock, 126 of whom had recurrent shock (28%). Univariate and multivariate analyses and a preprocessing method were used to evaluate and select 14 clinical and laboratory signs recorded at shock onset. Five variables (admission day, purpura/ecchymosis, ascites/pleural effusion, blood platelet count and pulse pressure) were finally trained and validated by a 10-fold validation strategy with 10 times of repetition, using a logistic regression model.
The results showed that shorter admission day (fewer days prior to admission), purpura/ecchymosis, ascites/pleural effusion, low platelet count and narrow pulse pressure were independently associated with recurrent shock. Our logistic prediction model was capable of predicting recurrent shock when compared to the null method (P < 0.05) and was not outperformed by other prediction models. Our final scoring rule provided relatively good accuracy (AUC, 0.73; sensitivity and specificity, 68%). Score points derived from the logistic prediction model revealed identical accuracy with AUCs at 0.73. Using a cutoff value greater than -154.5, our simple scoring rule showed a sensitivity of 68.3% and a specificity of 68.2%.
Our simple clinical rule is not to replace clinical judgment, but to help clinicians predict recurrent shock during a patient's first dengue shock episode.
In January 2020, we identified two severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2)‐infected patients in a familial cluster with one person coming from Wuhan, China. The complete genome ...sequences of two SARS‐CoV‐2 strains isolated from these patients were identical and 99.98% similar to strains isolated in Wuhan. This is genetically suggestive of human‐to‐human transmission of SARS‐CoV‐2 and indicates Wuhan as the most plausible origin of the early outbreak in Vietnam. The younger patient had a mild upper respiratory illness and a brief viral shedding, whereas the elderly with multi‐morbidity had pneumonia, prolonged viral shedding, and residual lung damage. The evidence of nonsynonymous substitutions in the ORF1ab region of the viral sequence warrants further studies.
Highlights
Transmission of SARS‐CoV‐2 is a global public health and clinical concern.
This report describes clinical features, virus isolation, and complete genome sequences from the first two SARS‐CoV‐2 infections in Vietnam.
Epidemiological and phylogenetic analysis suggested evidence of human‐to‐human transmission of SARS‐CoV‐2. Comparison of SARS‐CoV‐2 strains isolated from these two patients with those from Wuhan showed high similarities.
Nonsynonymous substitutions existed in the ORF1ab region of the viral sequence.
Compared with mild clinical and virological manifestations in the younger patient, the elderly suffered from pneumonia, prolonged viral shedding, and residual lung damage.
The COVID-19 pandemic has imposed a heavy burden on health care systems and governments. Health literacy (HL) and eHealth literacy (as measured by the eHealth Literacy Scale eHEALS) are recognized as ...strategic public health elements but they have been underestimated during the pandemic. HL, eHEALS score, practices, lifestyles, and the health status of health care workers (HCWs) play crucial roles in containing the COVID-19 pandemic.
The aim of this study is to evaluate the psychometric properties of the eHEALS and examine associations of HL and eHEALS scores with adherence to infection prevention and control (IPC) procedures, lifestyle changes, and suspected COVID-19 symptoms among HCWs during lockdown.
We conducted an online survey of 5209 HCWs from 15 hospitals and health centers across Vietnam from April 6 to April 19, 2020. Participants answered questions related to sociodemographics, HL, eHEALS, adherence to IPC procedures, behavior changes in eating, smoking, drinking, and physical activity, and suspected COVID-19 symptoms. Principal component analysis, correlation analysis, and bivariate and multivariate linear and logistic regression models were used to validate the eHEALS and examine associations.
The eHEALS had a satisfactory construct validity with 8 items highly loaded on one component, with factor loadings ranked from 0.78 to 0.92 explaining 76.34% of variance; satisfactory criterion validity as correlated with HL (ρ=0.42); satisfactory convergent validity with high item-scale correlations (ρ=0.80-0.84); and high internal consistency (Cronbach α=.95). HL and eHEALS scores were significantly higher in men (unstandardized coefficient B=1.01, 95% CI 0.57-1.45, P<.001; B=0.72, 95% CI 0.43-1.00, P<.001), those with a better ability to pay for medication (B=1.65, 95% CI 1.25-2.05, P<.001; B=0.60, 95% CI 0.34-0.86, P<.001), doctors (B=1.29, 95% CI 0.73-1.84, P<.001; B 0.56, 95% CI 0.20-0.93, P=.003), and those with epidemic containment experience (B=1.96, 95% CI 1.56-2.37, P<.001; B=0.64, 95% CI 0.38-0.91, P<.001), as compared to their counterparts, respectively. HCWs with higher HL or eHEALS scores had better adherence to IPC procedures (B=0.13, 95% CI 0.10-0.15, P<.001; B=0.22, 95% CI 0.19-0.26, P<.001), had a higher likelihood of healthy eating (odds ratio OR 1.04, 95% CI 1.01-1.06, P=.001; OR 1.04, 95% CI 1.02-1.07, P=.002), were more physically active (OR 1.03, 95% CI 1.02-1.03, P<.001; OR 1.04, 95% CI 1.03-1.05, P<.001), and had a lower likelihood of suspected COVID-19 symptoms (OR 0.97, 95% CI 0.96-0.98, P<.001; OR 0.96, 95% CI 0.95-0.98, P<.001), respectively.
The eHEALS is a valid and reliable survey tool. Gender, ability to pay for medication, profession, and epidemic containment experience were independent predictors of HL and eHEALS scores. HCWs with higher HL or eHEALS scores had better adherence to IPC procedures, healthier lifestyles, and a lower likelihood of suspected COVID-19 symptoms. Efforts to improve HCWs' HL and eHEALS scores can help to contain the COVID-19 pandemic and minimize its consequences.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
High-efficiency catalysts are required for the oxygen reduction reaction (ORR) in fuel cell applications. Herein, we present a novel hybrid material that is based on uniformly deposited nanoscale ...molybdenum phosphide (MoxPy) nanoparticles on the structure of graphene nanolayers doped with phosphorus atoms (PG). With a positive onset potential of only −0.046 V and a half-wave potential value of roughly −0.17 V (vs. Ag/AgCl), the obtained hybrid showed good catalytic activity for ORR in 0.1 M KOH electrolyte. It also demonstrated remarkable durability for oxygen reduction reaction in 0.1 M KOH electrolyte when compared to state-of-the-art Pt/C material. The excellent ORR performance can be correlated to the development of a highly conducting microporous structure with highly active sites, which in turn encourages optimal adsorption of intermediates during the ORR process and thus enhances the catalytic process. This work can open a new path for the growth of promising highly efficient catalysts for affordable fuel cell applications.
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•Uniform MoxPy nanoparticles dispersed P-doped G was prepared by a facile route.•The hybrid offered high catalytic performance for ORR, close to Pt/C.•The synergistic effect from MoxPy and P-doped Gr produced enhanced ORR performance.•The hybrid showed much better durability and methanol tolerance than Pt/C.
Dynamic hydrogel systems from N,O‐carboxymethyl chitosan (NOCC) are investigated in the past years, which has facilitated their widespread use in many biomedical engineering applications. However, ...the influence of the polymer's oxidation levels on the hydrogel biological properties is not fully investigated. In this study, chitosan is converted into NOCC and introduced to react spontaneously with oxidized xanthan gum (OXG) to form several injectable hydrogels with controlled degradability. Different oxidation levels of xanthan gum, as well as NOCC/OXG volume ratios, are trialed. The infrared spectroscopy spectra verify chemical modification on OXG and successful crosslinking. With increasing oxidation levels, more dialdehyde groups are introduced into the OXG, resulting in changes in physical properties including gelation, swelling, and self‐healing efficiency. Under different volume ratios, the hydrogel shows a stable structure and rigidity with higher mechanical properties, and a slower degradation rate. The shear‐thinning and self‐healing properties of the hydrogels are confirmed. In vitro assays with L929 cells show the biocompatibility of all formulations although the use of a high amount of OXG15 and OXG25 limited the cell proliferation capacity. Findings in this study suggested a suitable amount of OXG at different oxidation levels in NOCC hydrogel systems for tissue engineering applications.
The relationships between polymer modifications to the hydrogel's biological properties are essential to understand in developing a new hydrogel product. This work studies a hydrogel system consideration of the component's oxidation levels for potential use in tissue engineering applications. At different oxidation levels, hydrogels owned their characteristic properties. This suggests a suitable amount of oxidized xanthan gum used in hydrogels.
•Ozone foam fractionation removed over 90 % long-chain PFAS from landfill leachate.•Ozone removed short-chain PFAS 10 %–30 % less efficiently than air.•PFAS surface excess on ozone bubbles was 20–40 ...% lower than air bubbles.•Ozone's foamate volumes were 2–4 times smaller with 4 % lower wettability than air.
Landfills are the primary endpoint for the disposal of PFAS-laden waste, which subsequently releases PFAS to the surrounding environments through landfill leachate. Ozone foam fractionation emerges as a promising technology for PFAS removal to address the issue. This study aims to (i) assess the effectiveness of the ozone foam fractionation system to remove PFAS from landfill leachate, and (ii) quantify equilibrium PFAS adsorption onto the gas-water interface of ozone bubbles, followed by a comparison with air foam fractionation. The results show that ozone foam fractionation is effective for PFAS removal from landfill leachate, with more than 90 % long-chain PFAS removed. The identified operating conditions provide valuable insights for industrial applications, guiding the optimization of ozone flow rates (1 L/min), dosing (43 mg/L) and minimizing foamate production (4 % wettability). The equilibrium modelling reveals that the surface excess of air bubbles exceeds that of ozone bubbles by 20–40 % at a corresponding PFAS concentration. However, the overall removal of PFAS from landfill leachate by ozone foam fractionation remains substantial. Notably, ozone foam fractionation generates foamate volumes 2 – 4 times less, resulting in significant cost savings for the final disposal of waste products and reduced site storage requirements.
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