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A new sorbent based on Sepia shells (cuttlefish bones) has been synthesized (SSBC) and tested for the sorption of cationic dye (crystal violet, CV) and an anionic dye (congo red, CR). SSBC was produced by reaction of sepia shells powder with urea in the presence of formaldehyde. In the first part of the work, the sorbent was characterized using scanning electron microscopy, energy dispersive X-ray analysis, Fourier-transform infra-red spectrometry and titration (for determining pH PZC ). In a second step, sorption properties were tested on the two dyes through the study of pH effect, sorbent dosage, temperature and ionic strength; the sorption isotherms and uptake kinetics were analyzed at the optimum pH: Langmuir equation fits isotherm profiles while the kinetic profile can be described by the pseudo-second order rate equation. Maximum sorption capacities reach up to 0.536 mmol g −1 for CV and 0.359 mmol g −1 for CR, at pH 10.6 and 2.4, respectively. The comparison of sorption properties at different temperatures shows that the sorption is endothermic. Processing to the sorption under microwave irradiation (microwaved enforced sorption, MES) increases mass transfer and a contact time as low as 1 min is sufficient under optimized conditions (exposure time and power) reaching the equilibrium, while 2-3 h were necessary for "simple" sorption. Dye desorption was successfully tested using 0.5 M solutions of NaOH and HCl for the removal of CR and CV, respectively. The sorbent can be re-used for a minimum of four cycles of sorption/desorption. Finally, the sorbent was successfully tested on spiked tap water and real industrial wastewater.

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Teratogenic medications are often prescribed to women of childbearing age with autoimmune diseases. Literature suggests that appropriate use of contraception among these women is low, potentially resulting in high-risk unintended pregnancies. Preliminary review in our clinic showed suboptimal documentation of women’s contraceptive use. We therefore designed a quality improvement initiative to target three process measures: documentation of contraception usage and type, contraception counselling and provider action after counselling. We reviewed charts of rheumatology clinic female patients aged 18–45 over the course of 10 months; for those who were on teratogenic medications (methotrexate, leflunomide, mycophenolate and cyclophosphamide), we looked for evidence of documentation of contraception use. We executed multiple plan-do-study-act (PDSA) cycles to develop and evaluate interventions, which centred on interprofessional provider education, modification of electronic medical record (EMR) templates, periodic provider reminders, patient screening questionnaires and frequent feedback to providers on performance. Among eligible patients (n=181), the baseline rate of documentation of contraception type was 46%, the rate of counselling was 30% and interventions after counselling occurred in 33% of cases. Averaged intervention data demonstrated increased provider performance in all three domains: documentation of contraception type increased to 64%, counselling to 45% and provider action to 46%. Of the patients with documented contraceptives, 50% used highly effective, 27% used effective and 23% used ineffective contraception methods. During this project, one unintentional pregnancy occurred in a patient on methotrexate not on contraception. Our interventions improved three measures related to contraception counselling and documentation, but there remains a need for ongoing quality improvement efforts in our clinic. This high-risk population requires increased provider engagement to improve contraception compliance, coupled with system-wide EMR changes to increase sustainability.

Magnetic Schiff's base chitosan composite has been prepared starting from shrimp peels as a raw material. Chitosan extraction involved three main stages as preconditioning, demineralization deproteinization and deacetylation. Chitosan modification process took place through the reaction between chitosan and polymeric Schiff's base of thiourea/glutaraldehyde in the presence of magnetite. The synthetic hybrid composite was characterized by Fourier transform infrared spectroscopy and scanning electron microscopy-energy dispersive X-ray analyses and tested as sorbent for Cr(VI) recovery from aqueous solution. The performance of the sorbent was systematically evaluated by batch sorption experiments, followed by equilibrium and kinetic studies with different mathematical models. The isotherm study demonstrate that the sorbent achieved 99.1% (sorption capacity; 252.45 mg g) removal efficiency in Cr(VI) solution with concentrations up to 400 mg/L. Experimental data gave better mathematical fitting towards pseudo-second-order kinetic model and Langmuir isotherm model. The distribution coefficient was obtained at different temperatures and the thermodynamic parameters have been calculated: the sorption is endothermic, spontaneous and contributes to increase the randomness of the system. The sorbent could be recycled for three cycles of sorption/desorption.