Search results for: hospital waste

Authors: Anna Piasek, Anna Szymkiewicz, Gabriela Wiktor, Jolanta Pulit-Prociak, Marcin Banach

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Carbon dots (CDs) have great potential for application in many fields of science. They are characterized by fluorescent properties that can be manipulated. The nanomaterial has many advantages in addition to its unique properties. CDs may be obtained easily, and they undergo surface functionalization in a simple way. In addition, there is a wide range of raw materials that can be used for their synthesis. An interesting possibility is the use of numerous waste materials of natural origin. In the research presented here, the synthesis of CDs was carried out according to the principles of Green chemistry. Beet molasses was used as a natural raw material. It has a high sugar content. This makes it an excellent high-carbon precursor for obtaining CDs. To increase the fluorescence effect, we modified the surface of CDs with silver (Ag-CDs) nanoparticles. The process of obtaining CQD was based on the hydrothermal method by applying microwave radiation. Silver nanoparticles were formed via the chemical reduction method. The synthesis plans were performed on the Design of the Experimental method (DoE). Variable process parameters such as concentration of beet molasses, temperature and concentration of nanosilver were used in these syntheses. They affected the obtained properties and particle parameters. The Ag-CDs were analyzed by UV-vis spectroscopy. The fluorescence properties and selection of the appropriate excitation light wavelength were performed by spectrofluorimetry. Particle sizes were checked using the DLS method. The influence of the input parameters on the obtained results was also studied.

Keywords: fluorescence, modification, nanosilver, molasses, Green chemistry, carbon dots

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Authors: Pei-Chun Chen, Chi-Ting Tseng, Lih-Chi Chen, Kai-Hsiang Yang

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Introduction: The pharmacist is responsible for encouraging adverse drug reaction (ADR) reporting. In a local center in Northern Taiwan, promotion and rewarding of ADR reporting have continued for over six years but failed to bring significant changes. This study aims to find a solution to increase ADR reporting. Research question or hypothesis: We hypothesized that under-reporting is due to the inconvenience of the reporting system. Reports were made conventionally through printed sheets. We proposed that reports made per month will increase if they were computerized. Study design: An ADR reporting platform was established in April 2015, before which was defined as the first stage of this study (January-March, 2015) and after which the second stage. The third stage commenced in November, 2015, after adding a reporting module to physicians prescription system. ADRs could be reported simultaneously when documenting drug allergies. Methods: ADR report rates during the three stages of the study were compared. Effects of the information platform on reporting were also analyzed. Results: During the first stage, the number of ADR reports averaged 6 per month. In the second stage, the number of reports per month averaged 1.86. Introducing the information platform had little effect on the monthly number of ADR reports. The average number of reports each month during the third stage of the study was 11±3.06, with 70.43% made electronically. Reports per month increased significantly after installing the reporting module in November, 2015 (P<0.001, t-test). In the first two stages, 29.03% of ADR reports were made by physicians, as compared to 70.42% of cases in the third stage of the study. Increased physician reporting possibly account for these differences. Conclusion: Adding a reporting module to the prescription system significantly increased ADR reporting. Improved accessibility is likely the cause. The addition of similar modules to computer systems of other healthcare professions may be considered to encourage spontaneous ADR reporting.

Keywords: adverse drug reactions, adverse drug reaction reporting systems, regional hospital, prescription system

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Authors: Ali Kuzu

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There are about 800 thousand chemicals in our environment and the number is increasing more than a thousand every year. While most of these chemicals are used as components in various consumer products, some are faced as industrial waste in the environment. Unfortunately, many of these chemicals are hazardous and affect humans. According to the “International Program on Chemical Safety” of World Health Organization; Among the chronic health effects of chemicals, cancer is of major concern. Many substances have found in recent years to be carcinogenic in one or more species of laboratory animals. Especially with respect to long-term effects, the response to a chemical may vary, quantitatively or qualitatively, in different groups of individuals depending on predisposing conditions, such as nutritional status, disease status, current infection, climatic extremes, and genetic features, sex and age of the individuals. Understanding the response of such specific risk groups is an important area of toxicology research. People with age 65+ is defined as “aged (or elderly)”. The elderly population in the world is about 600 million, which corresponds to ~8 percent of the world population. While every 1 of each 4 people is aged in Japan, the elderly population is quite close to 20 percent in many developed countries. And elderly population in these countries is growing more rapidly than the total population. The negative effects of chemicals on elderly take an important place in health-care related issues in last decades. The aged population is more susceptible to the harmful effects of environmental chemicals. According to the poor health of the organ systems in elderly, the ability of their body to eliminate the harmful effects and chemical substances from their body is also poor. With the increasing life expectancy, more and more people will face problems associated with chemical residues.

Keywords: elderly, chemicals’ effects, aged care, care need

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Authors: Laila Salah Seada, Ashraf Ibrahim, Fawaz Al Rashid, Ihab Abdo, Hassan Kasim, Waleed Al Mansi, Saud Al Shabli

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Background and Objectives: Colorectal carcinoma is increasing among both men and women worldwide. It has a multifactorial etiology including genetic factors, environmental factors and inflammatory conditions of the digestive tract. A clinicopathologic assessment of colorectal carcinoma in Hail region is done, considering any changing patterns in two 5-year periods from 2005-2009 (A) and from 2012 to 2017 (B). All data had been retrieved from histopathology files of King Khalid Hospital, Hail. Results: During period (A), 75 cases were diagnosed as colorectal carcinoma. Male patients comprised 56/75 (74.7%) of the study, with a mean age of 58.4 (36-97), while females were 19/75 (25.3%) with a mean age of 50.3(30-85) and the difference was significant (p = 0.05). M:F ratio was 2.9:1. Most common histological type was adenocarcioma in 68/75 (90.7%) patients mostly well differentiated in 44/68 (64.7%). Mucinous neoplasms comprised only 7/75 (9.3%) of cases and tended to have a higher stage (p = 0.04). During period (B), 115 cases were diagnosed with an increase of 53.3% in number of cases than period (A). Male to female ratio also decreased to 1.35:1, females being 44.83% more affected. Adenocarcinoma remained the prevalent type (93.9%), while mucinous type was still rare (5.2%). No distal metastases found at time of presentation. Localization of tumors was rectosigmoid in group (A) in 41.4%, which increased to 56.6% in group (B), with an increase of 15.2%. Iliocecal location also decreased from 8% to 3.5%, being 56.25% less. Other proximal areas of the colon were decreased by 25.75%, from 53.9% in group (A) to 40% in group (B). Conclusion: Colorectal carcinoma in Hail region has increased by 53.3% in the past 5 years, with more females being diagnosed. Localization has also shifted distally by 15.2%. These findings are different from Western world patterns which experienced a decrease in incidence and proximal shift of the colon cancer localization. This might be due to better diagnostic tools, population awareness of the disease, as well as changing of life style and/or food habits in the region.

Keywords: colorectal cancer, Hail Region, changing pattern, distal shift

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Authors: Mimoza Canga, Irene Malagnino, Ruzhdie Qafmolla, Vergjini Mulo, Gresa Baboci, Vito Antonio Malagnino

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Background: Dental caries represents the most widespread pathology in childhood. The prevalence of dental caries varies with age, gender, socio economic status, geographical location, nutrition habits, and oral hygiene. Objective: The objective of the present longitudinal study is to show clearly the prevalence of dental caries in the children of age 6 and 7 years old in Vlore, Albania, in a two year time period with controls done every 6 months. Materials and methods: The present study was conducted on 530 children, with a controlled sample for a time period of 24 months from September 2019- September 2021. The children in the study had different economic and social backgrounds. The teeth controls were done by the dentists who work at the hospital of the city. The present study was conducted in accordance with Helsinki declaration. Permissions were obtained in written form, which allowed us to perform the observations. Parents had the right to withdraw their children at any time. Statistical analysis was performed using IBM SPSS Statistics 23.0. The significance level (α) was set at 0.05, whereas P-value and analysis of variance (ANOVA) were used to analyze the data. Results: The data of the present study showed that the age group of 6 years old had 139 or 52.3% of the children with dental caries and 127 or 47.7% of them had no dental caries, while at the age of 7 there were 184 or 69.7% of the children with dental caries problems in the permanent molars and 80 or 30.3% of them had no dental caries. In the present study, it was observed that there is a statistically significant association between age group and presence of caries. Children 7 years old had higher presence of dental caries (χ2 = 16.934 (df 1) p-value < 0.001). According to the present research, there is a statistically significant correlation between period of time and the presence of dental caries. Furthermore, in the actual research, it was established that in the time 18-24 months, the prevalence of dental caries was high (χ2=15,318 (df 1) p-value = 0.004). Conclusion: According to the results of the present study performed in Albania in a two year time period with controls done every 6 months, it is proved that the prevalence of dental caries was 17.4 percent higher among children 7 years old in comparison with the children 6 years old.

Keywords: age, children, dental caries, permanent molars

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Authors: N. Anand, P. S. Nayyer, V. Rana, S. Verma

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Background: Diabetes mellitus is a group of disorders characterized by hyperglycemia and associated with microvascular and macrovascular complications. Among the lesser known complications is the involvement of respiratory system. Changes in pulmonary volume, diffusion and elastic properties of lungs as well as the performance of the respiratory muscles lead to a restrictive pattern in lung functions. The present study was aimed to determine the changes in various parameters of pulmonary function tests amongst patients with Type 2 Diabetes Mellitus and also try to study the effect of duration of Diabetes Mellitus on pulmonary function tests. Methods: It was a cross sectional study performed at Dr Baba Saheb Ambedkar Hospital and Medical College in, Delhi, A Tertiary care referral centre which included 200 patients divided into 2 groups. The first group included diagnosed patients with diabetes and the second group included controls. Cases and controls symptomatic for any acute or chronic Respiratory or Cardiovascular illness or a history of smoking were excluded. Both the groups were subjected to spirometry to evaluate for the pulmonary function tests. Result: The mean Forced Vital Capacity (FVC), Forced Expiratory Volume in first second (FEV1), Peak Expiratory Flow Rate(PEFR) was found to be significantly decreased ((P < 0.001) as compared to controls while the mean ratio of Forced Expiratory Volume in First second to Forced Vital Capacity was not significantly decreased( p>0.005). There was no correlation seen with duration of the disease. Conclusion: Forced Vital Capacity (FVC), Forced Expiratory Volume in first second (FEV1), Peak Expiratory Flow Rate(PEFR) were found to be significantly decreased in patients of Diabetes mellitus while ratio of Forced Expiratory Volume in First second to Forced Vital Capacity (FEV1/FVC) was not significantly decreased. The duration of Diabetes mellitus was not found to have any statistically significant effect on Pulmonary function tests (p > 0.005).

Keywords: diabetes mellitus, pulmonary function tests, forced vital capacity, forced expiratory volume in first second

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Authors: F. Fatoye, C. E. Mbada, T. Gebrye, A. O. Ogunsola, C. Fatoye, O. Oyewole

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Musculoskeletal disorders (MSDs) are a major cause of pain and disability. It is likely to become a greater economic and public health burden that is unnecessary. Thus, reliable prevalence figures are important for both clinicians and policy-makers to plan health care needs for those affected with the disease. This study estimated hospital based real-world prevalence of MSDs in Nigeria. A review of medical charts for adult patients attending Physiotherapy Outpatient Clinic at the Obafemi Awolowo University Teaching Hospitals Complex, Osun State, Nigeria between 2009 and 2018 was carried out to identify common MSDs including low back pain (LBP), cervical spondylosis (CSD), post immobilization stiffness (PIS), sprain, osteoarthritis (OA), and other conditions. Occupational class of the patients was determined using the International Labour Classification (ILO). Data were analysed using descriptive statistics of frequency and percentages. Overall, medical charts of 3,340 patients were reviewed within the span of ten years (2009 to 2018). Majority of the patients (62.8%) were in the middle class, and the remaining were in low class (25.1%) and high class (10.5%) category. An overall prevalence of 47.35% of MSD was found within the span of ten years. Of this, the prevalence of LBP, CSD, PIS, sprain, OA, and other conditions was 21.6%, 10%, 18.9%, 2%, 6.3%, and 41.3%, respectively. The highest (14.2%) and lowest (10.5%) prevalence of MSDs was recorded in the year of 2012 and 2018, respectively. The prevalence of MSDs is considerably high among Nigerian patients attending outpatient a physiotherapy clinic. The high prevalence of MSDs underscores the need for clinicians and decision makers to put in place appropriate strategies to reduce the prevalence of these conditions. In addition, they should plan and evaluate healthcare services to improve the health outcomes of patients with MSDs. Further studies are required to determine the economic burden of the condition and examine the clinical and cost-effectiveness of physiotherapy interventions for patients with MSDs.

Keywords: musculoskeletal disorders, Nigeria, prevalence, real world

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Authors: Sadaf Karkoodi, Hassan Karampour

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There is a growing interest in the construction industry towards hybrid systems. The hybrid systems use construction materials such as timber, steel, and concrete smartly, can be prefabricated, and are cost-effective and sustainable solutions to an industry targeting reduced carbon footprint. Moreover, in case of periodical shortage in timber resources, reusable and waste wood such as fibres can be used in the hybrid modules, which facilitates the circular economy. In this research, a hybrid frame is proposed and experimentally validated by introducing dried wood fibre products inside cold-formed steel square hollow sections without using any adhesives. As such, fibre-filled steel tubular (FFST) columns, beams, and 2D frames are manufactured and tested. The results show that the FFST columns have stiffness and strength 44% and 55% higher than cold-formed steel columns, respectively. The bearing strength of the FFST beams shows an increase of 39.5% compared to steel only. The flexural stiffness and strength of the FFST beams are 8.5% and 28% higher than the bare steel beams, respectively. The FFST frame depicted an 18.4% higher ultimate load capacity than the steel-only frame under a mid-point concentrated load. Moreover, the FFST beam-to-column bolted connection showed high ductile performance. The initial results and the proposed simple manufacturing process suggest that the proposed FFST concept can be upscaled and used in real structures.

Keywords: wood fibre, reusing wood, fibre-filled steel, hybrid construction

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Authors: Yitao Lei, Xingxiang Zhai, Burra Venkata Durga Kumar

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As the quantity and complexity of computing in large-scale software systems increase, distributed system computing becomes increasingly important. The distributed system realizes high-performance computing by collaboration between different computing resources. If there are no efficient resource scheduling resources, the abuse of distributed computing may cause resource waste and high costs. However, resource scheduling is usually an NP-hard problem, so we cannot find a general solution. However, some optimization algorithms exist like genetic algorithm, ant colony optimization, etc. The large scale of distributed systems makes this traditional optimization algorithm challenging to work with. Heuristic and machine learning algorithms are usually applied in this situation to ease the computing load. As a result, we do a review of traditional resource scheduling optimization algorithms and try to introduce a deep reinforcement learning method that utilizes the perceptual ability of neural networks and the decision-making ability of reinforcement learning. Using the machine learning method, we try to find important factors that influence the performance of distributed system computing and help the distributed system do an efficient computing resource scheduling. This paper surveys the application of deep reinforcement learning on distributed system computing resource scheduling proposes a deep reinforcement learning method that uses a recurrent neural network to optimize the resource scheduling, and proposes the challenges and improvement directions for DRL-based resource scheduling algorithms.

Keywords: resource scheduling, deep reinforcement learning, distributed system, artificial intelligence

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Authors: Babak Mirzashahi, Arvin Najafi, Pejman Mansouri, Mahmoud Farzan

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Background: The most effective treatment of posterior cruciate ligament (PCL) tears and the consequence of untreated PCL injuries remain controversial. Objectives: The aim of this study is to assess outcomes of fixation of tibial posterior cruciate ligament (PCL) avulsion fractures via a modified technique. Patients and Methods: From January, 2009 to March, 2012, there were 45 cases of PCL tibial avulsion fractures that were referred to our hospital and were managed through a modified open posterior approach. Fixation of Tibial PCL avulsion fractures were fixed by means of a lag screw and washer placed through our modified open posterior approach. Range of motion was begun on the first postoperative day. Clinical stability, range of motion, gastrocnemius muscle strength, radiographic investigation, and patient’s overall quality of life was analyzed at final follow up visit. Results: The average of overall musculoskeletal functional evaluation scores was 15 (range 3–35). All patients achieved union of their fracture and had clinically stable knees at the latest follow-up. The mean preoperative Lysholm score for 15 knees was 62 ± 8 (range, 50-75); the mean postoperative Lysholm score was 92± 7 (range, 75-101). A significant difference in Lysholm scores between preoperative and final follow-up evaluations was found (P < .05). At first-year follow-up, 42 (93%) patients revealed a difference of less than 10 mm in thigh circumference between their injured and healthy knees. Conclusions: The management of displaced large PCL avulsion fractures with placement of a cancellous lag screw with washer by means of the modified open posterior approach leads to satisfactory clinical, radiographic, and functional results and reduces the operation time and less blood loss. Level of evidence: IV.

Keywords: posterior cruciate ligament, tibial fracture, lysholm knee score, patient outcome assessment

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Authors: Petcharat Kerdonfag, Surasak Taneepanichskul, Winai Wadwongtham

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Background: Although there have not been effective treatments for Noise Induced Hearing Loss (NIHL), it can be definitely preventable with promoting the use of Hearing Protection devices (HPDs) among workers who have been exposed to excessive noise for a long period. Objectives: The objectives of this study were to explore the use of HPDs among steel industrial workers in the high noise level zone in Samut Prakan province, Thailand and to examine the relationships of the HPDs use and hearing loss. Materials and Methods: In this cross-sectional study, eligible ninety-three participants were recruited in the designated zone of higher noise (> 85dBA) of two factories, using simple random sampling. The use of HPDs was gathered by the self-record form, examined and confirmed by the researcher team. Hearing loss was assessed by the audiometric screening at the regional Samut Prakan hospital. If an average threshold level exceeds 25 dBA at high frequency (4 and 6 Hz) in each ear, participants would be lost of hearing. Data were collected from October to December, 2016. All participants were examined by the same examiners for the validity. An Audiometric testing was performed with the participants who have been exposed to high noise levels at least 14 hours from workplace. Results: Sixty participants (64.5%) had secondary level of education. The average mean score of percent time of using HPDs was 60.5% (SD = 25.34). Sixty-seven participants (72.0%) had abnormal hearing which they have still needed to increase lower percent time of using HPDs (Mean = 37.01, SD = 23.81) than those having normal hearing (Mean = 45.77, SD = 28.44). However, there was no difference in the mean average of percent time of using HPDs between these two groups.Conclusion: The findings of this study have confirmed that the steel industrial workers still need to be motivated to use HPDs regularly. Future research should pay more attentions for creating a meaningful innovation to steel industrial workers.

Keywords: hearing protection devices, noise induced hearing loss, audiometric testing, steel industry

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Authors: Sandeep Vasaikar, Lary Obi

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Rapid and discriminative genotyping methods are useful for determining the clonality of the isolates in nosocomial or household outbreaks. Multilocus sequence typing (MLST) is a nucleotide sequence-based approach for characterising bacterial isolates. The genetic diversity and the clinical relevance of the drug-resistant Klebsiella isolates from Mthatha are largely unknown. For this reason, prospective, experimental study of the molecular epidemiology of Klebsiella isolates from patients being treated in Mthatha over a three-year period was analysed. Methodology: PCR amplification and sequencing of the drug-resistance-associated genes, and multilocus sequence typing (MLST) using 7 housekeeping genes mdh, pgi, infB, FusAR, phoE, gapA and rpoB were conducted. A total of 32 isolates were analysed. Results: The percentages of multidrug-resistant (MDR), extensively drug-resistance (XDR) and pandrug-resistant (PDR) isolates were; MDR 65.6 % (21) and XDR and PDR with 0 % each. In this study, K. pneumoniae was 19/32 (59.4 %). MLST results showed 22 sequence types (STs) were identified, which were further separated by Maximum Parsimony into 10 clonal complexes and 12 singletons. The most dominant group was Klebsiella pneumoniae with 23/32 (71.8 %) isolates, Klebsiella oxytoca as a second group with 2/32 (6.25 %) isolates, and a single (3.1 %) K. varricola as a third group while 6 isolates were of unknown sequences. Conclusions/significance: A phylogenetic analysis of the concatenated sequences of the 7 housekeeping genes showed that strains of K. pneumoniae form a distinct lineage within the genus Klebsiella, with K. oxytoca and K. varricola its nearest phylogenetic neighbours. With the analysis of 7 genes were determined 1 K. variicola, which was mistakenly identified as K. pneumoniae by phenotypic methods. Two misidentifications of K. oxytoca were found when phenotypic methods were used. No significant differences were observed between ESBL blaCTX-M, blaTEM and blaSHV groups in the distribution of Sequence types (STs) or Clonal complexes (CCs).

Keywords: phylogenetic analysis, phylogeny, klebsiella phylogenetic, klebsiella

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Authors: Antonella Cartoni, Mattea Carmen Castrovilli

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A biosensor for lactate detection has been developed using an environmentally friendly approach. The biosensor is based on lactate oxidase (LOX) and has remarkable capabilities for reuse and storage at room temperature. The manufacturing technique employed is ambient electrospray deposition (ESD), which enables efficient and sustainable immobilization of the LOX enzyme on a cost-effective com-mercial screen-printed Prussian blue/carbon electrode (PB/C-SPE). The study demonstrates that the ESD technology allows the biosensor to be stored at ambient pressure and temperature for extended periods without affecting the enzymatic activity. The biosensor can be stored for up to 90 days without requiring specific storage conditions, and it can be reused for up to 24 measurements on both freshly prepared electrodes and electrodes that are three months old. The LOX-based biosensor exhibits a lin-ear range of lactate detection between 0.1 and 1 mM, with a limit of detection of 0.07±0.02 mM. Ad-ditionally, it does not exhibit any memory effects. The immobilization process does not involve the use of entrapment matrices or hazardous chemicals, making it environmentally sustainable and non-toxic compared to current methods. Furthermore, the application of a electrospray deposition cycle on previously used biosensors rejuvenates their performance, making them comparable to freshly made biosensors. This highlights the excellent recycling potential of the technique, eliminating the waste as-sociated with disposable devices.

Keywords: green friendly, reuse, storage performance, immobilization, matrix-free, electrospray deposition, biosensor, lactate oxidase, enzyme

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Authors: Reena D. Souza, Tripti Vats, Prem F. Siril

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Esterification of free fatty acid (oleic acid) and transesterification of waste cooking oil (WCO) with ethanol over graphene oxide (GO), GO-Fe2O3, sulfonated GO (GO-SO3H), and Fe2O3/GO-SO3H catalysts were examined in the present study. Iron oxide supported graphene-based acid catalyst (Fe2O3/GO-SO3H) exhibited highest catalytic activity. GO was prepared by modified Hummer’s process. The GO-Fe2O3 nanocomposites were prepared by the addition of NaOH to a solution containing GO and FeCl3. Sulfonation was done using concentrated sulfuric acid. Transmissionelectron microscopy (TEM) and atomic force microscopy (AFM) imaging revealed the presence of Fe2O3 particles having size in the range of 50-200 nm. Crystal structure was analyzed by XRD and defect states of graphene were characterized using Raman spectroscopy. The effects of the reaction variables such as catalyst loading, ethanol to acid ratio, reaction time and temperature on the conversion of fatty acids were studied. The optimum conditions for the esterification process were molar ratio of alcohol to oleic acid at 12:1 with 5 wt% of Fe2O3/GO-SO3H at 1000C with a reaction time of 4h yielding 99% of ethyl oleate. This is because metal oxide supported solid acid catalysts have advantages of having both strong Brønsted as well as Lewis acid properties. The biodiesel obtained by transesterification of WCO was characterized by 1H NMR and Gas Chromatography techniques. XRD patterns of the recycled catalyst evidenced that the catalyst structure was unchanged up to the 5th cycle, which indicated the long life of the catalyst.

Keywords: Fe₂O₃/GO-SO₃H, Graphene Oxide, GO-Fe₂O₃, GO-SO₃H, WCO

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Authors: Walid Ibrahim, Abdul Kasem, Sudeendra Doddi, Ilaria Giono, Tareq Sabagh, Muhammad Ammar, Nermin Osman

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Background: wire-guided localization (WL) is the most widely used method for the localization of non-palpable breast lesions. SAVI SCOUT occult lesion localization (SSL) is a new technique in breast-conservative surgery. SSL has the potential benefit of improving radiology workflow as well as accurate localization. Purpose: The purpose of this study is to compare the breast tissue specimen volume and weight and margin excision between WL and SSL. Materials and methods: A single institution retrospective analysis of 377 female patients who underwent wide local breast excision with SAVI SCOUT and or wire-guided technique between 2018 and 2021 in a UK University teaching hospital. Breast department. Breast tissue specimen volume and weight, and margin excision have been evaluated in the three groups of different localization. Results: Three hundred and seventy-seven patients were studied. Of these, 261 had wire localization, 88 had SCOUT and 28 had dual localization techniques. Tumor size ranged from 1 to 75mm (Median 20mm). The pathology specimen weight ranged from 1 to 466gm (Median 46.8) and the volume ranged from 1.305 to 1560cm³ (Median 106.32 cm³). SCOUT localization was associated with a significantly low specimen weight than wire or the dual technique localization (Median 41gm vs 47.3gm and 47gm, p = 0.029). SCOUT was not associated with better specimen volume with a borderline significance in comparison to wire and combined techniques (Median 108cm³ vs 105cm³ and 105cm³, p = 0.047). There was a significant correlation between tumor size and pathology specimen weight in the three groups. SCOUT showed a better >2mm safety margin in comparison to the other 2 techniques (p = 0.031). Conclusion: Preoperative SCOUT localization is associated with better specimen weight and better specimen margin. SCOUT did not show any benefits in terms of specimen volume which may be due to difficulty in getting the accurate specimen volume due to the irregularity of the soft tissue specimen.

Keywords: scout, wire, localization, breast

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Authors: Hui Ling Chen

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This article describes the experience of caring for a 68-year-old lung cancer patient undergoing the initial stage of concurrent chemotherapy and radiation therapy during the period of October 21 to November 16. In this study, the author collected data through observation, interviews, medical examination, and the use of Roy’s adaptation model as a guide for data collection and assessment. This study confirmed that chemotherapy induced nausea and vomiting, and radiation therapy impaired skin integrity. At the same time, the patient experienced an anxious reaction to the initial cancer diagnosis and the insertion of subcutaneous infusion ports at the start of medical treatment. Similarly, the patient’s wife shares his anxiety, not to mention the feeling of inadequacy from the lack of training in cancer care. In response, the nursing intervention strategy has included keeping the patient and his family informed of his treatment progress, transfer of cancer care knowledge, and providing them with spiritual support. For example, the nursing staff has helped them draw up a mutually agreeable dietary plan that best suits the wife’s cooking skills, provided them with knowledge in pre- and post-radiation skin care, as well as means to cope with nausea and vomiting reactions. The nursing staff has also worked on building rapport with the patient and his spouse, providing them with encouragement, caring attention and companionship. After the patient was discharged from the hospital, the nursing staff followed up with caring phone calls to help the patient and his family make life-style adjustments to normalcy. The author hopes that his distinctive nursing experience can be useful as a reference for the clinical care of lung cancer patients undergoing the initial stage of concurrent chemotherapy and radiation therapy treatment.

Keywords: lung cancer, initiate diagnosis, concurrent chemotherapy and radiation therapy, nursing care

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Authors: Rahul Paliwal, Gulshan Maheshwari, Anant S. Jhaveri, Channamallikarjun S. Mathpati

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Large pumping facility is the necessary requirement of the cooling water systems for power plants, process and manufacturing facilities, flood control and water or waste water treatment plant. With a large capacity of few hundred to 50,000 m3/hr, cares must be taken to ensure the uniform flow to the pump to limit vibration, flow induced cavitation and performance problems due to formation of air entrained vortex and swirl flow. Successful prediction of these phenomena requires numerical method and turbulence model to characterize the dynamics of these flows. In the past years, single phase shear stress transport (SST) Reynolds averaged Navier Stokes Models (like k-ε, k-ω and RSM) were used to predict the behavior of flow. Literature study showed that two phase model will be more accurate over single phase model. In this paper, a 3D geometries simulated using detached eddy simulation (LES) is used to predict the behavior of the fluid and the results are compared with experimental results. Effect of different grid structure and boundary condition is also studied. It is observed that two phase flow model can more accurately predict the mean flow and turbulence statistics compared to the steady SST model. These validate model will be used for further analysis of vortex structure in lab scale model to generate their frequency-plot and intensity at different location in the set-up. This study will help in minimizing the ill effect of vortex on pump performance.

Keywords: grid structure, pump intake, simulation, vibration, vortex

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Authors: Balgaisha Mukanova, Natalya Glazyrina, Sergey Glazyrin

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The formulated problem of optimization of the technological process of water treatment for thermal power plants is considered in this article. The problem is of multiparametric nature. To optimize the process, namely, reduce the amount of waste water, a new technology was developed to reuse such water. A mathematical model of the technology of wastewater reuse was developed. Optimization parameters were determined. The model consists of a material balance equation, an equation describing the kinetics of ion exchange for the non-equilibrium case and an equation for the ion exchange isotherm. The material balance equation includes a nonlinear term that depends on the kinetics of ion exchange. A direct problem of calculating the impurity concentration at the outlet of the water treatment plant was numerically solved. The direct problem was approximated by an implicit point-to-point computation difference scheme. The inverse problem was formulated as relates to determination of the parameters of the mathematical model of the water treatment plant operating in non-equilibrium conditions. The formulated inverse problem was solved. Following the results of calculation the time of start of the filter regeneration process was determined, as well as the period of regeneration process and the amount of regeneration and wash water. Multi-parameter optimization of water treatment process for thermal power plants allowed decreasing the amount of wastewater by 15%.

Keywords: direct problem, multiparametric optimization, optimization parameters, water treatment

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Authors: Abrar Hussain, Kuen-Song Lin, Sayed Maeen Badshah, Jamshid Hussain

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The conversion of CO₂ into versatile, useful compounds such as fuels and other chemicals remains a challenging frontier in research, demanding the innovation of increasingly effective catalysts. In the present work, a catalyst-incorporating zirconium (Zr) modification within CuO–ZnO–Al₂O₃ (CZA) was synthesized via a co-precipitation method to convert CO₂ into methanol. Furthermore, bio-HZSM-5 was used to promote methanol dehydration to produce dimethyl ether (DME). We prepared the porous hierarchy bio-HZSM-5 with remarkable pore connectivity by utilizing an economical loofah sponge and rice husks as biotemplates. The synthesized catalysts were characterized using Field Emission Scanning Electron Microscopy (FE-SEM), X–ray diffraction (XRD), N₂ adsorption (BET), temperature-programmed desorption (NH₃-TPD) and thermogravimetric analysis (TGA). The Zr addition improved the performance of the CZZA catalyst as a structural promoter, leading to increased DME selectivity and total carbon conversion by enhancing active sites, surface area, and the synergistic interfaces between CuO and ZnO. The presence of silicon in the biomass, notably from the loofah sponge (0.016 wt %) and rice husks (8.3 wt %), also performed a pivotal role in the preparation of bio-HZSM-5. Furthermore, contrasted to the CZZA/com-ZSM-5 catalyst, the integration of CZZA with bio-HZSM-5-L bifunctional catalyst achieved the highest DME yield (12.1 %), DME selectivity (58.6%), CO₂ conversion (22.5%) at 280 °C and 30 bar. The payback time for 5 and 10-tons per day (5 and10-TPD) DME formation using the catalytic process of CO₂ from petrochemical refinery plant waste gas emissions was 2.98 and 2.44 years, respectively.

Keywords: Cost assessment, Dimethyl ether, low-cost bio-HZSM-5, CZZA catalyst, CO₂ hydrogenation

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Authors: O. A. Anjola, M. A. Adejobi, A. Ogunbameru, F. P. Agbaye, R. O. Odunukan

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This experiment was conducted for 8 weeks to evaluate the growth performance and economics of pullets fed on different dietary energy sources. A total of 300 Harco black was used for this experiment. The birds were completely randomized and divided into four diet treatment groups. Each treatment group had three replicates of twenty-five birds per replicate. Four diets containing maize, spaghetti, noodles, and biscuit was formulated to represent diet 1, 2, 3 and 4 respectively. Diet 1 containing maize is the control, while diet 2, 3, and 4 contains spaghetti, noodles, and biscuit waste meal at 100% replacement for maize on weight for weight basis. Performance indices on Feed intake, body weight, weight gain, feed conversion ratio (FCR) and economy of production were measured. Blood samples were also collected for heamatology and serum biochemistry assessment. The result of the experiment indicated that different dietary energy source fed to birds significantly (P < 0.05) affect feed intake, body weight, weight gain, and feed conversion ratio (FCR). The best cost of feed per kilogram of body weight gain was obtained in Spaghetti based diet (₦559.30). However, the best performance were obtained from diet 1(maize), it can be concluded that spaghetti as a replacement for maize in diet of pullet is most economical and profitable for production without any deleterious effects attached. Blood parameters of birds were not significantly (p > 0.05) influenced by the use of the dietary energy sources used in this experiment.

Keywords: growth performance, spaghetti, noodles, biscuit, profit, hematology, serum biochemistry

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Authors: Saji Varghese

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Naturally dried and fallen coconut leaves and found in abundance in India and other coconut growing regions of the world. These fallen coconut leaves are usually burnt by farmers in landfills and open kitchens, leading to CO2 and particulate emissions. The innovation of biodegradable drinking straws from naturally dried and fallen coconut leaves by this researcher and his team has opened up opportunities to create value out of this agri-waste leading to i. prevention of burning of these discarded leaves ii. income generating opportunities to women in rural areas of coconut growing regions iii. an alternative to single use plastic straws. The team has developed five special purpose machines, which are deployed in the three villages on a pilot basis where 36 women are employed. The women are trained in the use of these machines, and the straws which are in good demand are sold globally. The present paper analyses the prospective impact of this innovation on the incomes of women working at the straw production centres and the consequent impact on their standards of living, The paper also analyses the impact of this innovation in the reduction of CO2 and particulate emissions and makes a case for support from Govt and Non Govt organizations in coconut growing regions to set up straw production centres to boost rural circular economy and to reduce carbon footprint and eliminate plastic pollution

Keywords: drinking straws, coconut leaves, circular economy, sustainability

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Authors: Ahmad Al-Turki

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Composting is the suitable way of recycling organic waste for agricultural application and environment protection. In Saudi Arabia, several composting facilities are available and producing high quantity of composts. The aim of this study is to evaluate the physical characteristics of composts manufactured in Saudi Arabia and acquire a comprehensive image of its quality through the comparative with international standards of compost quality such as CCQC and PAS-100. In the present study different locally produced compost were identified and most of the producing factories were visited during the manufacturing of composts. Representative samples of different compost production stage were collected and Physical characteristics were determined, which included moisture content, bulk density, percentage of sand and the size of distribution of the compost particles. Results showed wide variations in all parameters investigated. Results of the study indicated generally that there is a wide variation in the physical characteristics of the types of compost under study. The initial moister contents in composts were generally low, it was less than 60% in most samples and not sufficient for microbial activities for biodegradation in 96% of the 96% of the types of compost and this will impede the decomposition of organic materials. The initial bulk density values ranged from 117 gL-1 to 1110.0 gL-1, while the final apparent bulk density ranged from 340.0 gL-1 to 1000gL-1 and about 45.4 % did not meet the ideal bulk density value. Sand percents in composts were between 3.3 % and 12.5%. This study has confirmed the need for a standard specification for compost manufactured in Saudi Arabia for agricultural use based on international standards for compost and soil characteristics and climatic conditions in Saudi Arabia.

Keywords: compost, maturity, Saudi Arabia, organic material

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Authors: Szu-Mei Hsiao

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Many nurses have concerns about the difficulties of providing spiritual care for ethnic-Chinese patients and family members within their cultural context. This is due to a lack of knowledge and training. Most family caregivers are female. There has been little research exploring the potential impact of Chinese cultural values on the spiritual distress of couple dyadic participants in Taiwan. This study explores the spiritual issues of Taiwanese women coping with their husband’s advanced cancer during palliative care to death. Qualitative multiple case studies were used. Data was collected through participant observation and in-depth face-to-face interviews. Transcribed interview data was analyzed by using qualitative content analysis. Three couples were recruited from a community-based rural hospital in Taiwan where the husbands were hospitalized in a medical ward. Four spiritual distress themes emerged from the analysis: (1) A personal conflict in trying to come to terms with love and forgiveness; the inability to forgive their husband’s mistakes; and, lack of their family’s love and support. (2) A feeling of hopelessness due to advanced cancer, such as a feeling of disappointment in their destiny and karma, including expressing doubt on survival. (3) A feeling of uncertainty in facing death peacefully, such as fear of facing the unknown world; and, (4) A feeling of doubt causing them to question the meaning and values in their lives. This research has shown that caregivers needed family support, friends, social welfare, and the help of their religion to meet their spiritual needs in coping within the final stages of life and death. The findings of this study could assist health professionals to detect the spiritual distress of ethnic-Chinese patients and caregivers in the context of their cultural or religious background as early as possible.

Keywords: advanced cancer, Buddhism, Confucianism, Taoism, qualitative research, spiritual distress

Procedia PDF Downloads 176

Authors: Nidhi S. Chandra, Veena Agrawal, Debprasad Chattopadhyay

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Background: Hepatitis E virus (HEV) is a major cause of acute viral hepatitis in developing countries. It spreads feco orally mainly due to contamination of drinking water by sewage. There is limited data on the genotypic comparison of HEV isolates from sewage water and humans. The aim of this study was to identify genotype and conduct phylogenetic analysis of HEV isolates from sewage water and humans. Materials and Methods: 14 sewage water and 60 serum samples from acute sporadic hepatitis E cases (negative for hepatitis A, B, C) were tested for HEV-RNA by nested polymerase chain reaction (RTnPCR) using primers designed with in RdRp (RNA dependent RNA polymerase) region of open reading frame-1 (ORF-1). Sequencing was done by ABI prism 310. The sequences (343 nucleotides) were compared with each other and were aligned with previously reported HEV sequences obtained from GeneBank, using Clustal W software. A Phylogenetic tree was constructed by using PHYLIP version 3.67 software. Results: HEV-RNA was detected in 49/ 60 (81.67%) serum and 5/14 (35.71%) sewage samples. The sequences obtained from 17 serums and 2 sewage specimens belonged to genotype I with 85% similarity and clustering with previously reported human HEV sequences from India. HEV isolates from human and sewage in North West India are genetically closely related to each other. Conclusion: These finding suggest that sewage acts as reservoir of HEV. Therefore it is important that measures are taken for proper waste disposal and treatment of drinking water to prevent outbreaks and epidemics due to HEV.

Keywords: hepatitis E virus, nested polymerase chain reaction, open reading frame-1, nucleotidies

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Authors: Oloniyo Rebecca Olajumoke

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The unstable free radicals molecules oxidize cells throughout the body to cause oxidative stress, which has been implicated in the pathogenesis of many chronic diseases. Thus, the consumption of antioxidant-rich snacks could help to reduce the production of these free radicals in the body. This study aimed at producing antioxidant–rich biscuits from an underutilized pearl millet and agricultural waste from orange peel flour (PMF and OPF, respectively) blends. Biscuits were produced from PMF, and OPF blends using various proportions (95:05; 90:10; 85:15; 80:20 with 100% PMF as control. The functional properties of the flours, as well as the antioxidant properties, physical evaluation, and consumer acceptability of the biscuits, were evaluated. The functional properties of the composite flour showed an increase in oil absorption capacity (7.73-8.80 g/ml), water absorption capacity (6.82-7.21 g/ml), foaming (3.91-5.88 g/ml), and emulsification (52.85-58.82 g/ml) properties. The increased addition of OPF significantly (p<0.05) increased the antioxidant properties of the biscuits produced from the composite flour. For instance, the ferric reducing properties (0.10-0.4 mgAAE/g), total flavonoid (1.20-8.12 mg QE/g), and ABTS radical scavenging (1.17-2.19 mmol/TEAC/g) of the composite flours were increasingly comparable to those of 100% PMF. The physical parameters of the biscuit were significantly different (p<0.05) from one another. The addition of OPF into PMF reduced the weight, diameter, and spread ratio of biscuits produced while contrarily increasing the height of the biscuit. The incorporation of OPF at 5% (95:05) substitution yielded a consumedly acceptable biscuit product. The significant increase in antioxidant properties with an increase in OPF during the production of biscuits would therefore increase the nutritional value and potential health benefits.

Keywords: orange peel, biscuit, antioxidant, pearl millet

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Authors: Hardisiswo Soedjana, Inne Caroline

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Deep dermal or full thickness burns are inevitably lead to post-burn contractures. These contractures remain to be one of the most concerning late complications of burn injuries. Surgical management includes releasing the contracture followed by resurfacing the defect accompanied by post-operative rehabilitation. Optimal treatment of post-burn contractures depends on the characteristics of the contractures. This study is aimed to describe clinical characteristics, problems, and management of post-burn contractures in adults and children. A retrospective analysis was conducted from medical records of patients suffered from contractures after burn injuries admitted to Hasan Sadikin general hospital between January 2016 and January 2018. A total of 50 patients with post burn contractures were included in the study. There were 17 adults and 33 children. Most patients were male, whose age range within 15-59 years old and 5-9 years old. Educational background was mostly senior high school among adults, while there was only one third of children who have entered school. Etiology of burns was predominantly flame in adults (82.3%); whereas flame and scald were the leading cause of burn injury in children (11%). Based on anatomical regions, hands were the most common affected both in adults (35.2%) and children (48.5%). Contractures were identified in 6-12 months since the initial burns. Most post-burn hand contractures were resurfaced with full-thickness skin graft (FTSG) both in adults and children. There were 11 patients who presented with recurrent contracture after previous history of contracture release. Post-operative rehabilitation was conducted for all patients; however, it is important to highlight that it is still challenging to control splinting and exercise when patients are discharged and especially the compliance in children. In order to improve quality of life in patients with history of deep burn injuries, prevention of contractures should begin right after acute care has been established. Education for the importance of splinting and exercise should be administered as comprehensible as possible for adult patients and parents of pediatric patients.

Keywords: burn, contracture, education, exercise, splinting

Procedia PDF Downloads 130

Authors: Induja R. Nimma, Anand Reddy Maligireddy, Artur Schneider, Melissa Lyle

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Background: Although heart failure is one of the most common causes of hospitalization in adult patients, there is limited knowledge on outcomes following initial hospitalization for COVID-19 with heart failure (HCF-19). We felt it pertinent to analyze 30-day readmission causes and outcomes among patients with HCF-19 using the United States using real-world big data via the National readmission database. Objective: The aim is to describe the rate and causes of readmissions and morbidity of heart failure with coinciding COVID-19 (HFC-19) in the United States, using the 2020 National Readmission Database (NRD). Methods: A descriptive, retrospective study was conducted on the 2020 NRD, a nationally representative sample of all US hospitalizations. Adult (>18 years) inpatient admissions with COVID-19 with HF and readmissions in 30 days were selected based on the International Classification of Diseases-Tenth Revision, Procedure Code. Results: In 2020, 2,60,372 adult patients were hospitalized with COVID-19 and HF. The median age was 74 (IQR: 64-83), and 47% were female. The median length of stay was 7(4-13) days, and the total cost of stay was 62,025 (31,956 – 130,670) United States dollars, respectively. Among the index hospital admissions, 61,527 (23.6%) died, and 22,794 (11.5%) were readmitted within 30 days. The median age of patients readmitted in 30 days was 73 (63-82), 45% were female, and 1,962 (16%) died. The most common principal diagnosis for readmission in these patients was COVID-19= 34.8%, Sepsis= 16.5%, HF = 7.1%, AKI = 2.2%, respiratory failure with hypoxia =1.7%, and Pneumonia = 1%. Conclusion: The rate of readmission in patients with heart failure exacerbations is increasing yearly. COVID-19 was observed to be the most common principal diagnosis in patients readmitted within 30 days. Complicated hypertension, chronic pulmonary disease, complicated diabetes, renal failure, alcohol use, drug use, and peripheral vascular disorders are risk factors associated with readmission. Familiarity with the most common causes and predictors for readmission helps guide the development of initiatives to minimize adverse outcomes and the cost of medical care.

Keywords: Covid-19, heart failure, national readmission database, readmission outcomes

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Authors: Menonjyoti Kalita, Pradip Baishya

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In recent times, the world has been facing serious environmental concerns and issues, such as sustainability and cost, due to the overproduction of synthetic materials and their participation in degrading the environment by means of industrial waste and non-biodegradable characteristics. As such, biocomposites come in handy to ease such troubles. Bio-based composites are promising materials for future applications for substituting synthetic packaging materials. The challenge of making packaging materials lighter, safer and cheaper leads to investigating advanced materials with desired properties. Also, awareness of environmental issues forces researchers and manufacturers to spend effort on composite and bio-composite materials fields. This paper explores and tests some nature-friendly materials has been done which can replace low-density plastics. The materials selected included sugarcane bagasse, areca palm, and bamboo leaves. Sugarcane bagasse bamboo leaves and areca palm sheath are the primary material or natural fibre for testing. These products were processed, and the tensile strength of the processed parts was tested in Micro UTM; it was found that areca palm can be used as a good building material in replacement to polypropylene and even could be used in the production of furniture with the help of epoxy resin. And for bamboo leaves, it was found that bamboo and cotton, when blended in a 50:50 ratio, it has great tensile strength. For areca, it was found that areca fibres can be a good substitute for polypropylene, which can be used in building construction as binding material and also other products.

Keywords: biodegradable characteristics, bio-composites, areca palm sheath, polypropylene, micro UTM

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Authors: Khizar Hayat Bhatti, Fiza Javed, Misbah Zafar

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Oat (Avena sativa L.) is a major cereal plant belonging to the family Poaceae. It is a very important source of carbohydrates, starch, minerals, vitamins and proteins that are beneficial for general health. Plants grow in the heavy metals contaminated soils that results in decline in growth. Glycine betaine application may improve plant growth, survival and resistance to metabolic disturbances due to stresses. Heavy metals, like nickels, have been accumulated for a long time in the soil because of industrial waste and sewage. The experiment was intended to alleviate the detrimental effects of heavy metal nickel stress on two oat varieties ‘Sgd-2011 and Hay’ using Glycine betain. Nickel was induced through soil application while GB was applied as foliar spray. After 10 days of nickel treatment, an exogenous spray of glycine betaine on the intact plant leaves. Data analysis was carried out using a Completely Randomized Design (CRD) with three replications in this study. For the analysis of all the data of the current research, Mini-Tab 19 software was used to compare the mean value of all treatments and Microsoft Excel software for generating the bars graphs. Significant accelerated plant growth was recorded when Ni exposed plants were treated with GB. Based on data findings, 3mM GB caused significant recovery from Ni stress doses. Overall results also demonstrated that the sgd-2011 variety of oats had the greatest outcomes for all parameters.

Keywords: CRD, foliar spray method, glycine betaine, heavy metals, nickel, ROS

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Authors: Harini Aiyer, Kalyani Premkumar

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Health professionals are the key players who can help achieve the goals of population health equity. Social accountability (SA) of health professionals emphasizes their role in addressing issues of equity in the population they serve. Therefore, health professional education must focus on instilling SA in health professionals. There is limited literature offering a longitudinal perspective of how students sustain the practice of SA in later life. This project aims to identify the drivers of social accountability among physicians. This study employed an exploratory mixed methods design (QUAL-> Quant) to explore alumni perceptions and experiences. The qualitative data, collected via 20 in-depth, semi-structured interviews, provided an understanding of the perceptions of the alumni regarding the influence of their undergraduate learning environment on their SA. This was followed by a quantitative portion -a questionnaire designed from the themes identified from the qualitative data. Emerging themes from the study highlighted community-centered education and a focus on social and preventative medicine in both curricular and non-curricular facilitators of SA among physicians. Curricular components included opportunities to engage with the community, such as roadside clinics, community-orientation programs, and postings at a secondary hospital. Other facilitators that emerged were the faculty leading by example, a subsidized fee structure, and a system that prepared students for practice in rural and remote areas. The study offers a fresh perspective and dimension on how SA is addressed by medical schools. The findings may be adapted by medical schools to understand how their own SA initiatives have been sustained among physicians over the long run.

Keywords: community-based work, global health, health education, medical education, providing health in remote areas, social accountability

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