Search results for: rare earth metals
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2847

Search results for: rare earth metals

2427 A Rare Case of Endometriosis Lesion in Caecum Causing Acute Small Bowel Obstruction

Authors: Freda Halim

Abstract:

Endometriosis in bowel is rare condition, about 3-37% of endometriosis cases. Most of bowel endometriosis rising in the rectosigmoid (90% of bowel endometriosis). The incidence of caecal endometriosis is very low ( < 5% of bowel endometriosis) and almost never causing acute small bowel obstruction. The aim of this paper is to show that although bowel obstruction caused by caecal endometriosis is difficult to diagnose as it is rare, and may require laparotomy to make definite diagnosis, but it should be considered in infertile female patient. The case is 37 years old woman infertile woman with intestinal obstruction with pre-operative diagnosis total acute small bowel obstruction caused by right colonic mass, with sepsis as the complication. Before the acute small bowel obstruction, she complained of chronic right lower quadrant pain with chronic constipation alternate with chronic diarrhea, symptoms that happened both in bowel endometriosis and colorectal malignancy. She also complained of chronic pelvic pain and dysmenorrhea. She was married for 10 years with no child. The patient was never diagnosed with endometriosis and never seek medical attention for infertility and the chronic pelvic pain. The patient underwent Abdominal CT Scan, with results: massive small bowel obstruction, and caecal mass that causing acute small bowel obstruction. Diagnosis of acute small bowel obstruction due to right colonic mass was made, and exploratory laparotomy was performed in the patient. During the laparotomy, mass at caecum and ileocaecal that causing massive small bowel obstruction was found and standard right hemicolectomy and temporary ileostomy were performed. The pathology examination showed ectopic endometriosis lesions in caecum and ileocaecal valve. The histopathology also confirmed with the immunohistochemistry, in which positive ER, PR, CD 10 and CD7 was found the ileocaecal and caecal mass. In the second operation, reanastomosis of the ileum was done 3 months after the first operation. The chronic pelvic pain is decreasing dramatically after the first and second operation. In conclusion, although bowel obstruction caused by caecal endometriosis is a rare cause of intestinal obstruction, but it can be considered as a cause in infertile female patient

Keywords: acute, bowel obstruction, caecum, endometriosis

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2426 Changes in Heavy Metals Bioavailability in Manure-Derived Digestates and Subsequent Hydrochars to Be Used as Soil Amendments

Authors: Hellen L. De Castro e Silva, Ana A. Robles Aguilar, Erik Meers

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Digestates are residual by-products, rich in nutrients and trace elements, which can be used as organic fertilisers on soils. However, due to the non-digestibility of these elements and reduced dry matter during the anaerobic digestion process, metal concentrations are higher in digestates than in feedstocks, which might hamper their use as fertilisers according to the threshold values of some country policies. Furthermore, there is uncertainty regarding the required assimilated amount of these elements by some crops, which might result in their bioaccumulation. Therefore, further processing of the digestate to obtain safe fertilizing products has been recommended. This research aims to analyze the effect of applying the hydrothermal carbonization process to manure-derived digestates as a thermal treatment to reduce the bioavailability of heavy metals in mono and co-digestates derived from pig manure and maize from contaminated land in France. This study examined pig manure collected from a novel stable system (VeDoWs, province of East Flanders, Belgium) that separates the collection of pig urine and feces, resulting in a solid fraction of manure with high up-concentration of heavy metals and nutrients. Mono-digestion and co-digestion processes were conducted in semi-continuous reactors for 45 days at mesophilic conditions, in which the digestates were dried at 105 °C for 24 hours. Then, hydrothermal carbonization was applied to a 1:10 solid/water ratio to guarantee controlled experimental conditions in different temperatures (180, 200, and 220 °C) and residence times (2 h and 4 h). During the process, the pressure was generated autogenously, and the reactor was cooled down after completing the treatments. The solid and liquid phases were separated through vacuum filtration, in which the solid phase of each treatment -hydrochar- was dried and ground for chemical characterization. Different fractions (exchangeable / adsorbed fraction - F1, carbonates-bound fraction - F2, organic matter-bound fraction - F3, and residual fraction – F4) of some heavy metals (Cd, Cr, Ni, and Cr) have been determined in digestates and derived hydrochars using the modified Community Bureau of Reference (BCR) sequential extraction procedure. The main results indicated a difference in the heavy metals fractionation between digestates and their derived hydrochars; however, the hydrothermal carbonization operating conditions didn’t have remarkable effects on heavy metals partitioning between the hydrochars of the proposed treatments. Based on the estimated potential ecological risk assessment, there was one level decrease (considerate to moderate) when comparing the HMs partitioning in digestates and derived hydrochars.

Keywords: heavy metals, bioavailability, hydrothermal treatment, bio-based fertilisers, agriculture

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2425 Juvenile Paget’s Disease(JPD) of Bone

Authors: Aftab Ahmed, Ghulam Mehboob

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The object of presentation is to highlight the importance of condition which is a very rare genetic disorder although Paget’s disease is common but its juvenile type is very rare and a late presentation due to very slow onset and lack of earlier standard management. We present a case of 25 years old male with a chronic history of bone pain and a slow onset of mild swelling, later on diagnosed as juvenile Paget disease of bone. Rarity of this condition with inaccessibility for standard health treatment can lead to a significant delay in presentation and its management. There have been 50 reported cases worldwide according to Genetic Home Reference. There is increased osteoclastic activity along with osteoblastic activity related to gene alteration and osteoprotegrin deficiency. Morbidity of disease is very significant which lead children to become immobilize.

Keywords: juvenile, Paget’s disease, bone, Northern Area of Pakistan

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2424 Risk Assessment of Contamination by Heavy Metals in Sarcheshmeh Copper Complex of Iran Using Topsis Method

Authors: Hossein Hassani, Ali Rezaei

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In recent years, the study of soil contamination problems surrounding mines and smelting plants has attracted some serious attention of the environmental experts. These elements due to the non- chemical disintegration and nature are counted as environmental stable and durable contaminants. Variability of these contaminants in the soil and the time and financial limitation for the favorable environmental application, in order to reduce the risk of their irreparable negative consequences on environment, caused to apply the favorable grading of these contaminant for the further success of the risk management processes. In this study, we use the contaminants factor risk indices, average concentration, enrichment factor and geoaccumulation indices for evaluating the metal contaminant of including Pb, Ni, Se, Mo and Zn in the soil of Sarcheshmeh copper mine area. For this purpose, 120 surface soil samples up to the depth of 30 cm have been provided from the study area. And the metals have been analyzed using ICP-MS method. Comparison of the heavy and potentially toxic elements concentration in the soil samples with the world average value of the uncontaminated soil and shale average indicates that the value of Zn, Pb, Ni, Se and Mo is higher than the world average value and only the Ni element shows the lower value than the shale average. Expert opinions on the relative importance of each indicators were used to assign a final weighting of the metals and the heavy metals were ranked using the TOPSIS approach. This allows us to carry out efficient environmental proceedings, leading to the reduction of environmental ricks form the contaminants. According to the results, Ni, Pb, Mo, Zn, and Se have the highest rate of risk contamination in the soil samples of the study area.

Keywords: contamination coefficient, geoaccumulation factor, TOPSIS techniques, Sarcheshmeh copper complex

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2423 Increased Circularity in Metals Production Using the Ausmelt TSL Process

Authors: Jacob Wood, David Wilson, Stephen Hughes

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The Ausmelt Top Submerged Lance (TSL) Process has been widely applied for the processing of both primary and secondary copper, nickel, lead, tin, and zinc-bearing feed materials. Continual development and evolution of the technology over more than 30 years has resulted in a more intense smelting process with higher energy efficiency, improved metal recoveries, lower operating costs, and reduced fossil fuel consumption. This paper covers a number of recent advances to the technology, highlighting their positive impacts on smelter operating costs, environmental performance, and contribution towards increased circularity in metals production.

Keywords: ausmelt TSL, smelting, circular economy, energy efficiency

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2422 Hafnium and Samarium Hydroxyapatite Composites and Their Characterization

Authors: Meltem Nur Erdöl, Feyzanur Bayrak, Elif Emanetçi, Faik Nüzhet Oktar, Cevriye Kalkandelen, Oğuzhan Gündüz

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Nowadays, the bioceramic graft applications are very important due to the fact that especially European population is getting much older. Consequently, healing approaches for some health problems become more important in the near future. For instance, osteoporosis is one of the reasons for serious hip fractures. Beside these, the traffic accidents playing role increasing of various hip fractures and other bone fractures. Naturally all these are leading the importance developing new bioceramic graft materials. Hydroxyapatite (HA) is one of the leading bioceramics on the market. Beside the high biocompatibility HA bioceramics unfortunately are weak materials for loaded areas. For improvement mechanical properties of HA material, some oxides and metallic powders can be added. In this study, some rare earth oxides like hafnium (IV) oxide (HfO₂) and samarium (III) oxide (Sm₂O₃) are added to HA for improvement of their material characteristics. Thus, compression, microhardness and theoretical density tests are performed. X-ray diffraction patterns are also investigated corresponding x-ray diffraction equipment. At the end, studies of scanning electron microscope (SEM) and energy-dispersive x-ray spectroscopy (EDX) are completed. All values were compared with past BHA and various composites.

Keywords: biocomposite, hafnium oxide, hydroxyapatite, nanotechnology, samarium oxide

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2421 Levels of Toxic Metals in Different Tissues of Lethrinus miniatus Fish from Arabian Gulf

Authors: Muhammad Waqar Ashraf, Atiq A. Mian

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In the present study, accumulation of eight heavy metals, lead (Pb), cadmium (Cd), manganese (Mn), copper (Cu), zinc (Zn), iron (Fe), nickel (Ni) and chromium (Cr)was determined in kidney, heart, liver and muscle tissues of Lethrinus miniatus fish caught from Arabian Gulf. Metal concentrations in all the samples were measured using Atomic Absorption Spectroscopy. Analytical validation of data was carried out by applying the same digestion procedure to standard reference material (NIST-SRM 1577b bovine liver). Levels of lead (Pb) in the liver tissue (0.60µg/g) exceeded the limit set by European Commission (2005) at 0.30 µg/g. Zinc concentration in all tissue samples were below the maximum permissible limit (50 µg/g) as set by FAO. Maximum mean cadmium concentration was found 0.15 µg/g in the kidney tissues. Highest content of Mn in the studied tissues was seen in the kidney tissue (2.13 µg/g), whereas minimum was found in muscle tissue (0.87 µg/g). The present study led to the conclusion that muscle tissue is the least contaminated tissue in Lethrinus miniatus and consumption of organs should be avoided as much as possible.

Keywords: lethrinus miniatus, arabian gulf, heavy metals, atomic absorption spectroscopy

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2420 Forecasting Unusual Infection of Patient Used by Irregular Weighted Point Set

Authors: Seema Vaidya

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Mining association rule is a key issue in data mining. In any case, the standard models ignore the distinction among the exchanges, and the weighted association rule mining does not transform on databases with just binary attributes. This paper proposes a novel continuous example and executes a tree (FP-tree) structure, which is an increased prefix-tree structure for securing compacted, discriminating data about examples, and makes a fit FP-tree-based mining system, FP enhanced capacity algorithm is used, for mining the complete game plan of examples by illustration incessant development. Here, this paper handles the motivation behind making remarkable and weighted item sets, i.e. rare weighted item set mining issue. The two novel brightness measures are proposed for figuring the infrequent weighted item set mining issue. Also, the algorithm are handled which perform IWI which is more insignificant IWI mining. Moreover we utilized the rare item set for choice based structure. The general issue of the start of reliable definite rules is troublesome for the grounds that hypothetically no inciting technique with no other person can promise the rightness of influenced theories. In this way, this framework expects the disorder with the uncommon signs. Usage study demonstrates that proposed algorithm upgrades the structure which is successful and versatile for mining both long and short diagnostics rules. Structure upgrades aftereffects of foreseeing rare diseases of patient.

Keywords: association rule, data mining, IWI mining, infrequent item set, frequent pattern growth

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2419 Assessment of Heavy Metal Contamination in Roadside Soils along Shenyang-Dalian Highway in Liaoning Province, China

Authors: Zhang Hui, Wu Caiqiu, Yuan Xuyin, Qiu Jie, Zhang Hanpei

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The heavy metal contaminations were determined with a detailed soil survey in roadside soils along Shenyang-Dalian Highway of Liaoning Province (China) and Pb, Cu, Cd, Ni and Zn were analyzed using the atomic absorption spectrophotometric method. The average concentration of Pb, Cu, Cd, Ni and Zn in roadside soils was determined to be 43.8, 26.5, 0.119, 32.1, 71.3 mg/kg respectively, and all of the heavy metal contents were higher than the background values. Different heavy metal distribution regularity was found in different land use type of roadside soil, there was an obvious peak of heavy concentration at 25m from road edge in the farmland, while in the forest and orchard soil, all heavy metals gradually decreased with the increase of distance from road edge and conformed to the exponential model. Furthermore, the heavy metal contents of heavy metals except Cd were markedly increased compared with those in 1999 and 2007, and the heavy metals concentrations of Shenyang- Dalian Highway were considered medium or low in comparison with those in other cities around the world. The assessment of heavy metal contamination of roadside soils illustrated a common low pollution for all heavy metal and recommended that more attention should be paid to Pb contamination in roadside soils in Shenyang-Dalian Highway.

Keywords: heavy metal contamination, roadside, highway, Nemerow Pollution Index

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2418 Levels of Heavy Metals in Different Tissues of Lethrinus Miniatus Fish from Arabian Gulf

Authors: Muhammad Waqar Ashraf

Abstract:

In the present study, accumulation of eight heavy metals, lead (Pb), cadmium (Cd), manganese (Mn), copper (Cu), zinc (Zn), iron (Fe), nickel (Ni) and chromium (Cr)was determined in kidney, heart, liver and muscle tissues of Lethrinus Miniatus fish caught from Arabian Gulf. Metal concentrations in all the samples were measured using Graphite Furnace Atomic Absorption Spectroscopy (GF-AAS). Analytical validation of data was carried out by applying the same digestion procedure to standard reference material (NIST-SRM 1577b bovine liver). Levels of lead (Pb) in the liver tissue (0.60µg/g) exceeded the limit set by European Commission (2005) at 0.30 µg/g. Zinc concentration in all tissue samples were below the maximum permissible limit (50 µg/g) as set by FAO. Maximum mean cadmium concentration was found to be 0.15 µg/g in the kidney tissues. Highest content of Mn in the studied tissues was seen in the kidney tissue (2.13 µg/g), whereas minimum was found in muscle tissue (0.87 µg/g). The present study led to the conclusion that muscle tissue is the least contaminated tissue in Lethrinus Miniatus and consumption of organs should be avoided as much as possible.

Keywords: Arabian gulf, Lethrinus miniatus, heavy metals, atomic absorption spectroscopy

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2417 Budd-Chiari Syndrome: Common Presentation, Rare Disease

Authors: Aadil Khan, Yasser Chomayil, P. P. Venugopalan

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Background: Budd-Chiari syndrome is caused by thrombosis of the hepatic veins and/or the thrombosis of the intrahepatic or suprahepatic IVC. The etiology remains idiopathic in 16% -35% of cases. Malignancy, rheumatological disorder, myeloproliferative disease, inheritable coagulopathy, infection or hyperestrogen state can be identified in many cases. Methodology: Review of case records of the patient presented to Aster Medcity, Emergency Department, Cochin. Introduction:17 years old female was presented to ED with fever, jaundice and abdominal distention since 1 week. O/E: Pallor+, icterus+. Abdomen- gross distension+, shifting dullness+, generalized anasarca+. USG abdomen showed hepatomegaly with mild coarse echotexture and moderate to gross ascites. CT abdomen and chest showed hepatomegaly with thrombosis of all three hepatic vein and moderate ascites suggestive of Budd-Chiari syndrome. Patient was taken for catheter vein thrombolysis. Venogram done the next day revealed almost > 50% opening of the right hepatic vein. Concurrent doppler showed colour and doppler signals in middle hepatic veins. She gradually improved and was discharged home on anticoagulant and adviced regular follow up. Conclusion: Being a rare disease in this young population, high suspicion is required when evaluating young patients with abdominal pain and jaundice.

Keywords: Budd-Chiari syndrome, rare disease, abdominal pain, India

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2416 Assessment of Trace Metals Contamination in Surficial and Core Sediments from Ghannouch- Gabes Coastline, Impact of Phosphogypsum Discharge, Southeastern of Tunisia, Mediterranean Sea: Geochemical and Mineralogical Approaches

Authors: Rim Ben Amor, Myriam Abidi, Moncef Gueddari

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The purpose of the present study is to assess the level and the distribution of CaO, SO3, Cd, Cu, Pb and Zn incore sediments of Ghannouch-Gabes coast, Gulf of Gabes, Tunisian Mediterranean coast. The XRD analyses indicate that the sediments of Ghannouch-Gabes coast are mainly composed of quartz, calcite, gypsum and fluorine reflecting the impact of the phosphate fertilizer industrial waste. The vertical distribution of surface sediments shows for all the elements analyzed, that the area located between the commercial and the fishing port of Gabes, is the most polluted zone, where the two harbors acted as barriers and limited the dispersion of phosphogypsum discharge. The abundance order of metals was found to be Zn > Cd > Cu >Pb and that the highest levels of heavy metals were found in the uppermost segment of the sediment core compared to lower depth subsurface due to a continuous input of PG release and showed that the area between the two harbor suffered from several types of pollutants compared to reference core C1, collected from non-industrialized area. The level of pollution was evaluated using contamination factor (Cf), pollution load index (PLI) and the geoaccumulation index (Igeo). The obtained results of Igeo allowed us to distinguish that the area between the commercial harbor of Ghannouch and the fishing harbor of Gabes is the most polluted where sediments are strongly contaminated for Pb, Cu and Cd. The pollution load index (PLI) of all sediments collected classified them as "polluted". According to contamination factor (Cf), the sediments can be considered as ‘considerable’ to ‘very high’ contaminated for Pb, ‘very high to moderate’ for Cd, ‘ moderate’ for Zn, between ‘moderate’ and ‘considerable’ for Cu. Statistical analyses show that heavy metals, fluoride, calcium and sulphate are resulting from the same anthropogenic origin. The metallic pollution status of sediments of Ghanouch -Gabes coast is worrying and requires a serious intervention.

Keywords: trace metals, phosphogypsum, core sediments, accumulation factor, contamination factor

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2415 Metal Contents in Bird Feathers (Columba livia) from Mt Etna Volcano: Volcanic Plume Contribution and Biological Fractionation

Authors: Edda E. Falcone, Cinzia Federico, Sergio Bellomo, Lorenzo Brusca, Manfredi Longo, Walter D’Alessandro

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Although trace metals are an essential element for living beings, they can become toxic at high concentrations. Their potential toxicity is related not only to the total content in the environment but mostly upon their bioavailability. Volcanoes are important natural metal emitters and they can deeply affect the quality of air, water and soils, as well as the human health. Trace metals tend to accumulate in the tissues of living organisms, depending on the metal contents in food, air and water and on the exposure time. Birds are considered as bioindicators of interest, because their feathers directly reflects the metals uptake from the blood. Birds are exposed to the atmospheric pollution through the contact with rainfall, dust, and aerosol, and they accumulate metals over the whole life cycle. We report on the first data combining the rainfall metal content in three different areas of Mt Etna, variably fumigated by the volcanic plume, and the metal contents in the feathers of pigeons, collected in the same areas. Rainfall samples were collected from three rain gauges placed at different elevation on the Eastern flank of the volcano, the most exposed to airborne plume, filtered, treated with HNO₃ Suprapur-grade and analyzed for Fe, Cr, Co, Ni, Se, Zn, Cu, Sr, Ba, Cd and As by ICP-MS technique, and major ions by ion chromatography. Feathers were collected from single individuals, in the same areas where the rain gauges were installed. Additionally, some samples were collected in an urban area, poorly interested by the volcanic plume. The samples were rinsed in MilliQ water and acetone, dried at 50°C until constant weight and digested in a mixture of 2:1 HNO₃ (65%) - H₂O₂ (30%) Suprapur-grade for 25-50 mg of sample, in a bath at near-to-boiling temperature. The solutions were diluted up to 20 ml prior to be analyzed by ICP-MS. The rainfall samples most contaminated by the plume were collected at close distance from the summit craters (less than 6 km), and show lower pH values and higher concentrations for all analyzed metals relative to those from the sites at lower elevation. Analyzed samples are enriched in both metals directly emitted by the volcanic plume and transported by acidic gases (SO₂, HCl, HF), and metals leached from the airborne volcanic ash. Feathers show different patterns in the different sites related to the exposure to natural or anthropogenic pollutants. They show abundance ratios similar to rainfall for lithophile elements (Ba, Sr), whereas are enriched in Zn and Se, known for their antioxidant properties, probably as adaptive response to oxidative stress induced by toxic metal exposure. The pigeons revealed a clear heterogeneity of metal uptake in the different parts of the volcano, as an effect of volcanic plume impact. Additionally, some physiological processes can modify the fate of some metals after uptake and this offer some insights for translational studies.

Keywords: bioindicators, environmental pollution, feathers, trace metals, volcanic plume

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2414 Analysis of Autonomous Orbit Determination for Lagrangian Navigation Constellation with Different Dynamical Models

Authors: Gao Youtao, Zhao Tanran, Jin Bingyu, Xu Bo

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Global navigation satellite system(GNSS) can deliver navigation information for spacecraft orbiting on low-Earth orbits and medium Earth orbits. However, the GNSS cannot navigate the spacecraft on high-Earth orbit or deep space probes effectively. With the deep space exploration becoming a hot spot of aerospace, the demand for a deep space satellite navigation system is becoming increasingly prominent. Many researchers discussed the feasibility and performance of a satellite navigation system on periodic orbits around the Earth-Moon libration points which can be called Lagrangian point satellite navigation system. Autonomous orbit determination (AOD) is an important performance for the Lagrangian point satellite navigation system. With this ability, the Lagrangian point satellite navigation system can reduce the dependency on ground stations. AOD also can greatly reduce total system cost and assure mission continuity. As the elliptical restricted three-body problem can describe the Earth-Moon system more accurately than the circular restricted three-body problem, we study the autonomous orbit determination of Lagrangian navigation constellation using only crosslink range based on elliptical restricted three body problem. Extended Kalman filter is used in the autonomous orbit determination. In order to compare the autonomous orbit determination results based on elliptical restricted three-body problem to the results of autonomous orbit determination based on circular restricted three-body problem, we give the autonomous orbit determination position errors of a navigation constellation include four satellites based on the circular restricted three-body problem. The simulation result shows that the Lagrangian navigation constellation can achieve long-term precise autonomous orbit determination using only crosslink range. In addition, the type of the libration point orbit will influence the autonomous orbit determination accuracy.

Keywords: extended Kalman filter, autonomous orbit determination, quasi-periodic orbit, navigation constellation

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2413 Recent Development on Application of Microwave Energy on Process Metallurgy

Authors: Mamdouh Omran, Timo Fabritius

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A growing interest in microwave heating has emerged recently. Many researchers have begun to pay attention to microwave energy as an alternative technique for processing various primary and secondary raw materials. Compared to conventional methods, microwave processing offers several advantages, such as selective heating, rapid heating, and volumetric heating. The present study gives a summary on our recent works related to the use of microwave energy for the recovery of valuable metals from primary and secondary raw materials. The research is mainly focusing on: Application of microwave for the recovery and recycling of metals from different metallurgical industries wastes (i.e. electric arc furnace (EAF) dust, blast furnace (BF), basic oxygen furnace (BOF) sludge). Application of microwave for upgrading and recovery of valuable metals from primary raw materials (i.e. iron ore). The results indicated that microwave heating is a promising and effective technique for processing primary and secondary steelmaking wastes. After microwave treatment of iron ore for 60 s and 900 W, about a 28.30% increase in grindability.Wet high intensity magnetic separation (WHIMS) indicated that the magnetic separation increased from 34% to 98% after microwave treatment for 90 s and 900 W. In the case of EAF dust, after microwave processing at 1100 W for 20 min, Zinc removal from 64 % to ~ 97 %, depending on mixture ratio and treatment time.

Keywords: dielectric properties, microwave heating, raw materials, secondary raw materials

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2412 Heavy Metal Contamination in Soils: Detection and Assessment Using Machine Learning Algorithms Based on Hyperspectral Images

Authors: Reem El Chakik

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The levels of heavy metals in agricultural lands in Lebanon have been witnessing a noticeable increase in the past few years, due to increased anthropogenic pollution sources. Heavy metals pose a serious threat to the environment for being non-biodegradable and persistent, accumulating thus to dangerous levels in the soil. Besides the traditional laboratory and chemical analysis methods, Hyperspectral Imaging (HSI) has proven its efficiency in the rapid detection of HMs contamination. In Lebanon, a continuous environmental monitoring, including the monitoring of levels of HMs in agricultural soils, is lacking. This is due in part to the high cost of analysis. Hence, this proposed research aims at defining the current national status of HMs contamination in agricultural soil, and to evaluate the effectiveness of using HSI in the detection of HM in contaminated agricultural fields. To achieve the two main objectives of this study, soil samples were collected from different areas throughout the country and were analyzed for HMs using Atomic Absorption Spectrophotometry (AAS). The results were compared to those obtained from the HSI technique that was applied using Hyspex SWIR-384 camera. The results showed that the Lebanese agricultural soils contain high contamination levels of Zn, and that the more clayey the soil is, the lower reflectance it has.

Keywords: agricultural soils in Lebanon, atomic absorption spectrophotometer, hyperspectral imaging., heavy metals contamination

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2411 Accumulation of PM10 and Associated Metals Due to Opencast Coal Mining Activities and Their Impact on Human Health

Authors: Arundhuti Devi, Gitumani Devi, Krishna G. Bhattacharyya

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The goal of this study was to assess the characteristics of the airborne dust created by opencast coal mining and its relation to population hospitalization risk for skin and lung diseases in Margherita Coalfield, Assam, India. Air samples were collected for 24 h in three 8-h periods. For the collection of particulate matter (PM10) and total suspended particulate matter (SPM) samples, respiratory dust samplers with glass microfiber filter papers were used. PM10 was analyzed for Cu, Cd, Cr, Mn, Zn, Ni, Fe and Pb with Flame Atomic Absorption Spectrophotometer (FAAS). SPM and PM10 concentrations were respectively found to be as high as 1,035 and 265.85 μg/m³ in work zone air. The concentration of metals associated with PM10 showed values higher than the permissible limits. It was observed that the average concentrations of the metals Fe, Pb, Ni, Zn, and Cu were very high during the winter month of December, those of Cd and Cr were high during the month of May and Mn was high during February. The morphology of the particles studied with scanning electron microscopy (SEM) gave significant results. Due to opencast coal mining, the air in the work zone, as well as the general ambient air, was found to be highly polluted with respect to dust. More than 8000 patient records maintained by the hospital authority were collected from three hospitals in the area. The highest percentage of people suffering from lung diseases are found in Margherita Civil Hospital (~26.77%) whereas most people suffering from skin diseases reported for treatment in the ESIC hospital (47.47%). Both PM10 and SPM were alarmingly high, and the results were in conformity with the high incidence of lung and other respiratory diseases in the study area.

Keywords: heavy metals, open cast coal mining, PM10, respiratory diseases

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2410 Asymptomatic Intercostal Schwannoma in a Patient with COVID-19: The First of Its Kind

Authors: Gabriel Hunduma

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Asymptomatic intra-thoracic neurogenic tumours are rare. Tumours arising from the intercostal nerves of the chest wall are exceedingly rare. This paper reports an incidental discovery of a neurogenic intercostal tumour while being investigated for Coronavirus Disease 2019 (COVID-19). A 54-year-old female underwent a thoracotomy and resection for an intercostal tumour. Pre-operative images showed an intrathoracic mass, and the biopsy revealed a schwannoma. The most common presenting symptom recorded in literature is chest pain; however, our case remained asymptomatic despite the size of the mass and thoracic area it occupied. After an extensive search of the literature, COVID-19 was found to have an influence on the development of certain cells in breast cancer. Hence there is a possibility that COVID-19 played a role in progressing the development of the schwannoma cells.

Keywords: thoracic surgery, intercostal schwannoma, chest wall oncology, COVID-19

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2409 Spatial Variability of Soil Metal Contamination to Detect Cancer Risk Zones in Coimbatore Region of India

Authors: Aarthi Mariappan, Janani Selvaraj, P. B. Harathi, M. Prashanthi Devi

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Anthropogenic modification of the urban environment has largely increased in the recent years in order to sustain the growing human population. Intense industrial activity, permanent and high traffic on the roads, a developed subterranean infrastructure network, land use patterns are just some specific characteristics. Every day, the urban environment is polluted by more or less toxic emissions, organic or metals wastes discharged from specific activities such as industrial, commercial, municipal. When these eventually deposit into the soil, the physical and chemical properties of the surrounding soil is changed, transforming it into a human exposure indicator. Metals are non-degradable and occur cumulative in soil due to regular deposits are a result of permanent human activity. Due to this, metals are a contaminant factor for soil when persistent over a long period of time and a possible danger for inhabitant’s health on prolonged exposure. Metals accumulated in contaminated soil may be transferred to humans directly, by inhaling the dust raised from top soil, or by ingesting, or by dermal contact and indirectly, through plants and animals grown on contaminated soil and used for food. Some metals, like Cu, Mn, Zn, are beneficial for human’s health and represent a danger only if their concentration is above permissible levels, but other metals, like Pb, As, Cd, Hg, are toxic even at trace level causing gastrointestinal and lung cancers. In urban areas, metals can be emitted from a wide variety of sources like industrial, residential, commercial activities. Our study interrogates the spatial distribution of heavy metals in soil in relation to their permissible levels and their association with the health risk to the urban population in Coimbatore, India. Coimbatore region is a high cancer risk zone and case records of gastro intestinal and respiratory cancer patients were collected from hospitals and geocoded in ArcGIS10.1. The data of patients pertaining to the urban limits were retained and checked for their diseases history based on their diagnosis and treatment. A disease map of cancer was prepared to show the disease distribution. It has been observed that in our study area Cr, Pb, As, Fe and Mg exceeded their permissible levels in the soil. Using spatial overlay analysis a relationship between environmental exposure to these potentially toxic elements in soil and cancer distribution in Coimbatore district was established to show areas of cancer risk. Through this, our study throws light on the impact of prolonged exposure to soil contamination in soil in the urban zones, thereby exploring the possibility to detect cancer risk zones and to create awareness among the exposed groups on cancer risk.

Keywords: soil contamination, cancer risk, spatial analysis, India

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2408 Understanding the Common Antibiotic and Heavy Metal Resistant-Bacterial Load in the Textile Industrial Effluents

Authors: Afroza Parvin, Md. Mahmudul Hasan, Md. Rokunozzaman, Papon Debnath

Abstract:

The effluents of textile industries have considerable amounts of heavy metals, causing potential microbial metal loads if discharged into the environment without treatment. Aim: In this present study, both lactose and non-lactose fermenting bacterial isolates were isolated from textile industrial effluents of a specific region of Bangladesh, named Savar, to compare and understand the load of heavy metals in these microorganisms determining the effects of heavy metal resistance properties on antibiotic resistance. Methods: Five different textile industrial canals of Savar were selected, and effluent samples were collected in 2016 between June to August. Total bacterial colony (TBC) was counted for day 1 to day 5 for 10-6 dilution of samples to 10-10 dilution. All the isolates were isolated and selected using 4 differential media, and tested for the determination of minimum inhibitory concentration (MIC) of heavy metals and antibiotic susceptibility test with plate assay method and modified Kirby-Bauer disc diffusion method, respectively. To detect the combined effect of heavy metals and antibiotics, a binary exposure experiment was performed, and to understand the plasmid profiling plasmid DNA was extracted by alkaline lysis method of some selective isolates. Results: Most of the cases, the colony forming units (CFU) per plate for 50 ul diluted sample were uncountable at 10-6 dilution, however, countable for 10-10 dilution and it didn’t vary much from canal to canal. A total of 50 Shigella, 50 Salmonella, and 100 E.coli (Escherichia coli) like bacterial isolates were selected for this study where the MIC was less than or equal to 0.6 mM for 100% Shigella and Salmonella like isolates, however, only 3% E. coli like isolates had the same MIC for nickel (Ni). The MIC for chromium (Cr) was less than or equal to 2.0 mM for 16% Shigella, 20% Salmonella, and 17% E. coli like isolates. Around 60% of both Shigella and Salmonella, but only 20% of E.coli like isolates had a MIC of less than or equal to 1.2 mM for lead (Pb). The most prevalent resistant pattern for azithromycin (AZM) for Shigella and Salmonella like isolates was found 38% and 48%, respectively; however, for E.coli like isolates, the highest pattern (36%) was found for sulfamethoxazole-trimethoprim (SXT). In the binary exposure experiment, antibiotic zone of inhibition was mostly increased in the presence of heavy metals for all types of isolates. The highest sized plasmid was found 21 Kb and 14 Kb for lactose and non-lactose fermenting isolates, respectively. Conclusion: Microbial resistance to antibiotics and metal ions, has potential health hazards because these traits are generally associated with transmissible plasmids. Microorganisms resistant to antibiotics and tolerant to metals appear as a result of exposure to metal-contaminated environments.

Keywords: antibiotics, effluents, heavy metals, minimum inhibitory concentration, resistance

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2407 Ground Water Contamination by Tannery Effluents and Its Impact on Human Health in Peshawar, Pakistan

Authors: Fawad Ali, Muhammad Ateeq, Ikhtiar Khan

Abstract:

Ground water, a major source of drinking water supply in Peshawar has been severely contaminated by leather tanning industry. Effluents from the tanneries contain high concentration of chromium besides several other chemical species. Release of untreated effluents from the tanning industry has severely damaged surface and ground water, agriculture soil as well as vegetables and crops. Chromium is a well-known carcinogenic and mutagenic agent. Once in the human food chain, it causes multiple problems to the exposed population including various types of cancer, skin dermatitis, and DNA damage. In order to assess the extent of chromium and other heavy metals contamination, water samples were analyzed for heavy metals using Graphite Furnace Atomic Absorption Spectrometer (GFAAS, Analyst 700, Perkin Elmer). Total concentration of chromium was above the permissible limit (0.048 mg/l) in 85% of the groundwater (drinking water) samples. The concentration of cobalt, manganese, cadmium, nickel, lead, zinc and iron was also determined in the ground water, surface water, agriculture soil, and vegetables samples from the affected area.

Keywords: heavy metals, soil, groundwater, tannery effluents, food chain

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2406 Design and Development of Permanent Magnet Quadrupoles for Low Energy High Intensity Proton Accelerator

Authors: Vikas Teotia, Sanjay Malhotra, Elina Mishra, Prashant Kumar, R. R. Singh, Priti Ukarde, P. P. Marathe, Y. S. Mayya

Abstract:

Bhabha Atomic Research Centre, Trombay is developing low energy high intensity Proton Accelerator (LEHIPA) as pre-injector for 1 GeV proton accelerator for accelerator driven sub-critical reactor system (ADSS). LEHIPA consists of RFQ (Radio Frequency Quadrupole) and DTL (Drift Tube Linac) as major accelerating structures. DTL is RF resonator operating in TM010 mode and provides longitudinal E-field for acceleration of charged particles. The RF design of drift tubes of DTL was carried out to maximize the shunt impedance; this demands the diameter of drift tubes (DTs) to be as low as possible. The width of the DT is however determined by the particle β and trade-off between a transit time factor and effective accelerating voltage in the DT gap. The array of Drift Tubes inside DTL shields the accelerating particle from decelerating RF phase and provides transverse focusing to the charged particles which otherwise tends to diverge due to Columbic repulsions and due to transverse e-field at entry of DTs. The magnetic lenses housed inside DTS controls the transverse emittance of the beam. Quadrupole magnets are preferred over solenoid magnets due to relative high focusing strength of former over later. The availability of small volume inside DTs for housing magnetic quadrupoles has motivated the usage of permanent magnet quadrupoles rather than Electromagnetic Quadrupoles (EMQ). This provides another advantage as joule heating is avoided which would have added thermal loaded in the continuous cycle accelerator. The beam dynamics requires uniformity of integral magnetic gradient to be better than ±0.5% with the nominal value of 2.05 tesla. The paper describes the magnetic design of the PMQ using Sm2Co17 rare earth permanent magnets. The paper discusses the results of five pre-series prototype fabrications and qualification of their prototype permanent magnet quadrupoles and a full scale DT developed with embedded PMQs. The paper discusses the magnetic pole design for optimizing integral Gdl uniformity and the value of higher order multipoles. A novel but simple method of tuning the integral Gdl is discussed.

Keywords: DTL, focusing, PMQ, proton, rate earth magnets

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2405 Adverse Impacts of Poor Wastewater Management Practices on Water Quality in Gebeng Industrial Area, Pahang, Malaysia

Authors: I. M. Sujaul, M. A. Sobahan, A. A. Edriyana, F. M. Yahaya, R. M. Yunus

Abstract:

This study was carried out to investigate the adverse effect of industrial waste water on surface water quality in Gebeng industrial estate, Pahang, Malaysia. Surface water was collected from 6 sampling stations. Physico-chemical parameters were characterized based on in-situ and ex-situ analysis according to standard methods by American Public Health Association (APHA). Selected heavy metals were determined by using Inductively Coupled Plasma Mass Spectrometry (ICP MS). The result reveled that the concentration of heavy metals such as Pb, Cu, Cd, Cr and Hg were high in samples. The result showed that the value of Pb and Hg were higher in the wet season in comparison to dry season. According to Malaysia National Water Quality Standard (NWQS) and Water Quality Index (WQI) all the sampling station were categorized as class IV (highly polluted). The present study reveled that the adverse effects of careless disposal of wastes and directly discharge of effluents affected on surface water quality. Therefore, the authorities should implement the laws to ensure the proper practices of waste water management for environmental sustainability around the study area.

Keywords: water, heavy metals, water quality index, Gebeng

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2404 X-Ray Shielding Properties of Bismuth-Borate Glass Doped with Rare-Earth Ions

Authors: Vincent Kheswa

Abstract:

X-rays are ionizing electromagnetic radiation that is used in various industries such as computed tomography scans, dental X-rays, and screening freight trains. However, they pose health risks to humans if they are not shielded properly. In recent years, many researchers around the globe have been searching for nontoxic best possible glass materials for shielding X-rays. In this work, the x-ray shielding properties of 45Na₂O + 10 Bi₂O₃ + (5 - x)TiO₂+ (x) Nb₂O₅ + 40 P₂O₅, were x = 0, 1, 3, 5 mol%, glass materials were studied. The results revealed that the glass sample with the highest TiO2 content has the highest mass and linear attenuation coefficients and lowest half-value thickness, tenth-value thickness and mean-free path in the 20 to 80 keV energy region. The sample with 3 mol% of Nb₂O₅ has the highest mass and linear attenuation coefficients and the lowest half-value thickness, tenth-value thickness, and mean-free path at 15 keV and photon energies between 80 to 300 keV. It was, therefore, concluded that 45Na₂O + 10 Bi₂O₃ + 5 TiO₂ + 40 P₂O₅ glass is best for shielding x-rays of energies between 20 and 80 keV, while 45Na₂O + 10 Bi₂O₃ + 2 TiO₂ + 3 Nb₂O₅ + 40 P₂O₅ is best for shielding 15 keV x-rays and x-rays of energies between 80 keV and 300 keV.

Keywords: bismuth-titanium-phosphate glass, x-ray shielding, LAC, MAC, radiation shielding

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2403 A Case Report on the Multidisciplinary Approach on Rectal Adenocarcinoma in Pregnancy

Authors: Maria Cristina B. Cabanag, Elijinese Marie S. Culangen

Abstract:

Pregnancy is a period in a woman's life wherein the body may undergo different physiological changes. These changes can be attributed to the interplay of hormones in the body but can mask a more sinister type of disease such as malignancy on rare occasions. Colorectal cancer (CRC) in pregnancy is an epidemiologically rare disease worldwide. To our knowledge, no available studies were reported in the Philippines at the time of this writing, posing a dilemma for its appropriate diagnosis and management. Signs and symptoms of colorectal malignancy may camouflage a normal pregnancy and, when overlooked, impedes an appropriate approach. This case of a 38-year-old elderly primigravid who presented with hematochezia on her 25th week of gestation. She was diagnosed with rectal adenocarcinoma later in pregnancy which warranted a predicament regarding her appropriate care and management. This paper explores the repertoire of the different diagnostic and treatment approaches to colorectal cancer in the second trimester of pregnancy, with the least possible maternal and fetal hazards.

Keywords: cancer in pregnancy, chemotherapy in pregnancy, colorectal cancer, hematochezia in pregnancy

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2402 Assessment of Heavy Metal Contamination in Soil and Groundwater Due to Leachate Migration from an Open Dumping Site

Authors: Kali Prasad Sarma

Abstract:

Indiscriminate disposal of municipal solid waste (MSW) in open dumping site is a common scenario in developing countries like India which poses a risk to the environment as well as human health. The objective of the present investigation was to find out the concentration of heavy metals (Pb, Cr, Ni, Mn, Zn, Cu, and Cd) and other physicochemical parameters of leachate and soil collected from an open dumping site of Tezpur town, Assam, India and its associated potential ecological risk. Tezpur is an urban agglomeration coming under the category of Class I UAs/Towns with a population of 105,377 as per data released by Government of India for Census 2011. Impact of the leachate on the groundwater was also addressed in our study. The concentrations of heavy metals were determined using ICP-OES. Energy dispersive X-Ray (SEM-EDS) microanalysis was also conducted to see the presence of the studied metals in the soil. X-Ray diffraction analysis (XRD) and Fourier Transform Infrared (FTIR) spectroscopy were also used to identify dominant minerals present in the soil samples. The trend of measured heavy metals in the soil samples was found in the following order: Mn > Pb > Cu > Zn > Cr > Ni > Cd. The assessment of heavy metal contamination in the soil was carried out by calculating enrichment factor (EF), geo-accumulation index (Igeo), contamination factor (Cfi), degree of contamination (Cd), pollution load index (PLI) and ecological risk factor (Eri). The study showed that the concentrations of Pb, Cu, and Cd were much higher than their respective average shale value and the EF of the soil samples depicted very severe enrichment for Pb, Cu, and Cd; moderate enrichment for Cr and Zn. Calculated Igeo values indicated that the soil is moderate to strongly contaminated with Pb and uncontaminated to moderately contaminated with Cd and Cu. The Cfi value for Pb indicates a very strong contamination level of the metal in the soil. The Cfi values for Cu and Cd were 2.37 and 1.65 respectively indicating moderate contamination level. To apportion the possible sources of heavy metal contamination in soil, principal components analysis (PCA) has been adopted. From the leachate, heavy metals are accumulated at the dumping site soil which could easily percolate through the soil and reach the groundwater. The possible relation of groundwater contamination due to leachate percolation was examined by analyzing the heavy metal concentrations in groundwater with respect to distance from the dumping site. The concentrations of Cd and Pb in groundwater (at a distance of 20m from dumping site) exceeded the permissible limit for drinking water as set by WHO. Occurrence of elevated concentration of potentially toxic heavy metals such as Pb and Cd in groundwater and soil are much environmental concern as it is detrimental to human health and ecosystem.

Keywords: groundwater, heavy metal contamination, leachate, open dumping site

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2401 Ultrasound-Assisted Soil Washing Process for the Removal of Heavy Metals from Clays

Authors: Sophie Herr, Antoine Leybros, Yves Barre, Sergey Nikitenko, Rachel Pflieger

Abstract:

The proportion of soil contaminated by a wide range of pollutants (heavy metals, PCBs, pesticides, etc.) of anthropogenic origin is constantly increasing, and it is becoming urgent to address this issue. Among remediation methods, soil washing is an effective, relatively fast, and widely used process. This study assesses its coupling with ultrasound: indeed, sonication induces the formation of cavitation bubbles in solution that enhance local mass transfer through agitation and particle erosion. The removal of target toxic elements Ni(II) and Zn(II) from vermiculite clay has been studied under 20 kHz ultrasound and silent conditions. Several acids were tested, and HCl was chosen as the solvent. The effects of solid/liquid ratio and particle size were investigated. Metal repartition in the clay has been followed by Tessier's sequential extraction procedure. The results showed that more metal elements bound to the challenging residual phase were desorbed with 20 kHz ultrasound than in silent conditions. This supports the promising application of ultrasound for heavy metal desorption in difficult conditions. Further experiments were performed at high-frequency US (362 kHz), and it was shown that fragmentation of the vermiculite particles is then limited, while positive effects of US in the decontamination are kept.

Keywords: desorption, heavy metals, ultrasound, vermiculite

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2400 The Distribution and Environmental Behavior of Heavy Metals in Jajarm Bauxite Mine, Northeast Iran

Authors: Hossein Hassani, Ali Rezaei

Abstract:

Heavy metals are naturally occurring elements that have a high atomic weight and a density at least five times greater than that of water. Their multiple industrial, domestic, agricultural, medical, and technological applications have led to their wide distribution in the environment, raising concerns over their potential effects on human health and the environment. Environmental protection against various pollutants, such as heavy metals formed by industries, mines and modern technologies, is a concern for researchers and industry. In order to assess the contamination of soils the distribution and environmental behavior have been investigated. Jajarm bauxite mine, the most important deposits have been discovered in Iran, which is about 22 million tons of reserve, and is the main mineral of the Diaspora. With a view to estimate the heavy metals ratio of the Jajarm bauxite mine area and to evaluate the pollution level, 50 samples have been collected and have been analyzed for the heavy metals of As, Cd, Cu, Hg, Ni and Pb with the help of Inductively Coupled Plasma-Mass Spectrometer (ICP- MS). In this study, we have dealt with determining evaluation criteria including contamination factor (CF), average concentration (AV), enrichment factor (EF) and geoaccumulation index (GI) to assess the risk of pollution from heavy metals(As, Cd, Cu, Hg, Ni and Pb) in Jajarm bauxite mine. In the samples of the studied, the average of recorded concentration of elements for Arsenic, Cadmium, Copper, Mercury, Nickel and Lead are 18, 0.11, 12, 0.07, 58 and 51 (mg/kg) respectively. The comparison of the heavy metals concentration average and the toxic potential in the samples has shown that an average with respect to the world average of the uncontaminated soil amounts. The average of Pb and As elements shows a higher quantity with respect to the world average quantity. The pollution factor for the study elements has been calculated on the basis of the soil background concentration and has been categorized on the basis of the uncontaminated world soil average with respect to the Hakanson classification. The calculation of the corrected pollutant degree shows the degree of the bulk intermediate pollutant (1.55-2.0) for the average soil sampling of the study area which is on the basis of the background quantity and the world average quantity of the uncontaminated soils. The provided conclusion from calculation of the concentrated factor, for some of the samples show that the average of the lead and arsenic elements stations are more than the background values and the unnatural metal concentration are covered under the study area, That's because the process of mining and mineral extraction. Given conclusion from the calculation of Geoaccumulation index of the soil sampling can explain that the copper, nickel, cadmium, arsenic, lead and mercury elements are Uncontamination. In general, the results indicate that the Jajarm bauxite mine of heavy metal pollution is uncontaminated area and extract the mineral from the mine, not create environmental hazards in the region.

Keywords: enrichment factor, geoaccumulation index, heavy metals, Jajarm bauxite mine, pollution

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2399 Dynamics of Understanding Earthquake Precursors-A Review

Authors: Sarada Nivedita Bhuyan

Abstract:

Earthquake is the sudden, rapid movement of the earth’s crust and is the natural means of releasing stress. Tectonic plates play a major role for earthquakes as tectonic plates are the crust of the planet. The boundary lines of tectonic plates are usually known as fault lines. To understand an earthquake before its occurrence, different types of earthquake precursors are studied by different researchers. Surface temperature, strange cloud cover, earth’s electric field, geomagnetic phenomena, ground water level, active faults, ionospheric anomalies, tectonic movements are taken as parameters for earthquake study by different researchers. In this paper we tried to gather complete and helpful information of earthquake precursors which have been studied until now.

Keywords: earthquake precursors, earthquake, tectonic plates, fault

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2398 Need for a National Newborn Screening Programme in India: Pilot Study Data

Authors: Sudheer Moorkoth, Leslie Edward Lewis, Pragna Rao

Abstract:

Newborn screening (NBS) is a part of routine newborn care in many countries worldwide to detect early any rare treatable conditions and inborn errors of metabolism (IEM). India has not started this program yet. In an attempt to understand the challenges in implementing a national newborn screening program in India, we initiated a pilot newborn screening project funded by the Government of Canada. Along with initiating the newborn screening at Kasturba Hospital, Manipal in South India, for screening six disorders (Congenital Hypothyroidism(CH), Congenital Adrenal Hyperplasia (CAH), Galactosemia, Biotinidase deficiency, Glucose-6-Phosphate Dehydrogenase deficiency (G-6PD) and Phenylketonurea), we also studied the awareness of various stakeholders on the newborn screening. In a period of nine months from August 2017 to March 2018 we could screen 1915 newborns (999 male and 916 female). The result showed that there were seven babies screened positive. This interim result points to an incidence rate of 1 in 270 children for these rare disorders collectively. This includes three confirmed cases of CH, two cases of G-6PD deficiency, and one case each for Galctosemia and CAH. A questionnaire based study to understand the awareness among various stakeholders revealed that there is little awareness among parents, adolescents and anganwadi workers (public health worker). The interim data points to the need for a national newborn screening programme in India. There is also an immediate need to undertake large-scale awareness programme to create knowledge on NBS among the various stakeholders.

Keywords: awareness, inborn errors of metabolism (IEM), newborn screening, rare disease

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