Search results for: innovative surgical treatment

Authors: Arthi Ganapathy, Rati Tandon, Saroj Kaler

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Introduction: A thorough knowledge of variations in lung anatomy is of prime significance during surgical procedures like lobectomy, pneumonectomy, and segmentectomy of lungs. The arrangement of structures in the lung hilum act as a guide in performing such procedures. The normal pattern of arrangement of hilar structures in the right lung is eparterial bronchus, pulmonary artery, hyparterial bronchus and pulmonary veins from above downwards. In the left lung, it is pulmonary artery, principal bronchus and pulmonary vein from above downwards. The arrangement of hilar structures from anterior to posterior in both the lungs is pulmonary vein, pulmonary artery, and principal bronchus. The bronchial arteries are very small and usually the posterior most structures in the hilum of lungs. Aim: The present study aims at reporting the variations in hilar anatomy (arrangement and number) of lungs. Methodology: 75 adult formalin fixed cadaveric lungs from the department of Anatomy AIIMS New Delhi were observed for variations in the lobar anatomy. Arrangement of pulmonary hilar structures was meticulously observed, and any deviation in the pattern of presentation was recorded. Results: Among the 75 adult lung specimens observed 36 specimens were of right lung and the rest of left lung. Seven right lung specimens showed only 2 lobes with an oblique fissure dividing them and one left lung showed 3 lobes. The normal pattern of arrangement of hilar structures was seen in 22 right lungs and 23 left lungs. Rest of the lung specimens (14 right and 16 left) showed a varied pattern of arrangement of hilar structures. Some of them showed alterations in the sequence of arrangement of pulmonary artery, pulmonary veins, bronchus, and others in the number of these structures. Conclusion: Alterations in the pattern of arrangement of structures in the lung hilum are quite frequent. A compromise in knowledge of such variations will result in inadvertent complications like intraoperative bleeding during surgical procedures.

Keywords: fissures, hilum, lobes, pulmonary

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Authors: Abigail Parra Parra, Jorge L. Morelos Hernandez, Pedro A. Marquez Agilar, Marina Vlasova, Jesus Colin De La Cruz

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Carbothermal reduction of metal oxides is widely used both in metallurgical processes and in the production of oxygen-free refractory ceramics. As a rule, crushed coke and graphite are used as a reducing agent. The products of carbonization of organic compounds are among the innovative reducing agents. The aim of this work was to study the process of reduction of iron oxide (hematite) down to iron by waste active sludge (WAS) carbonization products. WAS was chosen due to the accumulation of a large amount of this type of waste, soil pollution, and the relevance of the development of technologies for its disposal. The studies have shown that the temperature treatment of mixtures WAS-Fe₂O₃ in the temperature range 900-1000 ºC for 1-5 hours under oxygen deficiency is described by the following scheme: WAS + Fe₂O₃→ C,CO + Fe₂O₃→ C + FexO → Fe (amorphous and crystalline). During the heat treatment of the mixtures, strong samples are formed. The study of the electrical conductive properties of such samples showed that, depending on the ratio of the components in the initial mixtures, it is possible to change the values of electrical resistivity from 5.6 Ω‧m to 151.6 Ω‧m When a current is passed through the samples, they are heated from 240 to 378ºC. Thus, based on WAS-Fe₂O₃ mixtures, heating elements can be created that can be used to heat ceramics and concrete.

Keywords: Fe₂O₃, reduction, waste activate sludge, electroconductivity

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Authors: Q. Ahmed, Y. Ren, R. Emery, J. Newman, M. Agarwal

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Celery (Apium graveolens var. dulce) is grown in Australia for domestic consumption and export markets. Quarantine treatment enables export of celery to the world that enforces quarantine against springtails. In the field, celery bunches become host to the Australian native springtail (Hypogastrura vernalis) (Collembola: Hypogastruridae). Springtails live inside the celery bunch and do not cause damage to the product. Springtails are, however, considered a quarantine pest and have had a significant impact on celery exports. In this experiment, cold treatments were conducted on fresh celery to investigate their effect on springtail mortality. Four low-temperature treatments were used (3, 5, 10, and 15 ºC) over four treatment periods (3, 5, 7, and 14 days). Springtail mortality was not affected by the 3, 5, 10 and 15 ºC treatments for the treatment periods of 3, 5, 7, and 14 days. Low-temperature damage was observed most noticeably on celery in the 3 and 5 ºC treatments.

Keywords: springtails, fresh celery, cold treatment, quarantine treatment

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Authors: Khedidja Benouis

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Environmental issues in the food industry are related to the water because it consumes water and release large volumes of wastewater. The treatment of such discharges techniques can be adapted to different situations encountered. For dairy effluents, it is necessary and very effective to use a treatment that eliminates much of the pollutant load,thus, to drastically reduce the organic loading rate. This study aims to evaluate the Efficiency and limitations of physicochemical treatment by coagulation - flocculation of liquid effluent from this type of food industry in Algeria, to give an example of the type and the degree of pollution generated by this sector and in order to reduce pollution and minimize its environmental issues. Coagulation - flocculation-sedimentation was carried out using lime without addition of additive (flocculant), the processing efficiency is indicated by the concentration of pollutants in treated water. The results show that treatment is not sufficient to remove organic pollution, but it has significantly reduced the Total suspended solids (TSS), nitrate (NO3-N) and phosphate (PO4-P).

Keywords: Algeria, coagulation-flocculation, dairy effluent, treatment

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Authors: Manik Sharma

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Understanding the anatomy and normal anatomical variations of the lower limb arterial system is undeniably important not only to understand the pathology involving the vessels of the lower limb but also as a part of endovascular intervention and surgical planning in cases that demand them as a part of treatment. There have been very few cases of duplication of SFA cited in the literature, close to six worldwide and this being the seventh case in the world and first to be reported in the Indian population. We incidentally came across this normal variant during US lower limb (US-LL) duplex scan in a patient with claudicating pain in bilateral lower limbs hence suspected of having peripheral vascular disease. It was confirmed on CT-Peripheral Angiography (CT-PA), which was done successively.

Keywords: peripheral vascular disease, claudicating pain, normal anatomical variants, endovascular intervention, duplication, CT-peripheral angiography, duplex scan, Iohexol

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Authors: SunWoo Lee, TaeBum Lee, YoonHwa Park, YooJeong Kim

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Solar lentigines appear predominantly on chronically sun-exposed areas of skin, such as the face and the back of the hands. Among the several ways to lentigines treatment, quality-switched lasers are well-known effective treatment for removing solar lentigines. The present pilot study was therefore designed to assess the efficacy of quality-switched ruby laser treatment of such lentigines compare between pretreatment and posttreatment of skin brightness. Twenty-two adults with chronic sun-damaged skin (mean age 52.8 years, range 37–74 years) were treated at the Korean site. A 694 nm Q-switched ruby laser was used, with the energy density set from 1.4 to 12.5 J/cm2, to treat solar lentigines. Average brightness of skin color before ruby laser treatment was 137.3 and its skin color was brightened after ruby laser treatment by 150.5. Also, standard deviation of skin color was decreased from 17.8 to 16.4. Regarding the multivariate model, age and energy were identified as significant factors for skin color brightness change in lentigo depigmentation by ruby laser treatment. Their respective odds ratios were 1.082 (95% CI, 1.007–1.163), and 1.431 (95% CI, 1.051–1.946). Lentigo depigmentation treatment using ruby lasers resulted in a high performance in skin color brightness. Among the relative factors involve with ruby laser treatment, age and energy were the most effective factors which skin color change to brighter than pretreatment.

Keywords: depigmentation, lentigine, quality switched ruby laser, skin color

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Authors: Eric Lai, Sarah Lorger, David Eisinger, Richard Waugh

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Introduction: Percutaneous embolization of varicoceles has shown similar outcomes to surgery. However, there are advantages of radiological intervention as patients are not exposed to general anaesthesia, experience a quicker recovery and face a lower risk of major complications. Radiological interventions are also preferable after a failed surgical approach. We evaluate clinical outcomes of percutaneous embolization at a tertiary hospital in Sydney, Australia. Methods: Retrospective case series without a control group from a single site (Royal Prince Alfred Hospital, Sydney, Australia). A data search was performed on the interventional radiology database with the word “varicocele” between February 2017 and March 2022. 62 patients were identified. Each patient file was reviewed and included in the study if they met the inclusion criteria. Results: A total of 56 patients were included. 6 patients were excluded as they did not receive intervention after the initial diagnostic venography. Technical success was 100%. Complications were seen in 3 patients (5.3%). The complications included post-procedural pain and fever, venous perforation with no clinical adverse outcome, and a mild allergic reaction to contrast. Recurrence occurred in 3 patients (5.6%), all of whom received a successful second procedure. DISCUSSION: This study demonstrates comparable rates of technical success, complication rate and recurrence to other studies in the literature. When compared to surgical outcomes, the results were also similar. The main limitation is multiple patients lack long-term follow-up beyond 1 year, resulting in potential underestimation of the recurrence rate. Conclusion: Percutaneous embolization of varicocele is a safe alternative to surgical intervention.

Keywords: varicocele, interventional radiology, urology, radiology

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Authors: Sunitha Sampathi, Pankaj Kumar Tiriya, Sonia Gera, Sravanthi Reddy Pailla, V. Likhitha, A. J. Maruthi

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Surgical site infections (SSIs) are the most common nosocomial infections localized at the incision site. With an estimated 27 million surgical procedures each year in USA, approximately 2-5% rate of SSIs are predicted to occur annually. SSIs are treated with antibiotic medication. Current trend suggest that the direct drug delivery from the suture to the scared tissue can improve patient comfort and wound recovery. For that reason coating the surface of the medical device such as suture and catguts with broad spectrum antibiotics can prevent the formation of bactierial colonies with out comprimising the mechanical properties of the sutures.Hence, the present study was aimed to develop and evaluate a surgical suture coated with an antibiotic Ciprofloxacin hydrochloride loaded on gold nanoparticles. Gold nanoparticles were synthesized by chemical reduction method and conjugated with ciprofloxacin using Polyvinylpyrolidone as stabilizer and gold as carrier. Ciprofloxacin conjugated gold nanoparticles were coated over an absorbable surgical suture made of Polyglactan using sodium alginate as an immobilising agent by slurry dipping technique. The average particle size and Polydispersity Index of drug conjugated gold NPs were found to be 129±2.35 nm and 0.243±0.36 respectively. Gold nanoparticles are characterized by UV-Vis absorption spectroscopy, Fourier Transform Infrared Spectroscopy (FT-IR), Scanning electron microscopy and Transmission electron microscopy. FT-IR revealed that there is no chemical interaction between drug and polymer. Antimicrobial activity for coated sutures was evaluated by disc diffusion method on culture plates of both gram negative (E-coli) and gram positive bacteria (Staphylococcus aureus) and results found to be satisfactory. In vivo studies for coated sutures was performed on Swiss albino mice and histological evaluation of intestinal wound healing parameters such as wound edges in mucosa, muscularis, presence of necrosis, exudates, granulation tissue, granulocytes, macrophages, restoration, and repair of mucosal epithelium and muscularis propria on day 7 after surgery were studied. The control animal group, sutured with plain suture (uncoated suture) showed signs of restoration and repair, but presence of necrosis, heamorraghic infiltration and granulation tissue was still noticed. Whereas the animal group treated with ciprofloxacin and ciprofloxacin gold nanoparticle coated sutures has shown promising decrease in terms of haemorraghic infiltration, granulation tissue, necrosis and better repaired muscularis layers on comparision with plain coated sutures indicating faster rate of repair and less chance of sepsis. Hence coating of sutures with broad spectrum antibiotics can be an alternate technique to reduce SSIs.

Keywords: ciprofloxacin hydrochloride, gold nanoparticles, surgical site infections, sutures

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Authors: Shohreh Azizi, Wag Nel

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The rapid population growth in South Africa has increased the requirement of waste water treatment facilities. The aim of this study is to assess the potential use of Fluidized bed Bio Reactor for Mmabatho sewage treatment plant. The samples were collected from the Inlet and Outlet of reactor daily to analysis the pH, Chemical Oxygen Demand (COD), Biochemical Oxygen Demand (BOD), Total Suspended Solid (TSS) as per standard method APHA 2005. The studies were undertaken on a continue laboratory scale, and analytical data was collected before and after treatment. The reduction of 87.22 % COD, 89.80 BOD % was achieved. Fluidized Bed Bio Reactor remove Bod/COD removal as well as nutrient removal. The efforts also made to study the impact of the biological system if the domestic wastewater gets contaminated with any industrial contamination and the result shows that the biological system can tolerate high Total dissolved solids up to 6000 mg/L as well as high heavy metal concentration up to 4 mg/L. The data obtained through the experimental research are demonstrated that the FBBR may be used (<3 h total Hydraulic Retention Time) for secondary treatment in Mmabatho wastewater treatment plant.

Keywords: fluidized bed bioreactor, wastewater treatment plant, biological system, high TDS, heavy metal

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Authors: Sonja Gögele, Petra Kletzenbauer

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International strategies are ranked as one of the core activities in the development plans of Austrian universities. This has led to numerous promising activities in terms of internationalization (i.e. development of international degree programmes, increased staff, and student mobility, and blended international projects). The latest innovative approach are so called Blended Intensive Programmes (BIP), which combine jointly delivered teaching and learning elements of at least three participating ERASMUS universities in a virtual and short-term mobility setup. Students who participate in BIP can maintain their study plans at their home institution and include BIP as a parallel activity. This paper presents the experiences of this programme on the topic of sustainable computing hosted by the University of Applied Sciences FH JOANNEUM. By means of an online survey and face-to-face interviews with all stakeholders (20 students, 8 professors), the empirical study addresses the challenges of hosting an international blended learning programme (i.e. virtual phase and on-site intensive phase) and discusses the impact of such activities in terms of innovative pedagogy (i.e. virtual collaboration, research-based learning).

Keywords: internationalization, collaborative learning, blended intensive programme, pedagogy

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Authors: Akmez Nabeerasool, Michaelis Massaros, Nigel Brown, David Sanderson, David Parocki, Charlotte Thompson, Mike Lodge, Mikael Khan

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The provision of clean and safe drinking water is of paramount importance and is a basic human need. Water scarcity coupled with tightening of regulations and the inability of current treatment technologies to deal with emerging contaminants and Pharmaceuticals and personal care products means that alternative treatment technologies that are viable and cost effective are required in order to meet demand and regulations for clean water supplies. Logistically, the application of water treatment in rural areas presents unique challenges due to the decentralisation of abstraction points arising from low population density and the resultant lack of infrastructure as well as the need to treat water at the site of use. This makes it costly to centralise treatment facilities and hence provide potable water direct to the consumer. Furthermore, across the UK there are segments of the population that rely on a private water supply which means that the owner or user(s) of these supplies, which can serve one household to hundreds, are responsible for the maintenance. The treatment of these private water supply falls on the private owners, and it is imperative that a chemical free technological solution that can operate unattended and does not produce any waste is employed. Arvia’s patented advanced oxidation technology combines the advantages of adsorption and electrochemical regeneration within a single unit; the Organics Destruction Cell (ODC). The ODC uniquely uses a combination of adsorption and electrochemical regeneration to destroy organics. Key to this innovative process is an alternative approach to adsorption. The conventional approach is to use high capacity adsorbents (e.g. activated carbons with high porosities and surface areas) that are excellent adsorbents, but require complex and costly regeneration. Arvia’s technology uses a patent protected adsorbent, Nyex™, which is a non-porous, highly conductive, graphite based adsorbent material that enables it to act as both the adsorbent and as a 3D electrode. Adsorbed organics are oxidised and the surface of the Nyex™ is regenerated in-situ for further adsorption without interruption or replacement. Treated water flows from the bottom of the cell where it can either be re-used or safely discharged. Arvia™ Technology Ltd. has trialled the application of its tertiary water treatment technology in treating reservoir water abstracted near Glasgow, Scotland, with promising results. Several other pilot plants have also been successfully deployed at various locations in the UK showing the suitability and effectiveness of the technology in removing recalcitrant organics (including pharmaceuticals, steroids and hormones), COD and colour.

Keywords: Arvia™ process, adsorption, water treatment, electrochemical oxidation

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Authors: Sereen Itani

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As the world aspires for technological innovation, Innovative Robotics Technology-Supported Pedagogic Models in STEAM Education (Science, Technology, Engineering, Arts, and Mathematics) are critical in our global education system to build and enhance the next generation 21st century skills. Thus, diverse international schools endeavor in attempts to construct an integrated robotics and technology enhanced curriculum based on interdisciplinary subjects. Accordingly, it is vital that the globe remains resilient in STEAM fields by equipping the future learners and educators with Innovative Technology Experiences through robotics to support such fields. A variety of advanced teaching methods is employed to learn about Robotics Technology-integrated pedagogic models. Therefore, it is only when STEAM and innovations in Robotic Technology becomes integrated with real-world applications that transformational learning can occur. Robotics STEAM education implementation faces major challenges globally. Moreover, STEAM skills and concepts are communicated in separation from the real world. Instilling the passion for robotics and STEAM subjects and educators’ preparation could lead to the students’ majoring in such fields by acquiring enough knowledge to make vital contributions to the global STEAM industries. Thus, this necessitates the establishment of Pedagogic models such as Innovative Robotics Technologies to enhance STEAM education and develop students’ 21st-century skills. Moreover, an ICT innovative supported robotics classroom will help educators empower and assess students academically. Globally, the Robotics Design System and platforms are developing in schools and university labs creating a suitable environment for the robotics cross-discipline STEAM learning. Accordingly, the research aims at raising awareness about the importance of robotics design systems and methodologies of effective employment of robotics innovative technology-supported pedagogic models to enhance and develop (STEAM) education globally and enhance the next generation 21st century skills.

Keywords: education, robotics, STEAM (Science, Technology, Engineering, Arts and Mathematics Education), challenges

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Authors: Akanksha Pareek

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The Indian Handloom clusters are known for its tradition and heritage of excellent craftsmanship. The design development of Indian handloom clusters are oriented on traditionally dobby and jacquard design. This comprehensive paper proposes practises on handloom woven design based on primary colour gradation with the help of basic weaved on four shaft. The innovative design ideas are inspired from Nature and transferred into the handloom samples to achieve colour gradation with primary colours. In this paper, design methodology where in woven samples are strategically designed in such way that traditional knowledge of the weavers will be oriented to leveraged their skills.

Keywords: handloom, weaving, colour gradation, shaft

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Authors: Abeer N. Alshukairi, Abdulrahman A. Alrajhi, Abdulfattah W. Alamri, Adel F. Alothman

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We described the nosocomial transmission of a pre-XDR or an MDR case of pulmonary tuberculosis in a HIV negative health care worker in an area endemic for MDR & XDR tuberculosis. With inadequate therapy and non-compliance, his strain developed acquired resistance and he presented with extra-pulmonary XDR tuberculosis in the form of multi-focal osteomyelitis and encysted pleural effusion. He was cured after 2 years of therapy with various anti-tuberculous drugs in addition to interferon gamma.

Keywords: osteomyelitis, treatment, XDR tuberculosis, successful treatment

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Authors: A. Stifi, S. Gentes

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Undoubtedly from construction's perspective, the use of explosives will remove a large facility such as a 40-storey building , that took almost 3 to 4 years for construction, in few minutes. Usually, the reconstruction or decommissioning, the last phase of life cycle of any facility, is considered to be the shortest. However, this is proved to be wrong in the case of nuclear power plant. Statistics says that in the last 30 years, the construction of a nuclear power plant took an average time of 6 years whereas it is estimated that decommissioning of such plants may take even a decade or more. This paper is all about the decommissioning phase of a nuclear power plant which needs to be given more attention and encouragement from the research institutes as well as the nuclear industry. Currently, there are 437 nuclear power reactors in operation and 70 reactors in construction. With around 139 nuclear facilities already been shut down and are in different decommissioning stages and approximately 347 nuclear reactors will be in decommissioning phase in the next 20 years (assuming the operation time of a reactor as 40 years), This fact raises the following two questions (1) How far is the nuclear and construction Industry ready to face the challenges of decommissioning project? (2) What is required for a safety and reliable decommissioning project delivery? The decommissioning of nuclear facilities across the global have severe time and budget overruns. Largely the decommissioning processes are being executed by the force of manual labour where the change in regulations is respectively observed. In term of research and development, some research projects and activities are being carried out in this area, but the requirement seems to be much more. The near future of decommissioning shall be better through a sustainable development strategy where all stakeholders agree to implement innovative technologies especially for dismantling and decontamination processes and to deliever a reliable and safety decommissioning. The scope of technology transfer from other industries shall be explored. For example, remotery operated robotic technologies used in automobile and production industry to reduce time and improve effecincy and saftey shall be tried here. However, the innovative technologies are highly requested but they are alone not enough, the implementation of creative and innovative management methodologies should be also investigated and applied. Lean Management with it main concept "elimination of waste within process", is a suitable example here. Thus, the cooperation between international organisations and related industries and the knowledge-sharing may serve as a key factor for the successful decommissioning projects.

Keywords: decommissioning of nuclear facilities, innovative technology, innovative management, sustainable development

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Authors: Cristiane C. B. Alves, Livia Eisler, Gustavo Mota, Kurt Faltin Jr., Cristina L. F. Ortolani

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The correct positioning of the brackets is essential for the success of orthodontic treatment. Indirect bracket placing technique has the main objective of eliminating the positioning errors, which commonly occur in the technique of direct system of brackets. The objective of this study is to demonstrate that the exact positioning of the brackets is of extreme relevance for the success of the treatment. The present work shows a case report of an adult female patient who attended the clinic with the complaint of being in orthodontic treatment for more than 5 years without noticing any progress. As a result of the intra-oral clinical examination and documentation analysis, a class III malocclusion, an anterior open bite, and absence of all third molars and first upper and lower bilateral premolars were observed. For the treatment, the indirect bonding technique with self-ligating ceramic braces was applied. The preparation of the trays was done after the intraoral digital scanning and printing of models with a 3D printer. Brackets were positioned virtually, using a specialized software. After twelve months of treatment, correction of the malocclusion was observed, as well as the closing of the anterior open bite. It is concluded that the adequate and precise positioning of brackets is necessary for a successful treatment.

Keywords: anterior open-bite, CAD/CAM, orthodontics, malocclusion, angle class III

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Authors: D. Naresh Yadav, K. Anand Kishore, Bhaskar Bethi, Shirish H. Sonawane, D. Bhagawan

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The untreated industrial wastewater discharged into the environment causes the contamination of soil, water and air. Advanced treatment methods for enhanced wastewater treatment are attracting substantial interest among the currently employed unit processes in wastewater treatment. The textile industry is one of the predominant in wastewater production at current industrialized situation. The refused dyes at textile industry need to be treated in proper manner before its discharge into water bodies. In the present investigation, hybrid treatment process has been developed for the treatment of synthetic mixed dye wastewater. Photocatalysis and ceramic nanoporous membrane are mainly used for process integration to minimize the fouling and increase the flux. Commercial semiconducting powders (TiO2 and ZnO) has used as a nano photocatalyst for the degradation of mixed dye in the hybrid system. Commercial ceramic nanoporous tubular membranes have been used for the rejection of dye and suspended catalysts. Photocatalysis with catalyst has shown the average of 34% of decolorization (RB-32%, BG-34% and CR-36%), whereas ceramic nanofiltration has shown the 56% (RB-54%, BG-56% and CR-58%) of decolorization. Integration of photocatalysis and ceramic nanofiltration has shown 96% (RB-94%, BG-96% and CR-98%) of dye decolorization over 90 min of operation.

Keywords: photocatalysis, ceramic nanoporous membrane, wastewater treatment, advanced oxidation process, process integration

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Authors: D. Schafer, H. Booke, R. Nordmeier

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Patients suffering from chronic musculoskeletal pain ( > 12 months) are a challenging clientele for pain specialists. A multimodal approach, characterized by a two weeks inpatient treatment, often is the ultimate therapeutic attempt. The lasting effects of such a multimodal approach were analyzed, especially since two weeks of inpatient therapy, although very intense, often seem too short to make a difference in patients suffering from chronic pain for years. The study includes 32 consecutive patients suffering from chronic pain over years who underwent a two weeks multimodal inpatient treatment of pain. Twelve months after discharge, each patient was interviewed to objectify any lasting effects. Pain was measured on admission and 12 months after discharge using the numeric rating scale (NRS). For statistics, a paired students' t-test was used. Significance was defined as p < 0.05. The average intensity of pain on admission was 8,6 on the NRS. Twelve months after discharge, the intensity of pain was still reduced by an average of 48% (average NRS 4,4), p < 0.05. Despite this significant improvement in pain severity, two thirds (66%) of the patients still judge their treatment as not sufficient. In conclusion, inpatient treatment of chronic pain has a long-lasting effect on the intensity of pain in patients suffering from chronic musculoskeletal pain for more than 12 months.

Keywords: chronic pain, inpatient treatment, multimodal pain treatment, musculoskeletal pain

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Authors: Cecilia Moreira, Rita Paiva, Daniela Macedo, Leonor Ribeiro, Isabel Fernandes, Luis Costa

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Background: Head and neck paragangliomas are a rare group of tumors with a large spectrum of clinical manifestations. The approach to evaluate and treat these lesions has evolved over the last years. Surgery was the standard for the approach of these patients, but nowadays new techniques of imaging and radiation therapy changed that paradigm. Despite advances in treating, the growth potential and clinical outcome of individual cases remain largely unpredictable. Objectives: Characterization of our institutional experience with clinical management of these tumors. Methods: This was a cross-sectional study of patients followed in our institution between 01 January and 31 December 2017 with paragangliomas of the head and neck and cranial base. Data on tumor location, catecholamine levels, and specific imaging modalities employed in diagnostic workup, treatment modality, tumor control and recurrence, complications of treatment and hereditary status were collected and summarized. Results: A total of four female patients were followed between 01 January and 31 December 2017 in our institution. The mean age of our cohort was 53 (± 16.1) years. The primary locations were at the level of the tympanic jug (n=2, 50%) and carotid body (n=2, 50%), and only one of the tumors of the carotid body presented pulmonary metastasis at the time of diagnosis. None of the lesions were catecholamine-secreting. Two patients underwent genetic testing, with no mutations identified. The initial clinical presentation was variable highlighting the decrease of visual acuity and headache as symptoms present in all patients. In one of the cases, loss of all teeth of the lower jaw was the presenting symptomatology. Observation with serial imaging, surgical extirpation, radiation, and stereotactic radiosurgery were employed as treatment approaches according to anatomical location and resectability of lesions. As post-therapeutic sequels the persistence of tinnitus and disabling pain stands out, presenting one of the patients neuralgia of the glossopharyngeal. Currently, all patients are under regular surveillance with a median follow up of 10 months. Conclusion: Ultimately, clinical management of these tumors remains challenging owing to heterogeneity in clinical presentation, the existence of multiple treatment alternatives, and potential to cause serious detriment to critical functions and consequently interference with the quality of life of the patients.

Keywords: clinical outcomes, head and neck, management, paragangliomas

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Authors: Brid Joy

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This paper discusses some major psychological interventions and critiques their effectiveness in relation to the treatment of depression. Links are made between this evidence and the social work profession. This paper reviewed the relevant literature and evidence to ascertain the effectiveness of psychological interventions in the treatment of depression. Evidence suggests that psychological interventions are effective in the treatment of depression. However, a gulf between theory and practice remains and the difficulties in implementing evidence-based practice have been documented within this paper.

Keywords: psychological interventions, social work, depression, evidence based practice

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Authors: Nigatu Tadesse, Li Juan, Liuhong Ming

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Gastric cancer (GC) is the fifth most common and fourth deadly cancer in the world with limited treatment options at late advanced stage in which surgical therapy is not recommended with chemotherapy remain as the mainstay of treatment. However, the occurrence of chemoresistance as well as intera-tumoral and inter-tumoral heterogeneity of response to targeted and immunotherapy underlined a clear unmet treatment need in gastroenterology. Several molecular and cellular alterations ascribed for chemo resistance in GC including cancer stem cells (CSC) and tumor microenvironment (TME) remodeling. Cancer cells including CSC bears higher metabolic demand and major changes in TME involves alterations of gut microbiota interacting with nutrients metabolism. Metabolic upregulation in lipids, carbohydrates, amino acids, fatty acids biosynthesis pathways identified as a common hall mark in GC. Metabolic addiction to methionine metabolism occurs in many cancer cells to promote the biosynthesis of S-Adenosylmethionine (SAM), a universal methyl donor molecule for high rate of transmethylation in GC and promote cell proliferation. Targeting methionine metabolism found to promotes chemo-sensitivity with treatment non-heterogeneity. Methionine restriction (MR) promoted the arrest of cell cycle at S/G2 phase and enhanced downregulation of GC cells resistance to apoptosis (including ferroptosis), which suggests the potential of synergy with chemotherapies acting at S-phase of the cell cycle as well as inducing cell apoptosis. Accumulated evidences showed both the biogenesis as well as intracellular metabolism of exogenous methionine could be safe and effective target for therapy either alone or in combination with chemotherapies. This review article provides an over view of the upregulation in methionine biosynthesis pathway and the molecular signaling through the PI3K/Akt/mTOR-c-MYC axis to promote metabolic reprograming through activating the expression of L-type aminoacid-1 (LAT1) transporter and overexpression of Methionine adenosyltransferase 2A(MAT2A) for intercellular metabolic conversion of exogenous methionine to SAM in GC, and the potential of targeting with novel therapeutic agents such as methioninase (METase), Methionine adenosyltransferase 2A (MAT2A), c-MYC, methyl like transferase 16 (METTL16) inhibitors that are currently under clinical trial development stages and future perspectives.

Keywords: gastric cancer, methionine metabolism, pi3k/akt/mtorc1-c-myc axis, gut microbiota, MAT2A, c-MYC, METTL16, methioninase

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Authors: R. Sharma, S. Kumar, C. Sharma

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A number of toxic chlorophenolic compounds are formed during pulp bleaching. The nature and concentration of these chlorophenolic compounds largely depends upon the amount and nature of bleaching chemicals used. These compounds are highly recalcitrant and difficult to remove but are partially removed by the biochemical treatment processes adopted by the paper industry. Identification and estimation of these chlorophenolic compounds has been carried out in the primary and secondary clarified effluents from the paper mill by GCMS. Twenty-six chorophenolic compounds have been identified and estimated in paper mill waste waters. Electrochemical treatment is an efficient method for oxidation of pollutants and has successfully been used to treat textile and oil waste water. Electrochemical treatment using less expensive anode material, stainless steel electrodes has been tried to study their removal. The electrochemical assembly comprised a DC power supply, a magnetic stirrer and stainless steel (316 L) electrode. The optimization of operating conditions has been carried out and treatment has been performed under optimized treatment conditions. Results indicate that 68.7% and 83.8% of cholorphenolic compounds are removed during 2 h of electrochemical treatment from primary and secondary clarified effluent respectively. Further, there is a reduction of 65.1, 60 and 92.6% of COD, AOX and color, respectively for primary clarified and 83.8%, 75.9% and 96.8% of COD, AOX and color, respectively for secondary clarified effluent. EC treatment has also been found to increase significantly the biodegradability index of wastewater because of conversion of non- biodegradable fraction into biodegradable fraction. Thus, electrochemical treatment is an efficient method for the degradation of cholorophenolic compounds, removal of color, AOX and other recalcitrant organic matter present in paper mill waste water.

Keywords: chlorophenolics, effluent, electrochemical treatment, wastewater

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Authors: Danielle G. Saique

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Introduction: Promoting Gender Equality, Equity and Empowerment of Women (GEE&EW) can be attained by practicing thereby exercising Sexual and Reproductive Health and Rights (SRHR). Gender Inequality is manifested thru Violence Against Women (VAW). Objectives: This study presents causes, prevalence, effects of Gender Inequality for not practicing and violating SRHR. This proposes Action Plan by promoting, integrating SRHR in the “holistic approach” of Social Work education, practice and service-delivery in any work-set-ups. Limitations: VAW cases showed victim and violator are known, related and living together. Cases transpired at home, reported, investigated in the police and filed in the legal court of law for the year 2013. Methods: Data from blotters, reports, filed cases, case studies gathered by the Social Worker (SWr). Qualitative analysis identified cause, prevalence of VAW related in violating SRHR. SWr serves innovative interventions in any work settings by applying SRHR background, skills in educating, counseling client-victims. Results: 65 VAW cases on non-negotiation or refusal of practicing SRHR. Non-acceptance of Family Planning yielded unwanted, unplanned pregnancies, abandoned children, battered women. Neglected pre-post natal maternal care caused complications or death. Rape, incest led trauma or death. Unsafe, unprotected sex transmitted STDs. Conclusions: Non-availing SRHR from health facilities, from Medical Health SWr concluded to non-practicing or violating rights to life, health care, protection, rights to information, education, rights to plan family, rights from torture, ill-treatment. VAW brings undesirable effects to the well-being, wellness and humaneness of the victim. Recommendations: The innovative intervention services on SRHR of a SWr and the findings, results in violating SRHR are recommendations in Action Planning by adding “The SRHR Concepts” in Social Work thereby preventing VAW; empowering women’s rights to development, gender equality, equity liberty, security, freedom; resilience and involvement in promoting, practicing, exercising SRHR at home. Recommended therefore to duplicate this innovative practice and experience on SRHR as implemented by the SWr in any work setting.

Keywords: women development, promoting gender equality, equity, empowerment of women

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Authors: Mohammad Shahid Jamil

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In this study we have investigated students’ learning and satisfaction in one of the course offered in the Foundation Program at Qatar University. We implied innovative teaching methodology that emphasizes on enhancing students’ thinking skills, decision making, and problem solving skills. Some interesting results were found which can be used to further improve the teaching methodology. To make sure the full use of technology in Foundation Program at Qatar University has started implementing new ways of teaching Math course by using Blackboard as an innovative interactive tool to support standard teaching such as Discussion board, Virtual class, and Study plan in My Math Lab “MML”. In MML Study Plan is designed in such a way that the student can improve their skills wherever they face difficulties with in their Homework, Quiz or Test. Discussion board and Virtual Class are collaborative learning tools encourages students to engage outside of class time. These tools are useful to share students’ knowledge and learning experiences, promote independent and active learning and they helps students to improve their critical thinking skills through the learning process.

Keywords: blackboard, discussion board, critical thinking, active learning, independent learning, problem solving

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Authors: J. S. S. Neto, R. A. A. Lima, D. K. K. Cavalcanti, J. P. B. Souza, R. A. A. Aguiar, M. D. Banea

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In the last decade, investments in sustainable processes and products have gained space in several segments, such as in the civil, automobile, textile and other industries. In addition to increasing concern about the development of environmentally friendly materials that reduce, energy costs and reduces environmental impact in the production of these products, as well as reducing CO2 emissions. Natural fibers offer a great alternative to replace synthetic fibers, totally or partially, because of their low cost and their renewable source. The purpose of this research is to study the effect of surface chemical treatment on the thermal properties of hybrid fiber reinforced natural fibers (NFRC), jute + ramie, jute + sisal, jute + curauá, and jute fiber in polymer matrices. Two types of chemical treatment: alkalinization and silanization were employed, besides the condition without treatment. Differential scanning calorimetry (DSC), thermogravimetry (TG) and dynamic-mechanical analysis (DMA) were performed to explore the thermal stability and weight loss in the natural fiber reinforced composite as a function of chemical treatment.

Keywords: chemical treatment, hybrid composite, jute, thermal

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Authors: D. Hephzibah, P. Kumaran, N. M. Saifuddin

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Anaerobic digestion is a well-known technique for sustainable energy recovery from sewage sludge. However, sewage sludge digestion is restricted due to certain factors. Pre-treatment methods have been established in various publications as a promising technique to improve the digestibility of the sewage sludge and to enhance the biogas generated which can be used for energy recovery. In this study, continuous flow microwave (MW) pre-treatment with different intensities were compared by using 5 L semi-continuous digesters at a hydraulic retention time of 27 days. We focused on the effects of MW at different intensities on the sludge solubilization, sludge digestibility, and biogas production of the untreated and MW pre-treated sludge. The MW pre-treatment demonstrated an increase in the ratio of soluble chemical oxygen demand to total chemical oxygen demand (sCOD/tCOD) and volatile fatty acid (VFA) concentration. Besides that, the total volatile solid (TVS) removal efficiency and tCOD removal efficiency also increased during the digestion of the MW pre-treated sewage sludge compared to the untreated sewage sludge. Furthermore, the biogas yield also subsequently increases due to the pre-treatment effect. A higher MW power level and irradiation time generally enhanced the biogas generation which has potential for sustainable energy recovery from sewage treatment plant. However, the net energy balance tabulation shows that the MW pre-treatment leads to negative net energy production.

Keywords: anaerobic digestion, biogas, microwave pre-treatment, sewage sludge

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Authors: Kebede Mairie, Getahun Belete, Mitike Abeba

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Background: Leishmania aethiopica is a peculiar parasite causing cutaneous leishmaniasis in Ethiopia and its mainstay treatment is Sodium Stibogluconate. However, its treatment outcome in Ethiopia is not well documented. Objectives: To determine the treatment outcome of admitted cutaneous leishmaniasis patients and its associated factors in Addis Ababa, Ethiopia. Methods: A retrospective study was conducted from 1st November 2021 to 30th March 2022. Medical records of all cutaneous leishmaniasis-diagnosed and admitted patients who received parenteral sodium stibogluconate at All Africa Leprosy Rehabilitation and Training Center (ALERT) hospital, the main Leishmania treatment center in Ethiopia from July 2011 to September 2021 were reviewed. Results: A total of 827 charts of admitted cases from July 2011 to September 2021 were retrieved, but 667 (80.65%) were reviewed. Improvement in the treatment outcome was recorded in 93.36 % in the first course of SSG treatment and 96.23%, 94.62%, and 96.97% subsequently in the second, third and fourth treatment courses, respectively. Female gender and diffuse cutaneous leishmaniasis were the two predictive determinants in the treatment of cutaneous leishmaniasis. Conclusion: The study shows that parenteral sodium stibogluconate therapy treats hospitalized cutaneous leishmaniasis patients well, with female gender and diffuse cutaneous leishmaniasis having poor outcomes suggesting the need for a different approach for diffuse cutaneous leishmaniasis patients.

Keywords: cutaneous leishmaniasis, leishmania aethiopica, sodium stibogluconate, diffuse cutaneous leishmaniasis, pentostam

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Authors: Naqoosh Haidry

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Objective & Goal: Enucleation of the maxillomandibular cysts will lead to the creation of post-surgical bone defects which may take more than a year for complete bone healing. The use of bone grafts is common to aid bone regeneration in large defects. The study aimed to evaluate the healing and bone formation capabilities of polymer of injectable platelet fibrin (i-PRF) and hydroxyapatite (HA) as bone graft substitute in maxilla-mandibular postsurgical defects compared to hydroxyapatite alone. The primary objective was to find out the clinical and radiological assessment of healing postoperatively and compare the outcome of both groups. Material and Methods: After surgical enucleation of 19 maxillomandibular cysts/tumors, either HA or HA+ i-PRF graft was adapted to the defect. Clinical outcome variables such as pain (VAS score), edema, and mucosal color were evaluated on postoperative days 01, 03, and 07 while radiological outcome variables such as volume of defect (cc), density of new bone (HU) on computed tomography were evaluated at 2nd and 4th month. The results obtained were tabulated and compared with the inferential analysis. Results: Clinical parameters seem to be better in the HA + i-PRF group, but the result was non-significant. Radiologically, the mean healing ratios were significantly greater in the HA + i-PRF group (63.5 ± 2.34 at 2nd month, 90.3 ± 7.32 at 4th month) compared to the HA group (57.2 ± 5.21at 2nd month, 80.8 ± 5.33 at 4th month). When comparing the mean density of new bone, there was a statistically significant difference with a mean difference of 95.2 HU more in the HA + i-PRF (623 HU ± 42.9) compared to the HA group (528 HU ± 96.5) in 2nd month. Conclusion: The polymer of i-PRF and HA prepared as the sticky bone yields faster and better bone healing in post-enucleation maxillomandibular bony defects as compared to hydroxyapatite alone based on radiological findings till four months.

Keywords: bone defect, density of new bone, hydroxyapatite, injectable platelet rich fibrin, maxillomandibular cysts, surgical defect

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Authors: Peter Park, Alfonso Ayala, Douglas Saeks, Jordan Miller, Carmen Flores, Karen Nelson

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Introduction Hip fractures account for more than 300,000 hospital admissions every year. Many present as fragility fractures in geriatric patients with multiple medical comorbidities. Standardized protocols for the multidisciplinary management of this patient population have been shown to improve patient outcomes. A hip fracture protocol was implemented at a Level I Trauma center with a focus on pre-operative medical optimization and early surgical care. This study evaluates the efficacy of that protocol, including the early transition period. Methods A retrospective review was performed of all patients ages 60 and older with isolated hip fractures who were managed surgically between 2020 and 2022. This included patients 1 year prior and 1 year following the implementation of a hip fracture protocol at a Level I Trauma center. Results 530 patients were identified: 249 patients were treated before, and 281 patients were treated after the protocol was instituted. There was no difference in mean age (p=0.35), gender (p=0.3), or Charlson Comorbidity Index (p=0.38) between the cohorts. Following the implementation of the protocol, there were observed increases in time to surgery (27.5h vs. 33.8h, p=0.01), hospital length of stay (6.3d vs. 9.7d, p<0.001), and ED LOS (5.1h vs. 6.2h, p<0.001). There were no differences in in-hospital mortality (2.01% pre vs. 3.20% post, p=0.39) and complication rates (25% pre vs 26% post, p=0.76). A trend towards improved outcomes was seen after the early transition period but failed to yield statistical significance. Conclusion Early medical management and surgical intervention are key determining factors affecting outcomes following fragility hip fractures. The implementation of a hip fracture protocol at this institution has not yet significantly affected these parameters. This could in part be due to the restrictions placed at this institution during the COVID-19 pandemic. Despite this, the time to OR pre-and post-implementation was quicker than figures reported elsewhere in literature. Further longitudinal data will be collected to determine the final influence of this protocol. Significance/Clinical Relevance Given the increasing number of elderly people and the high morbidity and mortality associated with hip fractures in this population finding cost effective ways to improve outcomes in the management of these injuries has the potential to have enormous positive impact for both patients and hospital systems.

Keywords: hip fracture, geriatric, treatment algorithm, preoperative optimization

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Authors: Tshilenge Kabongo, John Kabuba

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The distillery wastewater has become major issues in sanitation sectors. One of the solutions to overcome this sewage is to install the Wastewater Treatment Plant. Economic analysis is fundamentally required for its viability. Integrated anaerobic digestion and advanced oxidation (AD-AOP) in the treatment of distillery wastewater (DWW), anaerobic digestion achieved sufficient biochemical oxygen demand (BOD) and chemical oxygen demand (COD) removals of 95% and 75%, respectively, and methane production of 0.292 L/g COD removed at an organic loading rate of 15 kg COD/m3/d. However, a considerable amount of biorecalcitrant compounds still existed in the anaerobically treated effluent, contributing to a residual COD of 4.5 g/L and an intense dark brown color. To remove the biorecalcitrant color and COD, ozonation, which is an AOP, was introduced as a post-treatment method to AD. Ozonation is a highly competitive treatment technique that can be easily applied to remove the biorecalcitrant compounds, including color, and turbidity. In the ozonation process carried out for an hour, more than 80% of the color was removed at an ozone dose of 45 mg O3/L/min (corresponding to 1.8 g O3/g COD). Thus, integrating AD with the AOP can be effective for organic load and color reductions during the treatment of DWW. The deliverable established the best configuration of the AD-AOP system, where DWW is first subjected to AD followed by AOP post-treatment. However, for establishing the feasibility of the industrial application of the integrated system, it is necessary to carry out the economic analysis. This may help the starting point of the wastewater treatment plant construction and its operation and maintenance costs.

Keywords: distillery wastewater, economic analysis, integrated anaerobic digestion, ozonolysis, treatment

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