Search results for: Enhanced Recovery after surgery

Authors: Shyh-Ming Chern, Kai-Ting Hsieh

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Organic solvents find various applications in many industrial sectors and laboratories as dilution solvents, dispersion solvents, cleaners and even lubricants. Millions of tons of Spent Organic Solvents (SOS) are generated each year worldwide, prompting the need for more efficient, cleaner and safer methods for the treatment and resource recovery of SOS. As a result, acetone, selected as a model compound for SOS, was gasified in supercritical water to assess the feasibility of resource recovery of SOS by means of supercritical water processes. Experiments were conducted with an autoclave reactor. Gaseous product is mainly consists of H2, CO, CO2 and CH4. The effects of three major operating parameters, the reaction temperature, from 673 to 773K, the dosage of oxidizing agent, from 0.3 to 0.5 stoichiometric oxygen, and the concentration of acetone in the feed, 0.1 and 0.2M, on the product gas composition, yield and heating value were evaluated with the water density fixed at about 0.188g/ml.

Keywords: acetone, gasification, SCW, supercritical water

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Authors: Swapnil V. Pakhale, Sunil S. Bhagwat

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Three phase partitioning (TPP) an efficient bioseparation technique integrates the concentration and partial purification step of downstream processing of a biomolecule. Three Phase Partitioning is reported here for the first time for purification of Serratiopeptidase from fermentation broths of Serratia marcescens NRRL B-23112. The influence of various salts and solvents, Concentration of ammonium sulphate (20-60% w/v), Crude extract to t-butanol ratio (1:0.5-1:2.5) and system pH on Serratiopeptidase partitioning were investigated and optimum conditions for TPP were obtained in order to enhance the degree of purification and activity recovery of Serratiopeptidase. Under the optimal conditions of TPP, serratiopeptidase has been efficiently separated and concentrated with maximum recovery and degree of purification of 95.70% and 4.95 fold respectively. The present study shows TPP as an attractive downstream process for the purification of serratiopeptidase.

Keywords: three phase partitioning, serratiopeptidase, serratia marcescens NRRL B-23112, t-butanol, bioseparation

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Authors: Njeim Pressila, Hajj-Boutros Guy, Antony D. Karelis

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Background: Acute resistance exercise is associated with an elevated inflammation response, which could lead to delayed onset muscle soreness (DOMS). There is evidence that suggests that ingesting foods that have anti-inflammation properties may help reduce DOMS. A vegan diet has also been shown to be an anti-inflammatory diet which could, in turn, decrease DOMS. Objective and hypothesis: The purpose of the present study will be to compare markers of DOMS between vegans and omnivores after acute resistance exercise in young females. We hypothesize that vegans will have a better recovery of DOMS markers after a resistance exercise session compared to omnivores. Methods: Population: We will recruit30 vegans and 30 omnivores to participate in this study. Allvolunteers will follow either a vegan or an omnivore diet for at least 2 years. Anthropometric measurements, body composition, musclestrength (leg and chest press), markers of DOMS (swelling, pain, and stiffness), and dietary factors, as well as a wellness and anxiety questionnaire will be measured. All participants will also perform an acute resistance exercise session in order to induce DOMS. Pertinence: This project will give us a better understanding on the recovery process of vegans after a resistance training session and, as such, provide useful information to health professionals and athletes/coaches (kinesiologists and nutritionists)

Keywords: vgeans, omnivores, delayed onset muscle soreness, pain, stifness

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Authors: Srestha Chaturabul, Wanchalerm Srirachat, Thanaporn Wannachod, Prakorn Ramakul, Ura Pancharoen, Soorathep Kheawhom

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The separation of mercury(II) from petroleum-produced water from the Gulf of Thailand was carried out using a hollow fiber supported liquid membrane system (HFSLM). Optimum parameters for feed pretreatment were 0.2 M HCl, 4% (v/v) Aliquat 336 for extractant and 0.1 M thiourea for stripping solution. The best percentage obtained for extraction was 99.73% and for recovery 90.11%, respectively. The overall separation efficiency noted was 94.92% taking account of both extraction and recovery prospects. The model for this separation developed along a combined flux principle i.e. convection–diffusion–kinetic. The results showed excellent agreement with theoretical data at an average standard deviation of 1.5% and 1.8%, respectively.

Keywords: separation, mercury(ii), petroleum produced water, hollow fiber, liquid membrane

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Authors: Parul Sahu

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In recent years, seawater desalination has been emerged as a potential resource to circumvent water scarcity, especially in coastal regions. Among the various methods, thermal evaporation or distillation and membrane operations like Reverse Osmosis (RO) has been exploited at commercial scale. However, the energy cost and maintenance expenses associated with these processes remain high. In this context Freeze Desalination (FD), subjected to the availability of low cost refrigeration, offers an exciting alternative. Liquefied Natural Gas (LNG) regasification terminals provide an opportunity to utilize the refrigeration available with regasification of LNG. This work presents the conceptualization and development of a process scheme integrating the ice and hydrate based FD to the LNG regasification process. This integration overcomes the high energy demand associated with FD processes by utilizing the refrigeration associated with LNG regasification. An optimal process scheme was obtained by performing process simulation using ASPEN PLUS simulator. The results indicated the new proposed process requires only 1 kWh/m³ of energy with the utilization of maximum refrigeration. In addition, a sensitivity analysis was also performed to study the effect of various process parameters on water recovery and energy consumption for the proposed process. The results show that the energy consumption decreases by 30% with an increase in water recovery from 30% to 60%. However, due to operational limitations associated with ice and hydrate handling in seawater, the water recovery cannot be maximized but optimized. The proposed process can be potentially used to desalinate seawater in integration with LNG regasification terminal.

Keywords: freeze desalination, liquefied natural gas regasification, process simulation, refrigeration

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Authors: M. Khazam, M. Altawil, A. Eljabri

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Fluid properties in states near a vapor-liquid critical region are the most difficult to measure and to predict with EoS models. The principal model difficulty is that near-critical property variations do not follow the same mathematics as at conditions far away from the critical region. Libyan NC98 field in Sirte basin is a typical example of near critical fluid characterized by high initial condensate gas ratio (CGR) greater than 160 bbl/MMscf and maximum liquid drop-out of 25%. The objective of this paper is to model NC98 phase behavior with the proper selection of EoS parameters and also to model reservoir depletion versus gas cycling option using measured PVT data and EoS Models. The outcomes of our study revealed that, for accurate gas and condensate recovery forecast during depletion, the most important PVT data to match are the gas phase Z-factor and C7+ fraction as functions of pressure. Reasonable match, within -3% error, was achieved for ultimate condensate recovery at abandonment pressure of 1500 psia. The smooth transition from gas-condensate to volatile oil was fairly simulated by the tuned PR-EoS. The predicted GOC was approximately at 14,380 ftss. The optimum gas cycling scheme, in order to maximize condensate recovery, should not be performed at pressures less than 5700 psia. The contribution of condensate vaporization for such field is marginal, within 8% to 14%, compared to gas-gas miscible displacement. Therefore, it is always recommended, if gas recycle scheme to be considered for this field, to start it at the early stage of field development.

Keywords: EoS models, gas-condensate, gas cycling, near critical fluid

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Authors: Ping-Ping Zhang, Hui-Zhang, Xu-Hui Sun

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Highly-uniform In2O3/CuO bilayer and multilayer porous thin films were successfully fabricated using self-assembled soft template and simple sputtering deposition technique. The sensor based on the In2O3/CuO bilayer porous thin film shows obviously improved sensing performance to ethanol at the lower working temperature, compared to single layer counterpart sensors. The response of In2O3/CuO bilayer sensors exhibits nearly 3 and 5 times higher than those of the single layer In2O3 and CuO porous film sensors over the same ethanol concentration, respectively. The sensing mechanism based on p-n hetero-junction, which contributed to the enhanced sensing performance was also experimentally confirmed by a control experiment which the SiO2 insulation layer was inserted between the In2O3 and CuO layers to break the p-n junction. In addition, the sensing performance can be further enhanced by increasing the number of In2O3/CuO junction layers. The facile process can be easily extended to the fabrication of other semiconductor oxide gas sensors for practical sensing applications.

Keywords: gas sensor, multilayer porous thin films, In2O3/CuO, p-n junction

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Authors: F. Yelles-Allam, A. A. Nouani

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In Algeria, whey is discarded without any treatment and this causes not only pollution problem, but also a loss in nutritive components of milk. In this paper, characterization of EDAM whey, which is resulted from pasteurised mixture of cow’s milk and skim milk, and recovery of whey protein by ultrafiltration / diafiltration, was studied. The physical-chemical analysis of whey has emphasized on its pollutant and nutritive characteristics. In fact, its DBO5 and DCO are 49.33, and 127.71 gr of O2/l of whey respectively. It contains: fat (1,90±0,1 gr/l), lactose (47.32±1,57 gr/l), proteins (8.04±0,2 gr/l) and ashes (5,20±0,15 gr/l), calcium (0,48±0,04 gr/l), Na (1.104gr/l), K (1.014 gr/l), Mg (0.118 gr/l) and P (0.482 gr/l). Ultrafiltration was carried out in a polyetersulfone membrane with a cut-off of 10K. Its hydraulic intrinsic resistance and permeability are respectively: 2.041.1012 m-1 and 176,32 l/h.m2 at PTM of 1 bar. The retentate obtained at FC6, contains 16,33g/l of proteins and 70,25 g/l of dry matter. The retention rate of protein is 97, 7% and the decrease in DBO5 and DCO are at 18.875 g /l and 42.818 g/l respectively. Diafiltration performed on protein concentrates allowed the complete removal of lactose and minerals. The ultrafiltration of the whey before the disposal is an alternative for Algéria dairy industry.

Keywords: diafiltration, DBO, DCO, protein, ultrafiltration, whey

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Authors: Lee Boudreau, Ash Kumar Khaitu, Laura A. S. MacDonald

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In April 2015, a magnitude 7.8 earthquake struck Nepal, killing, injuring, and displacing thousands of people. The earthquake also damaged water and sanitation service networks, leading to a high risk of diarrheal disease and the associated negative health impacts. In response to the disaster, the Environment and Public Health Organization (ENPHO), a Kathmandu-based non-governmental organization, worked with the Centre for Affordable Water and Sanitation Technology (CAWST), a Canadian education, training and consulting organization, to develop two training programs to educate volunteers on water, sanitation, and hygiene (WASH) needs. The first training program was intended for acute response, with the second focusing on longer term recovery. A key focus was to equip the volunteers with the knowledge and skills to formulate useful WASH advice in the unanticipated circumstances they would encounter when working in affected areas. Within the first two weeks of the disaster, a two-day acute response training was developed, which focused on enabling volunteers to educate those affected by the disaster about local WASH issues, their link to health, and their increased importance immediately following emergency situations. Between March and October 2015, a total of 19 training events took place, with over 470 volunteers trained. The trained volunteers distributed hygiene kits and liquid chlorine for household water treatment. They also facilitated health messaging and WASH awareness activities in affected communities. A three-day recovery phase training was also developed and has been delivered to volunteers in Nepal since October 2015. This training focused on WASH issues during the recovery and reconstruction phases. The interventions and recommendations in the recovery phase training focus on long-term WASH solutions, and so form a link between emergency relief strategies and long-term development goals. ENPHO has trained 226 volunteers during the recovery phase, with training ongoing as of April 2016. In the aftermath of the earthquake, ENPHO found that its existing pool of volunteers were more than willing to help those in their communities who were more in need. By training these and new volunteers, ENPHO was able to reach many more communities in the immediate aftermath of the disaster; together they reached 11 of the 14 earthquake-affected districts. The collaboration between ENPHO and CAWST in developing the training materials was a highly collaborative and iterative process, which enabled the training materials to be developed within a short response time. By training volunteers on basic WASH topics during both the immediate response and the recovery phase, ENPHO and CAWST have been able to link immediate emergency relief to long-term developmental goals. While the recovery phase training continues in Nepal, CAWST is planning to decontextualize the training used in both phases so that it can be applied to other emergency situations in the future. The training materials will become part of the open content materials available on CAWST’s WASH Resources website.

Keywords: water and sanitation, emergency response, education and training, building resilience

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Authors: Saut Samuel Simamora

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PURPOSE: Nucleus drop is one of the most feared and severe complications of modern cataract surgery. The lens material may drop through iatrogenic breaks of the posterior capsule. The incidence of the nucleus as the complication of phacoemulsification increases concomitant to the increased frequency of phacoemulsification. Pars plana vitrectomy (PPV) followed by endofragmentation and secondary intraocular lens (IOL) implantation is the choice of management procedure. This case report aims to present the outcome of PPV for the treatment dropped nucleus after cataract surgery METHODS: A 65 year old female patient came to Vitreoretina department with chief complaints blurry vision in her left eye after phacoemulsification one month before. Ophthalmological examination revealed visual acuity of the right eye (VA RE) was 6/15, and the left eye (VA LE) was hand movement. The intraocular pressure (IOP) on the right eye was 18 mmHg, and on the left eye was 59 mmHg. On her left eye, there were aphakic, dropped lens nucleus and secondary glaucoma.RESULTS: The patient got antiglaucoma agent until her IOP was decreased. She underwent pars plana vitrectomy to remove dropped nucleus and iris fixated IOL. One week post operative evaluation revealed VA LE was 6/7.5 and iris fixated IOL in proper position. CONCLUSIONS: Nucleus drop generally occurs in phacoemulsification cataract surgery techniques. Retained lens nucleus or fragments in the vitreous may cause severe intraocular inflammation leading to secondary glaucoma. The proper and good management for retained lens fragments in nucleus drop give excellent outcome to patient.

Keywords: secondary glaucoma, complication of phacoemulsification, nucleus drop, pars plana vitrectomy

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Authors: Selina Doncevic, Lisa Perla, Angela Kindvall

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The Global War on Terror which began after September 11, 2011, increased survivability of severe injuries requiring varying trajectories of rehabilitation and recovery. The costs encompass physiologic, functional, social, emotional, psychological, vocational and scholastic domains of life. The purpose of this poster is to inform private sector health care practitioners and clinicians at various levels of the unique and long term dynamics of healthcare recovery for polytrauma, and traumatic brain injured service members and veterans in the United States of America. Challenges include care delivery between the private sector, the department of defense, and veterans affairs healthcare systems while simultaneously supporting the dynamics of acute as well as latent complications associated with severe injury and illness. Clinical relevance, subtleties of protracted recovery, and overwhelmed systems of care are discussed in the context of lessons learned and in reflection on previous wars. Additional concerns for consideration and discussion include: the cost of protracted healthcare, various U.S. healthcare payer systems, lingering community reintegration challenges, ongoing care giver support, the rise of veterans support groups and the development of private sector clinical partnerships.

Keywords: brain injury, future, polytrauma, rehabilitation

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Authors: Michael Ward, Eliana Kalakouti, Andrew Alabi

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Aim: The handover process is recognized as a vulnerable step in the patient care pathway where errors are likely to occur. As such, it is a major preventable cause of patient harm due to human factors of poor communication and systematic error. The aim of this study was to audit the general surgery department’s weekend handover process compared to the recommended criteria for safe handover as set out by the Royal College of Surgeons (RCS). Method: A retrospective audit of the General Surgery department’s Friday patient lists and patient medical notes used for weekend handover in a London-based District General Hospital (DGH). Medical notes were analyzed against RCS's suggested criteria for handover. A standardized paper weekend handover proforma was then developed in accordance with guidelines and circulated in the department. A post-intervention audit was then conducted using the same methods for cycle 1. For cycle 2, we introduced an electronic weekend handover tool along with Electronic Patient Records (EPR). After a one-month period, a second post-intervention audit was conducted. Results: Following cycle 1, the paper weekend handover proforma was only used in 23% of patient notes. However, when it was used, 100% of them had a plan for the weekend, diagnosis and location but only 40% documented potential discharge status and 40% ceiling of care status. Qualitative feedback was that it was time-consuming to fill out. Better results were achieved following cycle 2, with 100% of patient notes having the electronic proforma. Results improved with every patient having documented ceiling of care, discharge status and location. Only 55% of patients had a past surgical history; however, this was still an increase when compared to paper proforma (45%). When comparing electronic versus paper proforma, there was an increase in documentation in every domain of the handover outlined by RCS with an average relative increase of 1.72 times (p<0.05). Qualitative feedback was that the autofill function made it easy to use and simple to view. Conclusion: These results demonstrate that the implementation of an electronic autofill handover proforma significantly improved handover compliance with RCS guidelines, thereby improving the transmission of information from week-day to weekend teams.

Keywords: surgery, handover, proforma, electronic handover, weekend, general surgery

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Authors: E. Solfaroli Camillocci, C. Mancini-Terracciano, V. Bocci, A. Carollo, M. Colandrea, F. Collamati, M. Cremonesi, M. E. Ferrari, P. Ferroli, F. Ghielmetti, C. M. Grana, M. Marafini, S. Morganti, M. Patane, G. Pedroli, B. Pollo, L. Recchia, A. Russomando, M. Schiariti, M. Toppi, G. Traini, R. Faccini

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A Radio-Guided Surgery technique exploiting β− emitting radio-tracers has been suggested to overcome the impact of the large penetration of γ radiation. The detection of electrons in low radiation background provides a clearer delineation of the margins of lesioned tissues. As a start, the clinical cases were selected between the tumors known to express receptors to a β− emitting radio-tracer: 90Y-labelled DOTATOC. The results of tests on ex-vivo specimens of meningioma brain tumor and abdominal neuroendocrine tumors are presented. Voluntary patients were enrolled according to the standard uptake value (SUV > 2 g/ml) and the expected tumor-to-non-tumor ratios (TNR∼10) estimated from PET images after administration of 68Ga-DOTATOC. All these tests validated this technique yielding a significant signal on the bulk tumor and a negligible background from the nearby healthy tissue. Even injecting as low as 1.4 MBq/kg of radiotracer, tumor remnants of 0.1 ml would be detectable. The negligible medical staff exposure was confirmed and among the biological wastes only urine had a significant activity.

Keywords: ex-vivo test, meningioma, neuroendocrine tumor, radio-guided surgery

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Authors: Bernard Bladergroen, David Vlotman, Bradley Cerff

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The agricultural sector is one which requires and consumes large amounts of water globally. Commercial wine production, in particular, uses extensive volumes of fresh water and generates significant volumes of wastewater through various processes. The wastewater produced by wineries typically exhibits elevated levels of chemical oxygen demand (COD), total suspended solids (TSS), total dissolved solids (TDS), acidic pH and varying salinity and nutrient contents. This study investigates the performance of a shear-enhanced flotation separation (SEFS) pilot plant as a primary treatment stage during winery wastewater processing by modifying a conventional Dissolved Air Flotation (DAF) system. The SEFS pilot plant achieved a 99% reduction in both turbidity and TSS in comparison to the 97% achieved with the conventional DAF system. The COD was reduced by 66% and 51% for the SEFS and DAF systems, respectively. SEFS shows the advantages of hydrodynamic shear to enhance the coagulation and subsequent flocculation processes with a significant reduction of coagulant and flocculant (36% and 31%, respectively).

Keywords: shear enhanced flotation, suspended solids, primary wastewater treatment, zeta potential

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Authors: Divya Pathak, James Sloane

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Surgical treatment of midface fractures should ideally occur within two weeks of injury, after which bony healing and consolidation make the repair more difficult for the operating surgeon. The oral and maxillofacial unit at the Royal Surrey Hospital is the tertiary referral center for maxillofacial trauma from five regional hospitals. This is a complete audit cycle of midface trauma referrals managed over a one year period. The standard set was that clinical assessment of the midface fracture would take place in a consultant led outpatient clinic within 7 days, and when indicated, surgical fixation would occur within 10 days of referral. Retrospective data was collected over one year (01/11/2018 - 31/12/2019). Three key changes were implemented: an IT referral mailbox, standardization of an on-call trauma table, and creation of a trauma theatre list. Re-audit was carried out over six months completing the cycle. 283 midface fracture referrals were received, of which 22 patients needed surgical fixation. The average time from referral to outpatient follow-up improved from 14.5 days to 8.3 days, and time from referral to surgery improved from 21.5 days to 11.6 days. Changes implemented in this audit significantly improved patient prioritization to appropriate outpatient clinics and shortened time to surgical intervention.

Keywords: maxillofacial trauma, midface trauma, oral and maxillofacial surgery, surgery fixation

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Authors: El Montassir Dahmane, Nadia Eladlani, Aziz Ouahrouch, Mohammed Rhazi, Moha Taourirte

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The present study was aimed to approximate the optimal conditions to chromium recovery from wastewater by nanoparticles and whiskers of chitosan. Chitosan with an average molecular weight of 63 kDa and a 96% deacetylation degree was prepared according to our previous study. Chromium recovery is influenced by different parameters. In our search, we determined the appropriate range of pH to form chitosan–Cr(III), nanoparticles Cr(III), and whiskers– Cr(III) complex. We studied also the influence of chromium concentration and the nature of chitosan-based materials on the complexation process. Our main aim is to approximate the optimal conditions to remove chromium(III) from the tanning bath, recuperated from tannery wastewater of Marrakech in Morocco. A Perkin Elmer optima 2000 Inductively Coupled Plasma- Optical Emission Spectrometer (ICP-OES), was used to determine the quantity of chromium persistent in tannery wastewater after complexation phenomenon. To the best of our knowledge, this is the first report interested in the optimal conditions for chromium recovery from wastewater by nanoparticles and whiskers of chitosan. From our research, we found that in chromium solution, the appropriate range of pH to form complex is between 5.6 and 6.7. Also, the complexation of Cr(III) is depending on the nature of complexing ligand and chromium concentration. The obtained results reveal that nanoparticles present an excellent adsorption capacity regardless of chromium concentration. In addition, after a critical chromium concentration (250 mg/l), our ligand becomes saturated, that requires an increase of ligand mass for increasing chromium concentration in order to have a better adsorption capacity. Hence, in the same conditions, we used chitosan, its nanoparticles, whiskers, and chitosan based films to remove Cr(III) from tannery wastewater. The pH of this effluent was around 6, and its chromium concentration was 300 mg/l. The results expose that the sequence of complexing ligand in the effluent is the same in chromium solution, determined via our previous study. However, the adsorbed quantity is less due to the presence of other metallic ions in tannery wastewater. We conclude that the best complexing ligand-based chitosan is chitosan nanoaprticles whether it’s in chromium solution or in tannery wastewater. Nanoparticles are the best complexing ligand after 24 h of contact nanoparticles can remove 70% of chromium from this tannery wastewater.

Keywords: nanoparticles, whiskers, chitosan, chromium

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Authors: Yong Geun Yun, Jong Hui kim, Sang Ho Baik

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This study was carried out to develop a fermented dandelion (Tarazacum officinale) beverage using lactic acid bacteria with cinnamoyl esterase (CE) activity isolated from human feces. Lactic acid bacteria were screened based on bacterial survival ability in dandelion extract and CE activity. Dandelion extract fermented by Lactobacillus acidophilus F-46 (LA-F46) maintained approximately 105-106 log CFU/mL over an 8 days period. After fermented dandelion beverage (FDB) with LA-46 for 8 days at 37oC the pH was decreased from pH 7.0 to 3.5. Antioxidant activity by using DPPH radical scavenging activity of the prepared FDB was significantly increased compared to that of non-fermented dandelion beverage (NFDB). Moreover, CE activity was significantly enhanced during fermentation and showed the approximately 4.3 times increased concentration of caffeic acid up to 9.91 mg/100 mL after 8 days of incubation compared to NFDB. Therefore, it concluded that dandelion can be a good source for preparing a functional beverage and fermentation by LA-F46 enhanced the food functionality with enhanced caffeic acids.

Keywords: cinnamoyl esterase, dandelion, fermented beverage, lactic acid bacteria

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Authors: A. Gazdzinska, P. Jagielski, E. Kaniewska, S. P. Gazdzinski, M. Wylezol

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Background: In the multi-factor etiology of obesity, an increasing degree of importance is attributed to behavioral factors. Lifestyle and health-oriented behaviors heavily influence the treatment of multiple diseases, including obesity. However, only a few studies evaluated health-related behaviors exhibited by patients qualified for bariatric surgery. None of them was performed in Polish population. Aim: Assessment of health behaviors of obese patients according to the degree of mood disorders. Method: The study involved 93 patients (66 females) who were qualified for bariatric surgery in the Department of Surgery of the Military Institute of Aviation Medicine in Warsaw. Diagnostic instrument was the Juczynski’s Inventory of Health Behavior (HBI), which evaluates health behavior in four categories, i.e. proper nutrition habits (PNH), preventive behavior (PH), health practices (HP) and positive mental attitude (PMA). The average HBI falls in the range between 24 and 120 points, for each category of health behaviors fall between 1 and 5 (higher score means higher severity declared healthy behaviors). The depressive symptoms in patients were assessed with Beck Depression Inventory (BDI). All analyses were conducted using STATISTICA 12. Results: The average age was 44.2 ± 11.5 years, mean BMI was 44.3 ± 10.5 kg/m2 and 46.8 ± 7.6 kg/m2, in females and males respectively. According to BDI, 32% patients had mild level of depression, 10% moderate and 14% severe depression. BDI scores were not different between females and males. Low results with regard to the health behaviors declared were obtained by 35.5 % of patients, medium by 44.0%, while high ones by only 20.5%. On average, patients gained 3.28 points in PNH, 3.37 points in PH, 3.29 points in HP, while 3.42 in the PMA category, showing average intensity of these behaviors. These health behaviors were practiced significantly more often by women (p = 0.04). The average HBI was 80.2; with average score of 81.5 for females and 76.6 for males, respectively (p = 0.03). Women were better in the PNH category (p = 0.02). A positive correlation was found between age and all categories of health behaviors, in particular PNH (R = 0.38; p = 0.001), PH (R = 0.26; p = 0.01), HP (R = 0.27; p = 0.01) and PMA (R = 0.24; p = 0.02), independent of gender. The severity of depression had a significant impact only on the behaviors associated with proper eating habits, which saw a negative correlation between BDI scores and the PNH (R = -0.21; p = 0.04). Conclusions: Majority of morbidly obese patients qualified for bariatric surgery obtained low to average scores in health behavior questionnaire. However, these results are similar in comparison with the Polish adult population. In accordance to these results, it seems that healthy behaviors, among them eating behaviors, do not appear to be a cause of obesity epidemic or they might be acquired when the disease is already underway. Female gender and age had a positive effect, and depression had a negative effect on the level of health behaviors among patients qualified for bariatric surgery.

Keywords: depression, habits, health behaviours, obesity

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Authors: Mark Angelo Maranon, David Endriga

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Objective: The aim of the study is to determine the differences in functional outcome and quality of life of adult patients with Potts disease who have undergone surgical versus non-surgical management. Methods: In this prospective cohort study, 45 patients were followed up for 1 year after undergoing pharmacologic treatment alone versus a combination of anti-Kochs and surgery for Potts disease. Oswestry Disability Index (ODI) and Short Form-36 (SF-36) were obtained on initiation of treatment, after three months, six months and one year. Results: ASIA scores from the onset of treatment and after 1 year significantly improved (p<0.001) for both non-surgical and surgical patients. ODI scores significantly improved after 6 months of treatment for both surgical and non-surgical patients. Both surgical and non-surgical patients showed significant improvement in their SF-36 scores, but scores were noted to be higher in patients who underwent surgery. Conclusions: Significant improvement with regards to functional outcome and quality of life was noted from both surgical and non-surgical patients after 1 year of treatment, with earlier improvements and better final scores in SF 36 and ODI in patients who underwent surgery.

Keywords: tuberculosis, spinal, potts disease, functional outcome

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Authors: T. Arkle, D. Pournaras, S. Lam, B. Kumar

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Introduction: Fundoplication is widely recognised as the best surgical option for gastro-oesophageal reflux disease (GORD) in the general population. However, there is controversy surrounding the use of conventional fundoplication in obese patients. Whilst the intra-operative failure of fundoplication, including wrap disruption, is reportedly higher in obese individuals, the more significant issue surrounds symptom recurrence post-surgery. Could a bariatric procedure be considered in obese patients for weight management, to treat the GORD, and to also reduce the risk of recurrence? Roux-en-Y gastric bypass, a widely performed bariatric procedure, has been shown to be highly successful both in controlling GORD symptoms and in weight management in obese patients. Furthermore, NICE has published clear guidelines on eligibility for bariatric surgery, with the main criteria being type 3 obesity or type 2 obesity with the presence of significant co-morbidities that would improve with weight loss. This study aims to identify the proportion of patients who undergo conventional fundoplication for GORD and/or hiatus hernia, which would have been eligible for bariatric surgery referral according to NICE guidelines. Methods: All patients who underwent fundoplication procedures for GORD and/or hiatus hernia repair at a single NHS foundation trust over a 10-year period will be identified using the Trust’s health records database. Pre-operative patient records will be used to find BMI and the presence of significant co-morbidities at the time of consideration for surgery. This information will be compared to NICE guidelines to determine potential eligibility for the bariatric surgical referral at the time of initial surgical intervention. Results: A total of 321 patients underwent fundoplication procedures between January 2011 and December 2020; 133 (41.4%) had available data for BMI or to allow BMI to be estimated. Of those 133, 40 patients (30%) had a BMI greater than 30kg/m², and 7 (5.3%) had BMI >35kg/m². One patient (0.75%) had a BMI >40 and would therefore be automatically eligible according to NICE guidelines. 4 further patients had significant co-morbidities, such as hypertension and osteoarthritis, which likely be improved by weight management surgery and therefore also indicated eligibility for referral. Overall, 3.75% (5/133) of patients undergoing conventional fundoplication procedures would have been eligible for bariatric surgical referral, these patients were all female, and the average age was 60.4 years. Conclusions: Based on this Trust’s experience, around 4% of obese patients undergoing fundoplication would have been eligible for bariatric surgical intervention. Based on current evidence, in class 2/3 obese patients, there is likely to have been a notable proportion with recurrent disease, potentially requiring further intervention. These patient’s may have benefitted more through undergoing bariatric surgery, for example a Roux-en-Y gastric bypass, addressing both their obesity and GORD. Use of patient written notes to obtain BMI data for the 188 patients with missing BMI data and further analysis to determine outcomes following fundoplication in all patients, assessing for incidence of recurrent disease, will be undertaken to strengthen conclusions.

Keywords: bariatric surgery, GORD, Nissen fundoplication, nice guidelines

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Authors: Nassim Bessaad, Qilian Bao, Zhao Jiangkang

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The fiber optics gyroscope in the strap-down inertial navigation system (FOG-SINS) suffers from precision degradation due to the influence of random errors. In this work, an enhanced Allan variance (AV) stochastic modeling method combined with discrete wavelet transform (DWT) for signal denoising is implemented to estimate the random process in the FOG signal. Furthermore, we devise a measurement-based iterative adaptive Sage-Husa nonlinear filter with augmented states to integrate a star tracker sensor with SINS. The proposed filter adapts the measurement noise covariance matrix based on the available data. Moreover, the enhanced stochastic modeling scheme is invested in tuning the process noise covariance matrix and the augmented state Gauss-Markov process parameters. Finally, the effectiveness of the proposed filter is investigated by employing the collected data in laboratory conditions. The result shows the filter's improved accuracy in comparison with the conventional Kalman filter (CKF).

Keywords: inertial navigation, adaptive filtering, star tracker, FOG

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Authors: Harshit Mahandra, Rashmi Singh, Bina Gupta

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Molybdenum is widely used in thermocouples, anticathode of X-ray tubes and in the production of alloys of steels. Molybdenum compounds are extensively used as a catalyst in petroleum-refining industries for hydrodesulphurization. Activity of the catalysts decreases gradually with time and are dumped as hazardous waste due to contamination with toxic materials during the process. These spent catalysts can serve as a secondary source for metal recovery and help to sort out environmental and economical issues. In present study, extraction and separation of molybdenum from a Mo-Co spent catalyst leach liquor containing 0.870 g L⁻¹ Mo, 0.341 g L⁻¹ Co, 0.422 ×10⁻¹ g L⁻¹ Fe and 0.508 g L⁻¹ Al in 3 mol L⁻¹ HCl has been investigated using solvent extraction technique. The extracted molybdenum has been finally recovered as molybdenum trioxide. Leaching conditions used were- 3 mol L⁻¹ HCl, 90°C temperature, solid to liquid ratio (w/v) of 1.25% and reaction time of 60 minutes. 96.45% molybdenum was leached under these conditions. For the extraction of molybdenum from leach liquor, Cyphos IL 104 [trihexyl(tetradecyl)phosphonium bis(2,4,4-trimethylpentyl)phosphinate] in toluene was used as an extractant. Around 91% molybdenum was extracted with 0.02 mol L⁻¹ Cyphos IL 104, and 75% of molybdenum was stripped from the loaded organic phase with 2 mol L⁻¹ HNO₃ at A/O=1/1. McCabe Thiele diagrams were drawn to determine the number of stages required for the extraction and stripping of molybdenum. According to McCabe Thiele plots, two stages are required for both extraction and stripping of molybdenum at A/O=1/1 which were also confirmed by countercurrent simulation studies. Around 98% molybdenum was extracted in two countercurrent extraction stages with no co-extraction of cobalt and aluminum. Iron was removed from the loaded organic phase by scrubbing with 0.01 mol L⁻¹ HCl. Quantitative recovery of molybdenum is achieved in three countercurrent stripping stages at A/O=1/1. Trioxide of molybdenum was obtained from strip solution and was characterized by XRD, FE-SEM and EDX techniques. Molybdenum trioxide due to its distinctive electrochromic, thermochromic and photochromic properties is used as a smart material for sensors, lubricants, and Li-ion batteries. Molybdenum trioxide finds application in various processes such as methanol oxidation, metathesis, propane oxidation and in hydrodesulphurization. It can also be used as a precursor for the synthesis of MoS₂ and MoSe₂.

Keywords: Cyphos IL 104, molybdenum, spent Mo-Co catalyst, recovery

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Authors: Bi Wa, Su-Yeon Kwon, Ik-Joong Kang

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Surface-enhanced Raman Scattering (SERS) as the principle for enhancing Raman scattering by molecules adsorbed on rough metal surfaces or by nanostructures is used to detect the concentration change of γ-Aminobutyric Acid (GABA). GABA is the mainly inhibitory neurotransmitter in the mammalian central nervous system in the human body. It plays such significant role in reducing neuronal excitability throughout the nervous system. In this case, the Mercaptopropionic Acid (MPA) is used to modified chitosan –gold nanoshell, which enhances the absorption between GABA and Chitosan-gold nanoshell. The sulfur end of the MPA is linked to gold which is the surface of the chitosan nanoparticles via the very strong S–Au bond, while a functional group (carboxyl group) attached to GABA. The controlling of particles’ size and the surface morphology are also the important factors during the whole experiment. The particle around 100nm is using to link to MPA, and the range of GABA from 1mM to 30mM was detected by the Raman Scattering to obtain the calibrate curve. In this study, DLS, SEM, FT-IR, UV, SERS were used to analyze the products to obtain the conclusion.

Keywords: chitosan-gold nanoshell, mercaptopropionic acid, γ-aminobutyric acid, surface-enhanced raman scattering

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Authors: M. R. Ghasemi, R. Ghiasi, H. Varaee

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Model updating method has received increasing attention in damage detection structures based on measured modal parameters. Therefore, a probability-based damage detection (PBDD) procedure based on a model updating procedure is presented in this paper, in which a one-stage model-based damage identification technique based on the dynamic features of a structure is investigated. The presented framework uses a finite element updating method with a Monte Carlo simulation that considers the uncertainty caused by measurement noise. Enhanced ideal gas molecular movement (EIGMM) is used as the main algorithm for model updating. Ideal gas molecular movement (IGMM) is a multiagent algorithm based on the ideal gas molecular movement. Ideal gas molecules disperse rapidly in different directions and cover all the space inside. This is embedded in the high speed of molecules, collisions between them and with the surrounding barriers. In IGMM algorithm to accomplish the optimal solutions, the initial population of gas molecules is randomly generated and the governing equations related to the velocity of gas molecules and collisions between those are utilized. In this paper, an enhanced version of IGMM, which removes unchanged variables after specified iterations, is developed. The proposed method is implemented on two numerical examples in the field of structural damage detection. The results show that the proposed method can perform well and competitive in PBDD of structures.

Keywords: enhanced ideal gas molecular movement (EIGMM), ideal gas molecular movement (IGMM), model updating method, probability-based damage detection (PBDD), uncertainty quantification

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Authors: Fedili Benamar, Beloulou Mohamed Lamine, Ouahes Hassane, Ghattas Samir

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Background and aims: While in Western countries, unilateral spinal anesthesia has been widely practiced for a long time, it remains little known in the local anesthesia community, and has not been the object of many studies. However, it is a simple, practical and effective technique. Our objective was to evaluate this practice in emergency anesthesia management in frail patients and to compare it with conventional spinal anesthesia. Methods: This is a prospective, observational, comparative study between hypobaric unilateral and conventional spinal anaesthesia for hip fracture surgery carried out in the operating room of the university military hospital of Staoueli. The work was spread over of 12-month period from 2019 to 2020. The parameters analyzed were hemodynamic variations, vasopressor use, block efficiency, postoperative adverse events, and postoperative morphine consumption. Results: -75 cases (mean age 72±14 years) -Group1= 41 patients (54.6%) divided into (ASA1=14.6% ASA2=60.98% ASA3=24.39%) single shoot spinal anaesthesia -Group2= 34 patients (45.3%) divided into (ASA1=2.9%, ASA2=26.4% ASA3=61.7%, ASA4=8.8%) unilateral hypobaric spinal anesthesia. -Hemodynamic variations were more severe in group 1 (51% hypotension) compared to 30% in group 2 RR=1.69 and odds ratio=2.4 -these variations were more marked in the ASA3 subgroup (group 1=70% hypotension versus group 2=30%) with an RR=2.33 and an odds ratio=5.44 -39% of group 1 required vasoactive drugs (15mg +/- 11) versus 32% of group 2 (8mg+/- 6.49) - no difference in the use of morphine in post-op. Conclusions: Within the limits of the population studied, this work demonstrates the clinical value of unilateral spinal anesthesia in ortho-trauma surgery in the frail patient.

Keywords: spinal anaesthesia, vasopressor, morphine, hypobaric unilateral spinal anesthesia, ropivacaine, hip surgery, eldery, hemodynamic

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Authors: Kyriaki Kalaitzidou, Athanasia Tolkou, Christina Raptopoulou, Manassis Mitrakas, Anastasios Zouboulis

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Phosphate rock is the main source of phosphorous (P) in fertilizers and is essential for high crop yield in agriculture; currently, it is considered as a critical element, phasing scarcity. Chemical precipitation, which is a commonly used method of phosphorous removal from wastewaters, finds its significance in that phosphates may be precipitated in appropriate chemical forms that can be reused-recovered. Most often phosphorous is removed from wastewaters in the form of insoluble phosphate salts, by using salts (coagulants) of multivalent metal ions, most frequently iron, aluminum, calcium, or magnesium. The removal degree is affected by various factors, such as pH, chemical agent dose, temperature, etc. In this study, phosphate precipitation from the secondary (biologically treated) effluent of a municipal wastewater treatment plant is examined. Using chlorosulfate (FeClSO4) it was attempted to either remove and/or recover PO43-. Results showed that the use of Fe3+ can achieve residual concentrations lower than the commonly applied legislation limit of PO43- (i.e. 3 mg PO43-/L) by adding 7.5 mg/L Fe3+ in the secondary effluent with an initial concentration of about 10 mg PO43-/L and at pH range between 6 to 9. In addition, the formed sediment has a percentage of almost 24% PO43- content. Therefore, simultaneous removal and recovery of PO43- as ferric phosphate can be achieved, making it possible for the ferric phosphate to be re-used as a possible (secondary) fertilizer source.

Keywords: ferric phosphate, phosphorus recovery, phosphorus removal, wastewater treatment

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Authors: Abraham J. Rizkalla, Tristan D. Yan

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Atrial myxoma is the most common primary cardiac tumor, and can result in cardiac failure secondary to obstruction, or systemic embolism due to fragmentation. Traditionally, excision of atrial an myxoma has been performed through median sternotomy, however the robotic approach offers several advantages including less pain, improved cosmesis, and faster recovery. Here, we highlight the less well recognized advantages and technical aspects to robotic myxoma resection. This video-presentation demonstrates the resection of a papillary subtype left atrial myxoma using the DaVinci© Xi surgical robot. The 10x magnification and 3D vision allows for the interface between the tumor and the interatrial septum to be accurately dissected, without the need to patch the interatrial septum. Several techniques to avoid tumor fragmentation and embolization are demonstrated throughout the procedure. The tumor was completely excised with clear margins. There was no atrial septal defect or mitral valve injury on post operative transesophageal echocardiography. The patient was discharged home on the fourth post-operative day. This video-presentation highlights the advantages of the robotic approach in atrial myxoma resection compared with sternotomy, as well as emphasizing several technical considerations to avoid potential complications.

Keywords: cardiac surgery, left atrial myxoma, cardiac tumour, robotic resection

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Authors: Sultan Ben Jaber

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Optical properties of molecules exhibit dramatic changes when adsorbed close to nano-structure metallic surfaces such as gold and silver nanomaterial. This phenomena opened a wide range of research to improve conventional spectroscopies efficiency. A well-known technique that has an intensive focus of study is surface-enhanced Raman spectroscopy (SERS), as since the first observation of SERS phenomena, researchers have published a great number of articles about the potential mechanisms behind this effect as well as developing materials to maximize the enhancement. Infrared and Raman spectroscopy are complementary techniques; thus, surface-enhanced infrared absorption (SEIRA) also shows a noticeable enhancement of molecules in the mid-IR excitation on nonmetallic structure substrates. In the SEIRA, vibrational modes that gave change in dipole moments perpendicular to the nano-metallic substrate enhanced 200 times greater than the free molecule’s modes. SEIRA spectroscopy is promising for the characterization and identification of adsorbed molecules on metallic surfaces, especially at trace levels. IR reflection-absorption spectroscopy (IRAS) is a well-known technique for measuring IR spectra of adsorbed molecules on metallic surfaces. However, SEIRA spectroscopy sensitivity is up to 50 times higher than IRAS. SEIRA enhancement has been observed for a wide range of molecules adsorbed on metallic substrates such as Au, Ag, Pd, Pt, Al, and Ni, but Au and Ag substrates exhibited the highest enhancement among the other mentioned substrates. In this work, trace levels of 3,4-methylenedioxymethamphetamine (MDMA) have been detected using gold nanoparticles (AuNPs) substrates with surface-enhanced infrared absorption (SEIRA). AuNPs were first prepared and washed, then mixed with different concentrations of MDMA samples. The process of fabricating the substrate prior SEIRA measurements included mixing of AuNPs and MDMA samples followed by vigorous stirring. The stirring step is particularly crucial, as stirring allows molecules to be robustly adsorbed on AuNPs. Thus, remarkable SEIRA was observed for MDMA samples even at trace levels, showing the rigidity of our approach to preparing SEIRA substrates.

Keywords: surface-enhanced infrared absorption (SEIRA), gold nanoparticles (AuNPs), amphetamines, methylene dioxy- methamphetamine (MDMA), enhancement factor

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Authors: Ramanjaneyulu Mogili, G.V.R.K. Acharyulu

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Indian organized retail sector is growing at a faster pace and gaining popularity. Indian Brand Equity Foundation (IBEF) reveals that the current market size of Indian retail industry is about US$ 520 billion with for growth rate 14 to 15 percent annually by 2018 the Indian retail sector is likely to grow at a CAGR of 13% to reach a size of US$ 950 billion. Developments in Information Technology have enabled online Retail sector that empowers customers to order products, conduct transactions without the need to interact physically with the retailers. In recent years, the online shopping industry has gained popularity to the point where certain categories of customers would consider buying electronic products online rather than visiting the stores. Conventionally the physical location of a store is seen as a source of competitive advantage. Online Retailing service sites provide virtual shopping space to the customers. Online Retail services are gaining momentum in India, with internet penetration improving in the country and smartphones becoming affordable along with changing lifestyles and preferences of customers. Although online shoppers prefer the convenience and choice available in online shopping, certain issues raised due to the occurrence of service failure. The proposed study attempts to measure the service recovery and failure process of electronic goods in Indian retail channels.

Keywords: service recovery, customer satisfaction, e-shopping, service failure

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Authors: Kun Liang Ang, Eng Toon Saw, Wei He, Xuecheng Dong, Seeram Ramakrishna

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Ester solvents are widely used in pharmaceutical, printing and flavor industry due to their good miscibility, low toxicity, and high volatility. Through pervaporation, these ester solvents can be recovered from industrial wastewater. While metal-doped silicalite 1 zeolite membranes are commonly used in organic solvent recovery in the pervaporation process, these ceramic membranes suffer from low membrane permeation flux, mainly due to the high thickness of the metal-doped zeolite membrane. Herein, a simple method of fabricating an ultrathin tin-silicalite 1 membrane supported on alumina tube is reported. This ultrathin membrane is able to achieve high permeation flux and separation factor for an ester in a diluted aqueous solution. Nanosized tin-Silicalite 1 seeds which are smaller than 500nm has been formed through hydrothermal synthesis. The sn-Silicalite 1 seeds were then seeded onto alumina tube through dip coating, and the tin-Silicalite 1 membrane was then formed by hydrothermal synthesis in an autoclave through secondary growth method. Multiple membrane synthesis factors such as seed size, ceramic substrate surface pore size selection, and secondary growth conditions were studied for their effects on zeolite membrane growth. The microstructure, morphology and the membrane thickness of tin-Silicalite 1 zeolite membrane were examined. The membrane separation performance and stability will also be reported.

Keywords: ceramic membrane, pervaporation, solvent recovery, Sn-MFI zeolite

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