Search results for: extra skin removal surgery

Authors: Amandeep Kaur, Sangeeta Sharma

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Keeping in view the serious entanglement of heavy metals ( Pb+2 and Ni+2) ions in an aqueous environment, a rapid search for efficient adsorbents for the adsorption of heavy metals has become highly desirable. In this quest, green synthesized Fe np’s have gathered attention because of their excellent adsorption capability of heavy metals from aqueous solution. This research report aims at the fabrication of Fe np’s using the fruit Cucumis melo and leaves of Ficus virens via a biogenic synthesis route. Further, synthesized CM-Fe-np’s and FV-Fe-np’s have been tested as potential bio-adsorbents for the removal of Pb+2 and Ni+2 by carrying out adsorption batch experiments. The influence of myriad parameters like initial concentration of Pb/Ni (5,10,15,20,25 mg/L), contact time (10 to 200 min.), adsorbent dosage (0.5, 0.10, 0.15 mg/L), shaking speed (120 to 350 rpm) and pH value (6,7,8,9) has been investigated. The maximum removal with CM-Fe-np’s and FV-Fe-np’s has been achieved at pH 7, metal conc. 5 mg/L, dosage 0.9 g/L, shaking speed 200 rpm and reaction contact time 200 min during the adsorption experiment. The results obtained are found to be in accordance with Freundlich and Langmuir's adsorption models; consequently, they could be highly applicable to the wastewater treatment plant.

Keywords: adsorption, biogenic synthesis, nanoparticles, nickel, lead

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Authors: Diane Ghanem, Whitney Kagabo, Rebecca Engels, Uma Srikumaran, Babar Shafiq

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Hospitalist co-management of orthopaedic surgery patients is a growing trend across the country. It was created as a collaborative effort to provide overarching care to patients with the goal of improving their postoperative care and decreasing in-hospital medical complications. The aim of this project is to provide a guide for implementing and optimizing a hospitalist co-management service in orthopaedic surgery. Key leaders from the hospitalist team, orthopaedic team and quality, safety and service team were identified. Multiple meetings were convened to discuss the comanagement service and determine the necessary building blocks behind an efficient and well-designed co-management framework. After meticulous deliberation, a consensus was reached on the final service agreement and a written guide was drafted. Fundamental features of the service include the identification of service stakeholders and leaders, frequent consensus meetings, a well-defined framework, with goals, program metrics and unified commands, and a regular satisfaction assessment to update and improve the program. Identified pearls for co-managing orthopaedic surgery patients are standardization, timing, adequate patient selection, and two-way feedback between hospitalists and orthopaedic surgeons to optimize the protocols. Developing a service agreement is a constant work in progress, with meetings, discussions, revisions, and multiple piloting attempts before implementation. It is a partnership created to provide hospitals with a streamlined admission process where at-risk patients are identified early, and patient care is optimized regardless of the number or nature of medical comorbidities. A wellestablished hospitalist co-management service can increase patient care quality and safety, as well as health care value.

Keywords: co-management, hospitalist co-management, implementation, orthopaedic surgery, quality improvement

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Authors: Ava Zarif Sanayei, Sedigheh Sina

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Interventional radiology (IR) uses imaging guidance, including X-rays and CT scans, to deliver therapy precisely. Most IR procedures are performed under local anesthesia and start with a small needle being inserted through the skin, which may be called pinhole surgery or image-guided surgery. There is increasing concern about radiation exposure during interventional radiology procedures due to procedure complexity. The basic aim of optimizing radiation protection as outlined in ICRP 139, is to strike a balance between image quality and radiation dose while maximizing benefits, ensuring that diagnostic interpretation is satisfactory. This study aims to estimate the equivalent doses to the main trunk of the body for the Interventional radiologist and Superintendent using LiF: Mg, Ti (TLD-100) chips at the IR department of a hospital in Shiraz, Iran. In the initial stage, the dosimeters were calibrated with the use of various phantoms. Afterward, a group of dosimeters was prepared, following which they were used for three months. To measure the personal equivalent dose to the body, three TLD chips were put in a tissue-equivalent batch and used under a protective lead apron. After the completion of the duration, TLDs were read out by a TLD reader. The results revealed that these individuals received equivalent doses of 387.39 and 145.11 µSv, respectively. The findings of this investigation revealed that the total radiation exposure to the staff was less than the annual limit of occupational exposure. However, it's imperative to implement appropriate radiation protection measures. Although the dose received by the interventional radiologist is a bit noticeable, it may be due to the reason for using conventional equipment with over-couch x-ray tubes for interventional procedures. It is therefore important to use dedicated equipment and protective means such as glasses and screens whenever compatible with the intervention when they are available or have them fitted to equipment if they are not present. Based on the results, the placement of staff in an appropriate location led to increasing the dose to the radiologist. Manufacturing and installation of moveable lead curtains with a thickness of 0.25 millimeters can effectively minimize the radiation dose to the body. Providing adequate training on radiation safety principles, particularly for technologists, can be an optimal approach to further decreasing exposure.

Keywords: interventional radiology, personal monitoring, radiation protection, thermoluminescence dosimetry

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Authors: A. Jéglot, F. Plauborg, M. K. Schnorr, R. S. Sørensen, L. Elsgaard

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Artificial wetlands such as woodchip bioreactors are efficient tools to remove nitrate from agricultural wastewater with a minimized environmental impact. However, the temperature dependence of the microbiological nitrate removal prevents the woodchip bioreactors from being an efficient system when the water temperature drops below 8℃. To quantify and describe the temperature effects on nitrate removal efficiency, we studied nitrate-reducing enrichments from a woodchip bioreactor in Denmark based on samples collected in Spring and Fall. Growth was quantified as optical density, and nitrate and nitrous oxide concentrations were measured in time-course experiments to compare the growth of the microbial population and the nitrate conversion efficiencies at different temperatures. Ammonia was measured to indicate the importance of dissimilatory nitrate reduction to ammonia (DNRA) in nitrate conversion for the given denitrifying community. The temperature responses observed followed the increasing trend proposed by the Arrhenius equation, indicating higher nitrate removal efficiencies at higher temperatures. However, the growth and the nitrous oxide production observed at low temperature provided evidence of the psychrotolerance of the microbial community under study. The assays conducted showed higher nitrate removal from the microbial community extracted from the woodchip bioreactor at the cold season compared to the ones extracted during the warmer season. This indicated the ability of the bacterial populations in the bioreactor to evolve and adapt to different seasonal temperatures.

Keywords: agricultural waste water treatment, artificial wetland, denitrification, psychrophilic conditions

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Authors: Obradith Caicedo, Paola Devia

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Methylene blue (MB) and malachite green (MG) are substances commonly used in classrooms for academic purposes. Nevertheless, in most cases, there is no adequate disposal of this type of waste, their presence in the environment affects ecosystems due to the presence of color and the reduction of photosynthetic processes. In this work, we evaluated properties of fibers of Luffa cylindrica in removal from dyes of aqueous solutions through an adsorption process. The point of zero charge, acid and basic sites was also investigated. The best conditions of the adsorption process were determined under a discontinuous system, evaluating an interval of the variables 2 3 : pH value, particle size of the adsorbent and contact time. The temperature (18ºC), agitation (220 rpm) and adsorbent dosage (10g/L) were constant. Measurements were made using UV- Visible spectrophotometry. The point of zero charge for Luffa cylindrica was 4,3. The number of acidic and basic sites was 2.441 meq/g and 1,009 meq/g respectively. These indicate a prevalence of acid groups. The maximum dye sorption was found to be at a pH of 5,5 (97,1 % for MB) and 5,0 (97,7% for MG) and particle size of the adsorbent 850 µm. The equilibrium uptake was attained within 60 min. With this study, it has been shown that Luffa cylindrica can be used as efficient adsorbent for the removal of methylene blue, and malachite green from aqueous solution in classrooms.

Keywords: adsorption, dye removal, low-cost adsorbents, Luffa cylindrical

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Authors: Nadjet Taoualit, Zoubida Chemat, Djamel-Eddine Hadj-Boussaad

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This study aims the removal of copper Cu (II) contained in wastewater by adsorption on a perfect synthesized mud. It is the materials Hydroxides Double Lamellar, HDL, prepared and synthesized by co-precipitation method at constant pH, which requires a simple titration assembly, with an inexpensive and available material in the laboratory, and also allows us better control of the composition of the reaction medium, and gives well crystallized products. A characterization of the adsorbent proved essential. Thus a range of physic-chemical analysis was performed including: FTIR spectroscopy, X-ray diffraction… The adsorption of copper ions was investigated in dispersed medium (batch). A systematic study of various parameters (amount of support, contact time, initial copper concentration, temperature, pH…) was performed. Adsorption kinetic data were tested using pseudo-first order, pseudo-second order, Bangham's equation and intra-particle diffusion models. The equilibrium data were analyzed using Langmuir, Freundlich, Tempkin and other isotherm models at different doses of HDL. The thermodynamics parameters were evaluated at different temperatures. The results have established good potentiality for the HDL to be used as a sorbent for the removal of Copper from wastewater.

Keywords: adsoption, copper, HDL, isotherm

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Authors: H. Jamili, S. Shakiba

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Today, one of the main concerns of human beings is facing the unpleasant changes of the environment. Buildings are responsible for a significant amount of natural resources consumption and carbon emissions production. In such a situation, this thought comes to mind that changing each building into a phenomenon of benefit to the environment. A change in a way that each building functions as an element that supports the environment, and construction, in addition to answering the need of humans, is encouraged, the way planting a tree is, and it is no longer seen as a threat to alive beings and the planet. Prospect: Today, different ideas of developing materials that can smartly function are realizing. For instance, Programmable Materials, which in different conditions, can respond appropriately to the situation and have features of modification in shape, size, physical properties and restoration, and repair quality. Studies are to progress having this purpose to plan for these materials in a way that they are easily available, and to meet this aim, there is no need to use expensive materials and high technologies. In these cases, physical attributes of materials undertake the role of sensors, wires and actuators then materials will become into robots itself. In fact, we experience robotics without robots. In recent decades, AI and technology advances have dramatically improving the performance of materials. These achievements are a combination of software optimizations and physical productions such as multi-materials 3D printing. These capabilities enable us to program materials in order to change shape, appearance, and physical properties to interact with different situations. nIt is expected that further achievements like Memory Materials and Self-learning Materials are also added to the Smart Materials family, which are affordable, available, and of use for a variety of applications and industries. From the architectural standpoint, the building skin is significantly considered in this research, concerning the noticeable surface area the buildings skin have in urban space. The purpose of this research would be finding a way that the programmable materials be used in building skin with the aim of having an effective and positive interaction. A Pixel Façade would be a solution for programming a building skin. The Pixel Facadeincludes components that contain a series of attributes that help buildings for their needs upon their environmental criteria. A PIXEL contains series of smart materials and digital controllers together. It not only benefits its physical properties, such as control the amount of sunlight and heat, but it enhances building performance by providing a list of features, depending on situation criteria. The features will vary depending on locations and have a different function during the daytime and different seasons. The primary role of a PIXEL FAÇADE can be defined as filtering pollutions (for inside and outside of the buildings) and providing clean energy as well as interacting with other PIXEL FACADES to estimate better reactions.

Keywords: building skin, environmental crisis, pixel facade, programmable materials, smart materials

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Authors: Laila Mahtout, Kerami Ahmed, Rabhi Souhila

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The objective of this work is to reduce the impact on the environment of an acid dye (Black Eriochrome T) using catalytic photo-degradation in the presence of the semiconductor powder (TiO₂) previously characterized. A series of tests have been carried out in order to demonstrate the influence of certain parameters on the degree of dye degradation by titanium dioxide in the presence of UV rays, such as contact time, the powder mass and the pH of the solution. X-ray diffraction analysis of the powder showed that the anatase structure is predominant and the rutile phase is presented by peaks of low intensity. The various chemical groups which characterize the presence of the bands corresponding to the anatase and rutile form and other chemical functions have been detected by the Fourier Transform Infrared spectroscopy. The photo degradation of the NET by TiO₂ is very interesting because it gives encouraging results. The study of photo-degradation at different concentrations of the dye showed that the lower concentrations give better removal rates. The degree of degradation of the dye increases with increasing pH; it reaches the maximum value at pH = 9. The ideal mass of TiO₂ which gives the high removal rate is 1.2 g/l. Thermal treatment of TiO₂ with the addition of CuO with contents of 5%, 10%, and 15% respectively gives better results of degradation of the NET dye. The high percentage of elimination is observed at a CuO content of 15%.

Keywords: acid dye, ultraviolet rays, degradation, photocatalyse

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Authors: Maryam Risla Shahul Hameed, Tharsiga Yogarajah, Fritzy Mathew, Tayyaba Syed, Shalin Shaunak

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Aim: Auditing the adherence of Trauma and Orthopaedics Operative notes to the RCS Good Surgical Practice Guidelines. Method: Clinical audit conducted on 150 operative notes over a period of 2 months April- May 2023, including emergency and elective surgeries performed in Ashford and St. Peter’s Hospital. The RCS Good Practice Surgical Guidelines for an ideal operative note were used to compare.Results: Date of the procedure and signature of the surgeon were mentioned in all the notes by default in the electronic template being used. Title of the operation performed and whether elective or emergency were mentioned by 92% and 45%, respectively. Name of theatre anaesthetist and operating surgeons were mentioned by 73% and 93% respectively. Time of surgery mentioned by 26%. Operative findings and operative diagnosis mentioned by 83% and 53% respectively. Incision and complications of surgery mentioned in 80% and 53%, respectively. Details of tissue added/ altered/ removed mentioned by 46%. Information on prosthesis or implant used is mentioned by 54%. Details of closure and anticipated blood loss mentioned in 91% and 45% respectively. Antibiotic prophylaxis was mentioned by 63%, out of which only 23% mentioned the name and duration of the antibiotic. VTE prophylaxis was mentioned by 84%, out of which only 23% and 29% mentioned the name and duration of the prophylaxis, respectively. Conclusion: There is more for improvement in the operative notes for better continuity of care between the operating surgeons and other doctors in the wards taking care of the patients post operatively. We recommend to follow a standardized guidelines by all the nationwide and a standard template to be followed by all.

Keywords: surgery, notes, RCS, guidelines

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Authors: Havva Tutar Kahraman, Erol Pehlivan

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In recent years, environmental pollution by wastewater rises very critically. Effluents discharged from various industries cause this challenge. Different type of pollutants such as organic compounds, oxyanions, and heavy metal ions create this threat for human bodies and all other living things. However, heavy metals are considered one of the main pollutant groups of wastewater. Therefore, this case creates a great need to apply and enhance the water treatment technologies. Among adopted treatment technologies, adsorption process is one of the methods, which is gaining more and more attention because of its easy operations, the simplicity of design and versatility. Ion exchange process is one of the preferred methods for removal of heavy metal ions from aqueous solutions. It has found widespread application in water remediation technologies, during the past several decades. Therefore, the purpose of this study is to the removal of hexavalent chromium, Cr(VI), from aqueous solutions. Cr(VI) is considered as a well-known highly toxic metal which modifies the DNA transcription process and causes important chromosomic aberrations. The treatment and removal of this heavy metal have received great attention to maintaining its allowed legal standards. The purpose of the present paper is an attempt to investigate some aspects of the use of three anion exchange resins: Eichrom 1-X4, Lewatit Monoplus M800 and Lewatit A8071. Batch adsorption experiments were carried out to evaluate the adsorption capacity of these three commercial resins in the removal of Cr(VI) from aqueous solutions. The chromium solutions used in the experiments were synthetic solutions. The parameters that affect the adsorption, solution pH, adsorbent concentration, contact time, and initial Cr(VI) concentration, were performed at room temperature. High adsorption rates of metal ions for the three resins were reported at the onset, and then plateau values were gradually reached within 60 min. The optimum pH for Cr(VI) adsorption was found as 3.0 for these three resins. The adsorption decreases with the increase in pH for three anion exchangers. The suitability of Freundlich, Langmuir and Scatchard models were investigated for Cr(VI)-resin equilibrium. Results, obtained in this study, demonstrate excellent comparability between three anion exchange resins indicating that Eichrom 1-X4 is more effective and showing highest adsorption capacity for the removal of Cr(VI) ions. Investigated anion exchange resins in this study can be used for the efficient removal of chromium from water and wastewater.

Keywords: adsorption, anion exchange resin, chromium, kinetics

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Authors: Ching-Yuan Chen, Lung-Kwang Pan

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Objective: Back pain is a major health problem costing billions of health budgets annually in Taiwan. Thousands of back pain surgeries are performed annually with up to 40% of patients complaining of back pain at time of post-surgery causing failed back surgery syndrome (FBSS), although diagnosis in these patients may be complex. The aim of study is to assess the feasibility of using bone SPECT-CT imaging to localize the active lesions causing persistent, recurrent or new backache after spine surgery. Materials and Methods: Bone SPECT-CT imaging was performed after the intravenous injection of 20 mCi of 99mTc-MDP for all the patients with diagnosis of FBSS. Patients were evaluated using status of subjectively pain relief, functional improvement and degree of satisfaction by reviewing the medical records and questionnaires in a 2 more years’ follow-up. Results: We enrolled a total of 16 patients were surveyed in our hospital from Jan. 2015 to Dec. 2016. Four people on SPEC/CT imaging ensured significant lesions were undergone a revised surgery (surgical treatment group). The mean visual analogue scale (VAS) decreased 5.3 points and mean Oswestry disability index (ODI) improved 38 points in the surgical group. The remaining 12 on SPECT/CT imaging were diagnosed as no significant lesions then received drug treatment (medical treatment group). The mean VAS only decreased 2 .1 point and mean ODI improved 12.6 points in the medical treatment group. In the posttherapeutic evaluation, the pain of the surgical treatment group showed a satisfactory improvement. In the medical treatment group, 10 of the 12 were also satisfied with the symptom relief while the other 2 did not improve significantly. Conclusions: Findings on SPECT-CT imaging appears to be easily explained the patients' pain. We recommended that SPECT/CT imaging was a feasible and useful clinical tool to improve diagnostic confidence or specificity when evaluating patients with FBSS.

Keywords: failed back surgery syndrome, oswestry disability index, SPECT-CT imaging, 99mTc-MDP, visual analogue scale

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Authors: Monika Rezacova

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Radiation-induced breast changes are a consequence of radiotherapy toxicity over the breast tissues either related to targeted breast cancer treatment or other thoracic malignancies (eg. lung cancer). This study has created an overview of different changes and their pathophysiology. The main conditions included were skin thickening, interstitial oedema, fat necrosis, dystrophic calcifications, skin retractions, glandular atrophy, breast fibrosis and radiation induced breast cancer. This study has performed focused literature search through multiple databases including pubmed, medline and embase. The study has reviewed English as well as non English publications. As a result of the literature the study provides comprehensive overview of radiation-induced breast changes and their pathophysiology with small focus on new development and prevention.

Keywords: radiotherapy toxicity, breast tissue changes, breast cancer treatment, radiation-induced breast changes

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Authors: Ebrahim Tilahun, Erkan Sahinkaya, Bariş Calli̇

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Raw biogas is a valuable renewable energy source however it usually needs removal of the impurities. The presence of hydrogen sulfide (H2S) in the biogas has detrimental corrosion effects on the cogeneration units. Removal of H2S from the biogas can therefore significantly improve the biogas quality. In this work, a conventional bioscrubber (CBS), and a dense membrane bioscrubber (DMBS) were comparatively evaluated in terms of H2S removal efficiency (RE), CH4 enrichment and alkaline consumption at gas residence times ranging from 5 to 20 min. Both bioscrubbers were fed with a synthetic biogas containing H2S (1%), CO2 (39%) and CH4 (60%). The results show that high RE (98%) was obtained in the DMBS when gas residence time was 20 min, whereas slightly lower CO2 RE was observed. While in CBS system the outlet H2S concentration was always lower than 250 ppmv, and its H2S RE remained higher than 98% regardless of the gas residence time, although the high alkaline consumption and frequent absorbent replacement limited its cost-effectiveness. The result also indicates that in DMBS when the gas residence time increased to 20 min, the CH4 content in the treated biogas enriched upto 80%. However, while operating the CBS unit the CH4 content of the raw biogas (60%) decreased by three fold. The lower CH4 content in CBS was probably caused by extreme dilution of biogas with air (N2 and O2). According to the results obtained here the DMBS system is a robust and effective biotechnology in comparison with CBS. Hence, DMBS has a better potential for real scale applications.

Keywords: biogas, bioscrubber, desulfurization, PDMS membrane

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Authors: Amina Omer, Ikram Elsiddig

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Arctostaphylos uvaursi is a plant of the family Ericaceae, it’s used in skin care products mostly for its depigmenting action, due to the presence of hydroquinones that are well known inhibitors of tyrosinase, an enzyme involved in melanin biosynthesis in humans. The main hydroquinone found within the A. uvaursi is arbutin, which is found with varying percentage within the plant depending on the season, and area from which the plant is harvested. An in vitro experiment has shown that the arbutin found within the bearberry leaf extract inhibited the biosynthesis of melanin in human melanoma cells and in three-dimensional human skin model. Madurella mycetomatis is filamentous fungus that causes the fungal form of mycetoma known as eumycetoma, with existing anti-fungals and surgery, only 35% of people living eumycetoma are treated, M. mycetomatis has been found to shield itself against the antifungal therapy through the production of melanin decreasing the effectiveness of the therapy, therefore there is a need for a new and more effective therapy. The aim of the study was to investigate and compare the effect of arbutin powder and aqueous extract of A. uvaursi containing arbutin on the biosynthesis of melanin by M. mycetomatis. The experiment was carried out by culturing M. mycetomatis on minimal media composed of 2% agar, 15 mM glucose, 10 mM MgSO4, 29.4 mM KH2PO4, 13 mM glycin and 80mg/l gentamicin, the media was supplied with different concentration of arbutin solution (5, 25 50,and 75mg) and aqueous extract of A. uvaursi to contain arbutin with concentrations (5, 25 50,and 75mg), the plates were incubated for two month and the result was observed by the naked eye. The results revealed that the arbutin powder had an inhibitory effect on melanin synthesis by M. mycetomatis that correlated with its established inhibitory effect on melanin synthesis in humans. The inhibitory effect of arbutin on melanin synthesis by M. mycetomatis was found to be dose dependent. A. uvaursi aqueous leaf extract containing arbutin was also found to decrease melanin production by M. mycetomatis, however plates containing high concentrations of aqueous extract couldn’t be assessed for its melanin inhibitory effect due to the high content of carbohydrates in the extract that promoted the growth of fungi Asperigullus niger rendering the plates unsuitable for visual inspection. In conclusion inhibition of melanin synthesis was observed on the arbutin powder as well as the aqueous extract containing arbutin. A. uvaursi is known to exhibit anti-inflammatory activity, which can aid in wound healing that is beneficial in the chronic inflammation caused by M. mycetomatis.

Keywords: arbutin, arctostaphylos, Madurella, melanin

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Authors: J. Franco Macías, E. Montes Alba, A. López Vásquez

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The growing development in the poultry industry has generated a strong and adverse impact on quality and availability of water resources. Inside this industry, is finding out the treatment of by-products such as feathers, viscera and blood demanding highly water consumption, generating contaminant discharges as well. As one of current of treatment of by-products is the effluent of cooking condensate steam that has contaminant organic load; therefore, it is necessary to implement removal treatments before discharging it toward water sources. The photo catalysis appears as a promising alternative of treatment due to the different advantages it has, among others, includes low cost, easily operation, high efficiency and elimination of a wide variety of contaminants in a watery environment. This study has evaluated a heterogeneous photo catalytic treatment for removal contaminant organic load. This process was developed in oxidation and reduction conditions. It was analyzed the effect of factors such as pH, catalyst and sacrifice agent concentration. Finally, good conditions to removal contaminant organic load were achieved to determine percentage of contaminant organic load by means of response surface methodology.

Keywords: poultry industry, advanced oxidation process, photocatalysis, photodegradation, TiO2

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Authors: Mekroud Amel

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Introduction The rate of use by the elderly of emergency departments, operating rooms and intensive care units has increased worldwide. Emergency surgery is a context where evaluation is often insufficient, with incomplete information gathering. The aim of this work is to shed light on the frequent use of emergency surgeries by the elderly and their characteristics, as well as on the lack of geriatric assessment scores in the emergency room. Material : Prospective, observational and descriptive, monocentric study. Patients aged 65 and over, admitted for emergency surgery in the operating room, were counted. Emergency operating room including visceral surgery, urology, traumatology and neurosurgery. Parameters studied: Patient characteristics, degree of autonomy, type of surgical pathology, operative management times, preoperative evaluation, postoperative outcome Results : 192 patients were identified over 12 months, from 09.01.2017 to 08.31.2018 Age from 65 to 101 years, 79.81 years +/- 8.38. With predominance of the age group between [65-75 years] 41.1% Female predominance, Sexratio = 0.81 Elderly subjects with total motor autonomy are in the majority at 57.8% Subjects without pathological ATCD represent 12.5% of cases Those who are on only one type of medication or without any treatment are at 36.9% Discussion : The emergency operative care of the elderly patient for a surgical or traumatological pathology is characterized by many specificities linked first to the emergency context, where the evaluation is often insufficient, besides the fact that the elderly patient has particularities requiring reception in centers with experience in the care of this category of patient, or, failing that, a center which uses the minimum of geriatric evaluation scores which are simplified for the emergency departments. In our hospital, we have not yet made this evaluation routine in the emergency room and this delay in the introduction of these scores can be directly attributed to the covid 19 pandemic. Besides the standard preoperative assessment, only 43.2% of patients were assessed in the preoperative period by an anesthesiologist. Traumatological emergencies come first 68.2% followed by visceral emergencies 19.2% (including proctological, urological emergencies), neurosurgical emergencies 7.8% and finally peripheral emergency surgery all acts combined 4.7%. Hospital stay at 9.6 +/- 16.8 days, average operability time of 4.5 +/- 3 days. Death rate at 7.29% Conclusion This work has demonstrated the major impact of emergency surgery, which remains curable for the most part, on the elderly patient despite total motor and cognitive autonomy preoperatively. The improvement of the preoperative evaluation, the reduction of the operating time and enhanced recovery after surgery, with personalized protocols, are the only guarantee for the resumption of preoperative autonomy in these patients.

Keywords: emergency surgery, elderly patients, preoperative geriatric scores, curable emergency surgical pathologies

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Authors: E. H. N. Gashti, M. Malaska, K. Kujala

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The thermo-mechanical behaviour of concrete energy pile foundations with different single and double U-tube shapes incorporated was analysed using the Comsol Multi-physics package. For the analysis, a 3D numerical model in real scale of the concrete pile and surrounding soil was simulated regarding actual operation of ground heat exchangers (GHE) and the surrounding ambient temperature. Based on initial ground temperature profile measured in situ, tube inlet temperature was considered to range from 6°C to 0°C (during the contraction process) over a 30-day period. Extra thermal stresses and deformations were calculated during the simulations and differences arising from the use of two different systems (single-tube and double-tube) were analysed. The results revealed no significant difference for extra thermal stresses at the centre of the pile in either system. However, displacements over the pile length were found to be up to 1.5-fold higher in the double-tube system than the single-tube system.

Keywords: concrete energy piles, stresses, displacements, thermo-mechanical behaviour, soil-structure interactions

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Authors: Ligia Florio, João Mauricio Castaldelli-Maia

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Background: Food addiction (FA) emerged in the 1990s as a possible contributor to the increasing prevalence of obesity and overweight, in conjunction with changing food environments and mental health conditions. However, FA is not yet listed as one of the disorders in the DSM-5 and/or the ICD-11. Although there are controversies and debates in the literature about the classification and construct of FA, the most common approach to access it is the use of a research tool - the Yale Food Addiction Scale (YFAS) - which approximates the concept of FA to the concept diagnosis of dependence on psychoactive substances. There is a need to explore the dimensional phenotypes accessed by YFAS in different population groups for a better understanding and scientific support of FA diagnoses. Methods: The primary objective of this project was to investigate the construct validity of the FA concept by mYFAS 2.0 in individuals who underwent bariatric surgery (n = 100) at the Hospital Estadual Mário Covas since 2011. Statistical analyzes were conducted using the STATA software. In this sense, structural or factor validity was the type of construct validity investigated using exploratory factor analysis (EFA) and item response theory (IRT) techniques. Results: EFA showed that the one-dimensional model was the most parsimonious. The IRT showed that all criteria contributed to the latent structure, presenting discrimination values greater than 0.5, with most presenting values greater than 2. Conclusion: This study reinforces a FA dimension in patients who underwent bariatric surgery. Within this dimension, we identified the most severe and discriminating criteria for the diagnosis of FA.

Keywords: obesity, food addiction, bariatric surgery, regain

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Authors: Omnia F. Kharoob, Nashwa M. Yossef

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Concrete-filled double skin steel tubular (CFDST) columns could be utilized in structures such as bridges, high-rise buildings, viaducts, and electricity transmission towers due to its great structural performance. Alternatively, lean duplex stainless steel has recently gained significant interest for its high structural performance, similar corrosion resistance and lower cost compared to the austenitic steel grade. Hence, this paper presents the nonlinear finite element (FE) analysis, behaviour and design of rectangular outer lean duplex stainless steel (EN 1.4162) CFDST short columns under compression. All classes of the outer rectangular hollow section according to the depth-to-thickness (D/t) ratios were considered. The results showed that the axial ultimate strength of rectangular CFDST short columns increased linearly by increasing the concrete compressive strength, while it does not influence when changing the hollow ratios. Finally, the axial capacities were compared with the available design methods, and recommendations were conducted for the design strength of this type of column.

Keywords: concrete-filled double skin columns, compressive strength, finite element analysis, lean duplex stainless steel, ultimate axial strength, short columns

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Authors: A. Bara, D. Barkat

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Liquid-liquid extraction is one of the most useful techniques for selective removal and recovery of metal ions from aqueous solutions, applied in purification processes in numerous chemical and metallurgical industries. In this work, The liquid-liquid extraction of cobalt (II) and copper (II) from aqueous solution by capric acid (HL) in chloroform at 25°C has been studied. Our interest in this paper is to study the effect of concentration of capric acid on the extraction of Co(II) and Cu(II) to see the complexes could be formed in the organic phase using various concentration of capric acid. The extraction of cobalt (II) and copper (II) is extracted as the complex CoL2 (HL )2, CuL2 (HL)2.

Keywords: capric acid, Cobalt(II), copper(II), liquid-liquid extraction

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Authors: N. Viji, K. Siddeswaran

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Field experiment was conducted at Eastern Block farm, Department of Farm Management, Tamil Nadu Agricultural University, Coimbatore during winter season of 2011-2012 to evaluate potassium salt based glyphosate (Roundup Crop Shield 460 SL) with and without intercultural operations on seed cotton yield and weed nutrient removal in irrigated cotton. The experiment was laid out in Randomized Block Design with treatments replicated thrice. The treatments consisted of POE glyphosate (Roundup Crop Shield 460 SL) at 1350 (T1), 1800 (T2), 2250 (T3) g a.e. ha-1, 1800 g a.e. ha-1 + IC (T4), PE pendimethalin at 750 g a.i. ha-1 + IC (T5), HW at 35 and 70 DAS + IC (T6), HWW at 35 and 70 DAS + IC (T7), PWW at 35 and 70 DAS + IC (T8), HW at 25 and 45 DAS (T9) and Unweeded control (T10). Among the weed management methods, decreased nutrient removal by weeds were observed with POE glyphosate at 1800 g a.e. ha-1 + IC which was comparable with PE pendimethalin at 750 g a.i. ha-1 + IC. Higher seed cotton yield was obtained with POE glyphosate at 1800 g a.e. ha-1 at 35 and 70 DAS with + IC at 45 and 55 DAS which was comparable with PE pendimethalin at 750 g a.i. ha-1 + IC at 45 and 55 DAS. Comparing treatments without intercultural operation, intercultural operation carried out treatments performed better and recorded more seed cotton yield.

Keywords: cotton, weed, glyphosate, nutrient

Procedia PDF Downloads 635

Authors: Jeong-Hyun Hong, Wonsuk Choi, Hyungdal Park, Jinseok Kim, Junesun Kim

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Identifying the chronic functions of an implanted neural electrode is an important factor in acquiring neural signals through the electrode or restoring the nerve functions after peripheral nerve injury. The purpose of this study was to investigate the biocompatibility of the chronic implanted neural electrode into the sciatic nerve. To do this, a sieve-type neural electrode was implanted at proximal and distal ends of a transected sciatic nerve as an experimental group (Sieve group, n=6), and the end-to-end epineural repair was operated with the cut sciatic nerve as a control group (reconstruction group, n=6). All surgeries were performed on the sciatic nerve of the right leg in Sprague Dawley rats. Behavioral tests were performed before and 1, 4, 7, 10, 14, and weekly days until 5 months following surgery. Changes in sensory function were assessed by measuring paw withdrawal responses to mechanical and cold stimuli. Motor function was assessed by motion analysis using a Qualisys program, which showed a range of motion (ROM) related to the joints. Neurofilament-heavy chain and fibronectin expression were detected 5 months after surgery. In both groups, the paw withdrawal response to mechanical stimuli was slightly decreased from 3 weeks after surgery and then significantly decreased at 6 weeks after surgery. The paw withdrawal response to cold stimuli was increased from 4 days following surgery in both groups and began to decrease from 6 weeks after surgery. The ROM of the ankle joint was showed a similar pattern in both groups. There was significantly increased from 1 day after surgery and then decreased from 4 days after surgery. Neurofilament-heavy chain expression was observed throughout the entire sciatic nerve tissues in both groups. Especially, the sieve group was showed several neurofilaments that passed through the channels of the sieve-type neural electrode. In the reconstruction group, however, a suture line was seen through neurofilament-heavy chain expression up to 5 months following surgery. In the reconstruction group, fibronectin was detected throughout the sciatic nerve. However, in the sieve group, the fibronectin was observed only in the surrounding nervous tissues of an implanted neural electrode. The present results demonstrated that the implanted sieve-type neural electrode induced a focal inflammatory response. However, the chronic implanted sieve-type neural electrodes did not cause any further inflammatory response following peripheral nerve injury, suggesting the possibility of the chronic application of the sieve-type neural electrodes. This work was supported by the Basic Science Research Program funded by the Ministry of Science (2016R1D1A1B03933986), and by the convergence technology development program for bionic arm (2017M3C1B2085303).

Keywords: biocompatibility, motor functions, neural electrodes, peripheral nerve injury, sensory functions

Procedia PDF Downloads 149

Authors: Maryam Panahi

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Background: Adjuvants such as ketamine, promethazine, and paracetamol could bring up patient's satisfaction and control the harmful effects of opioids besides lessening their needed doses, as seen by the fentanyl/paracetamol and fentanyl/ketamine combination before. The current study is headed to compare paracetamol and ketamine, in addition to fentanyl, applied by infusion pumps in order to pain relief following major surgery. Materials and Methods: Through a double-blinded, randomized clinical trial, patients between18 and 65 with elective surgery for tight or leg fractures with ASA Class 1 and 2 referred to a university hospital in Arak, a town in the central region of Iran, were recruited and used infusion pump for their postoperative pain control. The participants were divided into cases and controls regarding using ketamine/fentanyl (KF) or paracetamol/fentanyl (PF) infusion pumps. Results: The mean pain score was a total of 3.87, with the highest value in KF (5.06) and the lowest in PF (4.50) immediately after finishing the surgery and getting conscious when started using an infusion pump. There was no statistical difference between the groups in this regard. Concerning the side effects of the applied medications, blood pressure and heart rate had no differences comparing the groups. Conclusion: This study showed that paracetamol used in infusion pumps could be brilliant in pain control after major surgeries like those done in lower extremities and joint replacement while lessening opioid use. Although paracetamol was more effective than ketamine in the current trial, more qualified studies at bigger sizes and in other fields of surgery besides orthopedic ones would be useful to support the effects if applicable

Keywords: infusion pump, Ketamine, Paracetamol, pain

Procedia PDF Downloads 55

Authors: Chee Young Kim, Tae Hyun Kim, Anbok Lee, Hyun-Ah Kim, Woosung Lim, Ku Sang Kim, Jinsun Lee, Yoo Seok Kim, Beom Seok Ko

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Background: CollatampTM is Gentamicin-containing collagen sponge well known for its hemostatic effect, commonly utilized in surgeries. We inserted CollatempTM wrapped by SurgicelTM (oxidized cellulose polymer) to fill up the defect after breast conserving surgery. The purpose of this study is to verify the furthermore cosmetic value of CollatampTM in breast conserving surgery conducted in breast cancer patients. Methods: 17 patients were enrolled in this study, underwent breast conserving surgery with CollatampTM wrapped by SurgicelTM insertion, in Inje University Busan Paik Hospital from October 2015 to September 2016. Patient satisfaction, cosmetic outcome, results at 6 months from operation was analyzed to verify the effectiveness and usefulness of CollatampTM for cosmetics. Patient satisfaction was investigated through interviews on a scale of good, fair, poor, and the cosmetic outcome was investigated through physical examination by a surgeon who did not participate in the operations. Results: Among 17 patients, nine of them gave ‘good’ for patient satisfaction, eight gave ‘fair’ and none of them ‘poor’. Also, cosmetic outcome came out with 11 ‘good’s, six ‘fair’s, no ‘poor’. In ‘good’ patient satisfaction group, the mean value of resection to breast volume ratio was 16%, compared to 24% of ‘fair’ group. The mean value of actual resection volume was 100.6cm3, 102.7cm3 each. In ‘good’ cosmetic outcome group, the mean value of resection to breast volume ratio was 18%, compared to 23% of ‘fair’ group. The mean value of actual resection volume was 99.2cm3, 105.9cm3 respectively. According to these results, patient satisfaction and cosmetic outcome after surgeries were more reliable on the resection to breast volume ratio, rather than the actual resection volume. There were eight cases of postoperative complications, consisting of a lymphedema, a seroma, and six patients had mild pain. Conclusions: Cosmetic effect of CollatampTM in breast conserving surgery was more reliable on the resection to breast volume ratio, rather than the actual resection volume. In this short term survey, patients were tend to be satisfied with the cosmetics, all giving either good or fair scores. However, long term outcomes should be further assessed.

Keywords: breast cancer, breast conserving surgery, collatamp, cosmetics

Procedia PDF Downloads 253

Authors: Aashutosh Garg, Ankur Rajpal, A. A. Kazmi

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The efficiency of an on-site wastewater treatment system named Johkasou was evaluated based on its pollutant removal efficiency over 10 months. This system was installed at IIT Roorkee and had a capacity of treating 7 m3/d of sewage water, sufficient for a group of 30-50 people. This system was fed with actual wastewater through an equalization tank to eliminate the fluctuations throughout the day. Methanol and ammonium chloride was added into this equalization tank to increase the Chemical Oxygen Demand (COD) and ammonia content of the influent. The outlet from Johkasou is sent to a tertiary unit consisting of a Pressure Sand Filter and an Activated Carbon Filter for further treatment. Samples were collected on alternate days from Monday to Friday and the following parameters were evaluated: Chemical Oxygen Demand (COD), Biochemical Oxygen Demand (BOD), Total Suspended Solids (TSS), and Total Nitrogen (TN). The Average removal efficiency for Chemical Oxygen Demand (COD), Biochemical Oxygen Demand (BOD), Total Suspended Solids (TSS), and Total Nitrogen (TN) was observed as 89.6, 97.7, 96, and 80% respectively. The cost of treating the wastewater comes out to be Rs 23/m3 which includes electricity, cleaning and maintenance, chemical, and desludging costs. Tests for the coliforms were also performed and it was observed that the removal efficiency for total and fecal coliforms was 100%. The sludge generation rate is approximately 20% of the BOD removal and it needed to be removed twice a year. It also showed a very good response against the hydraulic shock load. We performed vacation stress analysis on the system to evaluate the performance of the system when there is no influent for 8 consecutive days. From the result of stress analysis, we concluded that system needs a recovery time of about 48 hours to stabilize. After about 2 days, the system returns again to original conditions and all the parameters in the effluent become within the limits of National Green Tribunal (NGT) standards. We also performed another stress analysis to save the electricity in which we turned the main aeration blower off for 2 to 12 hrs a day and the results showed that we can turn the blower off for about 4-6 hrs a day and this will help in reducing the electricity costs by about 25%. It was concluded that the Johkasou system can remove a sufficient amount of all the physiochemical parameters tested to satisfy the prescribed limit set as per Indian Standard.

Keywords: on-site treatment, domestic wastewater, Johkasou, nutrient removal, pathogens removal

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Authors: Raj Chavan

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Currently, there are over 14,500 Water Resource Recovery Facilities (WRRFs) in the United States, with ~35% of them having some type of nutrient limits in place. These WRRFs account for about 1% of overall power demand and 2% of total greenhouse gas emissions (GHG) in the United States and contribute for 10 to 15% of the overall nutrient load to surface rivers in the United States. The evolution of densification technologies toward more compact and energy-efficient nutrient removal processes has been impacted by a number of factors. Existing facilities that require capacity expansion or biomass densification for higher treatability within the same footprint are being subjected to more stringent requirements relating to nutrient removal prior to surface water discharge. Densification of activated sludge has received recent widespread interest as a means for achieving process intensification and nutrient removal at WRRFs. At the core of the technology are the aerobic sludge granules where the biological processes occur. There is considerable interest in the prospect of producing granular sludge in continuous (or traditional) activated sludge processes (CAS) or densification of biomass by moving activated sludge flocs to a denser aggregate of biomass as a highly effective technique of intensification. This presentation will provide a fundamental understanding of densification by presenting insights and practical issues. The topics that will be discussed include methods used to generate and retain densified granules; the mechanisms that allow biological flocs to densify; the role that physical selectors play in the densification of biological flocs; some viable ways for managing biological flocs that have become densified; effects of physical selection design parameters on the retention of densified biological flocs and finally some operational solutions for customizing the flocs and granules required to meet performance and capacity targets. In addition, it will present some case studies where biological and physical parameters were used to generate aerobic granular sludge in the continuous flow system.

Keywords: densification, aerobic granular sludge, nutrient removal, intensification

Procedia PDF Downloads 186

Authors: Claudiu Marcu, Cristina Paul, Adelina Andelescu, Corneliu Mircea Davidescu, Francisc Péter

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Heavy metal pollution has become a more serious environmental problem in the last several decades as a result of its toxicity and insusceptibility to the environment. Methods for removing metal ions from aqueous solution mainly consist of physical, chemical and biochemical procedures. Biosorption is defined as the removal of metal or metalloid species, compounds and particulates from solution by a biological material. Biosorption represents a very attractive method for the removal of toxic metal ions from aqueous effluents because it uses the ability of various biomass to bind the metal ions without the risk of releasing other toxic chemical compounds into the environment. The problem with using biomass or living cells as biosorbents is that their regeneration/reuse is often either impossible or very laborious. One of the most common chelating group found in biosorbents is the thiol group in cysteine. Therefore, we immobilized cysteine using covalent binding using glutaraldehyde as a linker on a synthetic sol-gel support obtained using 3-amino-propyl-trimetoxysilane and trimetoxysilane as precursors. The obtained adsorbents were used for removal of cadmium from aqueous solutions and the removal capacity was investigated in relation to the composition of the sol-gel hybrid composite, the loading of the biomolecule and the physical parameters of the biosorption process. In the same conditions, the bare sol-gel support without cysteine had no Cd removal effect, while the adsorbent with cysteine had an adsorption capacity up to 25.8 mg Cd/g adsorbent at pH 2.0 and 119 mg Cd/g adsorbent at pH 6.6, depending on cadmium concentration and adsorption conditions. We used atomic adsorption spectrometry to assess the cadmium concentration in the samples after the biosorbtion process. The parameters for the Freundlich and Langmuir adsorption isotherms where calculated from plotting the results of the adsorption experiments. The results for cysteine immobilization show a good loading capacity of the sol-gel support which indicates it could be used to immobilize metal binding proteins and by doing so boosting the heavy metal adsorption capacity of the biosorbent.

Keywords: biosorbtion, cadmium, cysteine covalent binding, sol-gel

Procedia PDF Downloads 294

Authors: Shabadini Sampath, Jinglang Feng

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With huge kinetic energy, space debris poses a major threat to astronauts’ space activities and spacecraft in orbit if a collision happens. The active removal of space debris is required in order to avoid frequent collisions that would occur. In addition, the amount of space debris will increase uncontrollably, posing a threat to the safety of the entire space system. But the safe and reliable removal of large-scale space debris has been a huge challenge to date. While capturing and deorbiting space debris, the space manipulator has to achieve high control precision. However, due to uncertainties and unknown disturbances, there is difficulty in coordinating the control of the space manipulator. To address this challenge, this paper focuses on developing a robust and intelligent control algorithm that controls joint movement and restricts it on the sliding manifold by reducing uncertainties. A neural network adaptive sliding mode controller (NNASMC) is applied with the objective of finding the control law such that the joint motions of the space manipulator follow the given trajectory. A computed torque control (CTC) is an effective motion control strategy that is used in this paper for computing space manipulator arm torque to generate the required motion. Based on the Lyapunov stability theorem, the proposed intelligent controller NNASMC and CTC guarantees the robustness and global asymptotic stability of the closed-loop control system. Finally, the controllers used in the paper are modeled and simulated using MATLAB Simulink. The results are presented to prove the effectiveness of the proposed controller approach.

Keywords: GNC, active removal of space debris, AI controllers, MatLabSimulink

Procedia PDF Downloads 132

Authors: Oscar Corredor, Alexander Guzman, Adan Leon

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Density is a bulk physical property that indicates the quality of a petroleum fraction. It is also a useful property to estimate various physicochemical properties of fraction and petroleum fluids; however, the determination of density of extra heavy residual (EHR) fractions by standard methodologies, (ASTM D70) shows limitations for samples with higher densities than 1.0879 g/cm3. For this reason, a dilution methodology was developed in order to determinate density for those particular fractions, 87 (EHR) fractions were obtained as products of the fractionation of Colombian typical Vacuum Distillation Residual Fractions using molecular distillation (MD) and extraction with Solvent N-hexane in Supercritical Conditions (SFEF) pilot plants. The proposed methodology showed reliable results that can be demonstrated with the standard deviation of repeatability and reproducibility values of 0.0031 and 0.0061 g/ml respectively. In the same way, it was possible to determine densities in fractions EHR up to 1.1647g/cm3 and °API values obtained were ten times less than the water reference value.

Keywords: API, density, vacuum residual, molecular distillation, supercritical fluid extraction

Procedia PDF Downloads 267

Authors: Reda Dzingelevičienė, Vytautas Abromaitis, Nerijus Dzingelevičius, Kęstutis Baranauskis, Saulius Raugelė, Malgorzata Mlynska-Szultka, Sergej Suzdalev, Reza Pashaei, Sajjad Abbasi, Boguslaw Buszewski

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A unique hybrid technology was developed for the removal of COVID-19 specific contaminants from wastewater. Reactor testing was performed using model water samples contaminated with COVID-19 pharmaceuticals and microplastics. Different hydraulic retention times, concentrations of pollutants and dissolved ozone were tested. Liquid Chromatography-Mass Spectrometry, solid phase extraction, surface area and porosity, analytical tools were used to monitor the treatment efficiency and remaining sorption capacity of the spent adsorbent. The combination of advanced oxidation and adsorption processes was found to be the most effective, with the highest 90-99% and 89-95% molnupiravir and microplastics contaminants removal efficiency from the model wastewater. The research has received funding from the European Regional Development Fund (project No 13.1.1-LMT-K-718-05-0014) under a grant agreement with the Research Council of Lithuania (LMTLT), and it was funded as part of the European Union’s measure in response to the COVID-19 pandemic.

Keywords: adsorption, hybrid reactor system, pharmaceuticals-microplastics, wastewater

Procedia PDF Downloads 85