Search results for: innovative surgical treatment

Authors: Alisher Agzamov, Hanan Al Harbi

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BACKGROUND: The timely assessment and treatment of ICU Surgical and Medical Oncology patients is important for Oncology surgeons and Medical Oncologists and Intensivists. We hypothesized that the use of Robot Physician’s (RP - 7) ICU management and care in ICU can improve ICU physician rapid response to unstable ICU Oncology patients. METHODS: This is a prospective study using a before-after, cohort-control design to test the effectiveness of RP. We have used RP to make multidisciplinary ICU rounds in the ICU and for Emergency cases. Data concerning several aspects of the RP interaction including the latency of the response, the problem being treated, the intervention that was ordered, and the type of information gathered using the RP were documented. The effect of RP on ICU length of stay and cost was assessed. RESULTS: The use of RP was associated with a reduction in latency of attending physician face-to-face response for routine and urgent pages compared to conventional care (RP: 10.2 +/- 3.3 minutes vs conventional: 220 +/- 80 minutes). The response latencies to Oncology Emergency (8.0 +/- 2.8 vs 150 +/- 55 minutes) and for Respiratory Failure (12 +/- 04 vs 110 +/- 45 minutes) were reduced (P < .001), as was the LOS for patients with AML (5 days) and ARDS (10 day). There was an increase in ICU occupancy by 20 % compared with the prerobot era, and there was an ICU cost savings of KD2.5 million attributable to the use of RP. CONCLUSION: The use of RP enabled rapid face-to-face ICU Intensivist - physician response to unstable ICU Oncology patients and resulted in decreased ICU cost and LOS.

Keywords: robot physician, oncology patients, rp - 7 in icu management, cost and icu occupancy

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Authors: Vahid Nourani, Atefeh Ashrafi

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Prediction of treated wastewater quality is a matter of growing importance in water treatment procedure. In this way artificial neural network (ANN), as a robust data-driven approach, has been widely used for forecasting the effluent quality of wastewater treatment. However, developing ANN model based on appropriate input variables is a major concern due to the numerous parameters which are collected from treatment process and the number of them are increasing in the light of electronic sensors development. Various studies have been conducted, using different clustering methods, in order to classify most related and effective input variables. This issue has been overlooked in the selecting dominant input variables among wastewater treatment parameters which could effectively lead to more accurate prediction of water quality. In the presented study two ANN models were developed with the aim of forecasting effluent quality of Tabriz city’s wastewater treatment plant. Biochemical oxygen demand (BOD) was utilized to determine water quality as a target parameter. Model A used Principal Component Analysis (PCA) for input selection as a linear variance-based clustering method. Model B used those variables identified by the mutual information (MI) measure. Therefore, the optimal ANN structure when the result of model B compared with model A showed up to 15% percent increment in Determination Coefficient (DC). Thus, this study highlights the advantage of PCA method in selecting dominant input variables for ANN modeling of wastewater plant efficiency performance.

Keywords: Artificial Neural Networks, biochemical oxygen demand, principal component analysis, mutual information, Tabriz wastewater treatment plant, wastewater treatment plant

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Authors: Tina Abrefa-Gyan

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Background: In Ghana and the rest of sub-Saharan Africa, HIV/AIDS is a public health threat and also causes medical crises for many who are infected with the virus. Objective: This study tested a social care intervention developed to help improve the quality of life of those living with HIV/AIDS in Ghana. Method: Adult respondents (N = 248) were assigned to receive the intervention or usual care for six weeks. Results: Results of the study revealed significant differences between the treatment and control groups in their reports of quality of life. Respondents reported better quality of life upon receiving the intervention. Implication: This study sheds light on the positive relationship between the intervention and quality of life among those living with HIV/AIDS in Ghana. Conclusion: The intervention is innovative and novel in the setting. It will, therefore, help to reduce the risks such as depression, low cognitive functioning, and low physical functioning associated with low quality of life among people living with HIV/AIDS in Ghana in specific, and in sub-Saharan Africa in general.

Keywords: social care intervention, HIV/AIDS, Ghana, quality of life

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Authors: G. K. Madhu, S. Bhaskar, M. S. Dinesh, R. Manii, C. A. Srinivasamurthy

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A field experiment was conducted in the premises of M/s Sri Chamundeshwari Sugars Ltd., Bharathinagar, Mandya District Pvt. Ltd., during 2014 to study the effect of sugar mill effluent (SME) on growth, yield and soil properties of ratoon cane with eight treatments replicated thrice using RCBD design. Significantly higher growth parameters like cane height (249.77 cm) and number of tillers per clump (12.22) were recorded in treatment which received cycle of 3 irrigations with freshwater + 1 irrigation with sugar mill effluent + RDF as compared to other treatments. Significantly lower growth attributes were recorded in treatment which received irrigation with sugar mill effluent alone. Significantly higher cane yield (104. 93 t -1) was recorded in treatment which received cycle of 3 irrigations with freshwater + 1 irrigation with sugar mill effluent + RDF as compared to other treatments. Significantly lower cane yield (87.40 t ha-1) was observed in treatment which received irrigation with sugar mill effluent alone. Soil properties like pH (7.84) was higher in treatment receiving Alternate irrigation with freshwater and sugar mill effluent + RDF. But EC was significantly higher in treatment which received Cycle of1 irrigation with freshwater + 2 irrigations with sugar mill effluent + RDF as compared to other treatments.

Keywords: sugar mill effluent, sugarcane, irrigation, cane yield

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Authors: Amil Suleimanov, Aigul Saduakassova, Denis Vinnikov

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Objective: To assess functional visceral fat (VAT) activity evaluated by ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) as a predictor of metastases in colorectal cancer (CRC). Materials and methods: We assessed 60 patients with histologically confirmed CRC who underwent 18F-FDG PET/CT after a surgical treatment and courses of chemotherapy. Age, histology, stage, and tumor grade were recorded. Functional VAT activity was measured by maximum standardized uptake value (SUVmax) using ¹⁸F-FDG PET/CT and tested as a predictor of later metastases in eight abdominal locations (RE – Epigastric Region, RLH – Left Hypochondriac Region, RRL – Right Lumbar Region, RU – Umbilical Region, RLL – Left Lumbar Region, RRI – Right Inguinal Region, RP – Hypogastric (Pubic) Region, RLI – Left Inguinal Region) and pelvic cavity (P) in the adjusted regression models. We also report the best areas under the curve (AUC) for SUVmax with the corresponding sensitivity (Se) and specificity (Sp). Results: In both adjusted for age regression models and ROC analysis, 18F-FDG accumulation in RLH (cutoff SUVmax 0.74; Se 75%; Sp 61%; AUC 0.668; p = 0.049), RU (cutoff SUVmax 0.78; Se 69%; Sp 61%; AUC 0.679; p = 0.035), RRL (cutoff SUVmax 1.05; Se 69%; Sp 77%; AUC 0.682; p = 0.032) and RRI (cutoff SUVmax 0.85; Se 63%; Sp 61%; AUC 0.672; p = 0.043) could predict later metastases in CRC patients, as opposed to age, sex, primary tumor location, tumor grade and histology. Conclusions: VAT SUVmax is significantly associated with later metastases in CRC patients and can be used as their predictor.

Keywords: ¹⁸F-FDG, PET/CT, colorectal cancer, predictive value

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Authors: Krupali Mukeshkumar, Jinesh Shah

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Background: Bilateral Sagittal Split Osteotomy (BSSO), used for the correction of mandibular deformities, is a common oral and maxillofacial surgical procedure. Inferior alveolar nerve dysfunction is commonly reported post-operatively by patients as paresthesia or anesthesia. The current literature lacks a consensus on the incidence of inferior alveolar nerve dysfunction as patients are not routinely assessed pre and post-operatively with an objective assessment. The range of incidence varies from 9% to 85% of patients, with some authors arguing that 100% of patients experience nerve dysfunction immediately post-surgery. Systematic reviews have shown a difference between incidence rates at different follow-up periods using objective and subjective methods. Aim: To identify the incidence of inferior alveolar nerve dysfunction following BSSO. Gold standard: Nerve dysfunction incidence rates similar or lower than current literature of 83% day one post-operatively and 18.4% at one year follow up. Setting: A retrospective cross-sectional audit of patients treated between 2017-2019 at the Royal Stoke University Hospital, Maxillofacial and Orthodontic departments. Sample: All patients who underwent a BSSO (with or without le fort one osteotomy) between 2017–2019 were identified from the database. Patients with pre-existing neurosensory disturbance, those who had a genioplasty at the same time and those with no follow-up were excluded. The sample consisted of 121 patients, 37 males and 84 females between the ages of 17-50 years at the time of surgery. Methods: Clinical records of 121 cases were reviewed to assess the age, sex, type of mandibular osteotomy, status of the nerve during the surgical procedure, type of bony split and incidence of nerve dysfunction at follow-up appointments. The surgical procedure was carried out by three Maxillo-facial surgeons and follow-up appointments were carried out in the Orthodontic and Oral and Maxillo-facial departments. Results: 120 patients were treated to correct the mandibular facial deformity and 1 patient was treated for sleep apnoea. Seventeen patients had a mandibular setback and 104 patients had mandibular advancement. 68 patients reported inferior alveolar nerve dysfunction at one week following their surgery. Seventy-six patients had temporary paresthesia present between 2 weeks and 12 months post-surgery. 13 patients had persistent nerve dysfunction at 12 months, of which 1 had a bad bony split during the BSSO. The incidence of nerve dysfunction postoperatively was 6.6% after 1 day, 56.1% at 1 week, 62.8% at 2 weeks, 59.5% between 3-6 weeks, 43.0% between 8-16 weeks and 10.7% at 1 year. Conclusions: The results of this audit show a similar incidence rate to the research gold standard at the one-year follow-up. Future Recommendations: No changes to surgical procedure or technique are indicated, but a need for improved documentation and a standardized approach for assessment of post-operative nerve dysfunction would be beneficial.

Keywords: bilateral sagittal split osteotomy, inferior alveolar nerve, mandible, nerve dysfunction

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Authors: Thobela Conco, Sheena Kumari, Chika Nnadozie, Mahmoud Nasr, Thor A. Stenström, Mushal Ali, Arshad Ismail, Faizal Bux

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The discharge of antibiotics and its residues into the wastewater treatment plants (WWTP’s) create a conducive environment for the development of antibiotic resistant pathogens. This presents a risk of potential dissemination of antibiotic resistant pathogens and antibiotic resistance genes into the environment. It is, therefore, necessary to study the level of antibiotic resistance genes (ARG’s) among bacterial pathogens that proliferate in biological wastewater treatment systems. In the current study, metagenomic and meta-transcriptomic sequences of samples collected from the influents, secondary effluents and post chlorinated effluents of three wastewater treatment plants treating domestic and hospital effluents in Durban, South Africa, were analyzed for profiling of ARG’s among bacterial pathogens. Results show that a variety of ARG’s, mostly, aminoglycoside, β-lactamases, tetracycline and sulfonamide resistance genes were harbored by diverse bacterial genera found at different stages of treatment. A significant variation in diversity of pathogen and ARGs between the treatment plant was observed; however, treated final effluent samples from all three plants showed a significant reduction in bacterial pathogens and detected ARG’s. Both pre- and post-chlorinated samples showed the presence of mobile genetic elements (MGE’s), indicating the inefficiency of chlorination to remove of ARG’s integrated with MGE’s. In conclusion, the study showed the wastewater treatment plant efficiently caused the reduction and removal of certain ARG’s, even though the initial focus was the removal of biological nutrients.

Keywords: antibiotic resistance, mobile genetic elements, wastewater, wastewater treatment plants

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Authors: Yu-Chieh Chen, Kuei-Feng Shen, Chia-Ling Chao

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The purpose of this report was to present the nursing experience and case of an unexpected cerebellar hemorrhagic stroke with acute hydrocephalus patient after lumbar spine surgery. The patient had been suffering from an emergent external ventricular drainage and stayed in the Surgical Intensive Care Unit from July 8, 2016, to July 22, 2016. During the period of the case, the data were collected for attendance, evaluation, observation, interview, searching medical record, etc. An integral evaluation of the patient's physiological 'psychological' social and spiritual states was also noted. The author noticed the following major nursing problems including ineffective cerebral perfusion 'physical activity dysfunction' family resource preparation for disability. The author provided nursing care to maintain normal intracranial pressure, along with a well-therapeutic relationship and applied interdisciplinary medical/nursing team to draft an individualized and appropriate nursing plan for them to face the psychosocial impact of the patient disabilities. We also actively participated in the rehabilitation treatments to improve daily activity and confidence. This was deemed necessary to empower them to a more positive attitude in the future.

Keywords: family resourace preparation inability, hemorrhagic sroke, ineffective tissue cerebral perfusion, lumbar spine surgery

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Authors: Dirk Winkler, Leon Koevener, Lamees AlHayary

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This paper contributes to the improvement of the municipal wastewater systems in Jordan. An important goal is increased energy efficiency in wastewater treatment plants and therefore lower expenses due to reduced electricity consumption. The chosen way to achieve this goal is through the implementation of Technical Sustainable Management adapted to the Jordanian context. Three wastewater treatment plants in Jordan have been chosen as a case study for the investigation. These choices were supported by the fact that the three treatment plants are suitable for average performance and size. Beyond that, an energy assessment has been recently conducted in those facilities. The project succeeded in proving the following hypothesis: Energy efficiency in wastewater treatment plants can be improved by implementing principles of Technical Sustainable Management adapted to the Jordanian context. With this case study, a significant increase in energy efficiency can be achieved by optimization of operational performance, identifying and eliminating shortcomings and appropriate plant management. Implementing Technical Sustainable Management as a low-cost tool with a comparable little workload, provides several additional benefits supplementing increased energy efficiency, including compliance with all legal and technical requirements, process optimization, but also increased work safety and convenient working conditions. The research in the chosen field continues because there are indications for possible integration of the adapted tool into other regions and sectors. The concept of Technical Sustainable Management adapted to the Jordanian context could be extended to other wastewater treatment plants in all regions of Jordan but also into other sectors including water treatment, water distribution, wastewater network, desalination, or chemical industry.

Keywords: energy efficiency, quality management system, technical sustainable management, wastewater treatment

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Authors: Jin Hun Choi, So Hyun Ahn, Seong Keun Wang, Ik-Seung Chee, Jung Lan Kim, Sun Woo Lee

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Objectives: The purpose of the study is to investigate the effects of day hospital care in hospitalized schizophrenic patients in terms of treatment adherence and treatment outcomes. Methods: Among schizophrenic patients hospitalized between 2011 and 2012, 23 day hospital care patient and 40 control subjects were included in the study. All candidates underwent Beck Cognitive Insight Scale, Drug Attitude Inventory, World Health Organization Quality of Life Assessment and Psychological Well-Being Scale when their symptoms were stabilized during hospitalization, and after being discharged, 23 patients received day hospital care for two months and then changed to out-patient care while 40 patients received out-patient care immediately after discharge. At the point of two months of out-patient care, the treatment adherence of the two groups was evaluated; tracking observation was performed until February, 2013, and survival rates were compared between the two groups. Results: Treatment adherence was higher in the day hospital care group than in the control group. Kaplan-Meier survival analysis showed a higher survival rate for the day hospital care group compared to the control group. Levels of cognitive insight and quality of life were higher after day hospital care than before day hospital care in the day hospital care group. Conclusions: Through the study, it was confirmed that when hospitalized schizophrenic patients received continuous day hospital care after being discharged, they received further out-patient care more faithfully. The study is considered to aid in the understanding regarding schizophrenic patients’ treatment adherence issues and improvement of treatment outcomes.

Keywords: schizophrenia, day hospital care, adherence, outcomes

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Authors: Ajmal Khan Kassi, Humayun Javed, Tariq Mukhtar

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The research was conducted to screen out resistance and susceptibility of okra varieties against Helicoverpa armigera under field conditions 2016. In this experiment, the different management practices viz. release Trichogramma chilonis, hoeing, and weeding, clipping, and lufenuron were tested individually and with all possible combinations for the controlling of American bollworm at 3 diverse localities viz. University research farm Koont, National Agriculture Research Centre (NARC) and farmer field Taxila by using resistant variety Arka Anamika. All the treatment combinations regarding damage of shoot and fruit showed significant results. The minimum fruit infestation, i.e., 3.20% and 3.58% was recorded with combined treatment (i.e., T. chilonis + hoeing + weeding + lufenuron) in two different localities. The minimum shoot infestation, i.e., 7.18%, 7.08%, and 6.85% was also observed with (T. chilonis + hoeing + weeding + lufenuron) combined treatment at all three different localities. The above-combined treatment (T. chilonis + hoeing + weeding + lufenuron) also resulted in maximum yield at NARC and Taxila, i.e., 57.67 and 62.66 q/ha respectively. On the basis of combined treatment (i.e., T. chilonis + hoeing + weeding + lufenuron) in three different localities, Arka Anamika variety proved to be comparatively resistant against H. armigera. So this variety is recommended for the cultivation in Pothwar region to get maximum yield and minimum losses against H. armigera.

Keywords: okra, screening, combine treatment, Helicoverpa armigera

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Authors: Jamal Alkoteesh, Mohammed Zeki, Mouza Alnaqbi

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Objective: To evaluate pregnancy outcomes, complications and neonatal outcomes in women who had previously undergone uterine arterial embolization. Design: Retrospective study. In this study, most women opted for UFE as a fertility treatment after failure of myomectomy or in vitro fertilization, or because hysterectomy was the only suggested option. Background. Myomectomy is the standard approach in patients with fibroids desiring a future pregnancy. However, myomectomy may be difficult in cases of numerous interstitial and/or submucous fibroids.In these cases, UFE has the advantage of embolizing all fibroids in one procedure. This procedure is an accepted nonsurgical treatment for symptomatic uterine fibroids. Study Methods: A retrospective study of 210 patients treated with UFE for symptomatic uterine fibroids between 2011-2016 was performed. UFE was performed using ((PVA; Embozen, Beadblock) (500-900 µm in diameter). Pregnancies were identified using screening questionnaires and the study database. Of the 210 patients who received UFE treatment, 35 women younger than the age of 40 wanted to conceive and had been unable. All women in our study were advised to wait six months or more after UFE before attempting to become pregnant, of which the reported time range before attempting to conceive was seven to 33 months (average 20 months). RESULTS: In a retrospective chart review of patients younger than the age of 40 (35 patients,18 patients reported 23 pregnancies, of which five were miscarriages. Two more pregnancies were complicated by premature labor. Of the 23 pregnancies, 16 were normal full-term pregnancies, 15 women had conceived once, and four had become pregnant twice. The remaining patients did not conceive. In the study, there was no reported intrauterine growth retardation in the prenatal period, fetal distress during labor, or problems related to uterine integrity. Two patients reported minor problems during pregnancy that were borderline oligohydramnios and low-lying placenta. In the cohort of women who did conceive, overall, 16 out of 18 births proceeded normally without any complications (86%). Eight women delivered by cesarean section, and 10 women had normal vaginal delivery. In this study of 210 women, UFE had a fertility rate of 47%. Our group of 23 pregnancies was small, but did confirm successful pregnancy after UFE. The 45.7% pregnancy rate in women below the age of 40 years old who completed a term pregnancy compares favorably with women who underwent myomectomy via other method. Of the women in the cohort who did conceive, subsequent birth proceeded normally (86%). Conclusion: Pregnancy after UFE is well-documented. The risks of infertility following embolization, premature menopause, and hysterectomy are small, as is the radiation exposure during embolization. Fertility rates appear similar to patients undergoing myomectomy.UFE should not be contraindicated in patients who want to conceive and they should be able to choose between surgical options and UFE.

Keywords: fibroid, pregnancy, therapeutic embolization, uterine artery

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Authors: Flavio Araujo, Livia Dias, Fabiolla Lima, Paulo Scalize, Antonio Albuquerque

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Water treatment residues (WTR) are solid waste produced during drinking water treatment and have recently been seen as a reusable material. The aim of this research was show how to use the residue generated in a Water Treatment Plant, located in Goiania, Brazil, following the considerations of the law of solid waste to obtain normative parameters and consider sustainable alternatives for reincorporation of the residues in the productive chain for manufacturing various materials construction. In order to reduce the environmental liabilities generated by sanitation companies and discontinue unsustainable forms of disposal. The analyzes performed: Granulometry, Scanning Electron Microscopy and X-Ray Diffraction demonstrated the potential application of residues to replace the soil and sand, because it has characteristics compatible with small aggregate and can be used as feedstock for the manufacture of materials as ceramic and soil-cement bricks, mortars, interlocking floors and concrete artifacts.

Keywords: residue, sustainable, water treatment plants, WTR, WTP

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Authors: Ayat E. Ali, Christeen R. Aziz, Merna A. Helmy, Mohammed M. Malek, Sherif H. El-Gohary

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Goal: Purpose of the project was to make a plastic surgery prediction by using pre-operative images for the plastic surgeries’ patients and to show this prediction on a screen to compare between the current case and the appearance after the surgery. Methods: To this aim, we implemented a software which used data from the internet for facial skin diseases, skin burns, pre-and post-images for plastic surgeries then the post- surgical prediction is done by using K-nearest neighbor (KNN). So we designed and fabricated a smart mirror divided into two parts a screen and a reflective mirror so patient's pre- and post-appearance will be showed at the same time. Results: We worked on some skin diseases like vitiligo, skin burns and wrinkles. We classified the three degrees of burns using KNN classifier with accuracy 60%. We also succeeded in segmenting the area of vitiligo. Our future work will include working on more skin diseases, classify them and give a prediction for the look after the surgery. Also we will go deeper into facial deformities and plastic surgeries like nose reshaping and face slim down. Conclusion: Our project will give a prediction relates strongly to the real look after surgery and decrease different diagnoses among doctors. Significance: The mirror may have broad societal appeal as it will make the distance between patient's satisfaction and the medical standards smaller.

Keywords: k-nearest neighbor (knn), face detection, vitiligo, bone deformity

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Authors: Syeda Azeem Unnisa

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The present study was undertaken at Jawaharnagar Solid Waste Municipal Dumpsite, Greater Hyderabad Municipal Corporation, Telangana State, India in 2017 which generates 90,000 litres of leachate per day. The main objective of the leachate treatment was to remove organic compounds like color, suspended solids, ammonia and COD by coagulation-flocculation using polyaluminum chloride (PAC) as coagulant which has higher coagulant efficiency and relative low cost compared to the conventional coagulants. Jar test apparatus was used to conduct experiments for pH 7, rapid mixing speed 150 rpm for 3 minute, slow mixing speed 30 rpm for 20 minute and the settling time of 30 minute for different dosage of PAC (0.5, 1.0, 1.5, 2.0, 2.5, 3.0, 3.5, 4.0, 4.5 and 5.0 g/L). The highest percentage of removal of suspended solids, color, COD and ammonical nitrogen are 97%, 96%, 60% and 37% with PAC optimum dose of 2.0 g/l. The results indicate that the PAC was effective in leachate treatment which is very much suitable for high toxicity of waste and economically feasible for Indian conditions. The treated water can be utilized for other purpose apart from drinking.

Keywords: coagulant, leachate, polyaluminium chloride, treatment

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Authors: Sergei Kosarev

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Wrong treatment tactics for hand and wrist sport-related injuries can lead to the inability to play sports in the future. It is especially important for professional athletes. The members of the Russian Olympic Team are treated in our hospital -Federal Clinical Research Center (Moscow). For their treatment, we use minimally invasive methods such as wrist arthroscopy and also orthobiologics procedures. In 2022 we had cases with scaphoid fracture and TFCC injuries. In all the cases, we were using the arthroscopy technic for treatment. The scaphoid fracture was fixed by K-wires with free bone grafting. For TFCC injures we used transossal sutures. Rehabilitation started the next day after surgery. Rehabilitation included hand therapy and physiotherapy. All athletes returned to the sport after 8-12 weeks after surgery. One of them had pain in the wrist after 12 weeks after surgery, not more than 4 point VAS. Pain syndrome was blocked after 2 PRP injections in the ulnar side of the wrist.

Keywords: sport trauma, wrist arthroscopy, wrist pain, scaphoid fracture

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Authors: Stephanie Guerra-Arias, Stephani Nevarez, Calvin Stewart, Rachel Grodsky, Denis Eichorst

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The objective of this study is to describe the framework for optimizing the heat treatment of alkali silicate glasses, to enhance the performance of hermetic seals in extreme environments. When connectors are exposed to elevated temperatures, residual stresses develop due to the mismatch of thermal expansions between the glass, metal pin, and metal shell. Excessive thermal expansion mismatch compromises the reliability of hermetic seals. In this study, a series of heat treatment schedules will be performed on two commercial sealing glasses (one conventional sealing glass and one crystallizable sealing glass) using a design of experiments (DOE) approach. The coefficient of thermal expansion (CTE) will be measured pre- and post-heat treatment using thermomechanical analysis (TMA). Afterwards, the flexural strength of the specimen will be measured using a four-point bend fixture mounted in a static universal testing machine. The measured material properties will be statistically analyzed using MiniTab software to determine which factors of the heat treatment process have a strong correlation to the coefficient of thermal expansion and/or flexural strength. Finally, a heat-treatment will be designed and tested to ensure the optimal performance of the hermetic seals in connectors.

Keywords: glass-ceramics, design of experiment, hermetic connectors, material characterization

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Authors: Susana F. Casla

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Talent Gaming is an innovative methodology based on a large research done for years about how table board games can be used to empower teams. This methodology was developed thinking about the efficiency of facilitating team coaching sessions and the importance of bringing out the best of individuals when working as a team. The fact that more senses are involved in playing a board game, linked with the psychological element of space and “permission to play”, help us travel to earlier stages of our life when our authenticity was at its heights. By being focused on playing the board game, the individual does not direct their consciousness in a particular way and is rather focused in winning the board game. By doing this, his or her inner talents and authenticity surfaces and the fact that all the senses are involved impacts enormously his behaviors and attitudes. All of this combined results in an arena where our talents show up and our decision making process is not impacted by other elements, such as appearances, status or hierarchy.

Keywords: talent, team, board game, business psychology, coaching teams at work

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Authors: Denys Sebov, Viktoriia Korotaieva, Kateryna Markina

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The clinical advantage of the multipill combination drugs administration (polypill-strategy) over single-component drugs (monopill-strategy) has been established in patients with comorbid arterial hypertension, heart failure, chronic coronary syndrome, diabetes. It was found that polypill-strategy provides better treatment adherence in 33.4% of the patients. It was proven a significant decrease in systolic and diastolic blood pressure, as well as a decrease in dispersion index due to the stability of the blood pressure profile in patients with the polypill-strategy treatment.

Keywords: polypill, artetial hypertension, cardiovascular disease, compliance

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Authors: Ehsan Ahmed Yahia

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Introduction: The nursing role in nutrition screening and assessing hospitalized patients is important. Malnutrition is a common and costly problem, particularly among hospitalized patients, and can have an adverse effect on the healing process. The study's goal is to assess the prevalence of malnutrition among adult hospitalized orthopedic patients and to detect the barriers to the nutrition screening process. Aim of the study: This study aimed to (a) assess the prevalence of malnutrition in hospitalized orthopedic patients and (b) evaluate the relationship between malnutrition and selected clinical outcomes. Material and Methods: This prospective field study was conducted for three months between 03/2022 and 06/2022 in the selected orthopedic departments in a teaching hospital affiliated withCairo University, Egypt. with a total number of one hundred twenty (120) patients. Patients' assessment included checking for malnutrition using the Nutritional Risk Screening Questionnaire. Patients at risk for malnourishment were defined as NRS score ≥ 3. Clinical outcomes under consideration included 1) length of hospitalization, 2) mobilization after surgery and conservative treatment, and 3) rate of adverse events. Results: This study found that malnutrition is a significant problem among patients hospitalized in an orthopedic ward. The prevalence of malnutrition was the highest in patients with lumbar spine and pelvis fractures, followed by the proximal femur and proximal humerus fractures. Patients at risk for malnutrition had significantly prolonged hospitalization, delayed postoperative mobilization, and increased incidence of adverse events.27.8% of the study sample were at risk for malnutrition. The highest prevalence of malnourishment was found in Septic Surgery with 32%, followed by Traumatology with 19.6% and Arthroplasty with 15.3%. A higher prevalence of malnutrition was detected among patients with typical fractures, such as lumbar spine and pelvis (46.7%), proximal femur (34.4%), and proximal humeral (23.7%) fractures. Additionally, patients at risk for malnutrition showed prolonged hospitalization (14.7 ± 11.1 vs. 21.2 ± 11.7 days), delayed postoperative mobilization (2.3 ± 2.9 vs. 4.1 ± 4.9 days), and delayed to mobilize after conservative treatment (1.1 ± 2.7 vs. 1.8 ± 1.9 days). A significant statistical correlation of NRS with individual parameters (Spearman's rank correlation, p < 0.05) was observed. The rate of adverse incidents in patients at risk for malnutrition was significantly higher than that of patients with a regular nutritional status (37.2% vs. 21.1%, p < 0.001). Conclusions: Our results indicate that the prevalence of malnutrition in surgical patients is significant. The nutritional status of patients with typical fractures is especially at risk. Prolonged hospitalization, delayed postoperative mobilization, and delayed mobilization after conservative treatment is significantly associated with malnutrition. In addition, the incidence of adverse events in patients at risk for malnutrition is significantly higher.

Keywords: malnutrition, nutritional risk screening, surgery, nursing, orthopedic nurse

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Authors: C. Kuoh, C. Lucas, T. Lopes, I. Mechie, J. Yoong, W. Yoong

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For all surgeons, there is one preventable but still highly occurring complication – wrong site surgeries. They can have potentially catastrophic, irreversible, or even fatal consequences on patients. With the exponential development of microsurgery and the use of advanced technological tools, the consequences of operating on the wrong side, anatomical part, or even person is seen as the most visible and destructive of all surgical errors and perhaps the error that is dreaded by most clinicians as it threatens their licenses and arouses feelings of guilt. Despite the implementation of the WHO surgical safety checklist more than a decade ago, the incidence of wrong-site surgeries remains relatively high, leading to tremendous physical and psychological repercussions for the clinicians involved, as well as a financial burden for the healthcare institution. In this presentation, the authors explore various factors which can lead to wrong site surgery – a combination of environmental and human factors and evaluate their impact amongst patients, practitioners, their families, and the medical industry. Major contributing factors to these “never events” include deviations from checklists, excessive workload, and poor communication. Two real-life cases are discussed, and systems that can be implemented to prevent these errors are highlighted alongside lessons learnt from other industries. The authors suggest that reinforcing speaking-up, implementing medical professional trainings, and higher patient’s involvements can potentially improve safety in surgeries and electrosurgeries.

Keywords: wrong side surgery, never events, checklist, workload, communication

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Authors: Benabdelaziz Soufyane

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The process of developing the activity of small and medium-sized enterprises(SME), and increasing the entrepreneurial sense, is becoming at the current period as one of the main bets, where many countries around the world try to give it the great importance because of their positive role in improving the economic development indicators in these countries. As a result of the sequential changes that international economic environment lives, the biggest global economic entities has become threatened because of different secretions financial crises and economic disorders. For this lots of countries tended to search for a mechanism to help it for creating new jobs and to spur the economy in order to face the foreign competition, fot this, we find the process of creating innovative entrepreneurial activity comes at the forefront of solutions for the purpose of achieving that. For the purpose of highlighting the role of this process and its future in the economy, this study seeks to consolidate the innovation’s concept and innovative entrepreneurship, then the success’s conditions of these entrepreneurships, to conclude with recommendations , solutions and important results.

Keywords: entrepreneurship, innovation, performance, vigilance, modernity, technology, business incubators

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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

Procedia PDF Downloads 390

Authors: Mohamed Abdelmongy

Abstract:

Autologous Blood for Conjunctival Autograft Fixation in Primary Pterygium Surgery: A Systematic Review and Meta-analysis Hossam Zein1,2, Ammar Ismail1,3, Mohamed Abdelmongy1,4, Sherif Elsherif1,5,6, Ahmad Hassanen1,4, Basma Muhammad2, Fathy Assaf1,3, Ahmed Elsehili1,7, Ahmed Negida1,7, Shin Yamane9, Mohamed M. Abdel-Daim8,9 and Kazuaki Kadonosono9 https://www.ncbi.nlm.nih.gov/pubmed/30277146 BACKGROUND: Pterygium is a benign ocular lesion characterized by triangular fibrovascular growth of conjunctival tissue over the cornea. Patients complain of the bad cosmetic appearance, ocular surface irritation and decreased visual acuity if the pterygium is large enough to cause astigmatism or encroach on the pupil. The definitive treatment of pterygium is surgical removal. However, outcomes are compromised by recurrence . The aim of the current study is to systematically review the current literature to explore the efficacy and safety of fibrin glue, suture and autologous blood coagulum for conjunctivalautograft fixation in primary pterygium surgery. OBJECTIVES: To assess the effectiveness of fibrin glue compared to sutures and autologous blood coagulum in conjunctival autografting for the surgical treatment of pterygium. METHODS: During preparing this manuscript, we followed the steps adequately illustrated in the Cochrane Handbook for Systematic Reviews of Interventions version 5.3, and reported it according to the preferred reporting of systematic review and meta-analysis (PRISMA) statement guidelines. We searched PubMed, Ovid (both through Medline), ISI Web of Science, and Cochrane Central Register of Controlled Trials (Central) through January 2017, using the following keywords “Pterygium AND (blood OR glue OR suture)” SELECTION CRITERIA: We included all randomized controlled trials (RCTs) that met the following criteria: 1) comparing autologous blood vs fibrin glue for conjunctivalautograft fixation in primary pterygium surgery 2) comparing autologous blood vs sutures for conjunctivalautograft fixation in primary pterygium surgery DATA COLLECTION AND ANALYSIS: Two review authors independently screened the search results, assessed trial quality, and extracted data using standard methodological procedures expected by Cochrane. The extracted data included A) study design, sample size, and main findings, B) Baseline characteristics of patients included in this review including their age, sex, pterygium site and grade, and graft size. C) Study outcomes comprising 1) primary outcomes: recurrence rate 2) secondary outcomes: graft stability outcomes (graft retraction, graft displacement), operation time (min) and postoperative symptoms (pain, discomfort, foreign body sensation, tearing) MAIN RESULTS: We included 7 RCTs and The review included662eyes (Blood: 293; Glue: 198; Suture: 171). we assess the 1) primary outcomes: recurrence rate 2) secondary outcomes: graft stability outcomes (graft retraction, graft displacement), operation time (min) and postoperative symptoms (pain, discomfort, foreign body sensation, tearing) CONCLUSIONS: Autologous blood for conjunctivalautograft fixation in pterygium surgery is associated with lower graft stability than fibrin glue or sutures. It was not inferior to fibrin glue or sutures regarding recurrence rate. The overall quality of evidence is low. Further well designed RCTs are needed to fully explore the efficacy of this new technique.

Keywords: pterygium, autograft, ophthalmology, cornea

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Authors: Mohamed Shafi Mahboob Ali

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Male breast cancer (MBC) is a rare entity with overall cases reported less than 1%. However, the incidence of MBC is regularly rising every year. Due to the lack of data on MBC, diagnosis and treatment are tailored to female breast cancer. MBC risk increases with age and is usually diagnosed ten years late as the disease progression is slow compared to female breast cancer (FBC). The most common feature of MBC is an intra-ductal variant, and often, upon diagnosis, the stage of the disease is already advanced. The Prognosis of MBC is often flawed, but new treatment modalities are emerging with the current knowledge and advancement. We presented a series of male breast cancer in our center, highlighting the clinicopathological, radiological and treatment options.

Keywords: male, breast, cancer, clinicopathology, ultrasound, CT scan

Procedia PDF Downloads 79

Authors: B. Petrović, L. Rutonjski, M. Baucal, M. Teodorović, O. Čudić, B. Basarić

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Radiotherapy treatment planning computers use CT data of the patient. For the computation of a treatment plan, treatment planning system must have an information on electron densities of tissues scanned by CT. This information is given by the conversion curve CT (CT number) to ED (electron density), or simply calibration curve. Every treatment planning system (TPS) has built in default CT to ED conversion curves, for the CTs of different manufacturers. However, it is always recommended to verify the CT to ED conversion curve before actual clinical use. Objective of this study was to check how the default curve already provided matches the curve actually measured on a specific CT, and how much it influences the calculation of a treatment planning computer. The examined CT scanners were from the same manufacturer, but four different scanners from three generations. The measurements of all calibration curves were done with the dedicated phantom CIRS 062M Electron Density Phantom. The phantom was scanned, and according to real HU values read at the CT console computer, CT to ED conversion curves were generated for different materials, for same tube voltage 140 kV. Another phantom, CIRS Thorax 002 LFC which represents an average human torso in proportion, density and two-dimensional structure, was used for verification. The treatment planning was done on CT slices of scanned CIRS LFC 002 phantom, for selected cases. Interest points were set in the lungs, and in the spinal cord, and doses recorded in TPS. The overall calculated treatment times for four scanners and default scanner did not differ more than 0.8%. Overall interest point dose in bone differed max 0.6% while for single fields was maximum 2.7% (lateral field). Overall interest point dose in lungs differed max 1.1% while for single fields was maximum 2.6% (lateral field). It is known that user should verify the CT to ED conversion curve, but often, developing countries are facing lack of QA equipment, and often use default data provided. We have concluded that the CT to ED curves obtained differ in certain points of a curve, generally in the region of higher densities. This influences the treatment planning result which is not significant, but definitely does make difference in the calculated dose.

Keywords: Computation of treatment plan, conversion curve, radiotherapy, electron density

Procedia PDF Downloads 459

Authors: Reni Francis

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Learning has transcended the classroom boundaries to create a learner centric, interactive, and integrative teaching learning environment. This study analysed the impact of iLearn on the teaching, learning, and evaluation among 100 teacher trainees. The objectives were to cater to the different learning styles of the teacher trainees, to incorporate innovative teaching learning activities, to assist in peer tutoring, to implement different evaluation processes. i: Identifying the learning styles among the teacher trainees through VARK Learning style checklist was followed by planning the teaching-learning process to meet the learning styles of the teacher trainees. L: Leveraging innovations in teaching- learning by planning and creating modules incorporating innovative teaching learning and hence the concept based year plan was prepared. E: Engage learning through constructivism using different teaching methodology to engage the teacher trainees in the learning process through Workshop, Round Robin, Gallery walk, Co-Operative learning, Think-Pair-Share, EDMODO, Course Networking, Concept Map, Brainstorming Sessions, Video Clippings. A: Assessing the learning through an Open Book assignment, Closed book assignment, and Multiple Choice Questions and Seminar presentation. R: Remediation through peer tutoring through Mentor-mentee approach in the tutorial groups, Group work, Library Hours. N: Norming new standards. This was done in the form of extended remediation and tutorials to understand the need of the teacher trainee and support them for further achievements in learning through Face to face interaction, Supervised Study Circle, Mobile (Device) learning. The findings of the study revealed the positive impact of iLearn towards student achievement and enhanced social skills.

Keywords: academic achievement, innovative strategy, learning styles, social skills

Procedia PDF Downloads 342

Authors: T. Z. Butt, T. A. Tabish, K. Anjum, H. Hafeez

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A study of martensitic stainless steel surgical grade AISI 420A produced in Japan was carried out in this research work. The sample was already annealed at about 898˚C. The sample were subjected to chemical analysis, hardness, tensile and metallographic tests. These tests were performed on as received annealed and heat treated samples. In the annealed condition the sample showed 0HRC. However, on tensile testing, in annealed condition the sample showed maximum elongation. The heat treatment is carried out in vacuum furnace within temperature range 980-1035°C. The quenching of samples was carried out using liquid nitrogen. After hardening, the samples were subjected to tempering, which was carried out in vacuum tempering furnace at a temperature of 220˚C. The hardened samples were subjected to hardness and tensile testing. In hardness testing, the samples showed maximum hardness values. In tensile testing the sample showed minimum elongation. The sample in annealed state showed coarse plates of martensite structure. Therefore, the studied steels can be used as biomaterials.

Keywords: biomaterials, martensitic steel, microsrtucture, tensile testing, hardening, tempering, bioinstrumentation

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Authors: S. Sehar, S. Khan, N. Ali, S. Ahmed

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In the last decade, the hunt for cost-effective, eco-friendly and energy sustainable technologies for waste water treatment are gaining much attention due to emerging water crisis and rapidly depleting existing water reservoirs all over the world. In this scenario, constructed wetland being a “green technology” could be a reliable mean for waste water treatment especially in small communities due to cost-effectiveness, ease in management, less energy consumption and sludge production. Therefore, a low cost, lab-scale sub-surface flow hybrid constructed wetland (SS-HCW) was established for domestic waste water treatment.It was observed that not only the presence but also choice of suitable vegetation along with hydraulic retention time (HRT) are key intervening ingredients which directly influence pollutant removals in constructed wetlands. Another important aspect of vegetation is that it may facilitate microbial attachment in rhizosphere, thus promote biofilm formation via microbial interactions. The major factors that influence initial aggregation and subsequent biofilm formation i.e. divalent cations (Ca2+) and extra cellular DNA (eDNA) were also studied in detail. The presence of Ca2+ in constructed wetland demonstrate superior performances in terms of effluent quality, i.e BOD5, COD, TDS, TSS, and PO4- than in absence of Ca2+. Finally, light and scanning electron microscopies coupled with EDS were carried out to get more insights into the mechanics of biofilm formation with or without Ca addition. Therefore, the same strategy can be implemented in other waste water treatment technologies.

Keywords: hybrid constructed wetland, biofilm formation, waste water treatment, waste water

Procedia PDF Downloads 384

Authors: Mustafa Gultekin

Abstract:

It is believed that drama can be used in language classes to create a positive atmosphere for students to use the target language in an interactive way. Thus, drama has been extensively used in many settings in language classes. Although happening has been generally used as a performance art of theatre, this new kind of performance has not been widely known in language teaching area. Therefore, it can be an innovative idea to use happening in language classes, and thus a positive environment can be created for students to use the language in an interactive way. Happening can be defined as an art performance that puts emphasis on interaction in an audience. Because of its interactive feature, happening can also be used in language classes to motivate students to use the language in an interactive environment. The present study aims to explain how a happening performance can be applied to a learning environment to teach vocabulary in English. In line with this purpose, a learning environment was designed for a vocabulary presentation lesson. At the end of the performance, students were asked to compare the traditional way of teaching and happening performance in terms of effectiveness. It was found that happening performance provided the students with a more creative and interactive environment to use the language. Therefore, happening can be used in language classrooms as an innovative tool for education.

Keywords: English, happening, language learning, vocabulary teaching

Procedia PDF Downloads 352