Search results for: tertiary wastewater treatment

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

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

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

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Authors: Seyedeh Pardis Hosseini

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With increased levels of clean and affordable water scarcity crises in many countries, wastewater treatment has been chosen as a viable method to produce freshwater for various consumptions. Even though reverse osmosis dominates the wastewater treatment market, forward osmosis (FO) processes have significant advantages, such as potentially using a renewable and low-grade energy source and improving water quality. FO is an osmotically driven membrane process that uses a high concentrated draw solution and a relatively low concentrated feed solution across a semi-permeable membrane. Among many novel FO membranes that have been introduced over the past decades, polybenzimidazole (PBI) membranes, a class of aromatic heterocyclic-based polymers, have shown high thermal and chemical stability because of their unique chemical structure. However, the studies reviewed indicate that the hydrophilicity of PBI membranes is comparatively low. Hence, there is an urgent need to develop novel FO membranes with modified PBI polymers to promote hydrophilicity. A few studies have been undertaken to improve the PBI hydrophilicity by fabricating mixed matrix polymeric membranes and surface modification. Thereby, in this study, two different sulfonated polybenzimidazole (SPBI) polymers with the same backbone but different functional groups, namely arylsulfonate PBI (PBI-AS) and propylsulfonate PBI (PBI-PS), are introduced as FO membranes and studied via the molecular dynamics (MD) simulation method. The FO simulation box consists of three distinct regions: a saltwater region, a membrane region, and a pure-water region. The pure-water region is situated at the upper part of the simulation box, while the saltwater region, which contains an aqueous salt solution of Na+ and Cl− ions along with water molecules, occupies the lower part of the simulation box. Specifically, the saltwater region includes 710 water molecules and 24 Na+ and 24 Cl− ions, resulting in a combined concentration of 10 weight percent (wt%). The pure-water region comprises 788 water molecules. Both the saltwater and pure-water regions have a density of 1.0 g/cm³. The membrane region, positioned between the saltwater and pure-water regions, is constructed from three types of polymers: PBI, PBI-AS, and PBI-PS, each consisting of three polymer chains with 30 monomers per chain. The structural and thermophysical properties of the polymers, water molecules, and Na+ and Cl− ions were analyzed using the COMPASS forcefield. All simulations were conducted using the BIOVIA Materials Studio 2020 software. By monitoring the variation in the number of water molecules over the simulation time within the saltwater region, the water permeability of the polymer membranes was calculated and subsequently compared. The results indicated that SPBI polymers exhibited higher water permeability compared to PBI polymers. This enhanced permeability can be attributed to the structural and compositional differences between SPBI and PBI polymers, which likely facilitate more efficient water transport through the membrane. Consequently, the adoption of SPBI polymers in the FO process is anticipated to result in significantly improved performance. This improvement could lead to higher water flux rates, better salt rejection, and overall more efficient use of resources in desalination and water purification applications.

Keywords: forward osmosis, molecular dynamics simulation, sulfonated polybenzimidazole, water permeability

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Authors: N. Khursheed, M. Fatima, S. Jamal, A. Raza, S. Rattani, Q. Ahsan, A. Rasheed, M. Jawed

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Introduction: Antibiotics are among the commonly prescribed medicines to treat bacterial infections. Their misuse intensifies resistance, and overuse incurs heavy losses to the healthcare system in terms of increased treatment costs and enhanced disease burden. Studies show that 40% of empirically used antibiotics are irrationally utilized. The objective of this study was to evaluate prescribing pattern of antibiotics at six public sector tertiary care hospitals across Pakistan. Methods: A multicenter cross-sectional point prevalence survey (PPS) was conducted in selected wards of six public sector tertiary care hospitals in Pakistan as part of the Clinical Engagement program by Fleming Fund Country Grant Pakistan in collaboration with Indus Hospital & Health Network (IHHN) from February to March 2021, these included Jinnah Postgraduate Medical Center and Dr. Ruth K. M. Pfau Civil Hospital from Karachi, Sheikh Zayed Hospital Lahore, Nishtar Medical University Hospital Multan, Medical Teaching Institute Hayatabad Medical Complex Peshawar, and Provincial Headquarters Hospital Gilgit. WHO PPS methodology was used for data collection (Hospital, ward, and patient level data was collected). Data was entered into the open-source Kobo Collect application and was analyzed using SPSS (version 22.0). Findings: Medical records of 837 in-patients were surveyed, of which the prevalence of antibiotics use was 78.5%. The most commonly prescribed antimicrobial was Ceftriaxone (21.7%) which is categorized in the Watch group of WHO AWaRe Classification, followed by Metronidazole (17.3%), Cefoperazone/Sulbactam (8.4%), Co-Amoxiclav (6.3%) and Piperacillin/Tazobactam (5.9%). The antibiotics were prescribed largely for surgical prophylaxis (36.7%), followed by community-acquired infections (24.7%). One antibiotic was prescribed to 46.7%, two to 39.9%, and three or more to 12.5 %. Two of six (30%) hospitals had functional drug and therapeutic committees, three (50%) had infection prevention and control committees, and one facility had an antibiotic formulary. Conclusion: Findings demonstrate high consumption of broad-spectrum antimicrobials and emphasizes the importance of expanding the antimicrobial stewardship program. Mentoring clinical teams will help to rationalize antimicrobial use.

Keywords: antimicrobial resistance, antimicrobial stewardship, point prevalence survey, antibiotics

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

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

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

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Authors: Ricardo Munguia-Perez, Nayeli Remigio-Alvarado, M.Miriam Hernandez-Arroyo, Elsa Castañeda-Roldan

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Fungi have emerged as important pathogens causing morbidity and mortality mainly in immunosuppressed, malnourished and elderly patients. It has detected an increase in resistance to azoles primarily to fluconazol. The fungal infections have become a problem of public health for the resistance to antifungal agents, they have developed new antifungals with broad-spectrum. The aim of this study was determine the antifungal susceptibility of yeasts isolated from clinical samples (respiratory secretions, exudates, wounds, blood cultures, urine cultures) obtained from inpatients and outpatients of a tertiary hospital from State of Puebla. The antifungal susceptibility of the yeast from several clinical samples were determined by the CLS M44-A disk diffusion methods. 149 samples of yeast were analyzed. All species were 100% susceptible to nystatin and amphotericin B. Candida albicans showed resistance of 95.5 % to fluconazole, 50.7 % to 5-flurocytosine and 55.2 % intermediate susceptibility to ketoconazole. Candida glabrata 81.3 % was susceptibility to ketoconazole and 75 % to fluconazole, for the case of 5-flurocytosine the 56.3 % was susceptible. Candida krusei 100 % was susceptible to ketoconazole, 50 % to fluconazole and 37.5 % to 5-flurocytosine. The internal medicine have greater diversity of yeast, the samples have susceptibility of 64.7% to ketoconazole, 47.1 % to fluconazole and 27.5 % to 5-flurocytosine. Hospitalized patients are more resistant to fluconazole and nystatin, but in the case of outpatients presents resistance to ketoconazole.

Keywords: antifungal, susceptibility, yeast, clinical samples

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Authors: Momen Yaseen M. Amin

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Despite widespread coverage of language policy in the literature, there has been scant research probing into English language education policy at tertiary levels in general and in the case of higher education context of Iraqi Kurdistan in particular. The present qualitative study investigated the results of a questionnaire on attitudes toward English language education policy in terms of attitudes toward the English language in general, the current English education policy, and the purposes for learning English among Kurdish EFL university students. Moreover, this study aimed to investigate this topic in light of the participants’ gender and major. To this end, an adapted version of Yang’s (2012) questionnaire was administered to university EFL students majoring in soft and hard sciences (N=300, male 34%, female 67%, four and two disciplines, respectively) at two-state and private universities in Iraqi Kurdistan. The findings revealed positive attitudes toward English as an international language in both soft and hard sciences. While strongly subscribing to the idea that all Iraqi Kurdish students should learn the English language and the courses to be offered in English as well as Kurdish, the majority of the participants expressed their readiness and enthusiasm to excel in English and considered such competency a significant academic accomplishment. However, a good number felt dissatisfied with the status quo of English education at their institutions. This paper provides some implications and recommendations for English education policies makers, administrators, and English language instructors at tertiary levels.

Keywords: attitudes, language policy, English language education, Iraqi Kurdistan

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

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

Keywords: osteomyelitis, treatment, XDR tuberculosis, successful treatment

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Authors: Richard White, Anne Drabble, Maureen O’Neill

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The University of the Sunshine Coast (USC) offers secondary school students in the final two years of school (Years 11 and 12, 16 – 18 years of age) an opportunity to participate in a program which provides an accelerated pathway to tertiary studies. Whilst still at secondary school, the students undertake two first year university subjects that are required subjects in USC undergraduate degree programs. The program is called Integrated Learning Pathway (ILP) and offers a range of disciplines, including business, design, drama, education, and engineering. Between 2010 and 2014, 38% of secondary students who participated in an ILP program commenced undergraduate studies at USC following completion of secondary school studies. The research reported here considers “before and after” literacy and numeracy competencies of students to determine what impact participation in the ILP program has had on their academic skills. Qualitative and quantitative data has been gathered via numeracy and literacy testing of the students, and a survey asking the students to self-evaluate their numeracy and literacy skills, and reflect on their views of these academic skills. The research will enable improved targeting of teaching strategies so that students will acquire not only course-specific learning outcomes but also collateral academic skills. This enhancement of academic skills will improve undergraduate experience and improve student retention.

Keywords: academic skills enhancement, accelerated pathways, improved teaching, student retention

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

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

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

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Authors: Abdelfatah Elsenosy, Mahmoud Ebrahim

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Background: Distal radius fractures are commonly encountered in orthopedic practice, especially in elderly patients. A number of clinical papers have supported the idea that anatomic restoration of the distal end of the radius is essential to gain superior results. Aim and objectives: The aim of the study is to systematically review the literature for the management of distal end radius in elderly persons (conservative treatment versus percutaneous wire fixation) as regards radiological and functional outcomes. Subjects and methods: Studies were identified from the Medline, Cochrane, EMBASE, and Google Scholar databases were searched until 2019 using combinations of the following search terms: distal radius fracture, conservative treatment, non-operative treatment, and nonsurgical treatment, surgical treatment, operative, elderly, and older. Reference lists of relevant studies were manually searched. Results: There was no statistical significance difference between CI and PKF groups’ frequency of complication in all of the selected studies. Based on the results, we recommend more analysis regarding every parameter of the radiographic and functional results and specific complications related to each fixation need to be accomplished, which requires more Randomized controlled trials (RCTs) with high quality. Conclusion: Surgical treatment seems to be more effective distal radius fracture compared with conservative treatment when the radiographic outcomes were analyzed, and no significant differences were detected in the functional outcomes and complication rate.

Keywords: radius, fracture, surgical, RCTs, conservative, radiographic, outcomes, orthopedic

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

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

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

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Authors: Ahmed Al Khamisi

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The Disaster Preparedness Standard (DPS) is one of the elements that is evaluated by the Accreditation Canada International (ACI). ACI emphasizes to train and educate all staff, including service providers and senior leaders, on emergency and disaster preparedness upon the orientation and annually thereafter. Lack of awareness and deficit of knowledge among the healthcare providers about DPS have been noticed in a tertiary hospital where ACI standards were implemented. Therefore, this paper aims to introduce a video-based e-learning (VB-EL) module that explains the hospital’s disaster plan in a simple language which will be easily accessible to all healthcare providers through the hospital’s website. The healthcare disaster preparedness coordinator in the targeted hospital will be responsible to ensure that VB-EL is ready by 25 April 2019. This module will be developed based on the Kirkpatrick evaluation method. In fact, VB-EL combines different data forms such as images, motion, sounds, text in a complementary fashion which will suit diverse learning styles and individual learning pace of healthcare providers. Moreover, the module can be adjusted easily than other tools to control the information that healthcare providers receive. It will enable healthcare providers to stop, rewind, fast-forward, and replay content as many times as needed. Some anticipated limitations in the development of this module include challenges of preparing VB-EL content and resistance from healthcare providers.

Keywords: Accreditation Canada International, Disaster Preparedness Standard, Kirkpatrick evaluation method, video-based e-learning

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Authors: Sadiq Sani, Muhammad B. Ibrahim

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Watermelon rinds powder (WRP) and neem-tree leaves powder (NLP) were used as adsorbents for equilibrium adsorption isotherms studies for detoxification of methyl orange dye (MO) from simulated wastewater. The applicability of the process to various isotherm models was tested. All isotherms from the experimental data showed excellent linear reliability (R2: 0.9487-0.9992) but adsorptions onto WRP were more reliable (R2: 0.9724-0.9992) than onto NLP (R2: 0.9487-0.9989) except for Temkin’s Isotherm where reliability was better onto NLP (R2: 0.9937) than onto WRP (R2: 0.9935). Dubinin-Radushkevich’s monolayer adsorption capacities for both WRP and NLP (qD: 20.72 mg/g, 23.09 mg/g) were better than Langmuir’s (qm: 18.62 mg/g, 21.23 mg/g) with both capacities higher for adsorption onto NLP (qD: 23.09 mg/g; qm: 21.23 mg/g) than onto WRP (qD: 20.72 mg/g; qm: 18.62 mg/g). While values for Langmuir’s separation factor (RL) for both adsorbents suggested unfavourable adsorption processes (RL: -0.0461, -0.0250), Freundlich constant (nF) indicated favourable process onto both WRP (nF: 3.78) and NLP (nF: 5.47). Adsorption onto NLP had higher Dubinin-Radushkevich’s mean free energy of adsorption (E: 0.13 kJ/mol) than WRP (E: 0.08 kJ/mol) and Temkin’s heat of adsorption (bT) was better onto NLP (bT: -0.54 kJ/mol) than onto WRP (bT: -0.95 kJ/mol) all of which suggested physical adsorption.

Keywords: adsorption isotherms, methyl orange, neem leaves, watermelon rinds

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Authors: Yi-An Liao, Lu-Wei Kuo, Yu-Jen Shih, Yao-Hui Huang

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Abstract—Imidacloprid (IMI, a widely used pesticide, iImidacloprid (IMI), a widely used pesticide, is known to affect the bee populations. A sulfate radical-based oxidation method was utilized to remove the commercial pesticide consisted of IMI, dimethylacetamide, N-methyl-2-pyrrolidone, and methanol (TOC0 = 497 ppm). The experimental results evidenced that sulfate radicals created by UV activation (254nm, 6.4 mW/cm2) of S2O82- could remove 97% of total organic carbon (TOC) from the synthetic wastewater in 4 h using 120 mM of oxidant dosage. The dose of oxidant, temperature and the light flux were the key factors to further improve the mineralization efficiency, while the ferrous ions decreased the efficacy of UV/S2O82- reaction due to the competition of UV-adsorption by complex formation of FeSO4+.s known to affect the bee populations. A sulfate radical-based oxidation method was utilized to remove the commercial pesticide consisted of IMI, dimethylacetamide, N-methyl-2-pyrrolidone, and methanol (TOC0 = 497 ppm). The experimental results evidenced that sulfate radicals created by UV activation (254nm, 6.4 mW/cm2) of S2O82- could remove 97% of total organic carbon (TOC) from the synthetic wastewater in 4 h using 120 mM of oxidant dosage. The dose of oxidant, temperature and the light flux were the key factors to further improve the mineralization efficiency, while the ferrous ions decreased the efficacy of UV/S2O82- reaction due to the competition of UV-adsorption by complex formation of FeSO4+.

Keywords: organic nitrogen, photochemical oxidation, imidacloprid, UV-persulfate, mineralization

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Authors: Brid Joy

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

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

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Authors: M. A. El-Khateeb

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The growth of the olive oil production in Saudi Arabia peculiarly in Al Jouf region in recent years has been accompanied by an increase in the discharge of associated processing waste. Olive mill waste is produced throughout the extraction of oil from the olive fruit using the traditional mill and press process. Deterioration of the environment due to olive mill disposal wastes is a serious problem. When olive mill waste disposed into the soil, it affects soil quality, soil micro flora, and also toxic to plants. The aim of this work is to isolate microorganism (bacterial or fungal strains) from OMW capable of degrading phenols. Olive mill wastewater, olive mill waste and soil (beside oil production mill) contaminated with olive waste were used for isolation of phenol tolerant microorganisms. Four strains (two fungal and two bacterial) were isolated from olive mill waste. The isolated strains were Candida tropicalis and Phanerochaete chrysosporium (fungal strains) and Bacillus sp. and Rhodococcus sp. (bacterial strains). These strains were able to degrade phenols and could be used for bioremediation of olive mill waste.

Keywords: bioremediation, bacteria, fungi, Sakaka

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Authors: S. K. M. Nzaba, H. H. Nyoni, B. Ntsendwana, B. B. Mamba, A. T. Kuvarega

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Azo dye effluents, released into water bodies are not only toxic to the ecosystem but also pose a serious impact on human health due to the carcinogenic and mutagenic effects of the compounds present in the dye discharge. Conventional water treatment methods such as adsorption, flocculation/coagulation and biological processes are not effective in completely removing most of the dyes and their natural degradation by-products. Advanced oxidation processes (AOPs) have proven to be effective technologies for complete mineralization of these recalcitrant pollutants. Therefore, there is a need for new technology that can solve the problem. Thus, this study examined the photocatalytic degradation of an azo dye brilliant black (BB) using non-metal/metal codoped TiO₂. N, Pt co-doped TiO₂ photocatalysts were prepared by a modified sol-gel method using amine-terminated polyamidoamine dendrimer generation 0 (PAMAM G0), amine-terminated polyamidoamine dendrimer generation 1 ( PAMAM G1) and hyperbranched polyethyleneimine (HPEI) as templates and source of nitrogen. Structural, morphological, and textural properties were evaluated using scanning electron microscopy coupled to energy dispersive X-ray spectroscopy (SEM/EDX), high-resolution transmission electron microscopy (HRTEM), X-ray diffraction spectroscopy (XRD), X-ray photoelectron spectroscopy (XPS), thermal gravimetric analysis (TGA), Fourier- transform infrared (FTIR), Raman spectroscopy (RS), photoluminescence (PL) and ultra-violet /visible spectroscopy (UV-Vis). The synthesized photocatalysts exhibited lower band gap energies as compared to the Degussa P-25 revealing a red shift in band gap towards the visible light absorption region. Photocatalytic activity of N, Pt co-doped TiO₂ was measured by the reaction of photocatalytic degradation of brilliant black (BB) dye. The N, metal codoped TiO₂ containing 0.5 wt. % of the metal consisted mainly of the anatase phase as confirmed by XRD results of all three samples, with a particle size range of 13–30 nm. The particles were largely spherical and shifted the absorption edge well into the visible region. Band gap reduction was more pronounced for the N, Pt HPEI (Pt 0.5 wt. %) codoped TiO₂ compared to PAMAM G0 and PAMAM G1. Consequently, codoping led to an enhancement in the photocatalytic activity of the materials for the degradation of brilliant black (BB).

Keywords: codoped TiO₂, dendrimer, photodegradation, wastewater

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Authors: Somen Mondal, Subrata Kumar Majumder

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Removal of metal pollutants by efficient activated carbon is challenging research in the present-day scenario. In the present study, the characteristic features of an efficient activated carbon (AC) synthesized from Indian gooseberry seed shells for the copper (II) adsorption are reported. A three-step chemical activation method consisting of the impregnation, carbonization and subsequent activation is used to produce the activated carbon. The copper adsorption kinetics and isotherms onto the activated carbon were analyzed. As per present investigation, Indian gooseberry seed shells showed the BET surface area of 1359 m²/g. The maximum adsorptivity of the activated carbon at a pH value of 9.52 was found to be 44.84 mg/g at 30°C. The adsorption process followed the pseudo-second-order kinetic model along with the Langmuir adsorption isotherm. This AC could be used as a favorable and cost-effective copper (II) adsorbent in wastewater treatment to remove the metal contaminants.

Keywords: activated carbon, adsorption isotherm, kinetic model, characterization

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Authors: Robyn Augustine, Irena Petrinic, Claus Helix-Nielsen, Marshall S. Sheldon

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This study examined the performance of two commercial forward osmosis (FO) membranes; an aquaporin (AQP) based biomimetic membrane, and cellulose triacetate (CTA) membrane in a fertiliser is drawn forward osmosis (FDFO) system for the reclamation of water from synthetic winery wastewater (SWW) operated over 24 hr. Straight, 1 M KCl and 1 M NH₄NO₃ fertiliser solutions were evaluated as draw solutions in the FDFO system. The performance of the AQP-based biomimetic and CTA FO membranes were evaluated in terms of permeate water flux (Jw), reverse solute flux (Js) and percentage water recovery (Re). The average water flux and reverse solute flux when using 1 M KCl as a draw solution against controlled feed solution, deionised (DI) water, was 11.65 L/m²h and 3.98 g/m²h (AQP) and 6.24 L/m²h and 2.89 g/m²h (CTA), respectively. Using 1 M NH₄NO₃ as a draw solution yielded average water fluxes and reverse solute fluxes of 10.73 L/m²h and 1.31 g/m²h (AQP) and 5.84 L/m²h and 1.39 g/m²h (CTA), respectively. When using SWW as the feed solution and 1 M KCl and 1 M NH₄NO₃ as draw solutions, respectively, the average water fluxes observed were 8.15 and 9.66 L/m²h (AQP) and 5.02 and 5.65 L/m²h (CTA). Membrane water flux decline was the result of a combined decrease in the effective driving force of the FDFO system, reverse solute flux and organic fouling. Permeate water flux recoveries of between 84-98%, and 83-89% were observed for the AQP-based biomimetic and CTA membrane, respectively after physical cleaning by flushing was employed. The highest water recovery rate of 49% was observed for the 1 M KCl fertiliser draw solution with AQP-based biomimetic membrane and proved superior in the reclamation of water from SWW.

Keywords: aquaporin biomimetic membrane, cellulose triacetate membrane, forward osmosis, reverse solute flux, synthetic winery wastewater and water flux

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Authors: Hui-Hsin Huang, Yi-Feng Lin, Che-Chia Hu

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To date, photocatalytic wastewater treatment using solar energy has attracted considerable attention. In this study, strontium titanates with various morphologies, i.e., nanofibers and cubic-like particles, were prepared as photocatalysts using the electrospinning (ES), solid-state (SS), and sol-gel (SG) methods. X-ray diffraction (XRD) analysis showed that ES and SS can be assigned to pure phase SrTiO3, while SG was referred to Sr2TiO4. These samples displayed optical absorption edges at 385-395 nm, indicating they can be activated in UV light irradiation. Scanning electron microscope (SEM) analyses revealed that ES SrTiO3 has a uniform fibrous structure with length and diameter of several microns and 100-200 nm, respectively. After loading of nanoparticulate Ag as a co-catalyst onto the surface of strontium titanates, ES sample exhibited highest photocatalytic activity to degrade methylene orange dye solution in comparison to that of SS and SG ones. These results indicate that Ag-loaded ES SrTiO3, which has a desirable SrTiO3 phase and a facile electron transfer along the preferential direction in fibrous structure, can be a promising photocatalyst.

Keywords: photocatalytic degradation, strontium titanate, electrospinning, co-catalyst

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Authors: Praveen Adusumilli, Meher Lakshmi Konatam, Sadashivudu Gundeti, Stalin Bala

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The invention of trastuzumab has changed the treatment of breast cancer and lives of many patients all over the world. Despite many patients getting benefitted from the drug, it is out of reach for most of the patients. There is very limited real world data regarding the epidemiology and clinical outcome of Her2neu positive breast cancer patients. Materials and Methods: This is a retrospective analysis of breast cancer patients presenting to a tertiary care cancer centre in Southern India from 2007 to2013. All early and locally advanced breast cancer patients, who were Her2neu 3+ on IHC are included in the study and evaluated in terms of epidemiology, 3-year disease free survival (DFS)and 5-year overall survival(OS). Chemotherapy regimens used were-FAC 6 cycles or AC 4 cycles followed by 12 cycles of weekly paclitaxel . Trastuzumab was given after 6 cycles of FAC or weekly with paclitaxel followed by 3weekly maintenance until 1 year. Results: Over the period of this study there were 885 newly diagnosed cases of carcinoma breast, of which 242 (27%) were Her2neu positive, 360(40%) were hormone receptor positive, and 212(24%) were triple negative. A total of 71(8%) were Her2neu equivocal of which only 10 patients got FISH test done. Of the 212 newly diagnosed patients, only 74 (29%) opted to have standard of care therapy with trastuzumab at our centre, out of which 52(24%), 8(3%), received under insurance, paying basis respectively. 14(9%) patients received the care as part of clinical trial program (ALTTO trial). 7 (9.72%) patients developed decrease of ejection fraction by greater than 10%, requiring stoppage of trastuzumab out of which 5 were restarted in 2 months. Patients receiving trastuzumab along with chemotherapy had longer 3year DFS 92% vs. 60% (p value<0.0001) when compared to chemotherapy alone. 5 year OS was 87% vs 44% (p-value <0.0001) compared to chemotherapy alone. Conclusion: Trastuzumab with chemotherapy improves the DFS and OS in Her2neu positive patients. The biggest constraint is the cost of the treatment and absence of universal health security net to treat all patients with this diagnosis.

Keywords: breast cancer, Her 2 neu positive, real world data, Trastuzumab

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Authors: Jacklyn Yek, Clara Tong, Shin Yuet Chong, Yee Yian Ong

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Background: While emergency manuals and cognitive aids (CA) have been used in high-hazard industries for decades, this has been a nascent field in healthcare. CAs can potentially offset the large cognitive load involved in crisis resource management and possibly facilitate the efficient performance of key steps in treatment. A crisis manual was developed based on local guidelines and the latest evidence-based information and introduced to a tertiary hospital setting in Singapore. Hence, the objective of this study is to evaluate the effectiveness of the crisis manual in guiding response and management of critical events. Methods: 7 surgical teams were recruited to participate in a series of simulated emergencies in high-fidelity operating room simulator over the period of April to June 2018. All teams consisted of a surgical consultant and medical officer/registrar, anesthesia consultant and medical officer/registrar; as well as a circulating, scrub and anesthetic nurse. Each team performed a simulated operation in which 1 or more of the crisis events occurred. The teams were randomly assigned to a scenario of the crisis manual and all teams were deemed to be equal in experience and knowledge. Before the simulation, teams were instructed on proper checklist use but the use of the checklist was optional. Results: 7 simulation sessions were performed, consisting of the following scenarios: Airway fire, Massive Transfusion Protocol, Malignant Hyperthermia, Eclampsia, and Difficult Airway. Out of the 7 surgical teams, 2 teams made use of the crisis manual – of which both teams had encountered a ‘Malignant Hyperthermia’ scenario. These team members reflected that the crisis manual assisted allowed them to work in a team, especially being able to involve the surgical doctors who were unfamiliar with the condition and management. A run chart plotted showed a possible upward trend, suggesting that with increasing awareness and training, staff would become more likely to initiate the use of the crisis manual. Conclusion: Despite the high volume load in this tertiary hospital, certain crises remain rare and clinicians are often caught unprepared. A crisis manual is an effective tool and easy-to-use repository that can improve patient outcome and encourage teamwork. With training, familiarity would allow clinicians to be increasingly comfortable with reaching out for the crisis manual. More simulation training would need to be conducted to determine its effectiveness.

Keywords: crisis resource management, high fidelity simulation training, medical errors, visual aids

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Authors: Jemini Vyas, Oluwatobi Adeyoe, Jenny Branagan, Chandran Tanabalan, John Beatty, Aakash Pai

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Introduction: The development of robotic surgery has accelerated centralisation to tertiary centres, where robotic radical prostatectomy (RP) is offered. The purpose of concentrating treatment in high volume specialist centres is to improve the quality of care and patient outcomes. The aim of this study was to assess the impact on clinical outcomes of centralisation for locally diagnosed patients undergoing RP. Methods: Clinical outcomes for 169 consecutive laparoscopic & open RP pre-centralisation were retrospectively compared with 50 consecutive robotic RP conducted over a similar period post-centralisation. Preoperative risk stratification and time to surgery were collected. Perioperative outcomes, including length of stay (LOS) and complications, were collated. Post-operative outcomes, including erectile dysfunction (ED), biochemical recurrence (BCR), and urinary continence, were assessed. Results: Preoperative risk stratification showed no difference between the two groups. The median time from diagnosis to treatment was similar between the two groups (pre-centralisation, 121 days, post-centralisation, 117 days). The mean length of stay (pre-centralisation, 2.1 days, post-centralisation, 1.6 days) showed no significant difference (p=0.073). Proportion of overall complications (pre-centralisation, 11.4%, post-centralisation, 8.7%) and complications, above Clavien-Dindo 2, were similar between the two groups (pre-centralisation1.2%, post-centralisation 2.2%). Post operative functional parameters, including continence and ED, were comparable. Five-year BCR free rate was 78% for the pre-centralisation group and 79% for the post centralisation group. Conclusion: For our cohort of patients, clinical outcomes have remained static during centralisation. It is imperative that centralisation is accompanied by increased capacity, streamlining of pathways, and training to ensure that improved quality of care is achieved. Our institution has newly acquired a robot, and prospectively studying this data may support the reversal of centralisation for RP surgery.

Keywords: prostate, cancer, prostatectomy, clinical

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

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

Keywords: chemical treatment, hybrid composite, jute, thermal

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

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

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

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Authors: Kebede Mairie, Getahun Belete, Mitike Abeba

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

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

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Authors: Keden Montgomery, Kathie Ardzejewska, Alison Casey, Rosemarie Hogan

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Research was undertaken to explore the question “what is known about the experiences of regional, rural and remote Australian women undertaking a Bachelor of Nursing program delivered online?”. The findings will support future research aimed at improving the retention and completion rates of women studying nursing in regional, rural and remote areas.  There is a critical shortage of nurses working in regional, rural and remote (RRR) Australia. It is well supported that this shortage of nurses is most likely to be addressed by nursing students who are completing their studies in RRR areas. Despite this, students from RRR Australia remain an equity group and experience poorer outcomes than their metropolitan counterparts. Completion rates for RRR students who enrol in tertiary education courses are much less than students from metropolitan areas. In addition to this, RRR students are less likely than students from metropolitan areas to gain a tertiary level qualification at all, and even less likely to gain a Bachelor level degree which is required for Registered Nurses. Supporting students to remain in regional, rural and remote areas while they study reduces the need for students to relocate to metropolitan areas and to continue living and working in RRR areas after graduation. This research holds implications for workforce shortages internationally.

Keywords: nurse education, online education, regional, rural, remote, workforce

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Authors: S. Delpeux-Ouldriane, M. Gineys, S. Masson, N. Cohaut, L. Reinert, L. Duclaux, F. Béguin

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Nowadays, a wide variety of organic contaminants are present at trace concentrations in wastewater effluents. In order to face these pollution problems, the implementation of the REACH European regulation has defined lists of targeted pollutants to be eliminated selectively in water. It therefore implies the development of innovative and more efficient remediation techniques. In this sense, adsorption processes can be successfully used to achieve the removal of organic compounds in waste water treatment processes, especially at low pollutant concentration. Especially, activated carbons possessing a highly developed porosity demonstrate high adsorption capacities. More specifically, carbon cloths show high adsorption rates, an easily handling, a good mechanical integrity and regeneration potentialities. When loaded with pollutants, these materials can be indeed regenerated using an electrochemical polarization.

Keywords: nanoporous carbons, activated carbon cloths, adsorption, micropollutants, emerging contaminants, regeneration, electrochemistry

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Authors: Fakhreia A. Al Sagheer, Enas I. Ibrahim, Khaled D. Khalil

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N-Acryloyl morpholine, NAM, was grafted onto chitosan utilizing homogeneous conditions with 1% acetic acid as the solvent, and potassium persulfate and sodium sulfite as the redox initiator. The effects of various reaction parameters, such as time, temperature, and monomer and initiator concentrations, on the percentage of grafting (G%) and the grafting efficiency (E%) were determined. The graft copolymer showed a remarkably improved crystallinity, as compared to the unmodified chitosan, based on the FESEM, XRD, and DSC results. Chitosan-g-poly(N-acryloyl morpholine) (Cs-PNAM), the copolymer obtained by using this procedure, was characterized by utilizing FTIR, FESEM, TGA, and XRD analysis. As expected, the results of an evaluation of antibacterial and antifungal activities show that the grafted chitosan copolymers exhibit stronger inhibitory effects against both types of microbes than does chitosan. Moreover, the size of the inhibition zone created by the graft copolymer was observed to be proportional to its G% corresponding to its morpholine content. Fortunately, the graft copolymer showed a marked growth inhibition against candidiasis (C.Albicans and C.Kefyr). We conclude that the graft copolymer may be highly effective in the prevention and treatment of candidiasis. In addition, the extent and pH dependence of uptake of different types of dyes (acidic: EBT, and MV; and basic: MB) by grafted chitosan in pH 6.5 aqueous solutions was determined. The results show that, the grafted copolymer exhibited a greater affinity to absorb the acid dyes more than the basic ones especially at relatively low temperature. Thus the modified chitosan can be used, in wastewater treatment, as efficient economic absorbent especially for anionic dyes from the industrial processing effluents.

Keywords: chitosan, N-Acryloyl morpholine, homogeneous grafting, antimicrobial activity, dye uptake

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Authors: Hebah M. Musalem, Jeylan El-Mansoury, Lin M. Tuleimat, Selwa Alhazza, Abdul-Aziz A. Al Zoba

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Background: Amblyopia is a condition that affects the visual system triggering a decrease in visual acuity without a known underlying pathology. It is due to abnormal vision development in childhood or infancy. Most importantly, vision loss is preventable or reversible with the right kind of intervention in most of the cases. Strabismus, sensory defects, and anisometropia are all well-known causes of amblyopia. However, ocular misalignment in Strabismus is considered the most common form of amblyopia worldwide. The risk of developing amblyopia increases in premature children, developmentally delayed or children who had brain lesions affecting the visual pathway. The prevalence of amblyopia varies between 2 to 5 % in the world according to the literature. Objective: To determine the different causes of Amblyopia in pediatric patients seen in ophthalmology clinic of a tertiary care center, i.e. King Faisal Specialist Hospital and Research Center (KFSH&RC). Methods: This is a hospital based, random retrospective, based on reviewing patient’s files in the Ophthalmology Department of KFSH&RC in Riyadh city, Kingdom of Saudi Arabia. Inclusion criteria: amblyopic pediatric patients who attended the clinic from 2015 to 2016, who are between 6 months and 18 years old. Exclusion Criteria: patients above 18 years of age and any patient who is uncooperative to obtain an accurate vision or a proper refraction. Detailed ocular and medical history are recorded. The examination protocol includes a full ocular exam, full cycloplegic refraction, visual acuity measurement, ocular motility and strabismus evaluation. All data were organized in tables and graphs and analyzed by statistician. Results: Our preliminary results will be discussed on spot by our corresponding author. Conclusions: We focused on this study on utilizing various examination techniques which enhanced our results and highlighted a distinguished correlation between amblyopia and its’ causes. This paper recommendation emphasizes on critical testing protocols to be followed among amblyopic patient, especially in tertiary care centers.

Keywords: amblyopia, amblyopia causes, amblyopia diagnostic criterion, amblyopia prevalence, Saudi Arabia

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