Search results for: circular building materials

Authors: Sreetama Ghosh, Sundara Ramaprabhu

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Carbon dioxide gas has been a major cause for the worldwide increase in green house effect, which leads to climate change and global warming. So CO₂ capture & sequestration has become an effective way to reduce the concentration of CO₂ in the environment. One such way to capture CO₂ in porous materials is by adsorption process. A potential material in this aspect is porous hexagonal boron nitride or 'white graphene' which is a well-known two-dimensional layered material with very high thermal stability. It had been investigated that the sample with hierarchical pore structure and high specific surface area shows excellent performance in capturing carbon dioxide gas and thereby mitigating the problem of environmental pollution to the certain extent. Besides, the presence of sulfur as well as nitrogen in the sample synergistically helps in the increase in adsorption capacity. In this work, a cost effective single step synthesis of highly porous boron nitride nanosheets doped with sulfur had been demonstrated. Besides, the CO₂ adsorption-desorption studies were carried on using a pressure reduction technique. The studies show that the nanosheets exhibit excellent cyclic stability in storage performance. Thermodynamic studies suggest that the adsorption takes place mainly through physisorption. The studies show that the nanosheets exhibit excellent cyclic stability in storage performance. Further, the surface modification of the highly porous nano sheets carried out by incorporating ionic liquids had further enhanced the capturing capability of CO₂ gas in the nanocomposite, revealing that this particular material has the potential to be an excellent adsorbent of carbon dioxide gas.

Keywords: CO₂ capture, hexagonal boron nitride nanosheets, porous network, sulfur doping

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Authors: Deependra Prasad Sarraf, Ashish Shrestha, Mehul Rajesh Jaisani, Gajendra Prasad Rauniar

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Background: Honey is the worlds’ oldest known wound dressing. Its wound healing properties are not fully established till today. Concerns about antibiotic resistance, and a renewed interest in natural remedies have prompted the resurgence in the antimicrobial and wound healing properties of Honey. Evidence from animal studies and some trials has suggested that honey may accelerate wound healing in burns, infected wounds and open wounds. None of these reports have documented the effect of honey on the healing of socket after tooth extraction. Therefore, the present experimental study was planned to evaluate the efficacy of honey on the healing of socket after tooth extraction in rabbits. Materials and Methods: An experimental study was conducted in six New Zealand White rabbits. Extraction of first premolar tooth on both sides of the lower jaw was done under anesthesia produced by Ketamine and Xylazine followed by application of honey on one socket (test group) and normal saline (control group) in the opposite socket. The intervention was continued for two more days. On the 7th day, the biopsy was taken from the extraction site, and histopathological examination was done. Student’s t-test was used for comparison between the groups and differences were considered to be statistically significant at p-value less than 0.05. Results: There was a significant difference between control group and test group in terms of fibroblast proliferation (p = 0.0019) and bony trabeculae formation (p=0.0003). Inflammatory cells were also observed in both groups, and it was not significant (p=1.0). Overlying epithelium was hyperplastic in both the groups. Conclusion: The study showed that local application of honey promoted the rapid healing process particularly by increasing fibroblast proliferation and bony trabeculae.

Keywords: honey, extraction wound, Nepal, healing

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Authors: Suheyla Kocaman, Gulnare Ahmetli, Alaaddin Cerit, Alize Yucel, Merve Gozukucuk

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Shell wastes represent a considerable quantity of byproducts in the shellfish aquaculture. From the viewpoint of ecofriendly and economical disposal, it is highly desirable to convert these residues into high value-added products for industrial applications. So far, the utilization of shell wastes was confined at relatively lower levels, e.g. wastewater decontaminant, soil conditioner, fertilizer constituent, feed additive and liming agent. Shell wastes consist of calcium carbonate and organic matrices, with the former accounting for 95-99% by weight. Being the richest source of biogenic CaCO₃, shell wastes are suitable to prepare high purity CaCO₃ powders, which have been extensively applied in various industrial products, such as paper, rubber, paints and pharmaceuticals. Furthermore, the shell waste could be further processed to be the filler of polymer composites. This paper presents a study on the potential use of mussel shell waste as biofiller to produce the composite materials with different epoxy matrices, such as bisphenol-A type, CTBN modified and polyurethane modified epoxy resins. Morphology and mechanical properties of shell particles reinforced epoxy composites were evaluated to assess the possibility of using it as a new material. The effects of shell particle content on the mechanical properties of the composites were investigated. It was shown that in all composites, the tensile strength and Young’s modulus values increase with the increase of mussel shell particles content from 10 wt% to 50 wt%, while the elongation at break decreased, compared to pure epoxy resin. The highest Young’s modulus values were determined for bisphenol-A type epoxy composites.

Keywords: biocomposite, epoxy resin, mussel shell, mechanical properties

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Authors: Aditi Jain

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Aim: To compare the canal transportation, centering ability and remaining dentin thickness of OneShape and WaveOne system using CBCT. Objective: To identify rotary system which respects original canal anatomy. Materials and Methods: Forty extracted human single-rooted premolars were used in the present study. Pre-instrumentation scans of all teeth were taken, canal curvatures were calculated, and the samples were randomly divided into two groups with twenty samples in each group, where Group 1 included WaveOne system and Group 2 Protaper rotary system. Post-instrumentation scans were performed, and the two scans were compared to determine canal transportation, centering ability and remaining dentin thickness at 1, 3, and 5 mm from the root apex. Results: Using Student’s unpaired t test results were as follows; for canal transportation Group 1 showed statistical significant difference at 3mm, 6mm and non-significant difference was obtained at 9mm but for Group 2 non-statistical significant difference was obtained at 3mm, 6mm, and 9mm. For centering ability and remaining dentin thickness Group 1 showed non-statistical significant difference at 3mm and 9mm, while statistical significant difference at 6mm was obtained. When comparison of remaining dentin thickness was done at three levels using two groups WaveOne and ProTaper. There was non-statistical significant difference between two groups. Conclusion: WaveOne single reciprocation file respects original canal anatomy better than ProTaper. WaveOne depicted the best centering ability.

Keywords: ShapeOne, WaveOne, transportation, centering ability, dentin thickness, CBCT (Cone Beam Computed Tomography)

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Authors: Rosy Chaudhary, Pushpa Parajuli

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Background and Objectives: Informational support to family members has a significant potential for reducing this distress related to hospitalization of their patient into the critical care unit, enabling them to cope better and support the patient. The objective of the study is to assess family members’ perception of informational support, anxiety, satisfaction with care and to reveal the association with selected socio-demographic variables and to investigate the correlation between informational support, anxiety and satisfaction with care. Materials and Methods: A descriptive cross-sectional study was conducted in 39 family caregivers of patients admitted in critical care unit of BPKIHS(B.P. Koirala Institute of Health Sciences). Consecutive sampling technique was used wherein data was collected over duration of one month using interview schedule. Descriptive and inferential statistics were used. Results: The mean age of the respondents was 34.97 ± 10.64 and two third (66.70%) were male. Mean score for informational support was 25.72(SD = 5.66; theoretical range of 10 - 40). Mean anxiety was 10.41 (SD = 5.02; theoretical range of 7 - 21). Mean score for satisfaction with care was 40.77 (SD = 6.77; theoretical range of 14 - 64). A moderate positive correlation was found between informational support and satisfaction with care (r = 0.551, p < .001) and a moderate negative correlation was found between anxiety and satisfaction with care (r = -0.590; p = 0.000). No relationship was noted between informational support and anxiety. Conclusion: The informational support and satisfaction of the family caregivers with the care provided to their patients was satisfactory. More than three fourth of the family caregivers had anxiety; the factors associated being educational status of the caregivers, the family income and duration of visiting hours. There was positive correlation between informational support and satisfaction with care provided justifying the need for comprehensive information to the family caregivers by the health personnel. There was negative correlation between anxiety and satisfaction with care.

Keywords: anxiety, caregivers, critical care unit, informational support, family

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Authors: Awais Ahmed, Atif Rana, Haseeb Zia, Maham Jahangir, Rashed Nazir, Faisal Dar

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Purpose: Biliary complications represent the most common cause of morbidity in living related liver donor transplantation and detailed preoperative evaluation of biliary anatomic variants is crucial for safe patient selection and improved surgical outcomes. Purpose of this study is to determine the accuracy of preoperative MRCP in predicting biliary variations when compared to intraoperative cholangiography in living related liver donors. Materials and Methods: From 44 potential donors, 40 consecutive living related liver donors (13 females and 28 males) underwent donor hepatectomy at our centre from April 2012 to August 2013. MRCP and IOC of all patients were retrospectively reviewed separately by two radiologists and a transplant surgeon.MRCP was performed on 1.5 Tesla MR magnets using breath-hold heavily T2 weighted radial slab technique. One patient was excluded due to suboptimal MRCP. The accuracy of MRCP for variant biliary anatomy was calculated. Results: MRCP accurately predicted the biliary anatomy in 38 of 39 cases (97 %). Standard biliary anatomy was predicted by MRCP in 25 (64 %) donors (100% sensitivity). Variant biliary anatomy was noted in 14 (36 %) IOCs of which MRCP predicted precise anatomy of 13 variants (93 % sensitivity). The two most common variations were drainage of the RPSD into the LHD (50%) and the triple confluence of the RASD, RPSD and LHD (21%). Conclusion: MRCP is a sensitive imaging tool for precise pre-operative mapping of biliary variations which is critical to surgical decision making in living related liver transplantation.

Keywords: intraoperative cholangiogram, liver transplantation, living related donors, magnetic resonance cholangio-pancreaticogram (MRCP)

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Authors: S. Abdi Goudazri, R. Ziaie Moayed, A. Nazeri

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Loose soils normally are of weak bearing capacity due to their structural nature. Being exposed to heavy traffic loads, they would fail in most cases. To tackle the aforementioned issue, geotechnical engineers have come up with different approaches; one of which is making use of geosynthetic-reinforced soil-aggregate systems. As these polymeric reinforcements have highlighted economic and environmentally-friendly features, they have become widespread in practice during the last decades. The present research investigates the efficiency of four different types of these reinforcements in increasing the bearing capacity of two-layered soil sections using a series California Bearing Ratio (CBR) test. The studied sections are comprised of a 10 cm-thick layer of no. 161 Firouzkooh sand (weak subgrade) and a 10 cm-thick layer of compacted aggregate materials (base course) classified as SP and GW according to the United Soil Classification System (USCS), respectively. The aggregate layer was compacted to the relative density (Dr) of 95% at the optimum water content (Wopt) of 6.5%. The applied reinforcements were including two kinds of geocomposites (type A and B), a geotextile, and a geogrid that were embedded at the interface of the lower and the upper layers of the soil-aggregate system. As the standard CBR mold was not appropriate in height for this study, the mold used for soaked CBR tests were utilized. To make a comparison between the results of stress-settlement behavior in the studied specimens, CBR values pertinent to the penetrations of 2.5 mm and 5 mm were considered. The obtained results demonstrated 21% and 24.5% increments in the amount of CBR value in the presence of geocomposite type A and geogrid, respectively. On the other hand, the effect of both geotextile and geocomposite type B on CBR values was generally insignificant in this research.

Keywords: geosynthetics, geogrid, geotextile, CBR test, increasing bearing capacity

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Authors: Pratikno Hidayat, Khamdan Cahyari

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Hydrogen is the ultimate choice of energy carriers in future. It contents high energy density (42 kJ/g), emits only water vapor during combustion and has high energy conversion up to 50% in fuel cell application. One of the promising methods to produce hydrogen is from organic waste through dark fermentation method. It utilizes sugar-rich organic waste as substrate and hydrogen-producing microorganisms to generate the hydrogen. Solid waste of sago processing industries in Indonesia is one of the promising raw materials for both producing biofuel hydrogen and mitigating the environmental impact due to the waste disposal. This research was meant to investigate the effect of chemical and biological pretreatment i.e. acid treatment and mushroom cultivation toward lignocellulosic waste of these sago industries. Chemical pretreatment was conducted through exposing the waste into acid condition using sulfuric acid (H2SO4) (various molar i.e. 0.2, 0.3, and 0.4 M and various duration of exposure i.e. 30, 60 and 90 minutes). Meanwhile, biological treatment was conducted through utilization of the solid waste as growth media of mushroom (Oyster and Ling-zhi) for 3 months. Dark fermentation was conducted at pH 5.0, temperature 27℃ and atmospheric pressure. It was noticed that chemical and biological pretreatment could improve hydrogen yield with the highest yield at 3.8 ml/g VS (31%v H2). The hydrogen production was successfully performed to generate high percentage of hydrogen, although the yield was still low. This result indicated that the explosion of acid chemical and biological method might need to be extended to improve degradability of the solid waste. However, high percentage of hydrogen was resulted from proper pretreatment of residual sludge of biogas plant to generate hydrogen-producing inoculum.

Keywords: hydrogen, sago waste, chemical, biological, dark fermentation, Indonesia

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Authors: Majid Azizi, Payam Ghorbannezhad, Mostafa Amiri, Mohammad Ghofrani

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Environmental issues in the furniture industry are of great importance due to the use of natural materials such as wood and chemical substances like adhesives and paints. These issues encompass environmental conservation and managing pollution and waste generated. Improper use of wood resources, along with the use of chemicals and their release, leads to the depletion of natural resources, damage to forests, and the emission of greenhouse gases. Therefore, identifying influential indicators in the life cycle assessment of classic furniture and proposing solutions to reduce environmental impacts becomes crucial. In this study, the life cycle of classic furniture was evaluated using a hierarchical analytical process from cradle to grave. The life cycle assessment was employed to assess the environmental impacts of the furniture industry, ranging from raw material extraction to waste disposal and recycling. The most significant indicators in the furniture industry's production chain were also identified. The results indicated that the wood quality indicator is the most essential factor in the life cycle of classic furniture. Furthermore, the relative contribution of each type of traditional furniture was proposed concerning impact categories in the life cycle assessment. The results showed that among the three proposed types, the design and production of furniture with prefabricated parts had the most negligible impact in categories such as global warming potential and ozone layer depletion compared to furniture design with solid wood and furniture design with recycled components. Among the three suggested types of furniture to reduce environmental impacts, producing furniture with solid wood or other woods was chosen as the most crucial solution.

Keywords: life cycle assessment, analytic hierarchy process, environmental issues, furniture

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Authors: Diane M. Bender

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In design education, professional education is delivered in a studio, where students learn and understand their discipline. This learning methodology culminates in a final review, where students present their work before instructors and invited reviewers, known as jurors. These jurors are recognized experts who add a wide diversity of opinions in their feedback to students. This feedback can be provided in multiple formats, mainly a verbal critique of the work. To better understand how these expert reviewers prepare for a studio review, a survey was distributed to reviewers at a multi-disciplinary design school within the United States. Five design disciplines are involved in this case study: architecture, graphic design, industrial design, interior design, and landscape architecture. Respondents (n=122) provided information about if and how they received training on how to critique and participate in a final review. Common forms of training included mentorship, modeled behavior from other designers/past professors, workshops on critique from the instructing faculty prior to the crit session, and by being a practicing design professional. Respondents also gave feedback about how much the instructor provided course materials prior to the review in order to better prepare for student interaction. Finally, respondents indicated if they had interaction, and in what format, with students prior to the final review. Typical responses included participation in studio desk crits, a midterm jury member, meetings with students, and email or social media correspondence. While the focus of this study is the studio review, the findings are equally applicable to other disciplines. Suggestions will be provided on how to improve the preparation of guests in the learning process and how their interaction can positively influence student engagement.

Keywords: critique, design, education, evaluation, juror

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Authors: Sehrish Ather

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Introduction: To improve organizational achievements through the production of new knowledge, health policy and system research is the basic requirement. An aging population is always the source of the increased burden of chronic diseases, disabilities, mental illnesses, and other co-morbidities; therefore the provision of quality health care services to every group of the population should be achieved by making strong policy and system research for the betterment of health care system. Unfortunately, the whole world is lacking policies and system research for providing health care to their elderly population. Materials and Methods: A literature review of published studies on aging diseases was done, ranging from the year 2011-2018. Geriatric, population, health policy, system, and research were the key terms used for the search. Databases searched were Google Scholar, PubMed, Science Direct, Ovid, and Research Gate. Grey literature was searched from various websites, including IHME, Library of the University of Lahore, World Health Organization (Ageing and Life Course), and Personal communication with Neuro-physicians. After careful reviewing published and un-published information, it was decided to carry on with commentary. Results and discussion: Most of the published studies have highlighted the need to advocate the funders of health policy and stakeholders of healthcare system research, and it was detected as a major issue, research on policy and healthcare system to provide health care to 'geriatric population' was found as highly neglected area. Conclusion: It is concluded that physicians are more involved with the policy and system research regarding any type of diseases, but scientists and researchers of basic and social science are less likely to be involved in methods used for health policy and system research due to lack of funding and resources. Therefore ageing diseases should be considered as a priority, and comprehensive policy and system research should be initiated for diseases of the geriatric population.

Keywords: geriatric population, health care system, health policy, system research

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Authors: Seyed Saeid Nabavi

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Background: Many infants with intrauterine growth disorder are screened for TORCH infections. This action has no economic justification in terms of the imposed costs. In this regard, due to the research gap in this field, this study aimed to investigate the relationship between intrauterine growth disorder and TORCH infection in neonates referred to Milad hospital in 2019 and 2020. Materials and Methods: In this cross-sectional study, 41IUGR newborns were selected and evaluated based on diagnostic and clinical studies in Milad Hospital in 2019 and 2020. TORCH results found in IgG and IgM antibody titer assay were tested in mother and infant. Antibody titers of toxoplasmosis, rubella, cytomegalovirus, herpes, and syphilis were determined in cases, and other variables were compared. The collected data were entered in SPSS software 25 and analyzed at a significant level of 0.05 using the statistical tests of Kolmogorov–Smirnov, Shapiro–Wilk, chi-square, and Mann–Whitney. Results: Most of the IUGR infants studied were girls (68.3%), Gravida and Parity were reported to be 68.3% and 80%, respectively, in the study. Mean weight, APGAR score, and neonatal gestational age are reported as 1710.62±334.43 g, 7.71±1.47, and 35.7+ 1.98 weeks, respectively. Most of the newborns were born by cesarean section (92.7%). TORCH infection was reported in three patients, 7.3%. The mean gestational age of IUGR infants with TORCH infection was reported to be less than other babies with IUGR. Therefore, the mean gestational age of subjects with TORCH infection was 33±1.4 weeks and in others 35.94±1.91 weeks (p-value = 0.038). No significant relationship between TORCH infection and gender, gravidity, and parity of newborns was found (p-value > 0.05). Conclusion: TORCH infection was reported in 3 patients( 7.3%). No significant relationship between TORCH infection and gender, gravidity, and parity of newborns was found. p-value > 0.05

Keywords: congenital infection, intrauterine growth restriction, TORCH infections, neonates

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Authors: Alireza Yavar, Sukiman Sarmani, Kok Siong Khoo

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Trace element analysis of human hair has the potential to disclose retroactive information about an individual’s nutritional status and exposure. The residents of villages in Kandal province of Cambodia, due to dietary habits, lifestyle and ecological conditions, are unprotected from toxic elements particularly arsenic (As). The purpose of this research was to valuation levels of toxic and vital elements in scalp human hair. Scalp hair samples of 12-17 school children from three villages of Anglong Romiot (AR), Svay Romiot (SR) and Kampong Kong (KK) in the Kandal province of Cambodia were evaluated using k0- instrumental neutron activation method (k0-INAA). The samples were irradiated 6 hours in a Malaysian nuclear agency (MNA) research reactor and afterward, an HPGe detector was utilized to obtain gamma peaks of radionuclides in samples. We achieved profiles of 31 elements in human hair in our studied area, namely, As, Au, Br, Ca, Ce, Co, Dy, Eu152m, Hg197, Hg203, Ho, Ir, K, La, Lu, Mn, Na, Pa, Pt195m, Pt197, Sb, Sc46, Sc47, Sm, Sn117m, W181, W187, Yb169, Yb175, Zn and Zn69m. The precision of the method was assessed by evaluating ERM-DB001-human hair as certified reference materials (CRMs), and which experimental result of ERM-DB001 was consistent with certified values. Whereas Arsenic (As) pollution is major contamination in our studied area, correlation between the concentration of As and other elements were determined by Pearson’s correlation test that it may be useful as a database source for toxic and essential elements in the hair of teenage individuals in our studied area

Keywords: scalp human hair, toxic and essential elements, Kandal province of Cambodia, k₀- instrumental neutron activation method

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Authors: Sukriti Sabharwal, Sonali Bhattar, Shikhar Saxena

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Introduction: COVID-19 molecular diagnostic laboratory is the cornerstone of the COVID-19 disease diagnosis as the patient’s treatment and management protocol depend on the molecular results. For this purpose, it is extremely important that the laboratory conducting these results adheres to the quality management processes to increase the accuracy and validity of the reports generated. We started our own molecular diagnostic setup at the onset of the pandemic. Therefore, we conducted this study to generate our quality management data to help us in improving on our weak points. Materials and Methods: A total of 14561 samples were evaluated by the retrospective observational method. The quality variables analysed were classified into pre-analytical, analytical, and post-analytical variables, and the results were presented in percentages. Results: Among the pre-analytical variables, sample leaking was the most common cause of the rejection of samples (134/14561, 0.92%), followed by non-generation of SRF ID (76/14561, 0.52%) and non-compliance to triple packaging (44/14561, 0.3%). The other pre-analytical aspects assessed were incomplete patient identification (17/14561, 0.11%), insufficient quantity of samples (12/14561, 0.08%), missing forms/samples (7/14561, 0.04%), samples in the wrong vials/empty VTM tubes (5/14561, 0.03%) and LIMS entry not done (2/14561, 0.01%). We are unable to obtain internal quality control in 0.37% of samples (55/14561). We also experienced two incidences of cross-contamination among the samples resulting in false-positive results. Among the post-analytical factors, a total of 0.07% of samples (11/14561) could not be dispatched within the stipulated time frame. Conclusion: Adherence to quality control processes is foremost for the smooth running of any diagnostic laboratory, especially the ones involved in critical reporting. Not only do the indicators help in keeping in check the laboratory parameters but they also allow comparison with other laboratories.

Keywords: laboratory quality management, COVID-19, molecular diagnostics, healthcare

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Authors: Ali Faisal Saleem, Farheen Quadri, Mach Ondrej, Anita Zaidi

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Purpose: Pakistan is the final frontier for a polio-free world. Chronic malnutrition is associated with lack of effective gut immunity, and possibly associated with poliomyelitis in children received multiple OPV. We evaluate IPV dose administered together with OPV results in higher immunogenicity and mucosal immunity compared to OPV alone in chronically malnourished infants. Methods AND Materials: A community-based, unblinded-randomized-trial, conducted in 5 peri-urban, low-middle-income households of Karachi, in infants 9-12 months. Two study groups were non-malnourished (HAZ= -2 or more) and chronic malnourished (HAZ <-2SD), with 2-arms each i) OPV and ii) OPV and IPV. Two blood specimens (2ml) at baseline and at day 28 and two stool specimens (6 gm.) at day 29 and after 7 days. All infants received a bOPV challenge dose after first stool specimen. Calculates sample size was 210 in each arm. Serological (baseline compared to 28 days post-vaccine) and mucosal immunity after one week of bOPV challenge dose were study outcomes. Results: Baseline seroprevalence in malnourished infants were low compared to non-malnourished (P1, P2 and P3 (p=<0.001). There is significant rise in antibody titer and P1 seroprevalence in Mal A and B after receiving study vaccine; much higher in Mal B. Infants randomized to bOPV + IPV study vaccine showed incremental immune response against P1 (Mal B, 92.2%; Nor B, 98.4%), P2 (Mal B, 90.4%; Nor B, 94.7%), and P3 (Mal B, 85.6% and Nor B, 93.5%) was observed. A significant proportion of infants in malnourished (P1, 13%; P2, 24%; P3, 26%) and normally nourished group (P1, 5%; P2, 11%; P3, 14%) were found to be seronegative at baseline. Infants who received BOPV + IPV as their study vaccine showed a very high seroconversion response after vaccine (p=<0.001 for P1, P2 and P3). Majority of the specimens were negative at baseline (Mal A, 2%, Mal B, 1%; Nor A, 2%; Nor B, 1%), and remains negative after bOPV challenge dose (Mal A, 8%, Mal B, 6%; Nor A, 11%; Nor B, 10%). Conclusion: Malnourished-infants have low poliovirus-seroprevalence that increased remarkably after IPV. There is less viral shedding after IPV in infants.

Keywords: chronic malnutrition, infants, IPV, OPV

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Authors: Ekin Ece Gürer, Tarık Onur Tiryaki, Sevgi Kalayoğlu Beşışık, Fatma Savran Oğuz, Uğur Sezerman, Fatma Erdem, Gülşen Günel, Dürdane Serap Kuruca, Zerrin Aktaş, Oral Öncül

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Aim: Chemotherapytreatment in HodgkinLymphomaandNon-HodgkinLymphoma (NHL) diseasescausesgastrointestinalepithelialdamage, disruptstheintestinalmicrobiotabalanceandcausesdysbiosis. Inourstudy, it wasaimedtoshowtheeffect of thedamagecausedbychemotherapy on themicrobiotaandtheeffect of thechangingmicrobiota flora on thecourse of thedisease. Materials And Methods: Seven adult HL and seven adult HL patients to be treatedwithchemotherapywereincluded in the study. Stoolsamplesweretakentwice, beforechemotherapytreatmentandafterthe 3th course of treatment. SamplesweresequencedusingNextGenerationSequencing (NGS) methodafternucleicacidisolation. OTU tableswerepreparedusing NCBI blastnversion 2.0.12 accordingtothe NCBI general 16S bacterialtaxonomyreferencedated 10.08.2021. Thegenerated OTU tableswerecalculatedwith R Statistical Computer Language version 4.04 (readr, phyloseq, microbiome, vegan, descrand ggplot2 packages) to calculate Alpha diversityandtheirgraphicswerecreated. Statistical analyzeswerealsoperformedusing R Statistical Computer Language version 4.0.4 and studio IDE 1.4 (tidyverse, readr, xlsxand ggplot2 packages). Expression of IL-12 and IL-17 cytokineswasperformedbyrtPCRtwice, beforeandaftertreatment. Results: InHL patients, a significantdecreasewasobserved in themicrobiota flora of Ruminococcaceae_UCG-014 genus (p:0.036) andUndefined Ruminococcaceae_UCG-014 species (p:0.036) comparedtopre-treatment. When the post-treatment of HL patientswerecomparedwithhealthycontrols, a significantdecreasewasfound in themicrobiota of Prevotella_7 genus (p:0.049) andButyricimonas (p:0.006) in the post-treatmentmicrobiota of HL patients. InNHL patients, a significantdecreasewasobserved in themicrobiota flora of Coprococccus_3 genus (p:0.015) andUndefined Ruminoclostridium_5 (p:0.046) speciescomparedtopre-treatment. When post-treatment of NHL patientswerecomparedwithhealthycontrols, a significantabundance in theBacilliclass (p:0.029) and a significantdecrease in theUndefinedAlistipesspecies (p:0.047) wereobserved in the post-treatmentmicrobiota of NHL patients. While a decreasewasobserved in IL-12 cytokineexpressionuntilbeforetreatment, an increase in IL-17 cytokineexpressionwasdetected. Discussion: Intestinal flora monitoringafterchemotherapytreatmentshowsthat it can be a guide in thetreatment of thedisease. It is thoughtthatincreasingthediversity of commensalbacteria can alsopositivelyaffecttheprognosis of thedisease.

Keywords: hodgkin lymphoma, non-hodgkin, microbiota, cytokines

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Authors: Khulood Zahran

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Background and Purpose: The effects of backpack on 'school-age' children (Age 9–12) years, have been a critical subject of discussion throughout the past years. It has been one of the factors that contribute to a bad posture for 40% to 70% of developed countries. A child carrying a heavy backpack for a prolonged period, on a daily base has shown significant changes in the child's spinal posture, foot shape, and gait. The back pain caused by the compensatory posture, or "Backpack syndrome", is also known for its headaches, fatigue, cervical and lumber pain caused by the abnormal body posture. The child tends to balance himself by bending forward to match the heavy backpack, moving his Centre of Gravity forward, resulting in decreased lumber lordosis and increased thoracic kyphosis. Since currently available bags have not addressed the weight distribution issue till now. Therefore, KZ bag is believed to prevent the huge backward shift of COG due to the load, and hence all the symptoms accompanied. This is thought to be possible by combining the design of a normal backpack with a messenger bag. The purpose of this study is to investigate the improvement of the child's spine and to minimize the compensatory posture after using the KZ bag. Materials and Methods: KZ bag would compromise the pros of a messenger bag (keeping the COG in place) by a diagonal load strap and of a backpack (distributing the load on both shoulders) by connecting another load strap parallel to the sagittal plane of the body. The design would be made adjustable to match the child's height, and the bag load kept within limits, (10-15%) of the child's body weight. Measurements of Postural angles (Cervical, shoulders, and Trunk) would be taken after the use of KZ bag for a specified period. Conclusion: KZ bag will prove an improved distribution of weight of the bag on the child's body, and reduce the degree of the compensatory posture, that occurs in the attempt to balance the external weight of the bag.

Keywords: backpack, backpack syndrome, posture, spine

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Authors: F. A. Adesoji, A. A. Ayandele

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There has been a concern over non-responsiveness of educational programme in Nigeria’s higher institutions to adequately meet social needs. The study, therefore, investigated the effectiveness of basic elements of the Social Studies Curriculum, the contributions of the Teacher–Related Variables (TRV) such as qualification, area of specialization, teaching experience, teaching methods, gender and teaching facilities to the implementation of the curriculum (IOC) in the Colleges of Education (COEs). The study adopted the descriptive survey design. Four COEs in Oyo, Osun, Ondo and Lagos States were purposively selected. Stratified sampling technique was used to select 455 Social Studies students and 47 Social Studies lecturers. Stakeholders’ Perception of Social Studies Curriculum (r = 0.86), Social Studies Curriculum Resources scale (r = 0.78) and Social Studies Basic Concepts Test (r = 0.78) were used for data collection. Data were analysed using descriptive statistics, multiple regression, and t-test at 0.05 level of significance. COEs teachers and students rated the elements of the curriculum to be effective with mean scores x̄ =3.02 and x̄ =2.80 respectively; x̄ =5.00 and x̄ = 2.50 being the maximum and minimum mean scores. The finding showed average level of availability (x̄ =1.60), adequacy (x̄ =1.55) and utilization (x̄ =1.64) of teaching materials, x̄ =3.00 and x̄ =1.50 being maximum and minimum mean scores respectively. Academic performance of the students is on average with the mean score of x̄ =51.4775 out of maximum mean score of x̄ =100. The TRV and teaching facilities had significant composite contribution to IOC (F (6,45) = 3.92:R² = 0.26) with 39% contributions to the variance of IOC. Area of specialization (β= 29, t = 2.05) and teaching facilities (β = -25, t = 1.181) contributed significantly. The implementation of bachelor degree in Social Studies curriculum was effective in the colleges of education. There is the need to beef-up the provision of facilities to improve the implementation of the curriculum.

Keywords: bachelor degree in social studies, colleges of education in southwestern Nigeria, curriculum implementation, social studies curriculum

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Authors: Mesfin Nigussie

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The objectives of the study were to identify factors affecting rural households’ willingness to install biogas plant and amount willingness to pay in order to examine determinants of effective demand for biogas technology. A multistage sampling technique was employed to select 120 respondents for the study. The binary probit regression model was employed to identify factors affecting rural households’ decision to install biogas technology. The probit model result revealed that household size, total household income, access to extension services related to biogas, access to credit service, proximity to water sources, perception of households about the quality of biogas, perception index about attributes of biogas, perception of households about installation cost of biogas and availability of energy source were statistically significant in determining household’s decision to install biogas. Tobit model was employed to examine determinants of rural household’s amount of willingness to pay. Based on the model result, age of the household head, total annual income of the household, access to extension service and availability of other energy source were significant variables that influence willingness to pay. Providing due considerations for extension services, availability of credit or subsidy, improving the quality of biogas technology design and minimizing cost of installation by using locally available materials are the main suggestions of this research that help to create effective demand for biogas technology.

Keywords: biogas technology, effective demand, probit model, tobit model, willingnes to pay

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Authors: Bujar Ismaili, Bahti Ismajli, Venhar Ismaili, Skender Ramadani

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In Kosovo, the problem with the electricity supply is huge and does not meet the demands of consumers. Older thermal power plants, which are regarded as big environmental polluters, produce most of the energy. Our experiment is based on the production of electricity using the closed method that does not affect environmental pollution by using waste as fuel that is considered to pollute the environment. The experiment was carried out in the village of Godanc, municipality of Shtime - Kosovo. In the experiment, a production line based on the production of electricity and central heating was designed at the same time. The results are the benefits of electricity as well as the release of temperature for heating with minimal expenses and with the release of 0% gases into the atmosphere. During this experiment, coal, plastic, waste from wood processing, and agricultural wastes were used as raw materials. The method utilized in the experiment allows for the release of gas through pipes and filters during the top-to-bottom combustion of the raw material in the boiler, followed by the method of gas filtration from waste wood processing (sawdust). During this process, the final product is obtained - gas, which passes through the carburetor, which enables the gas combustion process and puts into operation the internal combustion machine and the generator and produces electricity that does not release gases into the atmosphere. The obtained results show that the system provides energy stability without environmental pollution from toxic substances and waste, as well as with low production costs. From the final results, it follows that: in the case of using coal fuel, we have benefited from more electricity and higher temperature release, followed by plastic waste, which also gave good results. The results obtained during these experiments prove that the current problems of lack of electricity and heating can be met at a lower cost and have a clean environment and waste management.

Keywords: energy, heating, atmosphere, waste, gasification

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Authors: J. Prathap Kumar, G. Vaitheeswaran

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The present study investigates the role of ammonium and potassium ion in the electronic, bonding and optical properties of dinitramide salts due to their stability and non-toxic nature. A detailed analysis of bonding between NH₄ and K with dinitramide, optical transitions from the valence band to the conduction band, absorption spectra, refractive indices, reflectivity, loss function are reported. These materials are well known as oxidizers in solid rocket propellants. In the present work, we use full potential linear augmented plane wave (FP-LAPW) method which is implemented in the Wien2k package within the framework of density functional theory. The standard DFT functional local density approximation (LDA) and generalized gradient approximation (GGA) always underestimate the band gap by 30-40% due to the lack of derivative discontinuities of the exchange-correlation potential with respect to an occupation number. In order to get reliable results, one must use hybrid functional (HSE-PBE), GW calculations and Tran-Blaha modified Becke-Johnson (TB-mBJ) potential. It is very well known that hybrid functionals GW calculations are very expensive, the later methods are computationally cheap. The new developed TB-mBJ functionals use information kinetic energy density along with the charge density employed in DFT. The TB-mBJ functionals cannot be used for total energy calculations but instead yield very much improved band gap. The obtained electronic band gap at gamma point for both the ammonium dinitramide and potassium dinitramide are found to be 2.78 eV and 3.014 eV with GGA functional, respectively. After the inclusion of TB-mBJ, the band gap improved by 4.162 eV for potassium dinitramide and 4.378 eV for ammonium dinitramide. The nature of the band gap is direct in ADN and indirect in KDN. The optical constants such as dielectric constant, absorption, and refractive indices, birefringence values are presented. Overall as there are no experimental studies we present the improved band gap with TB-mBJ functional following with optical properties.

Keywords: ammonium dinitramide, potassium dinitramide, DFT, propellants

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Authors: Miral Selim, May Haggag, Ibrahim Abotaleb

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The aging of transportation infrastructure presents significant challenges, particularly concerning the monitoring and maintenance of bridges. This study investigates the application of Random Forest algorithms for predictive modeling of bridge conditions, utilizing data from the US National Bridge Inventory (NBI). The research is significant as it aims to improve bridge management through data-driven insights that can enhance maintenance strategies and contribute to overall safety. Random Forest is chosen for its robustness, ability to handle complex, non-linear relationships among variables, and its effectiveness in feature importance evaluation. The study begins with comprehensive data collection and cleaning, followed by the identification of key variables influencing bridge condition ratings, including age, construction materials, environmental factors, and maintenance history. Random Forest is utilized to examine the relationships between these variables and the predicted bridge conditions. The dataset is divided into training and testing subsets to evaluate the model's performance. The findings demonstrate that the Random Forest model effectively enhances the understanding of factors affecting bridge conditions. By identifying bridges at greater risk of deterioration, the model facilitates proactive maintenance strategies, which can help avoid costly repairs and minimize service disruptions. Additionally, this research underscores the value of data-driven decision-making, enabling better resource allocation to prioritize maintenance efforts where they are most necessary. In summary, this study highlights the efficiency and applicability of Random Forest in predictive modeling for bridge management. Ultimately, these findings pave the way for more resilient and proactive management of bridge systems, ensuring their longevity and reliability for future use.

Keywords: data analysis, random forest, predictive modeling, bridge management

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Authors: Stanley Russell

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Until the end of the 19th century, European painting dealt almost exclusively with the realistic representation of objects and landscapes, as can be seen in the work of realist artists like Gustav Courbet. Architects of the day typically made reference to and recreated historical precedents in their designs. The curriculum of the first architecture school in Europe, The Ecole des Beaux Artes, based on the study of classical buildings, had a profound effect on the profession. Painting exhibited an increasing level of abstraction from the late 19th century, with impressionism, and the trend continued into the early 20th century when Cubism had an explosive effect sending shock waves through the art world that also extended into the realm of architectural design. Architect /painter Le Corbusier with “Purism” was one of the first to integrate abstract painting and building design theory in works that were equally shocking to the architecture world. The interrelationship of the arts, including architecture, was institutionalized in the Bauhaus curriculum that sought to find commonality between diverse art disciplines. Renowned painter and Bauhaus instructor Vassily Kandinsky was one of the first artists to make a semi-scientific analysis of the elements in “non-objective” painting while also drawing parallels between painting and architecture in his book Point and Line to plane. Russian constructivists made abstract compositions with simple geometric forms, and like the De Stijl group of the Netherlands, they also experimented with full-scale constructions and spatial explorations. Based on the study of historical accounts and original artworks, of Impressionism, Cubism, the Bauhaus, De Stijl, and Russian Constructivism, this paper begins with a thorough explanation of the art theory and several key works from these important art movements of the late 19th and early 20th century. Similarly, based on written histories and first-hand experience of built and drawn works, the author continues with an analysis of the theories and architectural works generated by the same groups, all of which actively pursued continuity between their art and architectural concepts. With images of specific works, the author shows how the trend toward abstraction and geometric purity in painting coincided with a similar trend in architecture that favored simple unornamented geometries. Using examples like the Villa Savoye, The Schroeder House, the Dessau Bauhaus, and unbuilt designs by Russian architect Chernikov, the author gives detailed examples of how the intersection of trends in Art and Architecture led to a unique and fruitful period of creative synergy when the same concepts that were used by artists to generate paintings were also used by architects in the making of objects, space, and buildings. In Conclusion, this article examines the extremely pivotal period in art and architecture history from the late 19th to early 20th century when the confluence of art and architectural theory led to many painted, drawn, and built works that continue to inspire architects and artists to this day.

Keywords: modern art, architecture, design methodologies, modern architecture

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Authors: Mini P. Singh, Jagat Ram, Archit Kumar, Tripti Rungta, Jasmine Khurana, Amit Gupta, R. K. Ratho

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Introduction: Human adenovirus is the most common agent involved in viral conjunctivitis. The clinical manifestations vary with different serotypes. The identification of the circulating strains followed by phylogenetic analysis can be helpful in understanding the origin and transmission of the disease. The present study aimed to carry out molecular epidemiology of the adenovirus types in the patients with conjunctivitis presenting to the eye centre of a tertiary care hospital in North India. Materials and Methods: The conjunctival swabs were collected from 23 suspected adenoviral conjunctivitis patients between April-August, 2014 and transported in viral transport media. The samples were subjected to nested PCR targeting hexon gene of human adenovirus. The band size of 956bp was eluted and 8 representative positive samples were subjected to sequencing. The sequences were analyzed by using CLUSTALX2.1 and MEGA 5.1 software. Results: The male: female ratio was found to be 3.6:1. The mean age of presenting patients was 43.95 years (+17.2). Approximately 52.1% (12/23) of patients presented with bilateral involvement while 47.8% (11/23) with unilateral involvement of the eye. Human adenovirus DNA could be detected in 65.2% (15/23) of the patients. The phylogenetic analysis revealed presence of serotype 8 in 7 patients and serotype 4 in one patient. The serotype 8 sequences showed 99-100% identity with Tunisian, Indian and Japanese strains. The adenovirus serotype 4 strains had 100% identity with strains from Tunisia, China and USA. Conclusion: Human adenovirus was found be an important etiological agent for conjunctivitis in our set up. The phylogenetic analysis showed that the predominant circulating strains in our epidemic keratoconjunctivitis were serotypes 8 and 4.

Keywords: conjunctivitis, human adenovirus, molecular epidemiology, phylogenetics

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Authors: Odunayo Olawuyi Fadodun

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Dielectric elastomers (DEs) are a type of intelligent materials with salient features like electromechanical coupling, lightweight, fast actuation speed, low cost and high energy density that make them good candidates for numerous engineering applications. This paper adopts a new nonlinear electroelastic constitutive theory to examine radial deformation of a pressurized thick-walled spherical shell of soft dielectric material with compliant electrodes on its inner and outer surfaces. A general formular for the internal pressure, which depends on the deformation and a potential difference between boundary electrodes or uniform surface charge distributions, is obtained in terms of special function. To illustrate the effects of an applied electric field on the mechanical behaviour of the shell, three different energy functions with distinct mechanical properties are employed for numerical purposes. The observed behaviour of the shells is preserved in the presence of an applied electric field, and the influence of the field due to a potential difference declines more slowly with the increasing deformation to that produced by a surface charge. Counterpart results are then presented for the thin-walled shell approximation as a limiting case of a thick-walled shell without restriction on the energy density. In the absence of internal pressure, it is obtained that inflation is caused by the application of an electric field. The resulting numerical solutions of the theory presented in this work are in agreement with those predicted by the generally adopted Dorfmann and Ogden model.

Keywords: constitutive theory, elastic dielectric, electroelasticity, finite deformation, nonlinear response, spherical shell

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Authors: Shuji Fujimoto, Fumiko Kojima, Mika Shigematsu

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Biorisk management (Biosafety/Biosecurity) is required for anyone working in a clinical laboratory (including medical/clinical research laboratories) where infectious agents and potentially hazardous biological materials are examined/stored. Proper education and training based on international standards of biorisk management should be provided not only as a part of laboratory safety program in work place but also as a part of introductory training at educational institutions for continuity and to elevate overall baseline of the biorisk management. We reported results of the pilot study of biorisk management education for graduate students majored in laboratory diagnostics previously. However, postgraduate education is still late in their profession and the participants’ interview also revealed importance and demands of earlier biorisk management education for undergraduates. The aim of this study is to identify the need for biosafety/biosecurity education and training program which is designed for undergraduate students who are entering the profession in clinical microbiology. We modified the previous program to include more basic topics and explanations (risk management, principles of safe clinical lab practices, personal protective equipment, disinfection, disposal of biological substances) and provided incorporating in the routine educational system for faculty of medical sciences in Kyushu University. The results of the pre and post examinations showed that the knowledge of the students on biorisk control had developed effectively as a proof of effectiveness of the program even in the undergraduate students. Our study indicates that administrating the basic biorisk management program in the earlier stage of learning will add positive impact to the understanding of biosafety to the health professional education.

Keywords: biorisk management, biosafety, biosecurity, clinical microbiology, education for undergraduates

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Authors: H. Hadjeris, R. B. Ghoul, Lekhlaf, M. Nebbal

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Introduction: Adenoid cystic carcinomas of the lacrimal gland or orbital cylindroma constitute the second cause of epithelial tumors of this gland. It is a malignant tumor usually developed at the expense of the salivary glands; its orbital location is exceptional. It is a rare clinical entity, formidable by its malignancy and local aggressiveness; the recurrence rate is high. Materials and methods: Clinical case: 63 years old woman who presents with irreducible no pulsatile painful left exophthalmos with inflammatory chemosis and a decrease in visual acuity with a moderate intracranial hypertension syndrome that has been evolving for 03 months. Antecedent; a biopsy of the tumor was made; the histological examination was in favor of an adenoid cystic carcinoma of the lacrimal gland. Lesion assessment: computed tomography and brain MRI: show an intra and extra-conical mass; with sinus (ethmoido-frontal) and cerebral (left frontal) extension strongly enhanced after injection of contrast product surrounded by edema around the lesion, associated with left frontal bone lysis extension assessment: unremarkable treatment: Patient operated by left frontotemporal approach, a total exenteration was performed with macroscopically complete excision of the frontal lesion and wide frontal craniectomy with craniofacial reconstruction, followed by complementary radiotherapy. Results: The patient was seen again after 3 months in consultation; she does not present any signs in favor of a recurrence. Conclusion: Adenoid cystic carcinomas of the lacrimal gland are rare malignant tumors; they are very infiltrating and invasive. The prognosis is strongly linked to the treatment time.

Keywords: adenoid cystic, lacrimal gland, orbital location, fronto-temporal approac

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Authors: Blaga Alexandra Cristina, Kloetzer Lenuta, Bompa Amalia Stela, Galaction Anca Irina, Cascaval Dan

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Vitamin B9 is an important member of vitamins B group, being a growth factor, important for making genetic material as DNA and RNA, red blood cells, for building muscle tissues, especially during periods of infancy, adolescence and pregnancy. Its production by biosynthesis is based on the high metabolic potential of mutant Bacillus subtilis, due to a superior biodisponibility compared to that obtained by chemical pathways. Pertraction, defined as the extraction and transport through liquid membranes consists in the transfer of a solute between two aqueous phases of different pH-values, phases that are separated by a solvent layer of various sizes. The pertraction efficiency and selectivity could be significantly enhanced by adding a carrier in the liquid membrane, such as organophosphoric compounds, long chain amines or crown-ethers etc., the separation process being called facilitated pertraction. The aim of the work is to determine the impact of the presence of two extractants/carriers in the bulk liquid membrane, i.e. di(2-ethylhexyl) phosphoric acid (D2EHPA) and lauryltrialkylmetilamine (Amberlite LA2) on the transport kinetics of vitamin B9. The experiments have been carried out using two pertraction equipments for a free liquid membrane or bulk liquid membrane. One pertraction cell consists on a U-shaped glass pipe (used for the dichloromethane membrane) and the second one is an H-shaped glass pipe (used for h-heptane), having 45 mm inner diameter of the total volume of 450 mL, the volume of each compartment being of 150 mL. The aqueous solutions are independently mixed by means of double blade stirrers with 6 mm diameter and 3 mm height, having the rotation speed of 500 rpm. In order to reach high diffusional rates through the solvent layer, the organic phase has been mixed with a similar stirrer, at a similar rotation speed (500 rpm). The area of mass transfer surface, both for extraction and for reextraction, was of 1.59x10-³ m2. The study on facilitated pertraction with the mixture of two carriers, namely D2EHPA and Amberlite LA-2, dissolved in two solvents with different polarities: n-heptane and dichloromethane, indicated the possibility to obtain the synergic effect. The synergism has been analyzed by considering the vitamin initial and final mass flows, as well as the permeability factors through liquid membrane. The synergic effect has been observed at low D2EHPA concentrations and high Amberlite LA-2 concentrations, being more important for the low-polar solvent (n-heptane). The results suggest that the mechanism of synergic pertraction consists on the reaction between the organophosphoric carrier and vitamin B9 at the interface between the feed and membrane phases, while the aminic carrier enhances the hydrophobicity of this compound by solvation. However, the formation of this complex reduced the reextraction rate and, consequently, affects the synergism related to the final mass flows and permeability factor. For describing the influences of carriers concentrations on the synergistic coefficients, some equations have been proposed by taking into account the vitamin mass flows or permeability factors, with an average deviations between 4.85% and 10.73%.

Keywords: pertraction, synergism, vitamin B9, Amberlite LA-2, di(2-ethylhexyl) phosphoric acid

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Authors: Vijayabhaskar Reddy Kandula, Peter Provost Taillac, Balasubramanya M. A., Ram Krishnan Nair, Gokul Toshnival, Vibhu Dhawan, Vijaya Karanam, Buffy Cramer

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Introduction: The lack of Emergency Care Services (ECS) is a cause of extensive and serious public health problems in low- and middle-income countries (LMIC), Many LMIC countries have ambulance services that allow timely transfer of ill patients but due to poor care during the ‘Golden Hour’ many deaths occur which are otherwise preventable. Lack of adequate training as evidenced by a study in India is a major reason for poor care during the ‘Golden Hour’. Adapting developed country models which includes staffing specialty-trained doctors in emergency care, is neither feasible nor guarantees cost-effective ECS. Methods: Based on our assessment and felt needs by first-line doctors providing emergency care in 2014, Rajiv Gandhi Health Sciences University’s JeevaRaksha Trust in partnership with the University of Utah, USA, designed, piloted and successfully implemented a 4-day Comprehensive-Emergency Care and Life Support course (C-ECLS) for allopathic doctors. 1730 doctors completed the 4-day course between June 2014 and December- 2020. Subsequently, we conducted a survey to investigate the utilization rates and usefulness of the training. 1662 were contacted but only 309 completed the survey. The respondents had the following designations: Senior faculty (33%), junior faculty (25), Resident (16%), Private-Practitioners (8%), Medical-Officer (16%) and not-working (11%). 51% were generalists (51%) and the rest were specialists (>30 specialties). Results: 97% (271/280) felt they are better doctors because of C-ECLS. 79% (244/309) reported that training helped to save life- specialists more likely than generalists (91% v/s 68%. P<0.05). 64% agreed that they were confident of managing COVID-19 symptomatic patients better because of C-ECLS. 27% (77) were neutral; 9% (24) disagreed. 66% agreed that training helps to be confident in managing COVID-19 critically ill patients. 26% (72) were neutral; 8% (23) disagreed. Frequency of use of C-ECLS skills: Hemorrhage-control (70%), Airway (67%), circulation skills (62%), Safe-transport and communication (60%), managing critically ill patients (58%), cardiac arrest (51%), Trauma (49%), poisoning/animal bites/stings (44%), neonatal-resuscitation (39%), breathing (36%), post-partum-hemorrhage and eclampsia (35%). Among those who used the skills, the majority (ranging from (88%-94%) reported that they were able to apply the skill more effectively because of ECLS training. Conclusion: JeevaRaksha’s C-ECLS is the world’s first comprehensive training. It improves the confidence of front-line doctors and enables them to provide quality care during the ‘Golden Hour’ of emergency. It also prepares doctors to manage unknown emergencies (e.g., COVID-19). C-ECLS was piloted in Morocco, and Uzbekistan and implemented countrywide in Bhutan. C-ECLS is relevant to most settings and offers a replicable model across LMIC.

Keywords: comprehensive emergency care and life support, training, capacity building, low- and middle-income countries, developing countries

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Authors: Okhee Woo

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Purpose: With increasing concern of individual radiation exposure doses, studies analyzing radiation dosage in breast imaging modalities are required. Aim of this study is to compare radiation dosage and image quality between digital breast tomosynthesis (DBT) and full-field digital mammography (FFDM). Methods and Materials: 303 patients (mean age 52.1 years) who studied DBT and FFDM were retrospectively reviewed. Radiation dosage data were obtained by radiation dosage scoring and monitoring program: Radimetrics (Bayer HealthCare, Whippany, NJ). Entrance dose and mean glandular doses in each breast were obtained in both imaging modalities. To compare the image quality of DBT with two-dimensional synthesized mammogram (2DSM) and FFDM, 5-point scoring of lesion clarity was assessed and the better modality between the two was selected. Interobserver performance was compared with kappa values and diagnostic accuracy was compared using McNemar test. The parameters of radiation dosages (entrance dose, mean glandular dose) and image quality were compared between two modalities by using paired t-test and Wilcoxon rank sum test. Results: For entrance dose and mean glandular doses for each breasts, DBT had lower values compared with FFDM (p-value < 0.0001). Diagnostic accuracy did not have statistical difference, but lesion clarity score was higher in DBT with 2DSM and DBT was chosen as a better modality compared with FFDM. Conclusion: DBT showed lower radiation entrance dose and also lower mean glandular doses to both breasts compared with FFDM. Also, DBT with 2DSM had better image quality than FFDM with similar diagnostic accuracy, suggesting that DBT may have a potential to be performed as an alternative to FFDM.

Keywords: radiation dose, DBT, digital mammography, image quality

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