Search results for: surgical removal

Authors: Rozelle Labuschagne, Ronel Roos

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Individuals often experience a reduction in physical function, quality of life and basic activities of daily living after surgery. This is exponentially true for high-risk patients, especially the elderly and frail individuals. Not much is known about the physical function, physical activity preferences and factors associated with the six-minute walk test of elderly individuals who would undergo elective abdominal surgery in South Africa. Such information is important to design effective prehabilitation physiotherapy programs prior to elective surgery. The purpose of the study was to describe the demographic profile and physical function of elderly patients who would undergo elective surgery and to determine factors associated with their six-minute walk test distance findings. A cross-sectional descriptive study in elderly patients older than 60 years of age who would undergo elective abdominal surgery were consecutively sampled at a private hospital in Pretoria, South Africa. Participants’ demographics were collected and physical function assessed with the Functional Comorbidity Index (FCI), DeMorton Mobility Index (DEMMI), Lawton-Brody Instrumental Activities of Daily Living Scale (IADL) and six-minute walk test (6MWT). Descriptive and inferential statistics were used for data analysis with IBM SPSS 25. A p-value ≤ 0.05 were deemed statistically significant. The pilot study consisted of 12 participants (female (n=11, 91.7%), male (n=1, 8.3%) with a mean age of 65.8 (±4.5) years, body mass index of 28 (±4.2) kg.m2 with one (8.3%) participant being a current smoker and four (33.3%) participants having a smoking history. Nine (75%) participants lived independently at home and three (25%) had caregivers. Participants reported walking (n=6, 50%), stretching exercises (n=1, 8.3%), household chores & gardening (n=2, 16.7%), biking/swimming/running (n=1, 8.3%) as physical activity preferences. Physical function findings of the sample were: mean FCI score 3 (±1.1), DEMMI score 81.1 (±14.9), IADL 95 (±17.3), 6MWT 435.50 (IQR 364.75-458.50) with percentage 6MWT distance achieved 81.8% (IQR 64.4%-87.5%). A strong negative correlation was observed between 6MWT distance walked and FCI (r = -0.729, p=0.007). The majority of study participants reported incorporating some form of physical activity into their daily life as form of exercise. Most participants did not achieve their predicted 6MWT distance indicating less than optimal levels of physical function capacity. The number of comorbidities as determined by the FCI was associated with the distance that participants could walk with the 6MWT. The results of this pilot study could be used to indicate which elderly individuals would benefit most from a pre-surgical rehabilitation program. The main goal of such a program would be to improve physical function capacity as measured by the 6MWT. Surgeons could refer patients based on age and number of comorbidities, as determined by the FCI, to potentially improve surgical outcomes.

Keywords: abdominal surgery, elderly, physical function, six-minute walk test

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Authors: Homayon Ahmad Panahi, Amir Hesam Hassani, Akram Torki, Elham Moniri

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A new sorbent was synthesized through chemical modification of clinoptilolite zeolite using 2-naphtol, and characterized with fourier transform infrared spectroscopy and elemental analysis methods and applied for the removal and elimination of trace naphthalene from water samples. The optimum pH value for sorption of the naphthalene by modified zeolite was in acidic pH. The sorption capacity of modified zeolite was 142 mg. g−1. Isotherm models, Langmuir, Frendlich and Temkin were employed to analyze the adsorption capacity of modified zeolite, which revealed that naphthalene adsorption by this zeolite follows Langmuir model.

Keywords: zeolite, clinoptilolite, modification, naphthalene

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Authors: Eze R. Onukwugha

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The presence of cyanide in wastewater is known to inhibit the normal functioning of bio-reactors since it has the tendency to poison reactor micro-organisms. Bench scale models of activated sludge reactors with varying aspect ratios were operated for the treatment of cassava wastewater at several values of hydraulic retention time (HRT). The different values of HRT were achieved by the use of a peristaltic pump to vary the rate of introduction of the wastewater into the reactor. The main parameters monitored are the cyanide concentration and respective COD values of the influent and effluent. These observed values were then transformed into a mathematical model for the prediction of treatment efficiency.

Keywords: wastewater, aspect ratio, cyanide-inhibited wastewater, modeling

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Authors: Tharwat Ibrahim Rushdy, Warda Youssef Mohammed Morsy, Hanaa Ali Ahmed Elfeky

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Background: Intra-aortic balloon pump (IABP) is the first and the most commonly used mechanical circulatory support for patients with acute coronary syndromes and cardiogenic shock. Therefore, critical care nurses not only have to know how to monitor and operate the IABP, but also to provide interventions for preventing possible complications. Aim of the study: To assess nurses' knowledge and practices regarding care of patients connected to IABP at the ICUs of Cairo University Hospitals. Research design: A descriptive exploratory design was utilized. Sample: Convenience samples of 40 nurses were included in the current study. Setting: This study was carried out at the Intensive Care Units of Cairo University Hospitals. Tools of data collection: Three tools were developed, tested for clarity, and feasibility: a- Nurses' personal background sheet, b- IABP nurses' knowledge self-administered questionnaire, and c- IABP Nurses' practice observational checklist. Results: The majority of the studied sample had unsatisfactory knowledge and practice level (88% & 95%) respectively with a mean of 9.45+2.94 and 30.5+8.7, respectively. Unsatisfactory knowledge was found regarding description and physiological effects, nursing care, indications, contraindications, complications, weaning, and removal of IABP in percentage of 95%, 90%, 72.5%, and 57.5%, respectively, with a mean total knowledge score of 9.45 +2.94. In addition, unsatisfactory practice was found regarding about preparation and initiation of IABP therapy, nursing practice during therapy, weaning, and removal of IABP in percentages of (97.5%, 97.5%, and 90%), respectively. Finally, knowledge level was found to differ significantly in relation to gender (t = 2.46 at P ≤ 0.018). However, gender didn't play a role in relation to practice (t = 0.086 at P≤ 0.932). Conclusion: In spite of having vital role in assessment and management of critically ill patients, critical care nurses in the current study had in general unsatisfactory knowledge and practice regarding care of patients connected to IABP. Recommendation: updating knowledge and practice of ICU nurses through carrying out continuing educational programs about IABP; strict observation of nurses' practice when caring for patients connected to IABP and provision of guidance to correct of poor practices and replication of this study on larger probability sample selected from different geographical locations.

Keywords: knowledge, practice, intra-aortic balloon pump (IABP), ICU nurses, intensive care unit (ICU), introduction

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Authors: Yao-Hui Huang, Ming-Chun Yen, Jui-Yen Lin, Yu-Jen Shih

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This work investigated the reclamation of boron in industrial wastewaters by a chemical oxo-precipitation (COP) technique at room temperature. In COP, the boric acid was pretreated with H₂O₂, yielding various perborate anions. Afterwards, calcium chloride was used to efficiently remove boron through precipitation of calcium perborate. The important factors included reacted pH and the molar ratio of [Ca]/[B]. Under conditions of pH 11 and [Ca]/[B] of 1, the boron concentration could be reduced immediately from 600 ppm to 50 ppm in 10 minutes. The boron removal was enhanced with a higher [Ca]/[B], which further reduced boron to 20 ppm in 10 minutes. Nevertheless, the dissolution of carbon dioxide potentially affected the efficacy of COP and increased the boron concentration after 10 minutes.

Keywords: chemical oxo-precipitation, boron, carbon dioxide, hydrogen peroxide

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Authors: Piotr Tylec, Alicja Dudek, Grzegorz Torbicz, Magdalena Mizera, Natalia Gajewska, Michael Su, Tanawat Vongsurbchart, Tomasz Stefura, Magdalena Pisarska, Mateusz Rubinkiewicz, Piotr Malczak, Piotr Major, Michal Pedziwiatr

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Introduction: Quality of life after bariatric surgery is an important factor when evaluating the final result of the treatment. Considering the vast surgical options, we tried to globally compare available methods in terms of quality of following the surgery. The aim of the study is to compare the quality of life a year after bariatric intervention using network meta-analysis methods. Material and Methods: We performed a systematic review according to PRISMA guidelines with Bayesian network meta-analysis. Inclusion criteria were: studies comparing at least two methods of weight loss treatment of which at least one is surgical, assessment of the quality of life one year after surgery by validated questionnaires. Primary outcomes were quality of life one year after bariatric procedure. The following aspects of quality of life were analyzed: physical, emotional, general health, vitality, role physical, social, mental, and bodily pain. All questionnaires were standardized and pooled to a single scale. Lifestyle intervention was considered as a referenced point. Results: An initial reference search yielded 5636 articles. 18 studies were evaluated. In comparison of total score of quality of life, we observed that laparoscopic sleeve gastrectomy (LSG) (median (M): 3.606, Credible Interval 97.5% (CrI): 1.039; 6.191), laparoscopic Roux en-Y gastric by-pass (LRYGB) (M: 4.973, CrI: 2.627; 7.317) and open Roux en-Y gastric by-pass (RYGB) (M: 9.735, CrI: 6.708; 12.760) had better results than other bariatric intervention in relation to lifestyle interventions. In the analysis of the physical aspects of quality of life, we notice better results in LSG (M: 3.348, CrI: 0.548; 6.147) and in LRYGB procedure (M: 5.070, CrI: 2.896; 7.208) than control intervention, and worst results in open RYGB (M: -9.212, CrI: -11.610; -6.844). Analyzing emotional aspects, we found better results than control intervention in LSG, in LRYGB, in open RYGB, and laparoscopic gastric plication. In general health better results were in LSG (M: 9.144, CrI: 4.704; 13.470), in LRYGB (M: 6.451, CrI: 10.240; 13.830) and in single-anastomosis gastric by-pass (M: 8.671, CrI: 1.986; 15.310), and worst results in open RYGB (M: -4.048, CrI: -7.984; -0.305). In social and vital aspects of quality of life, better results were observed in LSG and LRYGB than control intervention. We did not find any differences between bariatric interventions in physical role, mental and bodily aspects of quality of life. Conclusion: The network meta-analysis revealed that better quality of life in total score one year after bariatric interventions were after LSG, LRYGB, open RYGB. In physical and general health aspects worst quality of life was in open RYGB procedure. Other interventions did not significantly affect the quality of life after a year compared to dietary intervention.

Keywords: bariatric surgery, network meta-analysis, quality of life, one year follow-up

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Authors: Pham-Thi Huong, Byeong-Kyu Lee, Chi-Hyeon Lee, Jitae Kim

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In this study synthesized Cu-nano-zeolite was evaluated for its potential use in CO2 capture. The specific surface area of Cu-nano zeolite was measured as 869.32 m2/g with a pore size of 3.86 nm. The adsorption capacity of CO2 by Cu-nano zeolite was decreased with increasing temperature. The identified adsorption capacity of CO2 by Cu-nano zeolite was 7.16 mmol/g at a temperature of 20 oC and at pressure of 1 atm. The adoption selectivity of CO2 over N2 strongly depend on the temperature and the highest selectivity by Cu-nano zeolite was 50.71 at 20 oC. From analysis of regeneration characteristics of CO2 loaded adsorbent, the percentage removal of CO2 was maintained at more than 78.2 % even after 10 cycles of adsorption-desorption. Based on these result, the Cu-nano zeolite can be used as an effective and economical adsorbent for CO2 capture.

Keywords: CO2 capture, selectivity, Cu-nano zeolite, regeneration.

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Authors: Klazina T. Havinga, Hilde R. H. de Geus

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Introduction: Pre-operative coagulation management of Apixaban prescribed patients, a new oral anticoagulant (a factor Xa inhibitor), is difficult, especially when chronic kidney disease (CKD) causes drug overdose. Apixaban is not dialyzable due to its high level of protein binding. An antidote, Andexanet α, is available but expensive and has an unfavorable short half-life. We report the successful extracorporeal removal of Apixaban prior to emergency surgery with the CytoSorb® Hemoadsorption device. Methods: A 89-year-old woman with CKD, with an Apixaban prescription for atrial fibrillation, was presented at the ER with traumatic rib fractures, a flail chest, and an unstable spinal fracture (T12) for which emergency surgery was indicated. However, due to very high Apixaban levels, this surgery had to be postponed. Based on the Apixaban-specific anti-factor Xa activity (AFXaA) measurements at admission and 10 hours later, complete clearance was expected after 48 hours. In order to enhance the Apixaban removal and reduce the time to operation, and therefore reduce pulmonary complications, CRRT with CytoSorb® cartridge was initiated. Apixaban-specific anti-factor Xa activity (AFXaA) was measured frequently as a substitute for Apixaban drug concentrations, pre- and post adsorber, in order to calculate the adsorber-related clearance. Results: The admission AFXaA concentration, as a substitute for Apixaban drug levels, was 218 ng/ml, which decreased to 157 ng/ml after ten hours. Due to sustained anticoagulation effects, surgery was again postponed. However, the AFXaA levels decreased quickly to sub-therapeutic levels after CRRT (Multifiltrate Pro, Fresenius Medical Care, Blood flow 200 ml/min, Dialysate Flow 4000 ml/h, Prescribed renal dose 51 ml-kg-h) with Cytosorb® connected in series into the circuit was initiated (within 5 hours). The adsorber-related (indirect) Apixaban clearance was calculated every half hour (Cl=Qe * (AFXaA pre- AFXaA post/ AFXaA pre) with Qe=plasma flow rate calculated with Ht=0.38 and system blood flow rate 200 ml-min): 100 ml/min, 72 ml/min and 57 ml/min. Although, as expected, the adsorber-related clearance decreased quickly due to saturation of the beads, still the reduction rate achieved resulted in a very rapid decrease in AFXaA levels. Surgery was ordered and possible within 5 hours after Cytosorb initiation. Conclusion: The CytoSorb® Hemoadsorption device enabled rapid correction of Apixaban associated anticoagulation.

Keywords: Apixaban, CytoSorb, emergency surgery, Hemoadsorption

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Authors: Saad Mohamed Elsaid Onaizah

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One of the reasons for the intensive use of pesticides is to protect agricultural crops and orchards from pests or agricultural worms. The period of time that pesticides stay inside the soil is estimated at about (2) to (12) weeks. Perhaps the most important reason that led to groundwater pollution is the easy leakage of these harmful pesticides from the soil into the aquifers. This research aims to find the best ways to use trated activated charcoal with gold nitrate solution; For the purpose of removing the deadly pesticides from the aqueous solution by adsorption phenomenon. The most used pesticides in Egypt were selected, such as Malathion, Methomyl Abamectin and, Thiamethoxam. Activated charcoal doped with gold ions was prepared by applying chemical and thermal treatments to activated charcoal using gold nitrate solution. Adsorption of studied pesticide onto activated carbon /Au was mainly by chemical adsorption forming complex with the gold metal immobilised on activated carbon surfaces. Also, gold atom was considered as a catalyst to cracking the pesticide molecule. Gold activated charcoal is a low cost material due to the use of very low concentrations of gold nitrate solution. its notice the great ability of activated charcoal in removing selected pesticides due to the presence of the positive charge of the gold ion, in addition to other active groups such as functional oxygen and lignin cellulose. The presence of pores of different sizes on the surface of activated charcoal is the driving force for the good adsorption efficiency for the removal of the pesticides under study The surface area of the prepared char as well as the active groups were determined using infrared spectroscopy and scanning electron microscopy. Some factors affecting the ability of activated charcoal were applied in order to reach the highest adsorption capacity of activated charcoal, such as the weight of the charcoal, the concentration of the pesticide solution, the time of the experiment, and the pH. Experiments showed that the maximum limit revealed by the batch adsorption study for the adsorption of selected insecticides was in contact time (80) minutes at pH (7.70). These promising results were confirmed, and by establishing the practical application of the developed system, the effect of various operating factors with equilibrium, kinetic and thermodynamic studies is evident, using the Langmuir application on the effectiveness of the absorbent material with absorption capacities higher than most other adsorbents.

Keywords: waste water, pesticides pollution, adsorption, activated carbon

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Authors: Chabungbam Niranjit Khuman, Makarand Madhao Ghangrekar, Arunabha Mitra

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The cost of aeration is one of the limiting factors in the upscaling of microbial fuel cells (MFC) for field-scale applications. Wetland macrophytes have the ability to release oxygen into the water to maintain aerobic conditions in their root zone. In this experiment, the efficacy of rhizospheric oxygen release of wetland macrophytes as a source of oxygen in the cathodic chamber of MFC was conducted. The experiment was conducted in an MFC consisting of a three-liter anodic chamber made of ceramic cylinder and a 27 L cathodic chamber. Untreated carbon felts were used as electrodes (i.e., anode and cathode) and connected to an external load of 100 Ω using stainless steel wire. Wetland macrophytes (Canna indica) were grown in the cathodic chamber of the MFC in a hydroponic fashion using a styrofoam sheet (termed as macrophytes assisted-microbial fuel cell, M-MFC). The catholyte (i.e., water) in the M-MFC had negligible contact with atmospheric air due to the styrofoam sheet used for maintaining the hydroponic condition. There was no mixing of the catholyte in the M-MFC. Sucrose based synthetic wastewater having chemical oxygen demand (COD) of 3000 mg/L was fed into the anodic chamber of the MFC in fed-batch mode with a liquid retention time of four days. The C. indica thrived well throughout the duration of the experiment without much care. The average dissolved oxygen (DO) concentration and pH value in the M-MFC were 3.25 mg/L and 7.07, respectively, in the catholyte. Since the catholyte was not in contact with air, the DO in the catholyte might be considered as solely liberated from the rhizospheric oxygen release of C. indica. The maximum COD removal efficiency of M-MFC observed during the experiment was 76.9%. The inadequacy of terminal electron acceptor in the cathodic chamber in M-MFC might have hampered the electron transfer, which in turn, led to slower specific microbial activity, thereby resulting in lower COD removal efficiency than the traditional MFC with aerated catholyte. The average operating voltage (OV) and open-circuit voltage (OCV) of 294 mV and 594 mV, respectively, were observed in M-MFC. The maximum power density observed during polarization was 381 mW/m³, and the maximum sustainable power density observed during the experiment was 397 mW/m³ in M-MFC. The maximum normalized energy recovery and coulombic efficiency of 38.09 Wh/m³ and 1.27%, respectively, were observed. Therefore, it was evidenced that rhizospheric oxygen release of wetland macrophytes (C. indica) was capable of sustaining the cathodic reaction in MFC for field-scale applications.

Keywords: hydroponic, microbial fuel cell, rhizospheric oxygen release, wetland macrophytes

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Authors: Faidon Kyriakou, William Dempster, David Nash

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Abdominal Aortic Aneurysm (AAA) is a major life-threatening pathology for which modern approaches reduce the need for open surgery through the use of stenting. The success of stenting though is sometimes jeopardized by the final position of the stent graft inside the human artery which may result in migration, endoleaks or blood flow occlusion. Herein, a finite element (FE) model of the commercial medical device AnacondaTM (Vascutek, Terumo) has been developed and validated in order to create a numerical tool able to provide useful clinical insight before the surgical procedure takes place. The AnacondaTM device consists of a series of NiTi rings sewn onto woven polyester fabric, a structure that despite its column stiffness is flexible enough to be used in very tortuous geometries. For the purposes of this study, a FE model of the device was built in Abaqus® (version 6.13-2) with the combination of beam, shell and surface elements; the choice of these building blocks was made to keep the computational cost to a minimum. The validation of the numerical model was performed by comparing the deployed position of a full stent graft device inside a constructed AAA with a duplicate set-up in Abaqus®. Specifically, an AAA geometry was built in CAD software and included regions of both high and low tortuosity. Subsequently, the CAD model was 3D printed into a transparent aneurysm, and a stent was deployed in the lab following the steps of the clinical procedure. Images on the frontal and sagittal planes of the experiment allowed the comparison with the results of the numerical model. By overlapping the experimental and computational images, the mean and maximum distances between the rings of the two models were measured in the longitudinal, and the transverse direction and, a 5mm upper bound was set as a limit commonly used by clinicians when working with simulations. The two models showed very good agreement of their spatial positioning, especially in the less tortuous regions. As a result, and despite the inherent uncertainties of a surgical procedure, the FE model allows confidence that the final position of the stent graft, when deployed in vivo, can also be predicted with significant accuracy. Moreover, the numerical model run in just a few hours, an encouraging result for applications in the clinical routine. In conclusion, the efficient modelling of a complicated structure which combines thin scaffolding and fabric has been demonstrated to be feasible. Furthermore, the prediction capabilities of the location of each stent ring, as well as the global shape of the graft, has been shown. This can allow surgeons to better plan their procedures and medical device manufacturers to optimize their designs. The current model can further be used as a starting point for patient specific CFD analysis.

Keywords: AAA, efficiency, finite element analysis, stent deployment

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Authors: Jian Cao

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This paper describes a novel watermarking technique which we call the random direction embedding (RDE) watermarking. Unlike traditional watermarking techniques, the watermark energy after the RDE embedding does not focus on a fixed direction, leading to the security against the traditional unauthorized watermark removal attack. In addition, the experimental results show that when compared with the existing secure watermarking, namely natural watermarking (NW), the RDE watermarking gains significant improvement in terms of robustness. In fact, the security of the RDE watermarking is not at the cost of low robustness, and it can even achieve more robust than the traditional spread spectrum watermarking, which has been shown to be very insecure.

Keywords: robustness, spread spectrum watermarking, watermarking security, random direction embedding (RDE)

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Authors: R. Trad Khodja, A. Guessmi, R. Ghoul, A. Mahtout, S. A. Benbouali, M. A. Boulahlib

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Cranioplasty is a surgical act that aims to restore cranial bone losses in order to protect the brain from external aggressions and to improve the patient's aesthetic appearance. This objective can be achieved by taking advantage of the current technological development in computer science and biomechanics. The objective of this paper is to present an approach for the realization of high-precision biocompatible cranial implants using new 3D printing technologies at the lowest cost. The proposed method is to reproduce the missing part of the skull by referring to its healthy contralateral part. Once the model is validated by the neurosurgeons, a mold is 3D printed for the production of a biocompatible implant in Poly-Methyl-Methacrylate (PMMA) acrylic cement. Using this procedure, ten patients underwent this procedure with excellent aesthetic results.

Keywords: cranioplasty, cranial defect, PMMA, 3d printing, custom made implants

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Authors: Rory Brown, Jessica Daniels, Babatunde Oremule, William Tsang, Sadie Khwaja

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Introduction: Dentures are common and are an intervention for both physical and psychological symptoms associated with tooth loss. However, the humble denture can cause morbidity and mortality if swallowed or aspirated. Numerous case reports document complications including hollow viscus perforation, fistula formation and airway compromise. The purpose of this review was to examine the literature documenting cases of swallowed or aspirated dentures over the past ten years to investigate factors that contribute to developing complications. Methods: A Medline literature search was performed to identify cases of denture ingestion or aspiration for over ten years. Data was collected to include patient, appliance and temporal factors that may contribute to developing complications including hollow viscus perforation, fistula formation, abscess, bowel obstruction, necrosis, hemorrhage and airway obstruction. The data was analyzed using observational and inferential statistics in the form of Chi-Squared and Pearson correlation tests. Results: Eighty-five cases of ingested or aspirated dentures were identified from 77 articles published between 1/10/2009 and 31/10/2019. Fourteen articles were excluded because they did not provide sufficient information on individual cases. Complications were documented in 37.6% of patients, and 2 cases resulted in death. There was no significant difference in complication risk based on patient age, hooked appliance, level of impaction, or radiolucency. However, symptoms of greater than 1-day duration are associated with an increased risk of complication (p=0.005). Increased time from ingestion or aspiration to removal is associated with an increased risk of complications, and the p-value remains significant up to and including day 4 (p=0.017). Conclusions: With denture use predicted to rise complications from the denture, ingestion and aspiration may become more frequent. We have demonstrated that increased symptom duration significantly increases the risk of developing complications. Additionally, we established the risk of developing complications is significantly reduced if the denture is removed with four days of aspiration or ingestion. By actively intervening early when presented with a case of swallowed or aspirated dentures, we may be able to reduce the morbidity associated with this unassuming device.

Keywords: aspiration, denture, ingestion, endoscopic foreign, body removal, foreign body impaction

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Authors: Zahra Jandaghian, Mehdi Ghobadi, Michal Bartko, Alex Hayes, Marianne Armstrong, Alexandra Thompson, Michael Lacasse

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The Intergovernmental Panel on Climate Change (IPCC) report stated the urgent need to cut greenhouse gas emissions to avoid the adverse impacts of climatic changes. The United Nations has forecasted that nearly 70 percent of people will live in urban areas by 2050 resulting in a doubling of the global building stock. Given that buildings are currently recognised as emitting 40 percent of global carbon emissions, there is thus an urgent incentive to decarbonize existing buildings and to build net-zero carbon buildings. To attain net zero carbon emissions in communities in the future requires action in two directions: I) reduction of emissions; and II) removal of on-going emissions from the atmosphere once de-carbonization measures have been implemented. Nature-based solutions (NBS) have a significant role to play in achieving net zero carbon communities, spanning both emission reductions and removal of on-going emissions. NBS for the decarbonisation of buildings can be achieved by using green roofs and green walls – increasing vertical and horizontal vegetation on the building envelopes – and using nature-based materials that either emit less heat to the atmosphere thus decreasing photochemical reaction rates, or store substantial amount of carbon during the whole building service life within their structure. The NBS approach can also mitigate urban flooding and overheating, improve urban climate and air quality, and provide better living conditions for the urban population. For existing buildings, de-carbonization mostly requires retrofitting existing envelopes efficiently to use NBS techniques whereas for future construction, de-carbonization involves designing new buildings with low carbon materials as well as having the integrity and system capacity to effectively employ NBS. This paper presents the opportunities and challenges in respect to the de-carbonization of buildings using NBS for both building retrofits and new construction. This review documents the effectiveness of NBS to de-carbonize Canadian buildings, identifies the missing links to implement these techniques in cold climatic conditions, and determine a road map and immediate approaches to mitigate the adverse impacts of climate change such as urban heat islanding. Recommendations are drafted for possible inclusion in the Canadian building and energy codes.

Keywords: decarbonization, nature-based solutions, GHG emissions, greenery enhancement, buildings

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Authors: Bernard Olumide Ewuoso, Asma Gharaibeh

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Rationale: Placental mesenchymal dysplasia (PMD) resembles molar pregnancy quite a bit. Although there have been documented live births of healthy babies, obtaining an objective diagnosis is crucial to assisting the mother in making an educated decision on what option of management she would like to explore. Prenatal invasive testing is recommended to help obtain an objective diagnosis in cases of abnormal placenta. We present a 23-year-old who, at 14 weeks, had ultrasonographic findings suggestive of placental mesenchymal dysplasia. She was offered prenatal invasive testing but declined and opted for surgical management, with a diagnosis of PMD confirmed on histopathology. There will be occasions such as this when prenatal invasive testing is declined. In these situations, careful consideration can be given to color Doppler and MRI, especially if the patient decides to keep pregnancy.

Keywords: placental mesenchymal dysplasisa, molar pregnancy, prenatal invasive testing, Color doppler, MRI

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Authors: Muhammad Saiful Islam Khan, Yun Ji Kim

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Organophosphorus pesticides (OPPs) have been widely used to replace more persistent organochlorine pesticides because OPPs are more soluble in water and decompose rapidly in aquatic systems. Extensive uses of OPPs in modern agriculture are the major cause of the contamination of surface water. Regardless of the advantages gained by the application of pesticides in modern agriculture, they are a threat to the public health environment. With the aim of reducing possible health threats, several physical and chemical treatment processes have been studied to eliminate biological and chemical poisons from food stuff. In the present study, a micro-plasma device was used to reduce pesticides from the surface of food stuff. Pesticide free food items chosen in this study were perilla leaf, tomato, broccoli and blueberry. To evaluate the removal efficiency of pesticides, different washing methods were followed such as soaking with water, washing with bubbling water, washing with plasma-treated water and washing with chlorine water. 2 mL of 2000 ppm pesticide samples, namely, diazinone and chlorpyrifos were individuality inoculated on food surface and was air dried for 2 hours before treated with plasma. Plasma treated water was used in two different manners one is plasma treated water with bubbling the other one is aerosolized plasma treated water. The removal efficiency of pesticides from food surface was studied using HPLC. Washing with plasma treated water, aerosolized plasma treated water and chlorine water shows minimum 72% to maximum 87 % reduction for 4 min treatment irrespective to the types of food items and the types of pesticides sample, in case of soaking and bubbling the reduction is 8% to 48%. Washing with plasma treated water, aerosolized plasma treated water and chlorine water shows somewhat similar reduction ability which is significantly higher comparing to the soaking and bubbling washing system. The temperature effect of the washing systems was also evaluated; three different temperatures were set for the experiment, such as 22°C, 10°C and 4°C. Decreasing temperature from 22°C to 10°C shows a higher reduction in the case of washing with plasma and aerosolized plasma treated water, whereas an opposite trend was observed for the washing with chlorine water. Further temperature reduction from 10°C to 4°C does not show any significant reduction of pesticides, except for the washing with chlorine water. Chlorine water treatment shows lesser pesticide reduction with the decrease in temperature. The color changes of the treated sample were measured immediately and after one week to evaluate if there is any effect of washing with plasma treated water and with chlorine water. No significant color changes were observed for either of the washing systems, except for broccoli washing with chlorine water.

Keywords: chlorpyrifos, diazinone, pesticides, micro plasma

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Authors: Ján Haščík, Štefan Čerba, Jakub Lüley, Branislav Vrban

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The presented paper is related to the design methods and neutronic characterization of the reactivity control system in the large power unit of Generation IV Gas cooled Fast Reactor – GFR2400. The reactor core is based on carbide pin fuel type with the application of refractory metallic liners used to enhance the fission product retention of the SiC cladding. The heterogeneous design optimization of control rod is presented and the results of rods worth and their interferences in a core are evaluated. In addition, the idea of reflector removal as an additive reactivity management option is investigated and briefly described.

Keywords: control rods design, GFR2400, hot spot, movable reflector, reactivity

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Authors: Paul Feyi Waboso

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This case report presents a 57-year-old female patient with a history of colon cancer, colostomy, and immunocompromise, who presented with an unusual bilateral vulval abscess, more prominent on the left side. Due to the atypical presentation, an MRI was performed, revealing a pelvic collection and a fistulous connection between the pelvis and vulva. This finding prompted an urgent surgical intervention. This case highlights the diagnostic and therapeutic challenges of managing complex abscesses and fistulas in immunocompromised patients. Introduction: Vulval abscesses in immunocompromised individuals can present with atypical features and may be associated with complex pathologies. Patients with a history of cancer, colostomy, and immunocompromise are particularly prone to infections and may present with unusual manifestations. This report discusses a case of a large bilateral vulval abscess with an underlying pelvic fistula, emphasizing the importance of advanced imaging in cases with atypical presentations. Case Presentation: A 57-year-old female with a known history of colon cancer, treated with colostomy, presented with severe pain and swelling in the vulval area. Physical examination revealed bilateral vulval swelling, with the abscess on the left side appearing larger and more pronounced than on the right. Given her immunocompromised status and the unusual nature of the presentation, we requested an MRI of the pelvis, suspecting an underlying pathology beyond a typical abscess. Investigations: MRI imaging revealed a significant pelvic collection and identified a fistulous tract between the pelvis and the vulva. This confirmed that the vulval abscess was connected to a deeper pelvic infection, necessitating urgent intervention. Management: After consultation with the multidisciplinary team (MDT), it was agreed that the patient required surgical intervention, having had 48 hours of antibiotics. The patient underwent evacuation of the left-sided vulval abscess under spinal anesthesia. During surgery, the pelvic collection was drained of 200 ml of pus. Outcome and Follow-Up: Postoperative recovery was closely monitored due to the patient’s immunocompromised state. Follow-up imaging and clinical evaluation showed improvement in symptoms, with gradual resolution of infection. The patient was scheduled for regular follow-up visits to monitor for recurrence or further complications. Discussion: Bilateral vulval abscesses are uncommon and, in an immunocompromised patient, warrant thorough investigation to rule out deeper infectious or fistulous connections. This case underscores the utility of MRI in identifying complex fistulous tracts and highlights the importance of a multidisciplinary approach in managing such high-risk patients. Conclusion: This case illustrates a rare presentation of bilateral vulval abscess with an associated pelvic fistula.

Keywords: vulval abscess, MDT team, colon cancer with pelvic fistula, vulval skin condition

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Authors: Dara Singh, Keikhosrow Firouzbakhsh, Mohammad Taghi Ahmadian

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In this paper, conventional laser Keratoplasty surgeries in the human eye are studied. For this purpose, a validated 3D finite volume model of the human eye is introduced. In this model the fluid flow has also been considered. The discretized domain of the human eye incorporates a bio-heat transfer equation coupled with a Boussinesq equation. Both continuous and pulsed lasers have been modeled and the results are compared. Moreover, two different conventional surgical positions that are upright and recumbent are compared for these laser therapies. The simulation results show that in these conventional surgeries, the temperature rises above the critical values at the laser insertion areas. However, due to the short duration and the localized nature, the potential damages are restricted to very small regions and can be ignored. The conclusion is that the present day lasers are acceptably safe to the human eye.

Keywords: eye, heat-transfer, keratoplasty laser, surgery

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Authors: Joshi Rajiv, Shah Priyank, Thavkar Amit, Rohira Poonam, Mehta Suyog

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Topical formulation containing minoxidil and finasteride helps hair growth in the treatment of male androgenetic alopecia. The objective of this study is to compare the irritation potential of three conventional formulations of minoxidil 5% + finasteride 0.1% topical solution of in human patch test. The study was a single centre, double blind, non-randomized controlled study in 53 healthy adult Indian subjects. Occlusive patch test for 24 hours was performed with three formulations of minoxidil 5% + finasteride 0.1% topical solution. Products tested included aqueous based minoxidil 5% + finasteride 0.1% (AnasureTM-F, Sun Pharma, India – Brand A), lipid based minoxidil 5% + finasteride 0.1% (Brand B) and aqueous based minoxidil 5% + finasteride 0.1% (Brand C). Isotonic saline 0.9% and 1% w/w sodium lauryl sulphate were included as negative control and positive control respectively. Patches were applied and removed after 24 hours. The skin reaction was assessed and clinically scored 24 hours after the removal of the patches under constant artificial daylight source using the Draize scale (0-4 points scale for erythema/dryness//wrinkles and for oedema). Follow-up was scheduled after one week to confirm recovery for any reaction. A combined mean score up to 2.0/8.0 indicates a product is “non-irritant” and a score between 2.0/8.0 and 4.0/8.0 indicates “mildly irritant” and a score above 4.0/8.0 indicates “irritant”. The procedure of the patch test followed the principles outlined by the Bureau of Indian Standards (BIS) (IS 4011:2018; Methods of Test for safety evaluation of Cosmetics-3rd revision). Fifty three subjects with mean age 31.9 years (25 males and 28 females) participated in the study. The combined mean score ± standard deviation were: 0.06 ± 0.23 (Brand A), 0.81 ± 0.59 (Brand B), 0.38 ± 0.49 (Brand C), 2.92 ± 0.47 (positive control) and 0.0 ± 0.0 (Negative control). This means the score of Brand A (Sun Pharma product) was significantly lower than that of Brand B (p=0.001) and that of Brand C (p=0.001). The combined mean erythema score ± standard deviation were: 0.06 ± 0.23 (Brand A), 0.81 ± 0.59 (Brand B), 0.38 ± 0.49 (Brand C), 2.09 ± 0.4 (Positive control) and 0.0 ± 0.0 (Negative control). The mean erythema score of Brand A was significantly lower than Brand B (p=0.001) and that of Brand C (p=0.001). Any reaction observed at 24hours after patch removal subsided in a week. All the three topical formulations of minoxidil 5% + finasteride 0.1% were non-irritant. Brand A of minoxidil 5% + finasteride 0.1% (Sun Pharma) was found to be the least irritant than Brand B and Brand C based on the combined mean score and mean erythema score in the human patch test as per the BIS, IS 4011:2018

Keywords: erythema, finasteride, irritation, minoxidil, patch test

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Authors: Petr Daniel Kovarik, Matt Kennedy, James Adams, Ajay Wilson, Andy Burns, Charles Kelly, Malcolm Jackson, Rahul Patil, Shahid Iqbal

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Introduction: Osteoradionecrosis (ORN) is a recognised toxicity of radiotherapy (RT) for head and neck cancer (HNC). Existing literature lacks any generally accepted definition and staging system for this toxicity. Objective: The objective is to analyse the outcome of the surgical and nonsurgical treatments of ORN. Material and Method: Data on 2303 patients treated for HNC with radical or adjuvant RT or RT-chemotherapy from January 2010 - December 2021 were retrospectively analysed. Median follow-up to the whole group of patients was 37 months (range 0–148 months). Results: ORN developed in 185 patients (8.1%). The location of ORN was as follows; mandible=170, maxilla=10, and extra oral cavity=5. Multiple ORNs developed in 7 patients. 5 patients with extra oral cavity ORN were excluded from treatment analysis as the management is different. In 180 patients with oral cavity ORN, median follow-up was 59 months (range 5–148 months). ORN healed in 106 patients, treatment failed in 74 patients (improving=10, stable=43, and deteriorating=21). Median healing time was 14 months (range 3-86 months). Notani staging is available in 158 patients with jaw ORN with no previous surgery to the mandible (Notani class I=56, Notani class II=27, and Notani class III=76). 28 ORN (mandible=27, maxilla=1; Notani class I=23, Notani II=3, Notani III=1) healed spontaneously with a median healing time 7 months (range 3–46 months). In 20 patients, ORN developed after dental extraction, in 1 patient in the neomandible after radical surgery as a part of the primary treatment. In 7 patients, ORN developed and spontaneously healed in irradiated bone with no previous surgical/dental intervention. Radical resection of the ORN (segmentectomy, hemi-mandibulectomy with fibula flap) was performed in 43 patients (all mandible; Notani II=1, Notani III=39, Notani class was not established in 3 patients as ORN developed in the neomandible). 27 patients healed (63%); 15 patients failed (improving=2, stable=5, deteriorating=8). The median time from resection to healing was 6 months (range 2–30 months). 109 patients (mandible=100, maxilla=9; Notani I=3, Notani II=23, Notani III=35, Notani class was not established in 9 patients as ORN developed in the maxilla/neomandible) were treated conservatively using a combination of debridement, antibiotics and Pentoclo. 50 patients healed (46%) with a median healing time 14 months (range 3–70 months), 59 patients are recorded with persistent ORN (improving=8, stable=38, deteriorating=13). Out of 109 patients treated conservatively, 13 patients were treated with Pentoclo only (all mandible; Notani I=6, Notani II=3, Notani III=3, 1 patient with neomandible). In total, 8 patients healed (61.5%), treatment failed in 5 patients (stable=4, deteriorating=1). Median healing time was 14 months (range 4–24 months). Extra orally (n=5), 3 cases of ORN were in the auditory canal and 2 in mastoid. ORN healed in one patient (auditory canal after 32 months. Treatment failed in 4 patients (improving=3, stable=1). Conclusion: The outcome of the treatment of ORN remains in general, poor. Every effort should therefore be made to minimise the risk of development of this devastating toxicity.

Keywords: head and neck cancer, radiotherapy, osteoradionecrosis, treatment outcome

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Authors: Eric Spruth, Lindsey Herbert, Danielle DiCristofano, Isis Violet Spruth, Drake Von Spruth

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Turning dreams into reality, the lifelong passion of Mr. Spruth and the company is to transform garbage-filled courtyards into flourishing flower and vegetable gardens, bringing light, hope, and wellness to not just the space but to the populations served within these public and private spaces. As an Expressive Art Therapist at Cook County Jail, Eric Spruth has implemented gardening projects, mobile radish carts, plant fostering systems, and large-scale murals. Lindsey Herbert, the Manager of Operations and Events at the International Museum of Surgical Science, supports gardening projects with Mr. Spruth along the front lawn of the museum, which will eventually accumulate into a community wellness garden. Mr. Spruth and Ms. Herbert both have dedicated efforts towards fostering awareness of hope and help and accountability for physical and mental wellbeing. Medicinal plants can rightfully be called one of nature’s wonderful healing tools with therapeutic powers. They can inhibit and kill bacteria, lower blood pressure, blood cholesterol, and blood sugar, prevent blood clotting, boost the immune system, and serve as a digestive aid. Some plants have the ability to stimulate the lymphatic system, which expedites the removal of waste products from the body to fight off evil toxins. Many plants are considered effective antioxidants to protect cells against free radical damage, serving to prevent some forms of cancer, heart disease, strokes, and viral infections. Garlic alone can provide us with over two hundred unusual chemicals that have the capability of protecting the human body from a wide variety of diseases. Besides the medicinal qualities of plants, plant and vegetable gardens also have an echoing effect on non-participants to look at something beautiful rather than a concrete courtyard or an unkempt lawn in front of a beautiful building. Plants also purify spaces and affect mood with color therapy. Collective gardening can foster a sense of community and purpose. Additionally, by recognizing the ever-evolving planet with global warming, horticulture therapy teaches important lessons in responsibility, accountability, and sustainability. Growing local food provides an opportunity to be involved in your own mental and physical health and gives you a chance for your own self-resilience, combating depression and a lack of nutrition. In adolescents, the process of watering and caring for plants can teach important life lessons that transcend beyond the garden by providing knowledge on how to care for yourself and how to be an active member of society. It also gives a sense of purpose and pride in transforming a small seed into a plant that can be consumed or enjoyed by others. Mr. Spruth and Ms. Herbert recognize the importance of bringing more green spaces to urban areas, both to serve a nutritional benefit and provide a beautiful transformation to underutilized areas. Gardens can bring beauty, wellness, and hope to dark spaces and provide immeasurable benefits for all.

Keywords: growth, hope, mental health, sustainability, transformation, wellness

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Authors: Elena Ivany, Leanne Aitken

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Little is known about the delivery of end-of-life care in cardiac intensive care unit (CICU) settings. The aims of this study were to highlight the nurse-identified barriers and facilitators to delivering end-of-life care in the CICU, and to identify whether any of the barriers and/or facilitators are specific to the CICU setting. This was an exploratory qualitative study utilizing semi-structured individual interviews as the data collection method and inductive thematic analysis to structure the data. Six CICU nurses took part in the study. Five key themes were identified, each theme including both barriers and facilitators. The five key themes are as follows: patient-centered care, emotional challenges, reaching concordance, nursing contribution and the surgical intensive care unit.

Keywords: end-of-life, cardiovascular disease, cardiac surgery, critical care

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Authors: Homayon Ahmad Panahi, Samira Tajik, Mohamad Hadi Dehghani, Mostafa Khezri, Elham Moniri

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In this research, poly urea-formaldehyde was prepared. The poly urea-formaldehyde was characterized by fourier transform infra-red spectroscopy. Then the effects of various parameters on Cd (II) sorption such as pH, contact time were studied. The optimum pH value for sorption of Cd(II) was 5.5. The sorption capacity of poly urea-formaldehyde for Cd (II) were 76.3 mg g−1. A Cd (II) removal of 55% was obtained. The profile of Cd (II) uptake on this sorbent reflects good accessibility of the chelating sites in the poly urea-formaldehyde. The developed method was utilized for determination of Cd (II) in environmental water samples by flame atomic absorption spectrometry with satisfactory results.

Keywords: poly urea-formaldehyde, cadmium ion, environmental sample, determination

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Authors: Katarzyna Mleczko

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Processes of production of innovative medical tools have interdisciplinary character. They consist of direct and indirect close cooperation of specialists of different scientific branches. The Knowledge they have seems to be important for undertaken design, construction and manufacturing processes. The Knowledge exchange between participants of these processes is therefore crucial for the final result, which are innovative medical products. The paper draws attention to the necessity of feedback from the end user to the designer / manufacturer of medical tools which will allow for more accurate understanding of user needs. The study describes prerequisites of production processes of innovative medical (surgical) tools including participants and category of knowledge resources occurring in these processes. They are the result of research in selected Polish organizations involved in the production of medical instruments and are the basis for further work on the development of knowledge sharing model in interdisciplinary teams geographically dispersed.

Keywords: interdisciplinary production processes, knowledge exchange, knowledge sharing, medical tools

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Authors: Widi Astuti, Triastuti Sulistyaningsih, Masni Maksiola

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Kapok sawdust, an inexpensive material, has been utilized as an adsorbent for the removal of methyl violet in aqueous solution. To increase the adsorption capacity, kapok sawdust was reacted with sodium hydroxide (NaOH) solution having various concentrations. Various physico-chemical parameters such as solution pH, contact time and initial dye concentration were studied. Langmuir, Freundlich and Redlich-Peterson isotherm model were used to analyze the equilibrium data. The research shows that the experimental data fitted well with the Redlich-Peterson model, with the value of constants are 41.001 for KR, 0.523 for aR and 0.799 for g.

Keywords: kapok sawdust, methyl violet, dye, adsorption

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Authors: Rajul Dwivedi, Mahesh Patel

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Due to the scarcity of natural resources, common rivers and coastal structures are too expensive to build and maintain. One such method is to use geotextile tube technology to build marine protected structures, such as dams, canals, jetties, free breakwaters, etc. Geotextile tube technology has evolved from other construction technologies and improved into a more efficient solution. The coastal erosion problems have been exacerbated by the development of infrastructure associated with the expansion of urban and industrial activities. Resources and harbours and the removal of sea sand for use in this erosion event will accelerate the erosion of the sea. but in the coastal areas, due to depletion of sand or beach sand

Keywords: geotextile tubes, slurry, dewatering, response surface

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Authors: G. Henini, Y. Laidani, F. Souahi, A. Labbaci, S. Hanini

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Environmental contamination is a major problem being faced by the society today. Industrial, agricultural, and domestic wastes, due to the rapid development in the technology, are discharged in the several receivers. Generally, this discharge is directed to the nearest water sources such as rivers, lakes, and seas. While the rates of development and waste production are not likely to diminish, efforts to control and dispose of wastes are appropriately rising. Wastewaters from textile industries represent a serious problem all over the world. They contain different types of synthetic dyes which are known to be a major source of environmental pollution in terms of both the volume of dye discharged and the effluent composition. From an environmental point of view, the removal of synthetic dyes is of great concern. Among several chemical and physical methods, adsorption is a promising technique due to the ease of use and low cost compared to other applications in the process of discoloration, especially if the adsorbent is inexpensive and readily available. The focus of the present study was to assess the potentiality of Brahea edulis (BE) for the removal of synthetic dye Yellow bemacid (YB) from aqueous solutions. The results obtained here may transfer to other dyes with a similar chemical structure. Biosorption studies were carried out under various parameters such as mass adsorbent particle, pH, contact time, initial dye concentration, and temperature. The biosorption kinetic data of the material (BE) was tested by the pseudo first-order and the pseudo-second-order kinetic models. Thermodynamic parameters including the Gibbs free energy ΔG, enthalpy ΔH, and entropy ΔS have revealed that the adsorption of YB on the BE is feasible, spontaneous, and endothermic. The equilibrium data were analyzed by using Langmuir, Freundlich, Elovich, and Temkin isotherm models. The experimental results show that the percentage of biosorption increases with an increase in the biosorbent mass (0.25 g: 12 mg/g; 1.5 g: 47.44 mg/g). The maximum biosorption occurred at around pH value of 2 for the YB. The equilibrium uptake was increased with an increase in the initial dye concentration in solution (C_o = 120 mg/l; q = 35.97 mg/g). Biosorption kinetic data were properly fitted with the pseudo-second-order kinetic model. The best fit was obtained by the Langmuir model with high correlation coefficient (R² > 0.998) and a maximum monolayer adsorption capacity of 35.97 mg/g for YB.

Keywords: adsorption, Brahea edulis, isotherm, yellow Bemacid

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Authors: Olais A. Ingrid, Peraza G. Leydi, Estrella C. Damaris

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Breast cancer is the most common among women worldwide; the different treatments can bring sequels that directly affect the quality of life, such as lymphedema. The objective was to determine if there is presence of lymphedema secondary to breast cancer in Yucatecan women. It was an observational, analytical, cross-sectional study, 92 women were included who met the following criteria: women with surgical treatment for unilateral: breast cancer, aged between 25 and 65 years old, minimum 6 weeks after unilateral breast surgery and have completed any type of chemotherapy or adjuvant radiotherapy treatment for breast cancer. The evaluation was through indirect measurement volume by circometry to determine the presence of lymphedema. 23% of women had lymphedema grade I. It related to the presence of some of the symptoms like stiffness, swelling, decreased range of motion and feeling of heaviness in the arm of the operated side of the breast. It is important to determine the presence of lymphedema to perform physical therapy treatment.

Keywords: breast cancer, lymphedema, physical therapy, Yucatan

Procedia PDF Downloads 350