Search results for: leachate treatment

Authors: Todd Jackson

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In this randomized control trial, we tested the effectiveness of a peer-facilitated version of the Body Project (BP) intervention among body-dissatisfied young women in China. Participants were randomly assigned to a peer-facilitator BP condition (N = 94) versus an educational video minimal intervention control condition (N = 89). Questionnaire measures of two primary outcomes (i.e., disordered eating and body dissatisfaction) and six secondary outcomes (thin-ideal internalization, pressure to be thin, negative affect, body surveillance, body shame, body appreciation and interest in cosmetic surgery) were administered at a pre-treatment baseline, a post-treatment assessment, and at a 12-month follow-up. A series of 2 (Group) x 2 (Time) analyses of variance indicated women in the peer-facilitated BP condition reported significant improvements in primary outcome measures of disordered eating and body dissatisfaction compared to women in the educational video control condition following treatment and at the 12-month follow-up. Furthermore, women in the peer-facilitated BP condition reported significant improvements in measures of body surveillance, body shame and body appreciation) compared to educational video controls that extended to the 12-month follow-up. Finally, although women in the peer-facilitated BP condition showed significant post-treatment improvements in thin-ideal internalization, negative affect, perceived pressure to be thin, and interest in cosmetic surgery compared to video controls, these differences were no longer statistically significant at the 12-month follow-up. In conclusion, findings supported the overall effectiveness of a peer-facilitated group version of the BP as an intervention for reducing disordered eating and several associated risk factors among at-risk young women in China.

Keywords: body project, disordered eating, body dissatisfaction, risk factors, prevention, China

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Authors: Rajandeep Kaur, Rajeev Gupta

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Background: Chronic myeloid leukemia (CML) is the most common leukaemia in India. The annual incidence of chronic myeloid leukemia in India was originally reported to be 0.8 to 2.2 per 1,00,000 population. CML is a clonal disorder that is usually easily diagnosed because the leukemic cells of more than 95% of patients have a distinctive cytogenetic abnormality, the Philadelphia chromosome (Ph1). The approval of tyrosine kinase inhibitors (TKIs), which target BCR-ABL1 kinase activity, has significantly reduced the mortality rate associated with chronic myeloid leukemia (CML) and revolutionized treatment. Material and Methods: 80 diagnosed cases of CML were taken. Investigations were done. Bone marrow and molecular studies were also done and with EUTOS, patients were stratified into low and high-risk groups and then treatment with Imatinib was given to all patients and the molecular response was evaluated at 6 months and 12 months follow up with BCR-ABL by RT-PCR quantitative assay. Results: In the study population, out of 80 patients in the study population, 40 were females and 40 were males, with M: F is 1:1. Out of total 80 patients’ maximum patients (54) were in 31-60 years age group. Our study showed a most common symptom of presentation is abdominal discomfort followed by fever. Out of the total 80 patients, 25 (31.3%) patients had high EUTOS scores and 55 (68.8%) patients had low EUTOS scores. On 6 months follow up 36.3% of patients had Complete Molecular Response, 16.3% of patients had Major Molecular Response and 47.5% of patients had No Molecular Response but on 12 months follow up 71.3% of patients had Complete Molecular Response, 16.25% of patients had Major Molecular Response and 12.5% patients had No Molecular Response. Conclusion: In this study, we found a significant correlation between EUTOS score and Molecular response at 6 months and 12 months follow up after Imatinib therapy.

Keywords: chronic myeloid leukemia, European treatment and outcome study score, hematological response, molecular response, tyrosine kinase inhibitor

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Authors: Song-Chol Pak, Yong-Jun Kim, Hak- Chol Choe, Yong-Son Choe

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We converted the coal-water-oil slurry (CWOS) into an alternative fuel (AF) for internal combustion engines by high-voltage discharge (HVD) and dielectric barrier discharge (DBD) plasmas. After its treatments, the CWOS had the average coal size reduced from 12.95 to 8.26㎛, improved dispersibility, fewer deposits, and calorific value enhanced by 35%. The effects of some parameters were analyzed on the conversion of CWOS to AF, and the AF was characterized. The plasma-treated CWOS is similar to other liquid fuels in rheological properties and calorific value. It is therefore concluded that it can be directly employed in internal combustion engines with a little design modification. The suggested method may be an alternative way of converting CWOS to AF without any dispersant or stabilizer.

Keywords: coal-water-oil slurry, high-voltage discharge, dielectric barrier discharge, plasma treatment, alternative fuel

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Authors: Nitin Rajan, Kashif Shakeel, Shashank Tiwari, Shachan Sagar

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Background: - Aegle Marmelos (Bael) leaf extract is taken twice daily to treat ophthalmia, ulcers, and intestinal worms, among other ailments. Poultice made from bael leaf is used in the treatment of eye conditions. The leaf juice has a variety of therapeutic applications, with the most notable being the treatment of diabetes. Fenugreek is used to cure red spots around the eyes, as well as to soften the throat and chest and to give relief from coughing. The use of this plant in the form of infusion, powder, pomade, and decoction has been extremely popular in Iranian traditional medicine. The plant may be used to wash one's vaginal linings. This plant is used as an emollient in the lack of appetite, treatment of pellagra, and gastrointestinal problems, as well as a general tonic. Calendula officinalis leaves are used to treat varicose veins on the outside of the body by infusing them. In Europe, the leaves are diaphoretic and resolvent in nature, while the blooms are employed as an emmenagogue and antispasmodic stimulant in Canada and the United States. The flowers were decocted and served as a posset drink when smallpox and measles were common in England, and the fresh juice was used to treat jaundice. Objective: - This study is done to compare the physicochemical parameter of the alcoholic extract of the leaves of Aegle Marmelos, Calendula Officinalis, and Fenugreek. Materials and Methods: Extraction and Isolation of Aegle Marmelos, Calendula Officinalis, Fenugreek, were done. Preliminary phytochemical study for alkaloids, cardiac glycosides, flavonoids, glycosides, phenols, resins, saponins, steroids, tannins, terpenoids of the extract was done individual by using the standard procedure. Result: - The phytochemical screening of Aegle Marmelos, Calendula Officinalis, and Fenugreek shows the presence of alkaloids, carbohydrates, total phenolics, total flavonoids, tannins, saponins gum. Conclusion: - In this study, we have found that crude aqueous and organic solvent extracts of Aegle Marmelos, Calendula Officinalis, and Fenugreek leaves contain some important bioactive compounds and it justifies their use in the traditional medicines for the treatment of different diseases.

Keywords: Aegle Marmelos, Calendula Officinalis, Fenugreek, physiochemical parameter

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Authors: Sonika Sharma, Mohan G. Vairale, Sibnarayan Datta, Soumya Chatterjee, Dharmendra Dubey, Rajesh Prasad, Raghvendra Budhauliya, Bidisha Das, Vijay Veer

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Bacteriophages are viruses that parasitize specific bacteria and multiply in metabolising host bacteria. Bacteriophages hunt for a single or a subset of bacterial species, making them potential antibacterial agents. Utilizing the ability of phages to control bacterial populations has several applications from medical to the fields of agriculture, aquaculture and the food industry. However, harnessing phage based techniques in wastewater treatments to improve quality of effluent and sludge release into the environment is a potential area for R&D application. Phage mediated bactericidal effect in any wastewater treatment process has many controlling factors that lead to treatment performance. In laboratory conditions, titer of bacteriophages (coliphages) isolated from effluent water of a specially designed anaerobic digester of human night soil (DRDO Biotoilet) was successfully increased with a modified protocol of the classical double layer agar technique. Enrichment of the same was carried out and efficacy of the phage enriched medium was evaluated at different conditions (specific media, temperature, storage conditions). Growth optimization study was carried out on different media like soybean casein digest medium (Tryptone soya medium), Luria-Bertani medium, phage deca broth medium and MNA medium (Modified nutrient medium). Further, temperature-phage yield relationship was also observed at three different temperatures 27˚C, 37˚C and 44˚C at laboratory condition. Results showed the higher activity of coliphage 27˚C and at 37˚C. Further, addition of divalent ions (10mM MgCl2, 5mM CaCl2) and 5% glycerol resulted in a significant increase in phage titer. Besides this, effect of antibiotics addition like ampicillin and kanamycin at different concentration on plaque formation was analysed and reported that ampicillin at a concentration of 1mg/ml ampicillin stimulates phage infection and results in more number of plaques. Experiments to test viability of phage showed that it can remain active for 6 months at 4˚C in fresh tryptone soya broth supplemented with fresh culture of coliforms (early log phase). The application of bacteriophages (especially coliphages) for treatment of effluent of human faecal matter contaminated effluent water is unique. This environment-friendly treatment system not only reduces the pathogenic coliforms, but also decreases the competition between nuisance bacteria and functionally important microbial populations. Therefore, the phage based cocktail to treat fecal pathogenic bacteria present in black water has many implication in wastewater treatment processes including ‘DRDO Biotoilet’, which is an ecofriendly appropriate and affordable human faecal matter treatment technology for different climates and situations.

Keywords: wastewater, microbes, virus, biotoilet, phage viability

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Authors: Mohamad Shurair, Fares Almomani, Simon Judd, Rahul Bhosale, Anand Kumar, Ujjal Gosh

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This study evaluated the use of mixed indigenous microalgae (MIMA) as a treatment process for wastewaters and CO2 capturing technology at different temperatures. The study follows the growth rate of MIMA, removals of organic matter, removal of nutrients from synthetic wastewater and its effectiveness as CO2 capturing technology from flue gas. A noticeable difference between the growth patterns of MIMA was observed at different CO2 and different operational temperatures. MIMA showed the highest growth grate when injected with CO2 dosage of 10% and limited growth was observed for the systems injected with 5% and 15 % of CO2 at 30 ◦C. Ammonia and phosphorus removals for Spirulina were 69%, 75%, and 83%, and 20%, 45%, and 75% for the media injected with 0, 5 and 10% CO2. The results of this study show that simple and cost-effective microalgae-based wastewater treatment systems can be successfully employed at different temperatures as a successful CO2 capturing technology even with the small probability of inhibition at high temperatures

Keywords: greenhouse, climate change, CO2 capturing, green algae

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Authors: Tatiana Franco, Hugo A. Estupinan

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Banana pseudostem fiber (BPF) and pineapple leaf fiber (PLF) for their excellent mechanical properties and biodegradability characteristics arouse interest in different areas of research. F In tropical regions, where the banana pseudostem and the pineapple leaf are transformed into hard-to-handle solid waste, they can be low-cost raw material and environmentally sustainable in research for composite materials. In terms of functionality of this type of fiber, an open structure would allow the adsorption and retention of organic, inorganic and metallic species. In general, natural fibers have closed structures on their surface with intricate internal arrangements that can be used for the solution of environmental problems and other technological uses, however it is not possible to access their internal structure and sublayers, exposing the fibers in the natural state. An alternative method to chemical and enzymatic treatment are the processes with the plasma treatments, which are known to be clean, economical and controlled. In this type of treatment, a gas contained in a reactor in the form of plasma acts on the fiber generating changes in its structure, morphology and topography. This work compares the effects on fibers of PLF and BPF treated with cold argon plasma, alternating time and current. These fibers are grown in the regions of Antioquia-Colombia. The morphological, compositional and wettability properties of the fibers were analyzed by Raman microscopy, contact angle measurements, scanning electron microscopy (SEM) and atomic force microscopy analysis (AFM). The treatment with cold plasma on PLF and BPF allowed increasing its wettability, the topography and the microstructural relationship between lignin and cellulose.

Keywords: cold plasma, contact angle, natural fibers, Raman, SEM, wettability

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Authors: Yang Zhao, Feng Zhang, Xuanchu Duan

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Trans-differentiation of human Tenon fibroblasts (HTFs) to myo-fibroblasts and fibrosis of episcleral tissue are the most common reasons for the failure of glaucoma filtration surgery, with limited treatment options like antimetabolites which always have side-effects such as leakage of filter bulb, infection, hypotony, and endophthalmitis. Rosiglitazone, a specific thiazolidinedione is a synthetic high-affinity ligand for PPAR-r, which has been used in the treatment of type2 diabetes, and found to have pleiotropic functions against inflammatory response, cell proliferation and tissue fibrosis and to benefit to a variety of diseases in animal myocardium models, steatohepatitis models, etc. Here, in vitro we cultured primary HTFs and stimulated with TGF- β to induced myofibrogenic, then treated cells with Rosiglitazone to assess for fibrogenic response. In vivo, we used rabbit glaucoma model to establish the formation of post- trabeculectomy scarring. Then we administered subconjunctival injection with Rosiglitazone beside the filtering bleb, later protein, mRNA and immunofluorescence of fibrogenic markers are checked, and filtering bleb condition was measured. In vitro, we found Rosiglitazone could suppressed proliferation and migration of fibroblasts through macroautophagy via TGF- β /Smad signaling pathway. In vivo, on postoperative day 28, the mean number of fibroblasts in Rosiglitazone injection group was significantly the lowest and had the least collagen content and connective tissue growth factor. Rosiglitazone effectively controlled human and rabbit fibroblasts in vivo and in vitro. Its subconjunctiiva application may represent an effective, new avenue for the prevention of scarring after glaucoma surgery.

Keywords: fibrosis, glaucoma, macroautophagy, rosiglitazone

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Authors: S. S. Sharma, P. R. Prabhu, K. Jagannath, Achutha Kini U., Gowri Shankar M. C.

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In present global scenario, aluminum alloys are coining the attention of many innovators as competing structural materials for automotive and space applications. Comparing to other challenging alloys, especially, 7xxx series aluminum alloys have been studied seriously because of their benefits such as moderate strength; better deforming characteristics, excellent chemical decay resistance, and affordable cost. 7075 Al-alloys have been used in the transportation industry for the fabrication of several types of automobile parts, such as wheel covers, panels and structures. It is expected that substitution of such aluminum alloys for steels will result in great improvements in energy economy, durability and recyclability. However, it is necessary to improve the strength and the formability levels at low temperatures in aluminium alloys for still better applications. Aluminum–Zinc–Magnesium with or without other wetting agent denoted as 7XXX series alloys are medium strength heat treatable alloys. Cu, Mn and Si are the other solute elements which contribute for the improvement in mechanical properties achievable by selecting and tailoring the suitable heat treatment process. On subjecting to suitable treatments like age hardening or cold deformation assisted heat treatments, known as low temperature thermomechanical treatments (LTMT) the challenging properties might be incorporated. T6 is the age hardening or precipitation hardening process with artificial aging cycle whereas T8 comprises of LTMT treatment aged artificially with X% cold deformation. When the cold deformation is provided after solution treatment, there is increase in hardness related properties such as wear resistance, yield and ultimate strength, toughness with the expense of ductility. During precipitation hardening both hardness and strength of the samples are increasing. Decreasing peak hardness value with increasing aging temperature is the well-known behavior of age hardenable alloys. The peak hardness value is further increasing when room temperature deformation is positively supported with age hardening known as thermomechanical treatment. Considering these aspects, it is intended to perform heat treatment and evaluate hardness, tensile strength, wear resistance and distribution pattern of reinforcement in the matrix. 2 to 2.5 and 3 to 3.5 times increase in hardness is reported in age hardening and LTMT treatments respectively as compared to as-cast composite. There was better distribution of reinforcements in the matrix, nearly two fold increase in strength levels and upto 5 times increase in wear resistance are also observed in the present study.

Keywords: reinforcement, precipitation, thermomechanical, dislocation, strain hardening

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Authors: Ifeanyichukwu Edeh, Tim Overton, Steve Bowra

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There is increasing interest in utilising low grade or waste biomass for the production of renewable bioenergy vectors i.e. waste to energy. In this study we have chosen to assess, activated sludge, which is a microbial biomass generated during the second stage of waste water treatment as a source of lipid for biodiesel production. To date a significant proportion of biodiesel is produced from used cooking oil and animal fats. It was reasoned that if activated sludge proved a viable feedstock it has the potential to support increase biodiesel production capacity. Activated sludge was obtained at different times of the year and from two different sewage treatment works in the UK. The biomass within the activated sludge slurry was recovered by filtration and the total weight of material calculated by combining the dry weight of the total suspended solid (TSS) and the total dissolved solid (TDS) fractions. Total lipids were extracted from the TSS and TDS using solvent extraction (Folch methods). The classes of lipids within the total lipid extract were characterised using high performance thin layer chromatography (HPTLC) by referencing known standards. The fatty acid profile and content of the lipid extract were determined using acid mediated-methanolysis to obtain fatty acid methyl esters (FAMEs) which were analysed by gas chromatography and HPTLC. The results showed that there were differences in the total biomass content in the activated sludge collected from different sewage works. Lipid yields from TSS obtained from both sewage treatment works differed according to the time of year (between 3.0 and 7.4 wt. %). The lipid yield varied slightly within the same source of biomass but more widely between the two sewage treatment works. The neutral lipid classes identified were acylglycerols, free fatty acids, sterols and wax esters while the phospholipid class included phosphatidylcholine, lysophosphatidycholine, phosphatidylethanolamine and phosphatidylinositol. The fatty acid profile revealed the presence of palmitic acid, palmitoleic acid, linoleic acid, oleic acid and stearic acid and that unsaturated fatty acids were the most abundant. Following optimisation, the FAME yield was greater than 10 wt. % which was required to have an economic advantage in biodiesel production.

Keywords: activated sludge, biodiesel, lipid, methanolysis

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Authors: Rio Hirakawa, Christian Gundlach, Sven Hartwig

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In recent years, the use of aluminium has further expanded and is expected to replace steel in the future as vehicles become lighter and more recyclable in order to reduce greenhouse gas (GHG) emissions and improve fuel economy. In line with this, structures and components are becoming increasingly multi-material, with different materials, including aluminium, being used in combination to improve mechanical utility and performance. A common method of assembling dissimilar materials is mechanical fastening, but it has several drawbacks, such as increased manufacturing processes and the influence of substrate-specific mechanical properties. Adhesive bonding and fusion bonding are methods that overcome the above disadvantages. In these two joining methods, surface pre-treatment of the substrate is always necessary to ensure the strength and durability of the joint. Previous studies have shown that laser surface treatment improves the strength and durability of the joint. Yan et al. showed that laser surface treatment of aluminium alloys changes α-Al2O3 in the oxide layer to γ-Al2O3. As γ-Al2O3 has a large specific surface area, is very porous and chemically active, laser-treated aluminium surfaces are expected to undergo physico-chemical changes over time and adsorb moisture and organic substances from the air or storage atmosphere. The impurities accumulated on the laser-treated surface may be released at the adhesive and bonding interface by the heat input to the bonding system during the joining phase, affecting the strength and durability of the joint. However, only a few studies have discussed the effect of such storage periods on laser-treated surfaces. This paper, therefore, investigates the ageing of laser-treated aluminium alloy surfaces through thermal analysis, electrochemical analysis and microstructural observations.AlMg3 of 0.5 mm and 1.5 mm thickness was cut using a water-jet cutting machine, cleaned and degreased with isopropanol and surface pre-treated with a pulsed fibre laser at 1060 nm wavelength, 70 W maximum power and 55 kHz repetition frequency. The aluminium surface was then analysed using SEM, thermogravimetric analysis (TGA), Fourier transform infrared spectroscopy (FTIR) and cyclic voltammetry (CV) after storage in air for various periods ranging from one day to several months TGA and FTIR analysed impurities adsorbed on the aluminium surface, while CV revealed changes in the true electrochemically active surface area. SEM also revealed visual changes on the treated surface. In summary, the changes in the laser-treated aluminium surface with storage time were investigated, and the final results were used to determine the appropriate storage period.

Keywords: laser surface treatment, pre-treatment, adhesion, bonding, corrosion, durability, dissimilar material interface, automotive, aluminium alloys

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Authors: Victorita Radulescu

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Introduction: The sewage treatment plants, in the second stage, are formed by tanks having as main purpose the formation of the suspensions with high possible solid concentration values. The paper presents a solution to produce a rapid concentration of the slurry and sludge, having as main purpose the minimization as much as possible the size of the tanks. The solution is based on a rotor with bars, tested into two different areas of industrial activity: the remediation of the wastewater from the oil industry and, in the last year, into the mining industry. Basic Methods: It was designed, realized and tested a thickening system with vertical bars that manages to reduce sludge moisture content from 94% to 87%. The design was based on the hypothesis that the streamlines of the vortices detached from the rotor with vertical bars accelerate, under certain conditions, the sludge thickening. It is moved at the lateral sides, and in time, it became sediment. The formed vortices with the vertical axis in the viscous fluid, under the action of the lift, drag, weight, and inertia forces participate at a rapid aggregation of the particles thus accelerating the sludge concentration. Appears an interdependence between the Re number attached to the flow with vortex induced by the vertical bars and the size of the hydraulic compaction phenomenon, resulting from an accelerated process of sedimentation, therefore, a sludge thickening depending on the physic-chemical characteristics of the resulting sludge is projected the rotor's dimensions. Major findings/ Results: Based on the experimental measurements was performed the numerical simulation of the hydraulic rotor, as to assure the necessary vortices. The experimental measurements were performed to determine the optimal height and the density of the bars for the sludge thickening system, to assure the tanks dimensions as small as possible. The time thickening/settling was reduced by 24% compared to the conventional used systems. In the present, the thickeners intend to decrease the intermediate stage of water treatment, using primary and secondary settling; but they assume a quite long time, the order of 10-15 hours. By using this system, there are no intermediary steps; the thickening is done automatically when are created the vortices. Conclusions: The experimental tests were carried out in the wastewater treatment plant of the Refinery of oil from Brazi, near the city Ploiesti. The results prove its efficiency in reducing the time for compacting the sludge and the smaller humidity of the evacuated sediments. The utilization of this equipment is now extended and it is tested the mining industry, with significant results, in Lupeni mine, from the Jiu Valley.

Keywords: experimental tests, hydrodynamic modeling, rotor efficiency, wastewater treatment

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Authors: Paola Millare, Nelinda Catherine Pangilinan

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Background and Aim: Cervical cancer is the most commonly diagnosed gynecological malignancy during pregnancy. Owing to the rarity of the disease, and the complexity of all factors that have to be taken into consideration, standardization of treatment is very difficult. Cervical cancer is the second most common malignancy among women. The treatment of cancer during pregnancy is most challenging in the case of cervical cancer, since the pregnant uterus itself is affected. This report aims to present a case of cervical cancer in a pregnant woman and how to manage this case and several issues accompanied with it. Methods: This is a case of a 28 year-old, Gravida 4 Para 2 (1111), who presented with watery to mucoid, whitish, non-foul smelling and increasing in amount. Internal examination revealed normal external genitalia, parous outlet, cervix was transformed into a fungating mass measuring 5x4 cm, with left parametrial involvement, body of uterus was enlarged to 24 weeks size, no adnexal mass or tenderness. She had cervical punch biopsy, which revealed, adenocarcinoma, well-differentiated cervical tissue. Standard management for cases with stage 2B cervical carcinoma was to start radiation or radical hysterectomy. In the case of patients diagnosed with cervical cancer and currently pregnant, these kind of management will result to fetal loss. The patient still declined the said management and opted to delay the treatment and wait for her baby to reach at least term and proceed to cesarean section as route of delivery. Results: The patient underwent an elective cesarean section at 37th weeks age of gestation, with an outcome of a term, live baby boy APGAR score 7,9 birthweight 2600 grams. One month postpartum, the patient followed up and completed radiotherapy, chemotherapy and brachytherapy. She was advised to go back after 6 months for monitoring. On her last check up, an internal examination was done which revealed normal external genitalia, vagina admits 2 fingers with ease, there is a palpable fungating mass at the cervix measuring 2x2 cm. A repeat gynecologic oncologic ultrasound was done revealing cervical mass, endophytic, grade 1 color score with stromal invasion 35% post radiation reactive lymph nodes with intact paracolpium, pericervical, and parametrial involvement. The patient was then advised to undergo pelvic boost and for close monitoring of the cervical mass. Conclusion: Cervical cancer in pregnancy is rare but is a dilemma for women and their physicians. Treatment should be multidisciplinary and individualized following careful counseling. In this case, the treatment was clearly on the side of preventing the progression of cervical cancer while she is pregnant, however due to ethical reasons, the management deviates on the right of the patient to decide for her own health and her unborn child. The collaborative collection of data relating to treatment and outcome is strongly encouraged.

Keywords: cancer, cervical, ethical, pregnancy

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Authors: Ezman Fitriansyah, Lestari Diah Restu, Wawan

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Adaro coal mine in South Kalimantan-Indonesia maintains catchment area of approximately 15,000 Ha for its mine operation. As an open pit surface coal mine with high erosion rate, the mine water in Adaro coal mine contains high TSS that needs to be treated before being released to rivers. For the treatment process, Adaro operates 21 Settling Ponds equipped with combination of physical and chemical system to separate solids and water to ensure the discharged water complied with regional environmental quality standards. However, the sludge created from the sedimentation process reduces the settling ponds capacity gradually. Therefore regular maintenance activities are required to recover and maintain the ponds' capacity. Trucking system and direct dredging had been the most common method to handle sludge in Adaro. But the main problem in applying these two methods is excessive area required for drying pond construction. To solve this problem, Adaro implements an alternative method called Geotube®. The principle of Geotube® method is the sludge contained in the Settling Ponds is pumped into Geotube® containers which have been designed to release water and retain mud flocks. During the pumping process, an amount of flocculants chemicals are injected into the sludge to form bigger mud flocks. Due to the difference in particle size, the mud flocks are settled in the container whilst the water continues to flow out through the container’s pores. Compared to the trucking system and direct dredging method, this method provides three advantages: space required to operate, increasing of overburden waste dump volume, and increasing of water treatment process speed and quality. Based on the evaluation result, Geotube® method only needs 1:8 of space required by the other methods. From the geotechnical assessment result conducted by Adaro, the potential loss of waste dump volume capacity prior to implementation of the Geotube® method was 26.7%. The water treatment process of TSS in well maintained ponds is 16% more optimum.

Keywords: geotube, mine water, settling pond, sludge handling, wastewater treatment

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Authors: Nathen A. Spitz, Dennis Martin Kivlighan III, Arwa Aburizik

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Background and Purpose: Presently, there is a paucity of naturalistic studies that directly compare the effectiveness of psychotherapy versus concurrent psychotherapy and psychiatric care for the treatment of depression and anxiety in cancer patients. Informed by previous clinical trials examining the efficacy of concurrent approaches, this study sought to test the hypothesis that a combined approach would result in the greatest reduction of depression and anxiety symptoms. Methods: Data for this study consisted of 433 adult cancer patients, with 252 receiving only psychotherapy and 181 receiving concurrent psychotherapy and psychiatric care at the University of Iowa Hospitals and Clinics. Longitudinal PHQ9 and GAD7 data were analyzed between both groups using latent growth curve analyses. Results: After controlling for treatment length and provider effects, results indicated that concurrent care was more effective than psychotherapy alone for depressive symptoms (γ₁₂ = -0.12, p = .037). Specifically, the simple slope for concurrent care was -0.25 (p = .022), and the simple slope for psychotherapy alone was -0.13 (p = .006), suggesting that patients receiving concurrent care experienced a greater reduction in depressive symptoms compared to patients receiving psychotherapy alone. In contrast, there were no significant differences between psychotherapy alone and concurrent psychotherapy and psychiatric care in the reduction of anxious symptoms. Conclusions: Overall, as both psychotherapy and psychiatric care may address unique aspects of mental health conditions, in addition to potentially providing synergetic support to each other, a combinatorial approach to mental healthcare for cancer patients may improve outcomes.

Keywords: psychiatry, psychology, psycho-oncology, combined care, psychotherapy, behavioral psychology

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Authors: Arman Kishan, Sanjay Kubsad, Steve Li, Mark Haft, Duc Nguyen, Dawn Laporte

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Objective: Carpal tunnel syndrome can be managed surgically with endoscopic or open carpal tunnel release (CTR). Rheumatoid arthritis (RA) is a known risk factor for Carpal Tunnel Syndrome (CTS) and is believed to be related to compression of the median nerve secondary to inflammation. We aimed to analyze national trends, outcomes, and patient-specific comorbidities associated with ECTR and OCTR in patients with RA. Methods: A retrospective cohort study was conducted using the PearlDiver database, identifying 683 RA patients undergoing ECTR and 4234 undergoing OCTR between 2010 and 2014. Demographic data, comorbidities, and complication rates were analyzed. Univariate and multivariable analyses assessed differences between the treatment methods. Results:  Patients with RA undergoing ECTR in comparison to OCTR had no significant differences in medical comorbidities such as hypertension, obesity, chronic kidney disease, hypothyroidism and diabetes mellitus. Patients in the ECTR group reported a risk ratio of 1.44 (95%CI: 1.10-1.89, p=0.01) of requiring repeat procedures within 90 days of the initial procedure. Five-year trends in ECTR and OCTR procedures reported a combined annual growth rate of 5.6% and 13.15, respectively. Conclusion: Endoscopic and open approaches to CTR are important considerations in surgical planning. RA and ECTR have previously been identified as independent risk factors for revision CTR. Our study has identified the 90-day risk of repeat procedures to be elevated in the ECTR group in comparison to the OCTR group. Additionally, the growth of OCTR procedures has outpaced the growth of ECTR procedures in the same period, likely in response to the trend of ECTR leading to higher rates of repeat procedures. The need for revision following ECTR in patients with RA could be related to chronic inflammation leading to transverse carpal ligament thickening and concomitant tenosynovitis. Future directions could include further characterization of repeat procedures performed in this subset of patients. 

Keywords: endoscopic treatment of carpal tunnel syndrome, open treatment of carpal tunnel syndrome, rheumatoid arthritis, trends analysis, carpal tunnel syndrome

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Authors: Mohammad K. Parvez, Ahmed H. Arbab, Mohammed S. Al-Dosari

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Cyperus rotendus rhizomes are used as traditional medicine, including Ayurveda in chronic liver diseases and hepatitis B. We investigated the in vitro hepatoprotective and anti-hepatitis B virus (HBV) potential of Cyperus rotundus rhizome organic and aqueous fractions. Of these, the n-butanol and aqueous fractions showed the most promising, dose-dependent hepatoprotection in DCFH-injured HepG2 cells at 48 h. DCFH-toxicated cells were recovered to about 88% and 96%, upon treatment with n-butanol and aqueous fractions (200 g/ml), respectively compared to DCFH-only treated cells. Further, C. rotundus fractions were tested for anti-HBV activities by measuring the expression levels of viral antigens (HBsAg and HBeAg) in the HepG2.2.15 culture supernatants. At 48 h post-treatment, the ethyl acetate, n-butanol and aqueous fractions showed dose-dependent inhibition wherein at a higher dose (100 g/ml), HBsAg production was reduced to 60.27%, 46.87 and 42.76%, respectively. In a time-course study, HBsAg production was inhibited up to 50% and 40% by ethyl acetate and n-butanol fractions (100 g/ml), respectively on day 5. Three three active fractions were further subjected to time-dependent inhibition of HBeAg expression, an indirect measure of HBV active DNA replication. At day 5 post-treatment, ethyl acetate and n-butanol fractions downregulated HBV replication by 44.14% and 24.70%, respectively. In conclusion, our results showed very promising hepatoprotective and anti-HBV potential of C. rotendus tubers fractions in vitro. Our data could, therefore, provide the basis for the claimed traditional use of C. rotendus for jaundice and hepatitis.

Keywords: anti-hepatitis B, cyperus rotundus, hepatitis B virus, hepatoprotection

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Authors: Dalila Oulhaci, Mohammed Zahaf

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The watering technique is essential to maintain a moist perimeter around the roots of the crop. This is the case with topical watering, where the soil around the root system can be kept permanently moist between the two extremes of water content. Moreover, one of the oldest methods used since Roman times throughout North Africa and the Near East was based on the repeated pouring of water into porous earthen vessels buried in the ground. In this context, these two techniques have been combined by replacing the earthen vase with plastic bottles filled with sand which release water through their perforated walls into the surrounding soil. The objective of this work is to first determine the purifying power of the activated sludge treatment plant of Toggourt and then that of the bottled Sawdust filter. For the station, the BOD purification rate was (96.5%), the COD purification rate was (87%) and suspended solids (90%). For the bottle, the BOD removal rate was (35%), and COD removal rate was (12.58%). This work falls within the framework of water saving, sustainable development and environmental protection, and also within the framework of agriculture.

Keywords: wasterwater, sawdust, purification, irrigation, touggourt (Algeria)

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Authors: N. Rambabu, H. Gururaj, Reynold Washington, Oommen George

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Motivation: Under the USAID Strengthening Health Outcomes through Private Sector (SHOPS-TB) initiative, Karnataka Health Promotion Trust (KHPT) with technical support of Abt associates is implementing a TB prevention and care model in Karnataka State, South India. KHPT is the interface agency between the public and private sectors, and providers and the target community facilitating early TB case detection and enhancing treatment compliance through private health care providers (pHCP) engagement in RNTCP. The project coverage is 0.84 million urban poor from 663 slums in 12 districts of Karnataka. Problem Statement: India with the highest burden of global TB (26%) and two million cases annually, accounts for approximately one fifth of the global incidence. WHO estimates 300,000 people die from TB annually in India. India expanded the coverage of Directly Observed Treatment, Short-course chemotherapy (DOTS) to the entire country as early as 2006. However, the performance of RNTCP has not been uniform across states. While the national annual new smear-positive (NSP) case notification rate is 53, it is much lower at 47 in Karnataka. A third of TB patients in India reside in urban slums. Approach: Under SHOPS, KHPT actively engages with communities through key opinion leaders and community structures. Interpersonal communication, by Outreach workers through house-to-house visits and at aggregation points, is the primary method used for communication about TB and its management and to increase demand for sputum examination and DOTS. pHCP are mapped, trained and mentored by KHPT. ORWs also provide patient and family counseling on TB treatment, side effects and adherence, screen close contacts of index patients especially children under 6 years of age and screen co-morbidities including HIV, diabetes and malnutrition and risk factors including alcoholism, tobacco use, occupational hazards making appropriate accompanied or documented referrals. A treatment ‘buddy’ system for the patients involving close friends or family members, ICT-based support, DOTS Prerana (inspiration) groups of TB patients, family members and community, DOTS Mitra (friend) helpline services are also used for care and support services. Results: The intervention educated 39988 slum dwellers, referred 1731 chest symptomatics, tested 1061 patients and initiated 248 patients on anti-TB treatment within three months of intervention through continuous community engagement. Conclusions: The intervention’s potential to increase access to preferred health care providers, reduce patient and health system delays in diagnosis and initiation of treatment, improve health seeking behaviour and enhance compliance of pHCPs to standard treatment protocols is being monitored. Initial results are promising.

Keywords: DOTS, KHPT, health outcomes, public and private sector

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Authors: Hazel James P. Agngarayngay, Arnold R. Elepaño

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Mango is the third most important export fruit in the Philippines. Despite the expanding mango trade in world market, problems on postharvest losses caused by pests and diseases are still prevalent. Many disease control and pest disinfestation methods have been studied and adopted. Heat treatment is necessary to eliminate pests and diseases to be able to pass the quarantine requirements of importing countries. During heat treatments, temperature and time are critical because fruits can easily be damaged by over-exposure to heat. Modeling the process enables researchers and engineers to study the behaviour of temperature distribution within the fruit over time. Understanding physical processes through modeling and simulation also saves time and resources because of reduced experimentation. This research aimed to simulate the heat transfer mechanism and predict the temperature distribution in ‘Carabao' mangoes during hot water treatment (HWT) and extended hot water treatment (EHWT). The simulation was performed in ANSYS CFD Software, using ANSYS CFX Solver. The simulation process involved model creation, mesh generation, defining the physics of the model, solving the problem, and visualizing the results. Boundary conditions consisted of the convective heat transfer coefficient and a constant free stream temperature. The three-dimensional energy equation for transient conditions was numerically solved to obtain heat flux and transient temperature values. The solver utilized finite volume method of discretization. To validate the simulation, actual data were obtained through experiment. The goodness of fit was evaluated using mean temperature difference (MTD). Also, t-test was used to detect significant differences between the data sets. Results showed that the simulations were able to estimate temperatures accurately with MTD of 0.50 and 0.69 °C for the HWT and EHWT, respectively. This indicates good agreement between the simulated and actual temperature values. The data included in the analysis were taken at different locations of probe punctures within the fruit. Moreover, t-tests showed no significant differences between the two data sets. Maximum heat fluxes obtained at the beginning of the treatments were 394.15 and 262.77 J.s-1 for HWT and EHWT, respectively. These values decreased abruptly at the first 10 seconds and gradual decrease was observed thereafter. Data on heat flux is necessary in the design of heaters. If underestimated, the heating component of a certain machine will not be able to provide enough heat required by certain operations. Otherwise, over-estimation will result in wasting of energy and resources. This study demonstrated that the simulation was able to estimate temperatures accurately. Thus, it can be used to evaluate the influence of various treatment conditions on the temperature-time history in mangoes. When combined with information on insect mortality and quality degradation kinetics, it could predict the efficacy of a particular treatment and guide appropriate selection of treatment conditions. The effect of various parameters on heat transfer rates, such as the boundary and initial conditions as well as the thermal properties of the material, can be systematically studied without performing experiments. Furthermore, the use of ANSYS software in modeling and simulation can be explored in modeling various systems and processes.

Keywords: heat transfer, heat treatment, mango, modeling and simulation

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Authors: Suzan Ghaddar, Aline Pinon, Manuel Gallardo-villagran, Mona Diab-assaf, Bruno Therrien, Bertrand Liagre

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Colorectal cancer (CRC) is the third most common cancer and exhibits a consistently rising incidence worldwide. Despite notable advancements in CRC treatment, frequent occurrences of side effects and the development of therapy resistance persistently challenge current approaches. Eventually, innovations in focal therapies remain imperative to enhance the patient’s overall quality of life. Photodynamic therapy (PDT) emerges as a promising treatment modality, clinically used for the treatment of various cancer types. It relies on the use of photosensitive molecules called photosensitizers (PS), which are photoactivated after accumulation in cancer cells, to induce the production of reactive oxygen species (ROS) that cause cancer cell death. Among commonly used metal-based drugs in cancer therapy, ruthenium (Ru) possesses favorable attributes that demonstrate its selectivity towards cancer cells and render it suitable for anti-cancer drug design. In vitro studies using distinct arene-Ru complexes, encapsulating porphin PS, are conducted on human HCT116 and HT-29 colorectal cancer cell lines. These studies encompass the evaluation of the antiproliferative effect, ROS production, apoptosis, cell cycle progression, molecular localization, and protein expression. Preliminary results indicated that these complexes exert significant photocytotoxicity on the studied colorectal cancer cell lines, representing them as promising and potential candidates for anti- cancer agents.

Keywords: colorectal cancer, photodynamic therapy, photosensitizers, arene-ruthenium complexes, apoptosis

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Authors: Mirosław Krzemieniewski, Marcin Zieliński, Marcin Dębowski

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This publication presents a device for depolymerisation of plant substrates applicable to agricultural biogas plants and closed-chamber sewage treatment plants where sludge fermentation is bolstered with plant mass. The device consists of a tank with a cover equipped with a heating system, an inlet for the substrate, and an outlet for the depolymerised substrate. Within the tank, a magnet shaft encased in a spiral casing is attached, equipped on its upper end with an internal magnetic disc. A motoreducer is mounted on an external magnetic disc located on the centre of the cover. Depolymerisation of the plant substrate allows for substrate destruction at much lower power levels than by conventional means. The temperature within the reactor can be lowered by 40% in comparison to existing designs. During the depolymerisation process, free radicals are generated within the magnetic field, oxidizing the conditioned substrate and promoting biodegradation. Thus, the fermentation time in the fermenters is reduced by approximately 20%.

Keywords: depolymerisation, pre-treatment, biomass, fermentation

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Authors: Efe Gumuslu, Guclu Insel, Gülten Yuksek, Nilay Sayi Ucar, Emine Ubay Cokgor, Tuğba Olmez Hanci, Didem Okutman Tas, Fatoş Germirli Babuna, Derya Firat Ertem, Ökmen Yildirim, Özge Erturan, Betül Kirci

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Although water reclamation and reuse are inseparable parts of sustainable production concept all around the world, current levels of reuse constitute only a small fraction of the total volume of industrial effluents. Nowadays, within the perspective of serious climate change, wastewater reclamation and reuse practices should be considered as a requirement. Industrial sector is one of the largest users of water sources. The OECD Environmental Outlook to 2050 predicts that global water demand for manufacturing will increase by 400% from 2000 to 2050 which is much larger than any other sector. Metal finishing industry is one of the industries that requires high amount of water during the manufacturing. Therefore, actions regarding the improvement of wastewater treatment and reuse should be undertaken on both economic and environmental sustainability grounds. Process wastewater can be reused for more purposes if the appropriate treatment systems are installed to treat the wastewater to the required quality level. Recent studies showed that membrane separation techniques may help in solving the problem of attaining a suitable quality of water that allows being recycled back to the process. The metal finishing factory where this study is conducted is one of the biggest white-goods manufacturers in Turkey. The sheet metal parts used in the cookers production have to be exposed to surface pre-treatment processes composed of degreasing, rinsing, nanoceramics coating and deionization rinsing processes, consecutively. The wastewater generating processes in the factory are enamel coating, painting and styrofoam processes. In the factory, the main source of water is the well water. While some part of the well water is directly used in the processes after passing through resin treatment, some portion of it is directed to the reverse osmosis treatment to obtain required water quality for enamel coating and painting processes. In addition to these processes another important source of water that can be considered as a potential water source is rainwater (3660 tons/year). In this study, process profiles as well as pollution profiles were assessed by a detailed quantitative and qualitative characterization of the wastewater sources generated in the factory. Based on the preliminary results the main water sources that can be considered for reuse in the processes were determined as painting and styrofoam processes.

Keywords: enamel coating, painting, reuse, wastewater

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Authors: Fakieh Alrabai

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This study investigated the effects on learner anxiety of anxiety-reducing strategies utilized by English as foreign language teachers in Saudi Arabia. The study was conducted in two stages. In the first stage, sources of foreign language anxiety for Saudi learners of English (N = 596) were identified using The Foreign Language Classroom Anxiety Scale (FLCAS). In the second stage, 465 learners who were divided almost equally into two groups (experimental vs. control) and 12 teachers were recruited. Anxiety-reducing strategies were implemented exclusively in the treatment group for approximately eight weeks. FLCAS was used to assess learners’ FL anxiety levels before and after treatment. Statistical analyses (e.g. ANOVA and ANCOVA) were used to evaluate the study findings. These findings revealed that the intervention led to significantly decreased levels of FL anxiety for learners in the experimental group compared with increased levels of anxiety for those in the control group.

Keywords: communication apprehension, EFL teaching/learning, fear of negative evaluation, foreign language anxiety

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Authors: T. Al-Alawi, N. Shorbaji, E. Rashaidi, M.Alidrisi

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Purpose/Objective(s): The main purpose of this study is to analyze the planning of SBRT treatments for localized prostate cancer with 6FFF and 10FFF energies to see if there is a dosimetric difference between the two energies and how we can increase the plan efficiency and reduce its complexity. Also, to introduce a planning method in our department to treat prostate cancer by utilizing high energy photons without increasing patient toxicity and fulfilled all dosimetric constraints for OAR (an organ at risk). Then toevaluate the target 95% coverage PTV95, V5%, V2%, V1%, low dose volume for OAR (V1Gy, V2Gy, V5Gy), monitor unit (beam-on time), and estimate the values of homogeneity index HI, conformity index CI a Gradient index GI for each treatment plan.Materials/Methods: Two treatment plans were generated for15 patients with localized prostate cancer retrospectively using the CT planning image acquired for radiotherapy purposes. Each plan contains two/three complete arcs with two/three different collimator angle sets. The maximum dose rate available is 1400MU/min for the energy 6FFF and 2400MU/min for 10FFF. So in case, we need to avoid changing the gantry speed during the rotation, we tend to use the third arc in the plan with 6FFF to accommodate the high dose per fraction. The clinical target volume (CTV) consists of the entire prostate for organ-confined disease. The planning target volume (PTV) involves a margin of 5 mm. A 3-mm margin is favored posteriorly. Organs at risk identified and contoured include the rectum, bladder, penile bulb, femoral heads, and small bowel. The prescription dose is to deliver 35Gyin five fractions to the PTV and apply constraints for organ at risk (OAR) derived from those reported in references. Results: In terms of CI=0.99, HI=0.7, and GI= 4.1, it was observed that they are all thesame for both energies 6FFF and 10FFF with no differences, but the total delivered MUs are much less for the 10FFF plans (2907 for 6FFF vs.2468 for 10FFF) and the total delivery time is 124Sc for 6FFF vs. 61Sc for 10FFF beams. There were no dosimetric differences between 6FFF and 10FFF in terms of PTV coverage and mean doses; the mean doses for the bladder, rectum, femoral heads, penile bulb, and small bowel were collected, and they were in favor of the 10FFF. Also, we got lower V1Gy, V2Gy, and V5Gy doses for all OAR with 10FFF plans. Integral dosesID in (Gy. L) were recorded for all OAR, and they were lower with the 10FFF plans. Conclusion: High energy 10FFF has lower treatment time and lower delivered MUs; also, 10FFF showed lower integral and meant doses to organs at risk. In this study, we suggest usinga 10FFF beam for SBRTprostate treatment, which has the advantage of lowering the treatment time and that lead to lessplan complexity with respect to 6FFF beams.

Keywords: FFF beam, SBRT prostate, VMAT, prostate cancer

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Authors: Mohammed Hassan Alshaikhi

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Vocabulary is essential factor of learning and mastering any languages, and it helps learners to communicate with others and to be understood. The aim of this study was to examine whether semantic mapping technique was helpful in terms of improving student's English vocabulary learning comparing to the traditional technique. The students’ age was between 11 and 13 years old. There were 60 students in total who participated in this study. 30 students were in the treatment group (target vocabulary items were taught with semantic mapping). The other 30 students were in the control group (the target vocabulary items were taught by a traditional technique). A t-test was used with the results of pre-test and post-test in order to examine the outcomes of using semantic mapping when teaching vocabulary. The results showed that the vocabulary mastery in the treatment group was increased more than the control group.

Keywords: English language, learning vocabulary, Saudi teachers, semantic mapping, teaching vocabulary strategies

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Authors: Najmeh Hoseini

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Strokerecovery happens through neuroplasticity, which is highly influenced by the environment, including neuro-rehabilitation. Transcranial direct current stimulation (tDCS) may enhance recovery by modulating neuroplasticity. With tDCS, weak direct currents are applied noninvasively to modify excitability in the cortical areas under its electrodes. Combined with functional activities, this may facilitate motor recovery in neurologic disorders such as stroke. The purpose of this case study was to examine the effect of tDCS combined with 30 minutes of traditional physical therapy (PT)on arm function following a stroke. A 29-year-old male with chronic stroke involving the left middle cerebral artery territory went through the treatment protocol. Design The design included 5 weeks of treatment: 1 week of traditional PT, 2 weeks of sham tDCS combined with traditional PT, and 2 weeks of tDCS combined with traditional PT. PT included functional electrical stimulation (FES) of wrist extensors followed by task-specific functional training. Dual hemispheric tDCS with 1 mA intensity was applied on the sensorimotor cortices for the first 20 min of the treatment combined with FES. Assessments before and after each treatment block included Modified Ashworth Scale, ChedokeMcmaster Arm and Hand inventory, Action Research Arm Test (ARAT), and the Box and Blocks Test. Results showed reduced spasticity in elbow and wrist flexors only after tDCS combination weeks (+1 to 0). The patient demonstrated clinically meaningful improvements in gross motor and fine motor control over the duration of the study; however, components of the ARAT that require fine motor control improved the greatest during the experimental block. Average time improvement compared to baseline was26.29 s for tDCS combination weeks, 18.48 s for sham tDCS, and 6.83 for PT standard of care weeks. Combining dual hemispheric tDCS with the standard of care PT demonstrated improvements in hand dexterity greater than PT alone in this patient case.

Keywords: tDCS, stroke, case study, physical therapy

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Authors: Agnieszka Stempniewicz, Piotr Ceranowicz, Wojciech Macyk, Jakub Cieszkowski, Beata Kuśnierz-Cabała, Katarzyna Gałązka, Zygmunt Warzecha

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Objectives: There are numerous strategies for the prevention or treatment of oral mucositis. However, their effectiveness is limited and does not correspond to expectations. Recent studies have shown that obestatin exhibits a protective effect and accelerates the healing of gastrointestinal mucosa. The aim of the present study was to examine the influence of obestatin administration on oral ulcers in rats. Methods: lingual ulcers were induced by the use of acetic acid. Rats were treated twice a day intraperitoneally with saline or obestatin(4, 8, or 16 nmol/kg/dose) for five days. The study determined: lingual mucosa morphology, cell proliferation, mucosal blood flow, and mucosal pro-inflammatory interleukin-1β level(IL-1β). Results: In animals without induction of oral ulcers, treatment with obestatin was without any effect. Obestatin administration in rats with lingual ulcers increased the healing rate of these ulcers. Obestatin given at the dose of 8 or 16 nmol/kg/dose caused the strongest and similar therapeutic effect. This result was associated with a significant increase in blood flow and cell proliferation in gingival mucosa, as well as a significant decrease in IL-1β level. Conclusions: Obestatin accelerates the healing of lingual ulcers in rats. This therapeutic effect is well-correlated with an increase in blood flow and cell proliferation in oral mucosa, as well as a decrease in pro-inflammatory IL-1β levels. Obestatin is a potentially useful candidate for the prevention and treatment of oral mucositis. Acknowledgment: Agnieszka Stempniewicz acknowledges the support of InterDokMed project no. POWR.03.02.00- 00-I013/16.

Keywords: oral mucositis, ulcers, obestatin, lingual mucosa

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Authors: Ling-Lang Huang

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Research Background: Historically, the evolution of medicine has not only aimed to extend life but has also inadvertently introduced suffering in the process of maintaining life, presenting a contemporary challenge. We must carefully assess the conflict between the length of life and the quality of living. Evidence-Based Medicine (EBM) exists primarily to ensure the quality of cures. However, EBM alone does not fulfill our ultimate medical goals; we must also evaluate Value-Based Medicine (VBM) to find the best treatment for patients. Research Methodology: We can attempt to integrate EBM with VBM. Within the five steps of EBM, the first three steps (Ask—Acquire—Appraise) focus on the physical aspect of humans. However, in the fourth and fifth steps (Apply—Assess), the focus shifts from the physical to applying evidence-based treatment to the patient and assessing its effectiveness, considering a holistic approach to the individual. To consider VBM for patients, we can divide the process into three steps: The first step is "awareness," recognizing that each patient inhabits a different life-world and possesses unique differences. The second step is "integration," akin to the hermeneutic concept of the Fusion of Horizons. This means being aware of differences and also understanding the origins of these patient differences. The third step is "respect," which involves setting aside our adherence to medical objectivity and scientific rigor to respect the ultimate healthcare decisions made by individuals regarding their lives. Discussion and Conclusion: After completing these three steps of VBM, we can return to the fifth step of EBM: Assess. Our assessment can now transcend the physical treatment focus of the initial steps to align with a holistic care philosophy.

Keywords: shared decision-making, evidence-based medicine, values-based medicine, holistic healthcare

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Authors: Sharmila Rathee

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Individuals with disability/ies often face negative attitudes, discrimination, exclusion, and inequality of treatment due to stigmatization and stigmatized treatment. While a significant number of studies in field of stigma suggest that group-identification has positive consequences for stigmatized individuals, ironically very miniscule empirical work in sight has attempted to investigate in-group identification as a coping measure against stigma, humiliation and related experiences among disability group. In view of death of empirical research on in-group identification among disability group, through present work, an attempt has been made to examine the experiences of stigma, humiliation, and in-group identification among disability group. Results of the study suggest that use of in-group identification as a coping strategy is not uniform across members of disability group and degree of in-group identification differs across different sub-groups of disability groups. Further, in-group identification among members of disability group depends on variables like degree and impact of disability, factors like onset of disability, nature, and visibility of disability, educational experiences and resources available to deal with disabling conditions.

Keywords: disability, stigma, in-group identification, social identity

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