Search results for: surgical removal

Authors: Loveneet Kaur

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Introduction: Osteoarthritis (OA) is one of the leading causes of disability, and the knee is the most commonly affected joint in the body. The last resort for treatment of knee OA is Total Knee Replacement (TKR) surgery. Despite numerous advances in prosthetic design, patients do not reach normal function after surgery. Current surgical decisions are made on 2D radiographs and patient interviews. Aims: The aim of this study was to compare knee kinematics pre and post-TKR surgery using computer-animated images of patient-specific models under everyday conditions. Methods: 7 subjects were recruited for the study. Subjects underwent 3D gait analysis during 4 everyday activities and medical imaging of the knee joint pre- and one-month post-surgery. A 3D model was created from each of the scans, and the kinematic gait analysis data was used to animate the images. Results: Improvements were seen in a range of motion in all 4 activities 1-year post-surgery. The preoperative 3D images provide detailed information on the anatomy of the osteoarthritic knee. The postoperative images demonstrate potential future problems associated with the implant. Although not accurate enough to be of clinical use, the animated data can provide valuable insight into what conditions cause damage to both the osteoarthritic and prosthetic knee joints. As the animated data does not require specialist training to view, the images can be utilized across the fields of health professionals and manufacturing in the assessment and treatment of patients pre and post-knee replacement surgery. Future improvements in the collection and processing of data may yield clinically useful data. Conclusion: Although not yet of clinical use, the potential application of 3D animations of the knee joint pre and post-surgery is widespread.

Keywords: Orthoporosis, Ortharthritis, knee replacement, TKR

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Authors: Mangala M. Pai, B. V. Murlimanju, Latha V. Prabhu, P. J. Jiji , Vandana Blossom

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Background:To study the morphological parameters of the axis vertebra in anatomical specimens. Methods: The present study was designed to obtain the morphometric data of axis vertebra. The superior and inferior articular facets of the axis were macroscopically observed for their shapes and the different parameters were measured using the digital Vernier caliper. It included 20 dried axis bones, which were obtained from the anatomy laboratory. Results: The morphometric data obtained in the present study are represented in the tables. The side wise comparison of the length and width of the articular facets of the axis vertebra were done. The present study observed that, there is no statistically significant difference observed among the parameters of right and left side articular facets (p>0.05). The superior and inferior articular facets were observed to have variable shapes. The frequencies of different shapes of superior and inferior articular facets are represented in figures. All the shapes of the inferior and superior articular facets were symmetrical over the right and left sides. Among the superior articular facets, the constrictions were absent in 13 cases (65%), 2 (10%) exhibited a single constriction, 3 (15%) had 2 constrictions and 2 (10%) were having 3 constrictions. The constrictions were absent in 11 (55%) of the inferior articular facets, 3 (15%) of them had 1 constriction, 3 (15%) were having 2 constrictions, 2 (10%) exhibited 3 constrictions and 1 (5%) of them had 4 constrictions. The constrictions of the inferior and superior articular facets were symmetrical over the right and left sides. Conclusion: We believe that the present study has provided additional information on the morphometric data of the axis vertebra. The data are important to the neurosurgeons, orthopedic surgeons and radiologists. The preoperative assessment of the axis vertebra may prevent dangerous complications like spinal cord and nerve root compression during the surgical intervention.

Keywords: axis, articular facet, morphology, morphometry

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Authors: Sandipika Gupta

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Objective: Due to admirably low 30-day mortality rates for paediatric cardiac surgery, it is now pertinent to turn towards more intermediate-length outcomes such as morbidities closely associated with these surgeries. One such morbidity, major adverse events (MAE) comprises a group of adverse outcomes associated with paediatric cardiac surgery (e.g. cardiac arrest, major haemorrhage). Methods: This is a retrospective study that analysed the incidence and impact of MAE which was the primary outcome in the UK population. The data was collected in 5 centres between October 2015 and June 2017, amassing 3090 surgical episodes. The incidence and risk factors for MAE, were assessed through descriptive statistical analyses and multivariate logistic regression. The secondary outcomes of life status at 6 months and the length of hospital stay were also evaluated to understand the impact of MAE on patients. Results: Out of 3090 episodes, 134 (4.3%) had a postoperative MAE. The majority of the episodes were in: neonates (47%, P<0.001), high-risk cardiac diagnosis groups (20.1%, P<0.001), episodes with longer 5mes on the bypass (72.4%, P<0.001) and urgent surgeries (57.9%, P<0.001). Episodes reporting MAE also reported longer lengths of stay in hospital (29 days vs 9 days, P<0.001). Furthermore, patients experiencing MAE were at a higher risk of mortality at the 6-month life status check (mortality rates: 29.2% vs 2%, P<0.001).Conclusions: Key risk factors were identified. An important negative impact of MAE was found for patients. The identified risk factors could be used to profile and flag at-risk patients. Monitoring of MAE rates and closer investigation into the care pathway before and after individual MAEs in children’s heart units may lead to a reduction in these terrible events.

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Procedia PDF Downloads 232

Authors: Chanchal Mewar, Shikha Gangil, Yashwant Parihar, Virendra Dhakar, Bharat Modhera

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Biodiesel was prepared from Karanja oil by three step methods: saponification, acidification and esterification. In first step, saponification was done in presence of methanol and KOH or NaOH with Karanja oil. During second step acidification, various acids such as H3PO4, HCl, H2SO4 were used as acid catalyst. In third step, esterification followed by purification was done with various silica sources as Ludox (colloidal silicate) and fumed silica gel. It was found that there was no significant change in density, kinematic viscosity, iodine number, acid value, saponification number, flash point, cloud point, pour point and cetane number after purification by these adsorbents. The objective of this research is the comparison among different adsorbents which were used for the purification of biodiesel. Ludox (colloidal silicate) and fumed silica gel were used as adsorbents for the removal of glycerin from biodiesel and evaluate the effectiveness of biodiesel purity. Furthermore, this study compared the results of distilled water washing also. It was observed that Ludox, fumed silica gel and distilled water produced yield about 93%, 91% and 83% respectively. Highest yield was obtained with Ludox at 100 oC temperature using H3PO4 as acid catalyst and NaOH as base catalyst with methanol, (3:1) alcohol to oil molar ratio in 90 min.

Keywords: biodiesel, three step method, purification, silica sources

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Authors: Anand Prakash Dwivedi, Sounak Kumar Choudhury

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Electric Discharge Machining (EDM) is a well-established and one of the most primitive unconventional manufacturing processes, that is used world-wide for the machining of geometrically complex or hard and electrically conductive materials which are extremely difficult to cut by any other conventional machining process. One of the major flaws, over all its advantages, is its very slow Material Removal Rate (MRR). In order to eradicate this slow machining rate, various researchers have proposed various methods like; providing rotational motion to the tool or work-piece or to both, mixing of conducting additives (such as SiC, Cr, Al, graphite etc) powders in the dielectric, providing vibrations to the tool or work-piece or to both etc. Present work is a comparative study of Rotational and Stationary Tool EDM, which deals with providing rotational motion to the copper tool for the machining of AISI D3 Tool Steel and the results have been compared with stationary tool EDM. It has been found that the tool rotation substantially increases the MRR up to 28%. The average surface finish increases around 9-10% by using the rotational tool EDM. The average tool wear increment is observed to be around 19% due to the tool rotation. Apart from this, the present work also focusses on the recast layer analysis, which are being re-deposited on the work-piece surface during the operation. The recast layer thickness is less in case of Rotational EDM and more for Stationary Tool EDM. Moreover, the cracking on the re-casted surface is also more for stationary tool EDM as compared with the rotational EDM.

Keywords: EDM, MRR, Ra, TWR

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Authors: Jordy Padilla

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The New Jersey Department of Transportation (NJDOT) initiated a research project to install and evaluate Ultra-High-Performance Concrete (UHPC) as an overlay on existing bridges. The project aims to implement UHPC overlays in NJDOT bridge deck strategies for preservation and repair. During design, four bridges were selected for construction. The construction involved the removal of the existing bridge asphalt overlays, partially removing the existing concrete deck surface, and resurfacing the deck with a UHPC overlay. In some cases, a new asphalt riding surface was placed. Additionally, existing headers were replaced with full-depth UHPC. The UHPC overlay is monitored through coring and Non-destructive testing (NDT) to ensure that the interfacial bond is intact and that the desired conditions are maintained. The NDT results show no evidence that the bond between the new UHPC overlay and the existing concrete deck is compromised. Bond strength test data demonstrates that, in general, the desired bond was achieved between UHPC and the substrate concrete, although the results were lower than anticipated. Chloride content is also within expectations except for one anomaly. The baseline testing was successful, and no significant defects were encountered.

Keywords: ultra-high performance concrete, rehabilitation, non-destructive testing

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Authors: Asadullah I. Qazi, Mansoor Ahsan, Zahir Ashraf, Uzair Ahmad

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System identification of an Unmanned Aerial Vehicle (UAV), to acquire its mathematical model, is a significant step in the process of aircraft flight automation. The need for reliable mathematical model is an established requirement for autopilot design, flight simulator development, aircraft performance appraisal, analysis of aircraft modifications, preflight testing of prototype aircraft and investigation of fatigue life and stress distribution etc.  This research is aimed at system identification of a fixed wing UAV by means of specifically designed flight experiment. The purposely designed flight maneuvers were performed on the UAV and aircraft states were recorded during these flights. Acquired data were preprocessed for noise filtering and bias removal followed by parameter estimation of longitudinal dynamics transfer functions using MATLAB system identification toolbox. Black box identification based transfer function models, in response to elevator and throttle inputs, were estimated using least square error   technique. The identification results show a high confidence level and goodness of fit between the estimated model and actual aircraft response.

Keywords: fixed wing UAV, system identification, black box modeling, longitudinal dynamics, least square error

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Authors: Asma Ahmed, Farah Khalid, Sahlah Sohail, Saira Banusokwalla, Sabiha Banu, Inaara Akbar, Safia Awan, Syed Iqbal Azam

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Background and Objectives: The level of knowledge regarding obesity as a disease condition and health-seeking behavior regarding its management is grossly lacking. We present data from our multidisciplinary obesity clinic at the large tertiary care facility in Karachi, Pakistan, to provide baseline profiles and outcomes of patients attending these clinics. Methods: 260 who attended the obesity clinic between June 2018 to March 2020 were enrolled in this study. The analysis included descriptive and ROC analysis to identify the best cut-offs of theanthropometric measurements to diagnose obesity-related comorbid conditions. Results: The majority of the studied population were women (72.3%) and employed(43.7%) with a mean age of 35.5 years. Mean BMIwas 37.4, waist circumference was 112.4 cm, visceral fat was 11.7%, and HbA1C was 6.9%. The most common comorbidities were HTN & D.M (33 &31%, respectively). The prevalence of MetS was 16.3% in patients and was slightly higher in males. Visceral fat was the main factor in predicting D.M (0.750; 95% CI: 0.665, 0.836) and MetS (0.709; 95% CI: 0.590, 0.838) compared to total body fat, waist circumference, and BMI. The risk of predicting DM &MetS for the visceral fat above 9.5% in women had the highest sensitivity (80% for D.M & 79% for MetS) and an NPV (92.75% for D.M & 95% for MetS). Conclusions: This study describes and establishes characteristics of these obese individuals, which can help inform clinical practices. These practices may involve using visceral fat for earlier identification and counseling-based interventions to prevent more severe surgical interventions down the line.

Keywords: obesity, metabolic syndrome, tertiary care facility, BMI, waist circumference, visceral fat

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Authors: F. Javier Benitez, Juan L. Acero, Francisco J. Real, Elena Rodriguez

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Five selected pollutants which are frequently present in waters and wastewaters have been degraded by the advanced oxidation process constituted by UV radiation activated with the additional presence of persulfate (UV/PS). These pollutants were 1H-benzotriazole (BZ), N,N-diethyl-m-toluamide or DEET (DT), chlorophene (CP), 3-methylindole (ML), and nortriptyline hydrochloride (NH).While UV radiation alone almost not degraded these substances, the addition of PS generated the very reactive and oxidizing sulfate radical SO₄⁻. The kinetic study provided the second order rate constants for the reaction between this radical and each pollutant. An increasing dose of PS led to an increase in the degradation rate, being the highest results obtained at near neutral pH. Several water matrices were tested, and the presence of bicarbonate showed different effects: a decrease in the elimination of DT, BZ, and NH; and an increase in the oxidation of CP and ML. The additional presence of humic acids (AH) decreased this degradation, because of several effects: light screening and radical scavenging. The presence of several natural substances in waters (both types, inorganic and organic matter) usually diminishes the oxidation rates of organic pollutants, but this combination UV/PS process seems to be an efficient solution for the removal of the selected contaminants when are present in contaminated waters.

Keywords: water purification, UV activated persulfate, kinetic study, sulfate radicals

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Authors: Darma Putra Sitepu, Dewi Larasati, Yohanes Wolter Hendrik George

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Sepsis is a life-threatening medical emergency frequently observed in intensive care unit (ICU). Surviving Sepsis Campaign in 2018 has recommended the administration of early vasopressor in the first hour of sepsis or septic shock but has not yet included de-resuscitation protocol. De-resuscitation in acute management of septic shock is where patient received active removal of accumulated fluid. It has been proposed by some studies and ongoing clinical trials. Here we present a case with early vasopressor and de-resuscitation. Male, 27 years old presenting to the emergency room with shortness of breath, altered mental status, and widespread blisters on his body and lips started a few hours prior, after receiving non-steroidal anti-inflammatory drug through intravenous injection. Patient was hypotensive, tachycardic, and tachypneic at admission, diagnosed with Steven Johnson Syndrome with Septic Shock. Patient received fluid resuscitation, early vasopressor, and diuresis agent aimed to actively remove fluid after the initial phase of resuscitation. Patient was admitted to ICU and progressively recovering. At day-10, patient was stabilized and was transferred to general ward. Early vasopressor and de-resuscitation are beneficial for the patient.

Keywords: sepsis, shock, de-resuscitation, vasopressor, fluid, case report

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Authors: Nanxi Miao, Junjie Wang

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The discovery of 2D materials with distinct compositions and properties has been a research aim since the report of graphene. One of the latest members of the 2D material family is MXene, which is produced from the topochemical deintercalation of the A layer from a laminate MAX phase. Recently, analogous 2D MBenes (transitional metal borides) have been predicted by theoretical calculations as excellent alternatives in applications such as metal-ion batteries, magnetic devices, and catalysts. However, the practical applications of two-dimensional (2D) transition-metal borides (MBenes) have been severely hindered by the lack of accessible MBenes because of the difficulties in the selective etching of traditional ternary MAB phases with orthorhombic symmetry (ort-MAB). Here, we discover a family of ternary hexagonal MAB (h-MAB) phases and 2D hexagonal MBenes (h-MBenes) by ab initio predictions and experiments. Calculations suggest that the ternary h-MAB phases are more suitable precursors for MBenes than the ort-MAB phases. Based on the prediction, we report the experimental synthesis of h-MBene HfBO by selective removal of in from h-MAB Hf2InB2. The synthesized 2D HfBO delivered a specific capacity of 420 mAh g-1 as an anode material in lithium-ion batteries, demonstrating the potential for energy-storage applications. The discovery of this h-MBene HfBO added a new member to the growing family of 2D materials and provided opportunities for a wide range of novel applications.

Keywords: 2D materials, DFT calculations, high-throughput screening, lithium-ion batteries

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Authors: S. Jaramillo, Y. Montoya, W. Agudelo, J. Bustamante

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Cardiovascular diseases (CVD) are related to affectations of the heart and blood vessels, within these are pathologies such as coronary or peripheral heart disease, caused by the narrowing of the vessel wall (atherosclerosis), which is related to the accumulation of Low-Density Lipoproteins (LDL) in the arterial walls that leads to a progressive reduction of the lumen of the vessel and alterations in blood perfusion. Currently, the main therapeutic strategy for this type of alteration is drug treatment with statins, which inhibit the enzyme 3-hydroxy-3-methyl-glutaryl-CoA reductase (HMG-CoA reductase), responsible for modulating the rate of cholesterol production and other isoprenoids in the mevalonate pathway. This enzyme induces the expression of LDL receptors in the liver, increasing their number on the surface of liver cells, reducing the plasma concentration of cholesterol. On the other hand, when the blood vessel presents stenosis, a surgical procedure with vascular implants is indicated, which are used to restore circulation in the arterial or venous bed. Among the materials used for the development of vascular implants are Dacron® and Teflon®, which perform the function of re-waterproofing the circulatory circuit, but due to their low biocompatibility, they do not have the ability to promote remodeling and tissue regeneration processes. Based on this, the present research proposes the development of a hydrolyzed collagen and polyethylene oxide electrospun membrane reinforced with medium and high-intensity statins, so that in future research it can favor tissue remodeling processes from its microarchitecture.

Keywords: atherosclerosis, medium and high-intensity statins, microarchitecture, electrospun membrane

Procedia PDF Downloads 137

Authors: Lakmali Anthony, Madeline Gillies

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Purpose: Decreasing mortality has led to increased focus on patient-reported outcomes such as quality of life (QoL) in breast cancer. Breast cancer patients often have decreased QoL even after treatment is complete. This systematic review of the literature aims to identify psychosocial factors associated with decreased QoL in post-treatment breast cancer patients. Methodology: This systematic review was performed in accordance with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations. The search was conducted in MEDLINE, EMBASE, and PsychINFO using MeSH headings. The two authors screened studies for relevance and extracted data. Results: Seventeen studies were identified, including 3,150 total participants (mean = 197) with a mean age of 51.9 years. There was substantial heterogeneity in measures of QoL. The most common was the European Organisation for Research and Treatment of Cancer QLQ-C30 (n=7, 41.1%). Most studies (n=12, 70.5%) found that emotional distress correlated with poor QoL, while 3 found no significant association. The most common measure of emotional distress was the Hospital Anxiety and Depression Scale (n=12, 70.5%). Other psychosocial factors associated with QoL were unmet needs, problematic social support, and negative affect. Clinicopathologic determinants included mastectomy without reconstruction, stage IV disease, and adjuvant chemotherapy. Conclusion: This systematic review provides a summary of the psychosocial determinants of poor QoL in post-treatment breast cancer patients, as well as the most commonly reported measures of these. An understanding of these potentially modifiable determinants of poor outcome is pivotal to the provision of quality, patient-centred care in surgical oncology.

Keywords: breast cancer, quality of life, psychosocial determinants, cancer surgery

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Authors: Gerard Bray, Derek Mao, Arya Bahadori, Sachinka Ranasinghe

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The EAU currently recommends partial nephrectomy as the preferred management for localised cT1 renal tumours, irrespective of surgical approach. With the advent of robotic assisted partial nephrectomy, there is growing evidence that warm ischaemia time may be reduced compared to the traditional laparoscopic approach. There is still no clear differences between the two approaches with regards to other peri-operative and oncological outcomes. Current limitations in the field denote the lack of single surgeon series to compare the two approaches as other studies often include multiple operators of different experience levels. To the best of our knowledge, this study is the first single surgeon series comparing peri-operative outcomes of robotic assisted and laparoscopic PN. The current study aims to reduce intra-operator bias while maintaining an adequate sample size to assess the differences in outcomes between the two approaches. We retrospectively compared patient demographics, peri-operative outcomes, and renal function derangements of all partial nephrectomies undertaken by a single surgeon with experience in both laparoscopic and robotic surgery. Warm ischaemia time, length of stay, and acute renal function deterioration were all significantly reduced with robotic partial nephrectomy, compared to laparoscopic nephrectomy. This study highlights the benefits of robotic partial nephrectomy. Further prospective studies with larger sample sizes would be valuable additions to the current literature.

Keywords: partial nephrectomy, robotic assisted partial nephrectomy, warm ischaemia time, peri-operative outcomes

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Authors: Brang Mai Lazing

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The central argument of this paper proposes that while democracy cannot guarantee transparency, authentic transparency within the hierarchy of the Church can be pursued as a means of dealing with cases of clergy sexual abuse. Amid the recent global scandal of clergy sexual abuse cases, a previous study has argued that a democratic rule should be applied to the administration of the Church so that, while a democratic Church could be compelled to exercise greater transparency when handling such cases, the Church might thereby regain credibility. Using the methodology of literature analysis, this paper explores the necessity for hierarchy and finds that democracy cannot be a guarantee for transparency. Further, through a dialogue between the theological insights of Benedict XVI and Edward Schillebeeckx, this paper argues that transparency practices are possible within the hierarchy of the Catholic Church in dealing with clergy sexual abuse cases. Finally, three implications of transparency in dealing with clergy sexual abuse cases are proposed, viz.: (a) that the harm which is ultimately done to the sacred faith of believers and to the sacred origin of the hierarchy through clergy sexual abuse cases should be given greater emphasis, (b) that the removal of unnecessary layers within the Church hierarchy or replacement with layers empowered with the authority to effect change might help implement accountability and transparency practices, and (c) that any changes made to enhance transparency should be made in terms of ‘adaptability’.

Keywords: Benedict XVI, clergy sexual abuses, democracy, Edward Schillebeeckx, hierarchy, transparency

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Authors: V. Veena, Suguna Yesodharan, E. P. Yesodharan

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Two Advanced Oxidation Processes (AOP) i.e., sono- and photo-catalysis mediated by semiconductor oxide catalyst, ZnO has been found effective for the removal of trace amounts of the toxic dye pollutant Indigocarmine (IC) from water. The effect of various reaction parameters such as concentration of the dye, catalyst dosage, temperature, pH, dissolved oxygen etc. as well as the addition of oxidisers and presence of salts in water on the rate of degradation has been evaluated and optimised. The degradation follows variable kinetics depending on the concentration of the substrate, the order of reaction varying from 1 to 0 with increase in concentration. The reaction proceeds through a number of intermediates and many of them have been identified using GCMS technique. The intermediates do not affect the rate of degradation significantly. The influence of anions such as chloride, sulphate, fluoride, carbonate, bicarbonate, phosphate etc. on the degradation of IC is not consistent and does not follow any predictable pattern. Phosphates and fluorides inhibit the degradation while chloride, sulphate, carbonate and bicarbonate enhance. Adsorption studies of the dye in the absence as well as presence of these anions show that there may not be any direct correlation between the adsorption of the dye on the catalyst and the degradation. Oxidants such as hydrogen peroxide and persulphate enhance the degradation though the combined effect and it is less than the cumulative effect of individual components. COD measurements show that the degradation proceeds to complete mineralisation. The results will be presented and probable mechanism for the degradation will be discussed.

Keywords: AOP, COD, indigocarmine, photocatalysis, sonocatalysis

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Authors: Adila Shaukat, Hussam Al Soub, Muna Al Maslamani, Abdullatif Al Khal

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Background: The aim of this study was to assess clinical presentation and antimicrobial susceptibility of Streptococcus (S.) anginosus group infections in Hamad General Hospital, a tertiary care hospital in the state of Qatar, which is a multinational community. The S. anginosus group is a subgroup of viridans streptococci that consist of 3 different species: S. anginosus, S. constellatus, and S. intermedius. Although a part of the human bacteria flora, they have potential to cause suppurative infections. Method: We studied a total of 101 patients with S. anginosus group infections from January 2006 until March 2012 by reviewing medical records and identification of organisms by VITEK 2 and MALDI-TOF. Results: The most common sites of infection were skin and soft tissue, intra-abdominal, and bacteremia (28.7%, 24.8%, and 22.7%, respectively). Abscess formation was seen in approximately 30% of patients. Streptococcus constellatus was the most common isolated species (40%) followed by S. anginosus(30%) and S. intermedius(7%). In 23% of specimens, the species was unidentified. The most common type of specimen for organism isolation was blood followed by pus and tissue (50%, 22%, and 8%, respectively). Streptococcus constellatus was more frequently associated with abdominal and skin and soft tissue infections than the other 2 species, whereas S. anginosus was isolated more frequently from blood. All isolates were susceptible to penicillin, ceftriaxone, and vancomycin. Susceptibility to erythromycin and clindamycin was also good, reaching 91% and 95%, respectively. Forty percent of patients needed surgical drainage along with antibiotic therapy. Conclusions: Identification of S. anginosus group to species level is helpful in clinical practice because different species exhibit different pathogenic potentials.

Keywords: abscess, bacterial infection, bacteremia, Streptococcus anginosus

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Authors: Fikri Turk, Sahika Pinar Akyer, Mevci Ozdemir, Mehmet Bulent Ozdemir, Ilgaz Akdogan

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The complications such as bleeding, thrombosis and air embolism depend on injuries emissary veins is often encountered in surgery. Detailed descriptions of the mastoid foramen, occipital foramen, parietal foramen, posterior condylar canal and foramen vesalius are lacking in the literature. For this reason, the purpose of our study was to explore and represent the morphology and morphometry of these emissary foramina in order to prevent complications and to guide for surgeons. The present study was made on 60 dry human skull in the laboratories of Pamukkale University, Faculty of Medicine Department of Anatomy. After taken photograph of emissary foramens by Canon 650D professional camera, the evaluation and measurement’s these foramens made with Matlab program by computer. The overall prevalence of mastoid foramen was 90.52%, occipital foramen was 72.52%, parietal foramen was 42.85%, posterior condylar canal was 91.25% and foramen vesalius was 78.26%. The mean diameter of the mastoid foramen was 1.81±0.76 mm, occipital foramen was 1.20±0.25 mm, parietal foramen was 1.49±0.46 mm, posterior condylar canal was 2.83±1.33 mm and foramen vesalius was 1.74±0.60 mm. Distances between emissary foramina and fixed bony landmarks were measured. Emissary veins are important in clinic practice and surgical procedures because they act a route of spread of exracranial infection to the intracranial structures and these veins may be a significant bleeding during surgery of the skull and they can be source of thrombosis and air embolism. The detailed anatomical knowledge of these veins and foraminas may help to prevent complications and to guide for surgeons.

Keywords: emissary foramina, mastoid foramen, occipital foramen, parietal foramen, posterior condylar canal, foramen vesalius, morphology, morphometry

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Authors: Atul Kumar, Veeranjaneyulu Gannedi, Qazi Naveed Ahmed

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Oligosaccharides, which are essential to all cellular organisms, play vital roles in cell recognition, signaling, and are involved in a broad range of biological processes. The chemical synthesis of carbohydrates represents a powerful tool to provide homogeneous glycans. In carbohydrate synthesis, the major concern is the orthogonal protection of hydroxyl groups that can be unmasked independently. Classical protecting groups include benzyl ethers (Bn), which are normally cleaved through hydrogenolysis or by means of metal reduction, and acetate (Ac), benzoate (Bz) or pivaloate esters, which are removed using base promoted hydrolysis. In present work a series of α-Oxoester (COBz) protected saccharides, with divergent base sensitivity profiles against benzoyl (Bz) and acetyl (Ac), were designed and KHSO₅/CH₃COCl in methanol was identified as an easy, mild, selective and efficient deprotecting reagent for their removal in the perspective of carbohydrate synthesis. Timely monitoring of later reagent was advantageous in establishing both sequential as well as simultaneous deprotecting of COBz, Bz, and Ac. The salient feature of our work is its ease to generate different acceptors using designed monosaccharides. In summary, we demonstrated α-Oxoester (COBz) as a new protecting group for carbohydrates and the application of this group for the synthesis of Glycosylphosphatidylinositol (GPI) anchor are in progress.

Keywords: α-Oxoester, oligosaccharides, new protecting group, acceptor synthesis, glycosylation

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Authors: Mishell Vaca, Gema Gonzales, Francisco Quiroz

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Heavy metals present in wastewater constitute a danger for living beings in general. In Ecuador, one of the sources of contamination is artisanal mining whose liquid effluents, in many of the cases without prior treatment, are discharged to the surrounding rivers. Lead is a pollutant that accumulated in the body causes severe health effects. Nowadays, there are several treatment methods to reduce this pollutant. The aim of this study is to reduce the concentration of lead II through the use of a porous material formed by a matrix of chitosan, in which hydroxyapatite and moringa particles smaller than 53 um are suspended. These materials are not toxic to the environment, and each one adsorbs metals independently, so the synergic effect between them will be evaluated. The synthesized material has a cylindrical design that allows increasing the surface area, which is expected to have greater capacity of adsorption. It has been determined that the best conditions for its preparation are to dissolve the chitosan in 1% v/v acetic acid with a pH = 5, then the hydroxyapatite and moringa are added to the mixture with magnetic stirring. This suspension is frozen, lyophilized and finally dried. In order to evaluate the performance of the synthesized material, synthetic solutions of lead are prepared at different concentrations, and the percentage of removal is evaluated. It is expected to have an effluent whose lead content is less than 0.2 mg/L which is the limit maximum allowable according to established environmental standards.

Keywords: adsorption, chitosan, hydroxyapatite, lead, moringa, water treatment

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Authors: Vignesh Ratnaraj, Jaewon Chang

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Background: Frailty is associated with poorer outcomes in cardiac surgery, but the heterogeneity in frailty assessment tools makes it difficult to ascertain its true impact in cardiac surgery. Slow gait speed is a simple, validated, and reliable marker of frailty. We performed a systematic review and meta-analysis to examine the effect of slow gait speed on postoperative cardiac surgical patients. Methods: PubMED, MEDLINE, and EMBASE databases were searched from January 2000 to August 2021 for studies comparing slow gait speed and “normal” gait speed. The primary outcome was in-hospital mortality. Secondary outcomes were composite mortality and major morbidity, AKI, stroke, deep sternal wound infection, prolonged ventilation, discharge to a healthcare facility, and ICU length of stay. Results: There were seven eligible studies with 36,697 patients. Slow gait speed was associated with an increased likelihood of in-hospital mortality (risk ratio [RR]: 2.32; 95% confidence interval [CI]: 1.87–2.87). Additionally, they were more likely to suffer from composite mortality and major morbidity (RR: 1.52; 95% CI: 1.38–1.66), AKI (RR: 2.81; 95% CI: 1.44–5.49), deep sternal wound infection (RR: 1.77; 95% CI: 1.59–1.98), prolonged ventilation >24 h (RR: 1.97; 95% CI: 1.48–2.63), reoperation (RR: 1.38; 95% CI: 1.05–1.82), institutional discharge (RR: 2.08; 95% CI: 1.61–2.69), and longer ICU length of stay (MD: 21.69; 95% CI: 17.32–26.05). Conclusion: Slow gait speed is associated with poorer outcomes in cardiac surgery. Frail patients are twofold more likely to die during hospital admission than non-frail counterparts and are at an increased risk of developing various perioperative complications.

Keywords: cardiac surgery, gait speed, recovery, frailty

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Authors: Z. Younsi, L. Koufi, H. Gidik, D. Lahem, W. Wim Thielemans

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This study investigated the efficiency of photocatalytic textile to remove the Volatile Organic Compounds (VOCs) present in indoor air. Functionalization of the fabric was achieved by adding a photocatalyst material active in the visible spectrum of light. This is a modified titanium dioxide photocatalyst doped with non-metal ions synthesized via sol-gel process, which should allow the degradation of the pollutants – ideally into H₂O and CO₂ – using photocatalysis based on visible light and no additionnal external energy source. The visible light photocatalytic activity of textile sample was evaluated for toluene and benzene gaseous removal, under the visible irradiation, in a test chamber with the total volume of 1m³. The suggested approach involves experimental investigations of the global behavior of the photocatalytic textile. The experimental apparatus permits simultaneous measurements of the degradation of pollutants and presence of eventually formed by-products. It also allows imposing and measuring concentration variations with respect to selected time scales in the test chamber. The observed results showed that the amount of TiO₂ incorporation improved the photocatalytic efficiency of functionalized textile significantly under visible light. The results obtained with such textile are very promising.

Keywords: benzene, C₆H₆, efficiency, photocatalytic degradation, textile fabrics, titanium dioxide, TiO₂, toluene, C₇H₈, visible light

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Authors: Yee Hui Lim, Elena Gusareva, Irvan Luhung, Yulia Frank, Stephan Christoph Schuster

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Environmental pollution from microplastics (MPs) is an emerging concern worldwide. While the presence of microplastics has been well established in the marine and terrestrial environments, the prevalence of microplastics in the atmosphere is still poorly understood. Wet depositions such as rain or snow scavenge impurities from the atmosphere as it falls to the ground. These wet depositions serve as a useful tool in the removal of airborne particles that are suspended in the air. Therefore, the aim of this study is to investigate the presence of atmospheric microplastics and fibres through the analysis of air, rainwater and snow samples. Air samples were collected with filter-based air samplers from outdoor locations in Singapore. The sampling campaigns were conducted during and after each rain event. Rainwater samples from Singapore and Siberia were collected as well. Snow samples were also collected from Siberia as part of the ongoing study. Genomic DNA was then extracted from the samples and sequenced with shotgun metagenomics approach. qPCR analysis was conducted to quantify the total bacteria and fungi in the air, rainwater and snow samples. The results compared the bioaerosol profiles of all the samples. To observe the presence of microplastics, scanning electron microscope (SEM) was used. From the preliminary results, microplastics were detected. It can be concluded that there is a significant amount of atmospheric microplastics present, and its occurrence should be investigated in greater detail.

Keywords: atmospheric microplastics, metagenomics, scanning electron microscope, wet deposition

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Authors: Ederaldo Godoy Junior, Ricardo O. Jesus, Pedro H. Jesus, José R. Camargo, Jorge Y. Oliveira, Nicoly Milhardo Lourenço

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This work aimed at the comparative study of the quality and quantity of biogas produced by archaea strain Methanothrix soehngenii operating in different versions of anaerobic digesters upflow sludge bed in the brewery wastewater treatment in Brazil in the tropical region. Four types of UASB digesters were studied made of different geometries and materials which are: a UASB IC steel 20 meters high; a circular UASB steel 6 meters high; an UASB reinforced concrete lined with geomembrane PEAB with 6 meters high; and finally a UASB plug flow comprising two UASB in serious rotomolded HDPE 6 meters high.Observed clearly that the biogas produced in the digester UASB steel H2S concentrations had values lower than the HDPE. With respect to efficiency in short time, the UASB IC showed the best results to absorb overloads, as the UASB circular steel showed an efficiency of 90% removal of the organic load. The UASB system plug flow in HDPE showed the lowest cost of deployment, and its efficiency in removing the organic load was 80%.

Keywords: biogas, achaeas, UASB, Brewery effluent

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Authors: Mostafa Mabrouk, Basma E. Abdel-Ghany, Mona Moaness, Bothaina M. Abdel-Hady, Hanan H. Beherei

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Tissue engineering became a promising field for bone repair and regenerative medicine in which cultured cells, scaffolds and osteogenic inductive signals are used to regenerate tissues. The annual cost of treating bone defects in Egypt has been estimated to be many billions, while enormous costs are spent on imported bone grafts for bone injuries, tumors, and other pathologies associated with defective fracture healing. The current study is aimed at developing a more strategic approach in order to speed-up recovery after bone damage. This will reduce the risk of fatal surgical complications and improve the quality of life of people affected with such fractures. 3D scaffolds loaded with cheap nano-particles that possess an osteogenic effect were prepared by nano-electrospinning. The Microstructure and morphology characterizations of the 3D scaffolds were monitored using scanning electron microscopy (SEM). The physicochemical characterization was investigated using X-ray diffractometry (XRD) and infrared spectroscopy (IR). The Physicomechanical properties of the 3D scaffold were determined by a universal testing machine. The in vitro bioactivity of the 3D scaffold was assessed in simulated body fluid (SBF). The bone-bonding ability of novel 3D scaffolds was also evaluated. The obtained nanofibrous scaffolds demonstrated promising microstructure, physicochemical and physicomechanical features appropriate for enhanced bone regeneration. Therefore, the utilized nanomaterials loaded with the drug are greatly recommended as cheap alternatives to growth factors.

Keywords: bone regeneration, cheap scaffolds, nanomaterials, active molecules

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Authors: Derlis Gregor, Kevin Cikel, Mario Arzamendia, Raúl Gregor

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This paper presents a self-sustaining mobile system for counting and classification of vehicles through processing video. It proposes a counting and classification algorithm divided in four steps that can be executed multiple times in parallel in a SBC (Single Board Computer), like the Raspberry Pi 2, in such a way that it can be implemented in real time. The first step of the proposed algorithm limits the zone of the image that it will be processed. The second step performs the detection of the mobile objects using a BGS (Background Subtraction) algorithm based on the GMM (Gaussian Mixture Model), as well as a shadow removal algorithm using physical-based features, followed by morphological operations. In the first step the vehicle detection will be performed by using edge detection algorithms and the vehicle following through Kalman filters. The last step of the proposed algorithm registers the vehicle passing and performs their classification according to their areas. An auto-sustainable system is proposed, powered by batteries and photovoltaic solar panels, and the data transmission is done through GPRS (General Packet Radio Service)eliminating the need of using external cable, which will facilitate it deployment and translation to any location where it could operate. The self-sustaining trailer will allow the counting and classification of vehicles in specific zones with difficult access.

Keywords: intelligent transportation system, object detection, vehicle couting, vehicle classification, video processing

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Authors: Hannah Nagel, Hayley Lang, Albert Sole Guitart, Natasha Lean, Rachel Allavena, Cleide Sprohnie-Barrera, Alex Young

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Aggressive neoplasia of the hoof is a rare occurrence in horses and has been only sporadically described in the literature. In the few cases reported intra-hoof wall, aggressive neoplasia has been documented radiographically and has been described with variable imaging characteristics. These include a well-defined osteolytic area, a smoothly outlined semi-circular defect, an extensive draining tract beneath the hoof wall, as well as an additional large area of osteolysis or an extensive central lytic region. A 20-year-old Quarterhorse gelding and a 10-year-old Thoroughbred gelding were both presented for chronic reoccurring lameness in the left forelimb and left hindlimb, respectively. Both of the cases displayed radiographic lesions that have been previously described but also displayed osteoproliferative expansile regions of additional bone formation. Changes associated with hoof neoplasia are often non-specific due to the nature and capacity of bone to react to pathological insult, which is either to proliferate or be absorbed. Both cases depict and describe imaging findings seen on radiography, contrast radiography, computed tomography, and magnetic resonance imaging before reaching a histological diagnosis of malignant melanoma and squamous cell carcinoma. Although aggressive hoof wall neoplasia is rare, there are some imaging features which may raise our index of suspicion for an aggressive hoof wall lesion. This case report documents two horses with similar imaging findings who underwent multiple assessments, surgical interventions, and imaging modalities with a final diagnosis of malignant neoplasia.

Keywords: horse, hoof, imaging, radiography, neoplasia

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Authors: M. G. Mostafa, Manjushree Chowdhury, Tapan Kumar Biswas, , Ananda Kumar Saha

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This study focused on effluents characterization and treatment process to reduce of toxicity from tannery effluents. Tanning industry is one of the oldest industries in the world. It is typically characterized as pollutants generated industries which produce wide varieties of high strength toxic chemicals. The study was conducted during the year 2008 to 2009 and the tannery effluents were collected three times in a year from the outlet of some selected leather industries located in Hagaribagh industrial zone Dhaka, Bangladesh. The analysis results of the raw effluents reveal that the effluents were yellowish-brown color, having basic pH, very high value of BOD5¬¬, COD, TDS, TSS, TS, and high concentrations of Cr, Na, SO42-, Cl- and other organic and inorganic constituents. The tannery effluents were treated with various doses of FeCl3 after settling and a subsequent filtration through sand-stone. The study observed that coagulant (FeCl3) 150 mg/L dose around neutral pH showed the best removal efficiency for major physico-chemical parameters. The analysis results of illustrate that the most of the physical and chemical parameters were found well below the prescribed permissible limits for effluent discharged. The study suggests that tannery effluents could be treated by a combined process consisting of settling, filtering and coagulating with FeCl3.

Keywords: characterization, effluent, tannery, treatment

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Authors: Ilana Margalith, Yaron Niv

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One of the most important factors of professional health treatment is teamwork, in which each discipline contributes its expert knowledge, thus ensuring quality and a high standard of care as well as efficient communication (one of the International Patient Safety Goals). However, in most countries, students are educated separately by each health discipline. They are exposed to teamwork only during their clinical experience, which in some cases is short and skill-oriented. In addition, health organizations in most countries are hierarchical and although changes have occurred in the hierarchy of the medical system, there are still disciplines that underrate the unique contributions of other health professionals, thus, young graduates of health professions develop and base their perception of their peers from other disciplines on insufficient knowledge. In order to establish a wide-ranging perception among nursing students as to the contribution of different health professionals to the health of their patients, students at the Clalit Nursing Academy, Rabin Campus (Dina), Israel, participated in an interdisciplinary clinical discussion with students from several different professions, other than nursing, who were completing their clinical experience at Rabin Medical Center in medicine, health psychology, social work, audiology, physiotherapy and occupational therapy. The discussion was led by a medical-surgical nursing instructor. Their tutors received in advance, a case report enabling them to prepare the students as to how to present their professional theories and interventions regarding the case. Mutual stimulation and acknowledgment of the unique contribution of each part of the team enriched the nursing students' understanding as to how their own nursing interventions could be integrated into the entire process towards a safe and speedy recovery of the patient.

Keywords: health professions' students, interdisciplinary clinical discussion, nursing education, patient safety

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Authors: O. O. Onafowokan, K. Anderson, M. R. Norton, R. G. Middleton

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Revision total hip arthroplasty (THA) is known to be a challenging procedure with potential for poor outcomes. Due to its lack of metaphyseal encroachment, hip resurfacing arthroplasty (HRA) is classified as a bone conserving procedure. Although the literature postulates that this is an advantage at time of revision surgery, there is no evidence to either support or refute this claim. We identified 129 hips that had undergone HRA and 129 controls undergoing first revision THA. We recorded the clinical assessment and survivorship of implants in a multi-surgeon, single centre, retrospective case control series for both arms. These were matched for age and sex. Data collected included demographics, indications for surgery, Oxford Hip Score (OHS), length of surgery, length of hospital stay, blood transfusion, implant complexity and further surgical procedures. Significance was taken as p < 0.05. Mean follow up was 7.5 years (1 to 15). There was a significant 6 point difference in postoperative OHS in favour of the revision resurfacing group (p=0.0001). The revision HRA group recorded 48 minutes less length of surgery (p<0.0001), 2 days less in length of hospital stay (p=0.018), a reduced need for blood transfusion (p=0.0001), a need for less complexity in revision implants (p=0.001) and a reduced probability of further surgery being required (P=0.003). Whilst we acknowledge the limitations of this study our results suggest that, in contrast to THA, the bone conservation element of HRA may make for a less traumatic revision procedure with better functional outcomes. Use of HRA has seen a dramatic decline as a result of concerns regarding metallosis. However, this information remains of relevance when counselling young active patients about their arthroplasty options and may become pertinent in the future if the promise of ceramic hip resurfacing is ever realized.

Keywords: hip resurfacing, metallosis, revision surgery, total hip arthroplasty

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