Search results for: successful treatment

Authors: Bernard Bladergroen, David Vlotman, Bradley Cerff

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The agricultural sector is one which requires and consumes large amounts of water globally. Commercial wine production, in particular, uses extensive volumes of fresh water and generates significant volumes of wastewater through various processes. The wastewater produced by wineries typically exhibits elevated levels of chemical oxygen demand (COD), total suspended solids (TSS), total dissolved solids (TDS), acidic pH and varying salinity and nutrient contents. This study investigates the performance of a shear-enhanced flotation separation (SEFS) pilot plant as a primary treatment stage during winery wastewater processing by modifying a conventional Dissolved Air Flotation (DAF) system. The SEFS pilot plant achieved a 99% reduction in both turbidity and TSS in comparison to the 97% achieved with the conventional DAF system. The COD was reduced by 66% and 51% for the SEFS and DAF systems, respectively. SEFS shows the advantages of hydrodynamic shear to enhance the coagulation and subsequent flocculation processes with a significant reduction of coagulant and flocculant (36% and 31%, respectively).

Keywords: shear enhanced flotation, suspended solids, primary wastewater treatment, zeta potential

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Authors: Lina Wu

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The excessive discharge of nitrogen in sewage greatly intensifies the eutrophication of water bodies and threatens water quality. Nitrogen pollution control has become a global concern. The concentration of nitrogen in water is reduced by converting ammonia nitrogen, nitrate nitrogen and nitrite nitrogen into nitrogen-containing gas through biological treatment, physicochemical treatment and oxidation technology. However, some wastewater containing high ammonia nitrogen including landfill leachate, is difficult to be treated by traditional nitrification and denitrification because of its high COD content. The core process of denitrification is that denitrifying bacteria convert nitrous acid produced by nitrification into nitrite under anaerobic conditions. Still, its low-carbon nitrogen does not meet the conditions for denitrification. Many studies have shown that the natural autotrophic anammox bacteria can combine nitrous and ammonia nitrogen without a carbon source through functional genes to achieve total nitrogen removal, which is very suitable for removing nitrogen from leachate. In addition, the process also saves a lot of aeration energy consumption than the traditional nitrogen removal process. Therefore, anammox plays an important role in nitrogen conversion and energy saving. The short-range nitrification and denitrification coupled with anaerobic ammoX ensures total nitrogen removal. It improves the removal efficiency, meeting the needs of society for an ecologically friendly and cost-effective nutrient removal treatment technology. In recent years, research has found that the symbiotic system has more water treatment advantages because this process not only helps to improve the efficiency of wastewater treatment but also allows carbon dioxide reduction and resource recovery. Microalgae use carbon dioxide dissolved in water or released through bacterial respiration to produce oxygen for bacteria through photosynthesis under light, and bacteria, in turn, provide metabolites and inorganic carbon sources for the growth of microalgae, which may lead the algal bacteria symbiotic system save most or all of the aeration energy consumption. It has become a trend to make microalgae and light-avoiding anammox bacteria play synergistic roles by adjusting the light-to-dark ratio. Microalgae in the outer layer of light particles block most of the light and provide cofactors and amino acids to promote nitrogen removal. In particular, myxoccota MYX1 can degrade extracellular proteins produced by microalgae, providing amino acids for the entire bacterial community, which helps anammox bacteria save metabolic energy and adapt to light. As a result, initiating and maintaining the process of combining dominant algae and anaerobic denitrifying bacterial communities has great potential in treating landfill leachate. Chlorella has a brilliant removal effect and can withstand extreme environments in terms of high ammonia nitrogen, high salt and low temperature. It is urgent to study whether the algal mud mixture rich in denitrifying bacteria and chlorella can greatly improve the efficiency of landfill leachate treatment under an anaerobic environment where photosynthesis is stopped. The optimal dilution concentration of simulated landfill leachate can be found by determining the treatment effect of the same batch of bacteria and algae mixtures under different initial ammonia nitrogen concentrations and making a comparison. High-throughput sequencing technology was used to analyze the changes in microbial diversity, related functional genera and functional genes under optimal conditions, providing a theoretical and practical basis for the engineering application of novel bacteria-algae symbiosis system in biogas slurry treatment and resource utilization.

Keywords: nutrient removal and recovery, leachate, anammox, Partial nitrification, Algae-bacteria interaction

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Authors: Adam J. Carinci

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Background: The opioid epidemic is the most pressing healthcare crisis of our time. There is increasing recognition that opioids have limited long-term efficacy and are associated with hyperalgesia, addiction, and increased morbidity and mortality. Therefore, alternative strategies to combat chronic pain are paramount. We initiated a multicenter retrospective case series to review the efficacy of DRG stimulation in facilitating opioid tapering, opioid discontinuation and as a viable alternative to chronic opioid therapy. Purpose: The dorsal root ganglion (DRG) plays a key role in the development and maintenance of pain. Recent innovations in neuromodulation, specifically, dorsal root ganglion stimulation, offers an effective alternative to opioids in the treatment of chronic pain. This retrospective case series demonstrates preliminary evidence that DRG stimulation facilitates opioid tapering, opioid discontinuation and presents a viable alternative to chronic opioid therapy. Procedure: This small multicenter retrospective case series provides preliminary evidence that DRG stimulation facilitates opioid weaning, opioid tapering and is a viable option to opioid therapy in the treatment of chronic pain. A retrospective analysis was completed. Visual analog scale pain scores and pain medication usage were collected at the baseline visit and after four weeks, 3 months and 6 months of treatment. Ten consecutive patients across two study centers were included. The pain was rated 7.38 at baseline and decreased to 1.50 at the 4-week follow-up, a reduction of 79.5%. All patients significantly decreased their opioid pain medication use with an average > 30% reduction in morphine equivalents and four were able to discontinue their medications entirely. Conclusion: This Retrospective case series demonstrates preliminary evidence that DRG stimulation facilitates opioid tapering, opioid discontinuation and presents a viable alternative to chronic opioid therapy.

Keywords: dorsal root ganglion, neuromodulation, opioid sparing, stimulation

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Authors: Haon-Yao Chen, Cheng-Fang Lin, Pui-Kwan Andy Hong, Ping-Yi Yang, Kok Kwang Ng, Sheng-Fu Yang

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Simultaneous nitrification and denitrification (SND) are a natural phenomenon in the soil environment that can be applied in wastewater treatment. At a domestic wastewater treatment plant, we performed a pilot test of installing bioplates with entrapped biomass into a conventional aeration basin for SND, and investigated the effects of bioplate packing ratio, hydraulic retention time, dissolved oxygen level, on/off aeration mode, and supplemental carbon and alkalinity on nitrogen removal. With the pilot aeration basin of 1.3 m3 loaded with mixed liquor suspended solids of 1500-2500 mg/L and bioplates at PR of 3.2% (3.2% basin volume) operated at HRT of 6 h and DO of 4-6 mg/L without supplemental carbon or alkalinity, nitrogen in the wastewater was removed to an effluent total nitrogen (TN) of 7.3 mg/L from an influent TN of 28 mg/L. The bioplate robust cellulose triacetate structure carrying the biomass shows promise in retrofitting conventional aeration basins for enhanced nutrient removal.

Keywords: immobilization, nitrification/denitrification, nutrient removal, total nitrogen

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Authors: Anne Prip, Kirsten Alling Møller, Dorte Lisbet Nielsen, Mary Jarden, Marie-Helene Olsen, Anne Kjaergaard Danielsen

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Background: The development in cancer care has shifted towards shorter hospital stays and more outpatient treatment. Today, cancer care and treatment predominantly takes place in outpatient settings where encounters between patients and health care professionals are often brief. This development will probably continue internationally as the global cancer burden seems to be growing significantly. Furthermore, the number of patients who require ambulatory treatments such as chemotherapy is increasing. Focusing on the encounters between health care professionals and patients during oncology treatment has thus become increasingly important due to a growing trend in outpatient cancer management. Objective: The aim of the systematic review was to summarize the literature from the perspective of the patient, on experiences of and the need for communication and relationships with the health care professional during chemotherapy treatment in an outpatient setting. Method: The review was designed and carried out according to the PRISMA guidelines and PICO framework. The systematic search was conducted in Medline, CINAHL, The Cochrane Library and Joanna Briggs Institute Evidence Based Practice Database. Results: In all, 1174 studies were identified by literature search. After duplicates were removed, the remaining studies (n = 1053) were screened for inclusion. Nine studies were included; qualitative (n = 5) and quantitative (n = 4) as they met the inclusions criteria. The review identified that communication and relationships between health care professionals and patients were important for the patients’ ability to cope with cancer and also had an impact on patients’ satisfaction with care in the outpatient clinic. Furthermore, the review showed that hope and positivity was a need and strategy for patients with cancer and was facilitated by health care professionals. Finally, it revealed that outpatient clinic visits framed and influenced communication and relationships. Conclusions: This review identified the significance of communication and the relationships between patients and health care professionals in the outpatient setting as it supports patients’ ability to cope with cancer. The review showed the need for health care professionals to pay attention to the relational aspects of communication in an outpatient clinic as encounters are often brief. Furthermore, the review helps to specify which elements of the communication are central in the patient-health care professional interaction from the patients' perspective. Finally, it shows a need for more research to investigate which type of interaction and intervention would be the most effective in supporting patients’ coping during chemotherapy in an outpatient clinic.

Keywords: ambulatory chemotherapy, communication, health care professional-patient relation, nurse-patient relation, outpatient care, systematic review

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Authors: Sridhar A. Malkaram, Tamer E. Fandy

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Purpose: 5-Azacytidine (5AC) and decitabine (DC) are DNA hypomethylating agents. We recently demonstrated that both drugs increase the enzymatic activity of the histone deacetylase enzyme SIRT6. Accordingly, we are comparing the changes H3K9 acetylation changes in the whole genome induced by both drugs using leukemia cells. Description of Methods & Materials: Mononuclear cells from the bone marrow of six de-identified naive acute myeloid leukemia (AML) patients were cultured with either 500 nM of DC or 5AC for 72 h followed by ChIP-Seq analysis using a ChIP-validated acetylated-H3K9 (H3K9ac) antibody. Chip-Seq libraries were prepared from treated and untreated cells using SMARTer ThruPLEX DNA- seq kit (Takara Bio, USA) according to the manufacturer’s instructions. Libraries were purified and size-selected with AMPure XP beads at 1:1 (v/v) ratio. All libraries were pooled prior to sequencing on an Illumina HiSeq 1500. The dual-indexed single-read Rapid Run was performed with 1x120 cycles at 5 pM final concentration of the library pool. Sequence reads with average Phred quality < 20, with length < 35bp, PCR duplicates, and those aligning to blacklisted regions of the genome were filtered out using Trim Galore v0.4.4 and cutadapt v1.18. Reads were aligned to the reference human genome (hg38) using Bowtie v2.3.4.1 in end-to-end alignment mode. H3K9ac enriched (peak) regions were identified using diffReps v1.55.4 software using input samples for background correction. The statistical significance of differential peak counts was assessed using a negative binomial test using all individuals as replicates. Data & Results: The data from the six patients showed significant (Padj<0.05) acetylation changes at 925 loci after 5AC treatment versus 182 loci after DC treatment. Both drugs induced H3K9 acetylation changes at different chromosomal regions, including promoters, coding exons, introns, and distal intergenic regions. Ten common genes showed H3K9 acetylation changes by both drugs. Approximately 84% of the genes showed an H3K9 acetylation decrease by 5AC versus 54% only by DC. Figures 1 and 2 show the heatmaps for the top 100 genes and the 99 genes showing H3K9 acetylation decrease after 5AC treatment and DC treatment, respectively. Conclusion: Despite the similarity in hypomethylating activity and chemical structure, the effect of both drugs on H3K9 acetylation change was significantly different. More changes in H3K9 acetylation were observed after 5 AC treatments compared to DC. The impact of these changes on gene expression and the clinical efficacy of these drugs requires further investigation.

Keywords: DNA methylation, leukemia, decitabine, 5-Azacytidine, epigenetics

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Authors: Ahlam Said Al Azkawi, Nallusamy Sivakumar, Saif Nasser Al Bahri

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Diverse approaches and pathways are under development with the determination to develop cellulosic biofuels and other bio-products eventually at commercial scale in “bio-refineries”; however, the key challenge is mainly the high level of complexity in processing the feedstock which is complicated and energy consuming. To overcome the complications in utilizing the naturally occurring lignocellulose biomass, using waste paper as a feedstock for bio-production may solve the problem. Besides being abundant and cheap, bioprocessing of waste paper has evolved in response to the public concern from rising landfill cost from shrinking landfill capacity. Cardboard (CB) is one of the major components of municipal solid waste and one of the most important items to recycle. Although 50-70% of cardboard constitute is known to be cellulose and hemicellulose, the presence of lignin around them cause hydrophobic cross-link which physically obstructs the hydrolysis by rendering it resistant to enzymatic cleavage. Therefore, pretreatment is required to disrupt this resistance and to enhance the exposure of the targeted carbohydrates to the hydrolytic enzymes. Several pretreatment approaches have been explored, and the best ones would be those can influence cellulose conversion rates and hydrolytic enzyme performance with minimal or less cost and downstream processes. One of the promising strategies in this field is the application of surfactants, especially non-ionic surfactants. In this study, triton-X 100 was used as surfactants to treat cardboard prior enzymatic hydrolysis and compare it with acid treatment using 0.1% H2SO4. The effect of the surfactant enhancement was evaluated through its effect on hydrolysis rate in respect to time in addition to evaluating the structural changes and modification by scanning electron microscope (SEM) and X-ray diffraction (XRD) and through compositional analysis. Further work was performed to produce ethanol from CB treated with triton-X 100 via separate hydrolysis and fermentation (SHF) and simultaneous saccharification and fermentation (SSF). The hydrolysis studies have demonstrated enhancement in saccharification by 35%. After 72 h of hydrolysis, a saccharification rate of 98% was achieved from CB enhanced with triton-X 100, while only 89 of saccharification achieved from acid pre-treated CB. At 120 h, the saccharification % exceeded 100 as reducing sugars continued to increase with time. This enhancement was not supported by any significant changes in the cardboard content as the cellulose, hemicellulose and lignin content remained same after treatment, but obvious structural changes were observed through SEM images. The cellulose fibers were clearly exposed with very less debris and deposits compared to cardboard without triton-X 100. The XRD pattern has also revealed the ability of the surfactant in removing calcium carbonate, a filler found in waste paper known to have negative effect on enzymatic hydrolysis. The cellulose crystallinity without surfactant was 73.18% and reduced to 66.68% rendering it more amorphous and susceptible to enzymatic attack. Triton-X 100 has proved to effectively enhance CB hydrolysis and eventually had positive effect on the ethanol yield via SSF. Treating cardboard with only triton-X 100 was a sufficient treatment to enhance the enzymatic hydrolysis and ethanol production.

Keywords: cardboard, enhancement, ethanol, hydrolysis, treatment, Triton-X 100

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Authors: Mohammed S. Mohammed, Asmaa M. S. Mohammed

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Background: To achieve the quality of cancer care, the oncologic academic programs should be continuously developed with establishing new ones. We highlighted three disciplines, Clinical nutrition, medical biophysics and radiobiology and Psycho-oncology programs; without a doubt, the Egyptian National Cancer Institute, in ‎the accreditation era, will be establishing them ‎ due to their importance in improving the skills of cancer practitioners. Methods: The first suggested program in Clinical Nutrition that is dealing with the assessment of the patient's well-being before, during and after treatment to avoid the defects in the metabolism resulting from the cancer disease and its treatment by giving the supplements in the patient's diet. The second program is Medical Biophysics and Radiobiology, which there's no denying that it ‎is ‎provided ‎in Cairo University as a good program in the faculty of science but lacks the clinical ‎practice. Hence, it is probably better to establish this program in our institute to ‎improve the ‎practitioner skills and introduce a tailored radiation therapy regimen for every patient according to ‎their characteristic profile.‎ While patients are receiving their treatment, the risk of post-traumatic stress disorder arises, so the importance of the third program, Psycho-Oncology, is clearly obtained. This program is concerned with the psychological, social, behavioral, and ethical aspects of cancer. The area of multi-disciplinary interest has boundaries with the major specialties in oncology: the clinical disciplines (surgery, medicine, pediatrics, and radiotherapy), epidemiology, immunology, endocrinology, biology, pathology, bioethics, palliative care, rehabilitation medicine, clinical trials research and decision making, as well as psychiatry and psychology. Results: It is a prospective academic plan which is compatible with the institutional vision and its strategic plan. Conclusion: In this context, evaluating and understanding the suggested academic programs has become a mandatory part of cancer care. And it is essential to be provided by the NCI.

Keywords: clinical nutrition, psycho-oncology, medical biophysics and radiobiology, medical education

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Authors: O. John Makinde

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A total of 60 crossbred weaned rabbits with an average initial body weight of 650 ±2.00 g were used to study the effects of dietary inclusion of graded levels of Ensiled sweet potato vines (ESPV) based diets on growth performance. Four experimental diets were formulated such that ESPV was included at the graded levels of 0, 10, 20 and 30 % in diets 1, 2, 3 and 4 respectively. The rabbits were randomly assigned into 4 treatments with 15 rabbits per treatment; each treatment was replicated thrice (5 rabbits per replicate) in a completely randomised design. The rabbits were managed based on standard experimental procedures. Feed and water were given ad libitum. Results of growth performance were not significantly different (p > 0.05) for final weight, total weight gain, total feed intake, feed conversion ratio and mortality. Carcass characteristics were not significantly (p > 0.05) affected by the treatments. The economics of production showed that diet with 30 % ESPV had the least cost/kg diets. It was concluded that ESPV can be included up to 30 % in growing rabbit diets without adverse effect on their performance, blood indices and cost of production.

Keywords: ensiled, sweet potato vines, performance, rabbits, Oryctolagus cuniculus

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Authors: Pooja Balasubramanian, Ghida Karbala

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Unfair treatment at the workplace encourages workers to adjust their behavior in order to restore fairness and align monetary returns to costs. This adjustment of behavior, however, may differ depending on the reference group considered to evaluate equity. In this aspect two main questions are to be considered: How do workers respond to unfair treatment at the workplace? And how does this response change depending on the identity of the reference group? To answer the above research questions, this paper utilizes data from a randomized field experiment conducted in Kolkata, India where student assistants were hired to help in a data entry task. Recruited workers were working in a team of two and were offered a fixed wage per hour. Workers were randomly assigned to one of the following treatment groups: A control group not subjected (1) to wage cuts (2) A general wage cut (3) A unilateral wage cut in reference to colleagues with similar social identity (4) A unilateral wage cut in reference to colleagues with a different social identity, where social identity is defined in terms of gender. Results show a significant decrease in the quantity and quality of work following a general wage cut. A more severe drop in productivity was presented by men in the case of unilateral wage cut, while women experiencing unilateral wage cuts didn’t exhibit a similar behavior regardless of the gender of the team member. To the contrary, women matched with a male colleague and experiencing unilateral wage cut show a slight increase in productivity, a result that contributes to the discussion regarding the paradox of the 'content female worker'. These findings highlight the necessity of a better understanding of the social comparison processes prevailing at the workplace, given the major role they play in determining the level of productivity supplied.

Keywords: effort supply, fairness, reference groups, social comparison

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Authors: L. Grinis, N. Lubashevsky, Y. Ostrovski

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In waste water treatment processes, aeration introduces air into a liquid. In these systems, air is introduced by different devices submerged in the waste water. Smaller bubbles result in more bubble surface area per unit of volume and higher oxygen transfer efficiency. Jet pumps are devices that use air bubbles and are widely used in waste water treatment processes. The principle of jet pumps is their ability to transfer energy of one fluid, called primary or motive, into a secondary fluid or gas. These pumps have no moving parts and are able to work in remote areas under extreme conditions. The objective of this work is to study experimentally the characteristics of the jet pump and the size of air bubbles in the laboratory water tank. The effect of flow rate ratio on pump performance is investigated in order to have a better understanding about pump behavior under various conditions, in order to determine the efficiency of receiving air bubbles different sizes. The experiments show that we should take care when increasing the flow rate ratio while seeking to decrease bubble size in the outlet flow. This study will help improve and extend the use of the jet pump in many practical applications.

Keywords: jet pump, air bubbles size, retention time, waste water

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Authors: Hyuk Sung Yoon, In-Lee Choi, Min Jae Jeong, Jun Pill Baek, Ho-Min Kang

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This study was conducted to improve storability by using suitable laser ablation oxygen transmission rate (OTR) films and effectiveness of high carbon dioxide at strawberry 'Maehyang' for export. Strawberries were grown by hydroponic system in Gyeongsangnam-do province. These strawberries were packed by different laser ablation OTR films (Daeryung Co., Ltd.) such as 1,300 cc, 20,000 cc, 40,000 cc, 80,000 cc, and 100,000 cc•m-2•day•atm. And CO2 injection (30%) treatment was used 20,000 cc•m-2•day•atm OTR film and perforated film was as a control. Temperature conditions were applied simulated shipping and distribution conditions from Korea to Singapore, there were stored at 3 ℃ (13 days), 10 ℃ (an hour), and 8 ℃ (7 days) for 20 days. Fresh weight loss rate was under 1% as maximum permissible weight loss in treated OTR films except perforated film as a control during storage. Carbon dioxide concentration within a package for the storage period showed a lower value than the maximum CO2 concentration tolerated range (15 %) in treated OTR films and even the concentration of high OTR film treatment; from 20,000cc to 100,000cc were less than 3%. 1,300 cc had a suitable carbon dioxide range as over 5 % under 15 % at 5 days after storage until finished experiments and CO2 injection treatment was quickly drop the 15 % at storage after 1 day, but it kept around 15 % during storage. Oxygen concentration was maintained between 10 to 15 % in 1,300 cc and CO2 injection treatments, but other treatments were kept in 19 to 21 %. Ethylene concentration was showed very higher concentration at the CO2 injection treatment than OTR treatments. In the OTR treatments, 1,300 cc showed the highest concentration in ethylene and 20,000 cc film had lowest. Firmness was maintained highest in 1,300cc, but there was not shown any significant differences among other OTR treatments. Visual quality had shown the best result in 20,000 cc that showed marketable quality until 20 days after storage. 20,000 cc and perforated film had better than other treatments in off-odor and the 1,300 cc and CO2 injection treatments have occurred strong off-odor even after 10 minutes. As a result of the difference between Hunter ‘L’ and ‘a’ values of chroma meter, the 1,300cc and CO2 injection treatments were delayed color developments and other treatments did not shown any significant differences. The results indicate that effectiveness for maintaining the freshness was best achieved at 20,000 cc•m-2•day•atm. Although 1,300 cc and CO2 injection treatments were in appropriate MA condition, it showed darkening of strawberry calyx and excessive reduction of coloring due to high carbon dioxide concentration during storage. While 1,300cc and CO2 injection treatments were considered as appropriate treatments for exports to Singapore, but the result was shown different. These results are based on cultivar characteristics of strawberry 'Maehyang'.

Keywords: carbon dioxide, firmness, shelf-life, visual quality

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Authors: Abayomi O. Adetuyi, Jamiu M. Jabar, Samuel O. Afolabi

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Vegetable fibres are classes of fibres of low density, biodegradable and non-abrasive that are largely abundant fibre materials with specific properties and mostly found/ obtained in plants on earth surface. They are classified into three categories, depending on the part of the plant from which they are gotten from namely: fruit, Blast and Leaf fibre. Ever since four/five millennium B.C, attention has been focussing on the commonest and highly utilized cotton fibre obtained from the fruit of cotton plants (Gossypium spp), for the production of cotton fabric used in every home today. The present study, therefore, focused on the ability of three underutilized vegetable (fruit) fibres namely: coir fiber (Eleas coniferus), palm kernel fiber and empty fruit bunch fiber (Elias guinensis) through chemical modifications for better composite value addition performance to polyurethane form and dye adsorption. These fibres were sourced from their parents’ plants, identified and cleansed with 2% hot detergent solution 1:100, rinsed in distilled water and oven-dried to constant weight, before been chemically modified through alkali bleaching, mercerization and acetylation. The alkali bleaching involves treating 0.5g of each fiber material with 100 mL of 2% H2O2 in 25 % NaOH solution with refluxing for 2 h. While that of mercerization and acetylation involves the use of 5% sodium hydroxide NaOH solution for 2 h and 10% acetic acid- acetic anhydride 1:1 (v/v) (CH3COOH) / (CH3CO)2O solution with conc. H2SO4 as catalyst for 1 h, respectively on the fibres. All were subsequently washed thoroughly with distilled water and oven dried at 105 0C for 1 h. These modified fibres were incorporated as composite into polyurethane form and used in dye adsorption study of indigo. The first two treatments led to fiber weight reduction, while the acidified acetic anhydride treatment gave the fibers weight increment. All the treated fibers were found to be of less hydrophilic nature, better mechanical properties, higher thermal stabilities as well as better adsorption surfaces/capacities than the untreated ones. These were confirmed by gravimetric analysis, Instron Universal Testing Machine, Thermogravimetric Analyser and the Scanning Electron Microscope (SEM) respectively. The fiber morphology of the modified fibers showed smoother surfaces than unmodified fibres.The empty fruit bunch fibre and the coconut coir fibre are better than the palm kernel fibres as reinforcers for composites or as adsorbents for waste-water treatment. Acetylation and alkaline bleaching treatment improve the potentials of the fibres more than mercerization treatment. Conclusively, vegetable fibres, especially empty fruit bunch fibre and the coconut coir fibre, which are cheap, abundant and underutilized, can replace the very costly powdered activated carbon in wastewater treatment and as reinforcer in foam.

Keywords: chemical modification, industrial application, value addition, vegetable fibre

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Authors: Bouafia-Chergui Souâd, Chabani Malika, Bensmaili Aicha

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Water treatment and especially, medicament pollutants are nowadays important problems. Degradation of oxytetracycline was carried out using combined process of low-frequency ultrasound (US), ultraviolet irradiation and a catalyst. The effectiveness of the coupled processes has been evaluated by studying the effects of various operating parameters including initial OTC concentration, solution pH and catalyst mass. For the photolysis process, the monochromatic ultraviolet light wavelength utilized was 365 nm. The sonolysis experiments were performed with ultrasound at a frequency of 40 kHz. The heterogeneous photocatalysis was studied in the presence of TiO2. The processes were employed individually, and simultaneously to examine the details of the processes and to investigate the contribution of each process. Low UV intensity (12W), low pH and high mass of TiO2 conditions enhanced the sono-photocatalytic degradation of OTC. The results showed that the individual contribution sonochemical and photochemical reactions are very low, however, their coupling increases the degradation rate of 8 times compared to photolysis and 2 times compared to sonolysis. There is a synergistic effect between the two modes of radiation, UV and U.S. leading to 82.04% degradation yield. An application of these combined processes on the treatment of a real pharmaceutical wastewater was examined.

Keywords: sonolysis, photocatalysis, combined process, antibiotic

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Authors: Mehrnaz Mostafavi, Mahtab Shabani, Alireza Azani, Fatemeh Ghafari

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Artificial intelligence (AI) can transform breast cancer diagnosis and therapy by providing sophisticated solutions for screening, imaging interpretation, histopathological analysis, and treatment planning. This literature review digs into the many uses of AI in breast cancer treatment, highlighting the need for collaboration between AI scientists and healthcare practitioners. It emphasizes advances in AI-driven breast imaging interpretation, such as computer-aided detection and diagnosis (CADe/CADx) systems and deep learning algorithms. These have shown significant potential for improving diagnostic accuracy and lowering radiologists' workloads. Furthermore, AI approaches such as deep learning have been used in histopathological research to accurately predict hormone receptor status and categorize tumor-associated stroma from regular H&E stains. These AI-powered approaches simplify diagnostic procedures while providing insights into tumor biology and prognosis. As AI becomes more embedded in breast cancer care, it is crucial to ensure its ethical, efficient, and patient-focused implementation to improve outcomes for breast cancer patients ultimately.

Keywords: breast cancer, artificial intelligence, cancer diagnosis, clinical practice

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Authors: N. R. Harris, J. Curry

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This paper describes the construction and operation of an experimental LoRaWAN network surrounding the University of Southampton in the United Kingdom. Following successful installation, an experimental node design is built and characterised, with particular emphasis on radio range. Several configurations are investigated, including different data rates, and varying heights of node. It is concluded that although range can be great (over 8 km in this case), environmental topology is critical. However, shorter range implementations, up to about 2 km in an urban environment, are relatively insensitive although care is still needed. The example node and the relatively simple base station reported demonstrate that LoraWan can be a very low cost and practical solution to Internet of Things type applications for distributed monitoring systems with sensors spread over distances of several km.

Keywords: long-range, wireless, sensor, network

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Authors: Amirhossen Zare Rahvard

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Freemium games based on the gacha mechanic have proven highly successful in recent years - games with simple graphics and simple gameplay systems but with a highly profitable market. Attempts at developing gacha games have even been made in Iran. Since gacha games are both profitable and easy to develop, they seem to be a suitable starting point for establishing a video game market in underdeveloped countries. This article aims to review the gacha games' approach to gaining revenue by studying the case of Arknights game in order to draw an outline of how simple games have led to great markets.

Keywords: gacha games, game’s economy, underdeveloped countries and games, arkngihts

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Authors: Grazia Disciglio, Annalisa Tarantino, Emanuele Tarantino

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The production system of Foggia province (Apulia, Southern Italy) is characterized by the presence of numerous agro-food industries whose activities include the processing of vegetables products that release large quantities of wastewater. The reuse in agriculture of these wastewaters offers the opportunity to reduce the costs of their disposal and minimizing their environmental impact. In addition, in this area, which suffers from water shortage, the use of agro-industrial wastewater is essential in the very intensive irrigation cropping systems. The present investigation was carried out in years 2009 and 2010 to monitor the physico-chemical and microbiological characteristics of the industrial wastewater (IWW) from the secondary treatment plant of the 'Industrial Area of Foggia'. The treatment plant released on average about 567,000 m3y-1 of IWW, which distribution was not uniform over the year. The monthly values were about 250,000 m3 from November to June and about 90,000 m3 from July to October. The obtained results revealed that IWW was characterized by low values of Total Suspended Solids (TSS), Biological Oxygen Demand (BOD), Chemical Oxygen Demand (COD), Electrical Conductivity (EC) and Sodium Absorption Rate (SAR). An occasional presence of heavy metal and high concentration of total phosphorus, total nitrogen, ammoniacal nitrogen and microbial organisms (Escherichia coli and Salmonella) were observed. Due to the presence of this pathogenic microorganisms and sometimes of heavy metals, which may raise sanitary and environmental problems in order to the possible irrigation reuse of this IWW, a tertiary treatment of wastewater based on filtration and disinfection in line are recommended. Researches on the reuse of treated IWW on crops (olive, artichoke, industrial tomatoes, fennel, lettuce etc.) did not show significant differences among the irrigated plots for most of the soil and yield characteristics.

Keywords: agroindustrial wastewater, irrigation, microbiological characteristic, physico-chemical characteristics

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Authors: Lisa Shambare, Jean Mulopo, Sehliselo Ndlovu

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One of the major challenges of sustainable development is promoting an industry which is both ecologically durable and economically viable. This requires processes that are material and energy efficient whilst also being able to limit the production of waste and toxic effluents through effective methods of process synthesis and intensification. In South Africa and globally, both miniaturisation and technological advances have substantially increased the amount of electronic wastes (e-waste) generated annually. Vast amounts of e-waste are being generated yearly with only a minute quantity being recycled officially. The passion for electronic devices cannot ignore the scarcity and cost of mining the noble metal resources which contribute significantly to the efficiency of most electronic devices. It has hence become imperative especially in an African context that sustainable strategies which are environmentally friendly be developed for recycling of the noble metals from e-waste. This paper investigates the recovery of gold, silver and palladium from electronic wastes, which consists of a vast array of metals, using ionic liquids which have the potential of reducing the gaseous and aqueous emissions associated with existing hydrometallurgical and pyrometallurgical technologies while also maintaining the economy of the overall recycling scheme through solvent recovery. The ionic liquids 1-butyl-3-methyl imidazolium hydrogen sulphate (BmimHSO4) which behaves like a protic acid and was used in the present research for the selective leaching of gold and silver from e-waste. Different concentrations of the aqueous ionic liquid were used in the experiments ranging from 10% to 50%. Thiourea was used as the complexing agent in the investigation with Fe3+ as the oxidant. The pH of the reaction was maintained in the range of 0.8 to 1.5. The preliminary investigations conducted were successful in the leaching of silver and palladium at room temperature with optimum results being at 48hrs. The leaching results could not be explained because of the leaching of palladium with the absence of gold. Hence a conclusion could not be drawn and there was the need for further experiments to be run. The leaching of palladium was carried out with hydrogen peroxide as oxidant and 1-butyl-3-methyl imidazolium chloride (BmimCl) as the solvent. The experiments at carried out at a temperature of 60 degrees celsius and a very low pH. The chloride ion was used to complex with palladium metal. From the preliminary results, it could be concluded that pretreatment of the treatment e-waste was necessary to improve the efficiency of the metal recovery process. A conclusion could not be drawn for the leaching experiments.

Keywords: BmimCl, BmimHSO4, gold, palladium, silver

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Authors: Martha Lilia Del Rio Duque, Michelle Bonatti, Katharina Loehr, Marcos Lana, Tatiana Rodriguez, Stefan Sieber

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Nowadays, most agricultural practices can reduce the ability of ecosystems to provide goods and services. To enhance environmentally friendly food production and to maximize social and economic benefits, sustainable land use systems (SLUS) are one of the most critical strategies increasingly/strongly promoted by donors organizations, international agencies, and policymakers. This process involves the question of how SLUS can be scaled out also large-scale landscapes and not merely isolated experiments. As SLUS are context-specific strategies, diffusion and replication of successful SLUS in Colombia required the identification of main factors that facilitate this scaling out process. We applied a case study approach to investigate the scaling out process of SLUS in cocoa and livestock sector within peacebuilding territories in Colombia, specifically, in Cesar and Caqueta region. These two regions are contrasting, but both have a current trend of increasing land degradation. Presently in Colombia, Caqueta is one of the most deforested departments, and Cesar has some most degraded soils. Following a qualitative research approach, 19 semi-structured interviews and 2 focus groups were conducted with agroforestry experts in both regions to analyze (1) what does it mean a sustainable land use system in Cocoa/Livestock, specifically in Caqueta or Cesar and (2) to identify the key elements at the level of the following dimensions: biophysical, economic and profitability, market, social, policy and institutions that can explain how and why SLUS are replicated and spread among more producers. The Interviews were coded and analyzed using MAXQDA to identify, analyze and report patterns (themes) within data. As the results show, key themes, among which: premium market, solid regional markets and price stability, water availability and management, generational renewal, land use knowledge and diversification, producer organization and certifications are crucial to understand how the SLUS can have an impact across large-scale landscapes and how the scaling out process can be set up best in order to be successful across different contexts. The analysis further reveals which key factors might affect SLUS efficiency.

Keywords: agroforestry, cocoa sector, Colombia, livestock sector, sustainable land use system

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Authors: Muhammad Muzamal, Anders Rasmuson

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Wood material is extensively considered as a raw material for the production of bio-polymers, bio-fuels and value-added chemicals. However, the shortcoming in using wood as raw material is that the enzymatic hydrolysis of wood material is difficult because the accessibility of enzymes to hemicelluloses and cellulose is hindered by complex chemical and physical structure of the wood. The steam explosion (SE) pre-treatment improves the digestion of wood material by creating both chemical and physical modifications in wood. In this process, first, wood chips are treated with steam at high pressure and temperature for a certain time in a steam treatment vessel. During this time, the chemical linkages between lignin and polysaccharides are cleaved and stiffness of material decreases. Then the steam discharge valve is rapidly opened and the steam and wood chips exit the vessel at very high speed. These fast moving wood chips collide with each other and with walls of the equipment and disintegrate to small pieces. More damaged and disintegrated wood have larger surface area and increased accessibility to hemicelluloses and cellulose. The energy required for an increase in specific surface area by same value is 70 % more in conventional mechanical technique, i.e. attrition mill as compared to steam explosion process. The mechanism of wood disintegration during the SE pre-treatment is very little studied. In this study, we have simulated collision and impact of wood chips (dimension 20 mm x 20 mm x 4 mm) with each other and with walls of the vessel. The wood chips are simulated as a 3D orthotropic material. Damage and fracture in the wood material have been modelled using 3D Hashin’s damage model. This has been accomplished by developing a user-defined subroutine and implementing it in the FE software ABAQUS. The elastic and strength properties used for simulation are of spruce wood at 12% and 30 % moisture content and at 20 and 160 OC because the impacted wood chips are pre-treated with steam at high temperature and pressure. We have simulated several cases to study the effects of elastic and strength properties of wood, velocity of moving chip and orientation of wood chip at the time of impact on the damage in the wood chips. The disintegration patterns captured by simulations are very similar to those observed in experimentally obtained steam exploded wood. Simulation results show that the wood chips moving with higher velocity disintegrate more. Moisture contents and temperature decreases elastic properties and increases damage. Impact and collision in specific directions cause easy disintegration. This model can be used to efficiently design the steam explosion equipment.

Keywords: dynamic simulation, disintegration of wood, impact, steam explosion pretreatment

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Authors: Amin Derakhshan, Mohammad Mikaili, Mohammad Ali Khalilzadeh, Amin Mohammadian

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This paper proposes a stress recognition system from multi-modal bio-potential signals. For stress recognition, Support Vector Machines (SVM) and LDA are applied to design the stress classifiers and its characteristics are investigated. Using gathered data under psychological polygraph experiments, the classifiers are trained and tested. The pattern recognition method classifies stressful from non-stressful subjects based on labels which come from polygraph data. The successful classification rate is 96% for 12 subjects. It means that facial thermal imaging due to its non-contact advantage could be a remarkable alternative for psycho-physiological methods.

Keywords: stress, thermal imaging, face, SVM, polygraph

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Authors: Qamar Raza

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This paper deals with the human concern and onus which every person should provide to his/her society. Especially the rules and regulations described in constitution or traditions which we have inherited from ancestors should be followed, and also our lives should be led in accordance with them. The main concern of paper would be personal behavior with others in a good manner especially what he/she should exercise for society’s welfare. As human beings are the fundamental organ of society, who play a crucial role in reforming the society, they should try their best to develop it as well as maintain harmony, peace, we-feeling and mutual contact in the society. Focusing on how the modern society and its elements keep society successful. Regulations of our constitution and tradition are essential for reforming the society. In a nutshell, a human has to mingle in his society and keep mutual respect and understand the value of others as well as for himself.

Keywords: constitution, human beings, society, traditions

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Authors: Laila Nassiri, Aziza Irhza, Jamal Ibijbijen, Fouad Rachidi, Ghizlane Echchgadda

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The introduction of agroecological practices in ecosystems can contribute to meeting the challenges posed by the diversion of current agricultural production systems towards efficient production methods that are more respectful of the environment, including a reasoned use of inputs and resources. Intercropping is one of these practices that requires the production of two or more crops on the same plot and during the same growing season. Organic fertilization also can contribute to increase the yield due to the potential availability of nutrients. The objective of this work is to study the effect of intercropping and organic fertilization, which are two important practices of agroecology, on potato yield. Intercropping of potato and faba bean was carried out at the Agroecology and Environment platform (ENA, Meknes). The soil is silty-clay, the climate is warm with an average temperature of 17.1°C, and the annual average rainfall of 511mm. Four treatments were tested: Potato sole crop (T1), potato + organic fertilization (T2), Potato + faba bean (T3), Potato + faba bean + organic fertilization (T4). The results showed that there is a significant effect of the treatment on the evolution of the agronomical characters studied, especially the number of leaves and the yield. The number of stems at t0 was equal to 1 in all treatments; it began to grow after 30 days from the date of sowing with a slight increase in treatments containing organic fertilization (T2-T4), then it stabilized 60 days after sowing. In terms of the mean value of the number of leaves, a significant difference was noted between the treatments, the highest value was recorded in treatment T2. The T2 treatment showed the highest average yield, followed by the control (T1). As for the yield, treatments T2 and T1 recorded the highest number of tubers. In order to evaluate two of the practices of agroecology, this work focuses on the evaluation of the effect of intercropping and organic fertilization on the growth and yield parameters of the potato. The results obtained show that agroecological practices have a significant effect on the measured parameters.

Keywords: agroecology, intercropping, organic fertilization, potato yield

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Authors: Cecile Laval, Harriet Lowe

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Processing Instruction is a psycholinguistic pedagogical approach drawing insights from the Input Processing Model which establishes the initial innate strategies used by second language learners to connect form and meaning of linguistic features. With the ever-growing use of technology in Second Language Acquisition research, the present study uses eye-tracking to measure the effectiveness of Processing Instruction in the acquisition of French and its effects on learner’s cognitive strategies. The experiment was designed using a TOBII Pro-TX300 eye-tracker to measure participants’ default strategies when processing French linguistic input and any cognitive changes after receiving Processing Instruction treatment. Participants were drawn from lower intermediate adult learners of French at the University of Greenwich and randomly assigned to two groups. The study used a pre-test/post-test methodology. The pre-tests (one per linguistic item) were administered via the eye-tracker to both groups one week prior to instructional treatment. One group received full Processing Instruction treatment (explicit information on the grammatical item and on the processing strategies, and structured input activities) on the primary target linguistic feature (French past tense imperfective aspect). The second group received Processing Instruction treatment except the explicit information on the processing strategies. Three immediate post-tests on the three grammatical structures under investigation (French past tense imperfective aspect, French Subjunctive used for the expression of doubt, and the French causative construction with Faire) were administered with the eye-tracker. The eye-tracking data showed the positive change in learners’ processing of the French target features after instruction with improvement in the interpretation of the three linguistic features under investigation. 100% of participants in both groups made a statistically significant improvement (p=0.001) in the interpretation of the primary target feature (French past tense imperfective aspect) after treatment. 62.5% of participants made an improvement in the secondary target item (French Subjunctive used for the expression of doubt) and 37.5% of participants made an improvement in the cumulative target feature (French causative construction with Faire). Statistically there was no significant difference between the pre-test and post-test scores in the cumulative target feature; however, the variance approximately tripled between the pre-test and the post-test (3.9 pre-test and 9.6 post-test). This suggests that the treatment does not affect participants homogenously and implies a role for individual differences in the transfer-of-training effect of Processing Instruction. The use of eye-tracking provides an opportunity for the study of unconscious processing decisions made during moment-by-moment comprehension. The visual data from the eye-tracking demonstrates changes in participants’ processing strategies. Gaze plots from pre- and post-tests display participants fixation points changing from focusing on content words to focusing on the verb ending. This change in processing strategies can be clearly seen in the interpretation of sentences in both primary and secondary target features. This paper will present the research methodology, design and results of the experimental study using eye-tracking to investigate the primary effects and transfer-of-training effects of Processing Instruction. It will then provide evidence of the cognitive benefits of Processing Instruction in Second Language Acquisition and offer suggestion in second language teaching of grammar.

Keywords: eye-tracking, language teaching, processing instruction, second language acquisition

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Authors: Yadollah Hezarjaribi, Mahdie Yari Esboi

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In this paper, a novel MEMS capacitive pressure sensor with small size and high sensitivity is presented. This sensor has the separated clamped square diaphragm and the movable plate. The diaphragm material is polysilicon. The movable and fixed plates and mechanical coupling are gold. The substrate and diaphragm are pyrex glass and polysilicon, respectively. In capacitive sensor the sensitivity is proportional to deflection and capacitance changes with pressure for this reason with this design is improved the capacitance and sensitivity with small size. This sensor is designed for low pressure between 0-60 mmHg that is used for medical application such as treatment of an incurable disease called glaucoma. The size of this sensor is 350×350 µm2 and the thickness of the diaphragm is 2µm with 1μ air gap. This structure is designed by intellisuite software. In this MEMS capacitive pressure sensor the sensor sensitivity, diaphragm mechanical sensitivity for polysilicon diaphragm are 0.0469Pf/mmHg, 0.011 μm/mmHg, respectively. According to the simulating results for low pressure, the structure with polysilicon diaphragm has more change of the displacement and capacitance, this leads to high sensitivity than other diaphragms.

Keywords: glaucoma, MEMS capacitive pressure sensor, square clamped diaphragm, polysilicon

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Authors: Faran Chaudhry, Anser Daud, Doris Braunstein, Oleg Safir, Allan Gross, Paul Kuzyk

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Background: Acetabular reconstruction in the context of massive acetabular bone loss is challenging. In rare scenarios where the extent of bone loss precludes shell placement (cup-cage), reconstruction at our center consisted of a cage combined with highly porous metal augments. This study evaluates survivorship, complications, and functional outcomes using this technique. Methods: A total of 131 cup-cage implants (129 patients) were included in our retrospective review of revisions of total hip arthroplasty from January 2003 to January 2022. Among these cases, 100/131 (76.3%) were women, the mean age at surgery time was 68.7 years (range, 29.0 to 92.0; SD, 12.4), and the mean follow-up was 7.7 years (range, 0.02 to 20.3; SD, 5.1). Kaplan-Meier survivorship analysis was conducted with failure defined as revision surgery and/or failure of the cup-cage reconstruction. Results: A total of 30 implants (23%) reached the study endpoint involving all-cause revision. Overall survivorship was 74.8% at 10 years and 69.8% at 15 years. Reasons for revision included infection 12/131 (9.1%), dislocation 10/131 (7.6%), aseptic loosening of cup and/or cage 5/131 (3.8%), and aseptic loosening of the femoral stem 2/131 (1.5%). The mean LLD improved from 12.2 ± 15.9 mm to 3.9 ± 11.8 (p<0.05). The horizontal and vertical hip centres on plain film radiographs were significantly improved (p<0.05). Functionally, there was a decrease in the number of patients requiring the use of gait aids, with fewer patients (34, 25.9%) using a cane, walker, or wheelchair post-operatively compared to pre-operatively (58, 44%). There was a significant increase in the number of independent ambulators from 24 to 47 (36%). Conclusion: The cup-cage construct is a reliable treatment option for the treatment of various acetabular defects. There are favourable survivorship, clinical and radiographic outcomes, with a satisfactory complication rate.

Keywords: revision total hip arthroplasty, acetabular defect, pelvic discontinuity, trabecular metal augment, cup-cage

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Authors: Blessing A. Aderibigbe

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Combination therapy is a treatment approach that is used to prevent the emergence of drug resistance. This approach is used for the treatment of many chronic and infectious diseases. Potentiating agents are currently explored in combination therapy, resulting in excellent therapeutic outcomes. Breast cancer and malaria are two chronic conditions responsible globally for high death rates. In this research, a class of polymer-drug conjugates containing potentiating agents with either antimalarial or anticancer drugs were prepared by Michael Addition Polymerization reaction and ring-opening polymerization reaction. Conjugation of potentiating agents with bioactive compounds into the polymers resulted in conjugates with good water solubility, highly selective and non-toxic. In vitro cytotoxicity and in vitro antiplasmodial evaluation on the conjugates revealed that the conjugates were more effective when compared to the free drugs. The drug release studies further showed that the release profile of the drugs from the conjugates was sustained. The findings revealed the potential of polymer-drug conjugates to overcome drug toxicity and drug resistance, which is common with the currently used antimalarial and anticancer drugs.

Keywords: anticancer, antimalarials, combination therapy, polymer-drug conjugates

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Authors: Hossam E. Emam

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Metal–organic frameworks (MOFs) are new hybrid materials investigated from 15 years ago; they synthesized from metals as inorganic center joined with multidentate organic linkers to form a 1D, 2D or 3D network structure. MOFs have unique properties such as pore crystalline structure, large surface area, chemical tenability and luminescent characters. These significant properties enable MOFs to be applied in many fields such like gas storage, adsorption/separation, drug delivery/biomedicine, catalysis, polymerization, magnetism and luminescence applications. Recently, many of published reports interested in superiority of MOFs for functionalization of textiles to exploit the unique properties of MOFs. Incorporation of MOFs is found to acquire the textiles some additional formidable functions to be used in considerable fields such like water treatment and fuel purification. Modification of textiles with MOFs could be easily performed by two main techniques; Ex-situ (preparation of MOFs then applied onto textiles) and in-situ (ingrowth of MOFs within textiles networks). Uniqueness of MOFs could be assimilated in acquirement of decorative color, antimicrobial character, anti-mosquitos character, ultraviolet radiation protective, self-clean, photo-luminescent and sensor character. Additionally, textiles treatment with MOFs make it applicable as filter in the adsorption of toxic gases, hazardous materials (such as pesticides, dyes and aromatics molecules) and fuel purification (such as removal of oxygenated, nitrogenated and sulfur compounds). Also, the porous structure of MOFs make it mostly utilized in control release of insecticides from the surface of the textile. Moreover, MOF@textiles as recyclable materials lead it applicable as photo-catalyst composites for photo-degradation of different dyes in the day light. Therefore, MOFs is extensively considered for imparting textiles with formidable properties as ingeniousness way for textile functionalization.

Keywords: MOF, functional textiles, water treatment, fuel purification, environmental applications

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Authors: Rajish Shil, Mohammad Ali Houri, Mohammad Milad Ismail, Fatimah Al Kaabi

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The clinical presentation of Primary hyperparathyroidism can vary from simple asymptomatic hypercalcemia to severe life-threatening hypercalcemic crisis with multi-organ dysfunction, which can be due to parathyroid adenoma or sometimes with malignant cancer. This cascade of clinical presentation can lead to a diagnostic and therapeutic challenge for treating the disease. We are presenting a case of severe hypercalcemic crisis due to parathyroid adenoma with an emphasis on early management, diagnosis, and interventions to prevent any lifelong complications and any permanent organ dysfunction. A 30 years old female with a history of primary Infertility, admitted to Al Ain Hospital critical care unit with Acute Severe Necrotizing Pancreatitis. She initially had a 1-month history of abdominal pain on and off, for which she was treated conservatively with no much improvement, and later on, she developed life-threatening severe pancreatitis, which required her to be admitted to the critical care unit. She was transferred from a private healthcare facility, where she was found to have a very high level of calcium up to 15mmol/L. She received systemic Zoledronic Acid, which lowered her calcium level transiently and later was increased again. She went on to develop multiple end-organ damages along with multiple electrolytes disturbances. She was found to have high levels of Parathyroid hormone, which was correlated with a parathyroid mass on the neck via radiological imaging. After a long course of medical treatment to lower the calcium to a near-normal level, parathyroidectomy was done, which showed parathyroid adenoma on histology. She developed hungry bone syndrome after the surgery and pancreatic pseudocyst after resolving of pancreatitis. She required aggressive treatment with Intravenous calcium for her hypocalcemia as she received zoledronic acid at the beginning of the disease. Later on, she was discharged on long term calcium and other electrolytes supplements. In patients presenting with hypercalcemia, it is prudent to investigate and start treatment early to prevent complications and end-organ damage from hypercalcemia and also to treat the primary cause of the hypercalcemia, with conscious follow up to prevent hypocalcemic complications after treatment. It is important to follow up patients with parathyroid adenomas for a long period in order to detect any recurrence of the tumor or to make sure if the primary tumor is either benign or malignant.

Keywords: hypercalcemia, pancreatitis, hypocalcemia, hyperparathyroidism

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