Search results for: poor outcome of delayed breast cancer treatment

Authors: Aishik Deb, Rituparna Sinha

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We have developed an algorithm to detect the abnormal segment/"structural variation in the genome across a number of samples. We have worked on simulated as well as real data from the BAM Files and have designed a segmentation algorithm where abnormal segments are detected. This algorithm aims to improve the accuracy and performance of the existing CNV-CH algorithm. The next-generation sequencing (NGS) approach is very fast and can generate large sequences in a reasonable time. So the huge volume of sequence information gives rise to the need for Big Data and parallel approaches of segmentation. Therefore, we have designed a map-reduce approach for the existing CNV-CH algorithm where a large amount of sequence data can be segmented and structural variations in the human genome can be detected. We have compared the efficiency of the traditional and map-reduce algorithms with respect to precision, sensitivity, and F-Score. The advantages of using our algorithm are that it is fast and has better accuracy. This algorithm can be applied to detect structural variations within a genome, which in turn can be used to detect various genetic disorders such as cancer, etc. The defects may be caused by new mutations or changes to the DNA and generally result in abnormally high or low base coverage and quantification values.

Keywords: cancer detection, convex hull segmentation, map reduce, next generation sequencing

Procedia PDF Downloads 129

Authors: Jesmin Akter, Chang Hyuk Ahn, Ilho Kim, Fumitake Nishimura, Jaiyeop Lee

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This study aimed to compare two pre-treatment and two RNA extraction methods, namely PEG, and Nano bubble, Viral RNA Soil, and Mini Kit, in terms of their efficiency in detecting SARS-CoV-2 and PMMoV in influent and 1st sedimentation samples from a wastewater treatment plant. The extracted RNA samples were quantified and evaluated for purity, yield, and integrity. The results indicated that the nanobubble PEG method provided the highest yield of RNA, while the QIAamp Viral RNA Mini Kit produced the purest RNA samples. In terms of sensitivity and specificity, all these methods were able to detect SARS-CoV-2 and PMMoV in both influent and 1st sedimentation samples. However, the nanobubble PEG method showed slightly higher sensitivity compared to the other methods. These findings suggest that the choice of RNA extraction method should depend on the downstream application and the quality of the RNA required. The study also highlights the potential of wastewater-based epidemiology as an effective and non-invasive method for monitoring the spread of infectious diseases in a community.

Keywords: influent, PMMoV, SARS-CoV-2, wastewater based epidemiology

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Authors: Donghee Kang

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Background: Cancer pain is very difficult to control as the mechanism of pain is varied, and the patient has several co-morbidities. The use of Intravenous Patient-Controlled Analgesia (IV-PCA) can effectively control underlying pain and breakthrough pain. Ketamine is used in many pain patients due to its unique analgesic effect. In this study, it was checked whether there was a difference in the amount of analgesic usage, pain control degree, and side effects between patients who controlled pain with fentanyl-based IV-PCA and those who added Ketamine for pain control. Methods: Among the patients referred to this department for cancer pain, IV-PCA was applied to patients who were taking sufficient oral analgesics but could not control them or had blood clotting disorders that made the procedure difficult, and this patient group was targeted. In IV-PCA, 3000 mcg of Fentanyl, 160 mg of Nefopam, and 0.3 mg of Ramosetrone were mixed with normal saline to make a total volume of 100 ml. Group F used this IV-PCA as it is, and group K mixed 250 mg of Ketamine with normal saline to make a total volume of 100 ml. For IV-PCA, the basal rate was 0.5ml/h, the bolus was set to 1ml when pressed once, and the lockout time was set to 15 minutes. If pain was not controlled after IV-PCA application, 500 mcg of Fentanyl was added, and if excessive sedation or breathing difficulties occurred, the use was stopped for one hour. After that, the degree of daily pain control, analgesic usage, and side effects were investigated for seven days using this IV-PCA. Results: There was no difference between the two groups in the demographic data. Both groups had adequate pain control. Initial morphine milligram equivalents did not differ between the two groups, but the total amount of Fentanyl used for seven days was significantly different between the two groups [p=0.014], and group F used more Fentanyl through IV-PCA. In addition, the amount of sleeping pills used during the seven days was higher in Group F [p<0.01]. Overall, there was no difference in the frequency of side effects between the two groups, but the nausea was more frequent in Group F [p=0.031]. Discussion: When the two groups were compared, pain control was good in both groups. This seems to be because Fentanyl-based IV-PCA showed an adequate pain control effect. However, there was a significant difference in the total amount of opioid (Fentanyl) used, which is thought to be the opioid-sparing effect of Ketamine. Also, among the side effects, nausea was significantly less, which is thought to be possible because the amount of opioids used in the Ketamine group was small. The frequency of requesting sleeping pills was significantly less in the group using Ketamine, and it seems that Ketamine also helped improve sleep quality. In conclusion, using Ketamine with an opioid to control pain seems to have advantages. IV-PCA, which can be used effectively when other procedures are difficult, is more effective and safer when used together with Ketamine than opioids alone.

Keywords: cancer pain, intravenous patient-controlled analgesia, Ketamine, opioid

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Authors: Awole Seid, Yosef Zenebe, Hadgu Gerensea, Kebede Haile Misgina

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Background: Clinical competence is one of the ultimate goals of nursing education. Clinical skills are more than successfully performing tasks; it incorporates client assessment, identification of deficits and the ability to critically think to provide solutions. Assessment of clinical competence, particularly identifying gaps that need improvement and determining the educational needs of nursing students have great importance in nursing education. Thus this study aims determining clinical self-efficacy of final year school of nursing students in three universities of Tigray Region. Methods: A cross-sectional study was conducted on 224 final year school of nursing students from department of nursing, psychiatric nursing, and midwifery on three universities of Tigray region. Anonymous self-administered questionnaire was administered to generate data collected on June, 2017. The data were analyzed using SPSS version 20. The result is described using tables and charts as required. Logistic regression was employed to test associations. Result: The mean age of students was 22.94 + 1.44. Generally, 21% of students have been graduated in the department in which they are not interested. The study demonstrated 28.6% had poor and 71.4% had good perceived clinical self-efficacy. Beside this, 43.8% of psychiatric nursing and 32.6% of comprehensive nursing students have poor clinical self-efficacy. Among the four domains, 39.3% and 37.9% have poor clinical self- efficacy with regard to ‘Professional development’ and ‘Management of care’. Place of the institution [AOR=3.480 (1.333 - 9.088), p=0.011], interest during department selection [AOR=2.202 (1.045 - 4.642), p=.038], and theory-practice gap [AOR=0.224 (0.110 - 0.457), p=0.000] were significantly associated with perceived clinical self-efficacy. Conclusion: The magnitude of students with poor clinically self efficacy was high. Place of institution, theory-practice gap, students interest to the discipline were the significant predictors of clinical self-efficacy. Students from youngest universities have good clinical self-efficacy. During department selection, student’s interest should be respected. The universities and other stakeholders should improve the capacity of surrounding affiliate teaching hospitals to set and improve care standards in order to narrow the theory-practice gap. School faculties should provide trainings to hospital staffs and monitor standards of clinical procedures.

Keywords: clinical self-efficacy, nursing students, Tigray, northern Ethiopia

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Authors: Adam Haliński, Andrzej Haliński

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Introduction: Flexible ureterorenoscopy is a surgery technique used for the treatment of the upper urinary tract. It is very often used in adult patients; however, due to the advancing miniaturization of the equipment as well as its precision, this technique has also become possible in the treatment process in children. Material and method: We would like to present 26 cases of flexible ureterorenoscopy carried out in children with nephrolithiasis of the upper urinary tract aged 6 to 17 years. The average age was 9.5 years and the children were treated in our department from June 2013 to January 2015. The first surgery in Poland took place in our Department on 06.06.2013. Because of nephrolithiasis all the children had been subjected earlier to ESWL treatment, which was unsuccessful. Results: 14 children had deposits in the lower calyx, 9 children had deposits in the middle and lower calyx and in 3 children a stone was located in the initial ureter. An efficiency of 88 % was achieved. Conclusions: Flexible ureterorenoscopy is effective and minimally invasive tool both for the diagnosis and treatment of upper urinary tract. We believe that the advancing miniaturization of the equipment and gaining experience will enable carrying out of this procedure in smaller children with high efficiency.

Keywords: flexible ureterorenoscopy, urolithisis, endourology, nephrolithiasis

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Authors: Arpit Gite

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Purpose: We have evaluated the role of Total Neoadjuvant Therapy in patients with Locally Advanced Rectal cancer by giving Chemoradiotherapy followed by consolidation chemotherapy (CRT-CNCT) and, after that, the strategy of wait and watch. Methods: In this prospective case series, we evaluated the results of three locally advanced Rectal cancers, two cases Stage II (cT3N0) and one case Stage III ( cT4aN2). All three patients' growth was 4-6 cm from the anal verge. We have treated with Chemoradiotherapy to dose of 45Gy/25 Fractions to elective nodal regions (Inguinal node in anal canal Involvement)and Primary and mesorectum (Phase I) followed by 14.4Gy/8 Fractions to Primary and Mesorectum(Phase II) to a total dose of 59.4Gy/33 Fractions with concurrent chemotherapy Tab Capecitabine 825mg/m2 PO BD with Radiation therapy. After 6 weeks of completion of Chemoradiotherapy, advised six cycles of consolidative chemotherapy, CAPEOX regimen, Oxaliplatin 130mg/m2 on day 1 and Capecitabine 1000mg/m2 PO BD on days 1-14 repeated on a 21-day cycle for a total of six cycles. The primary endpoint is Disease-free survival (DFS); the secondary endpoint is adverse events related to chemoradiotherapy. Radiation toxicity is assessed by RTOG criteria, and chemotherapy toxicity is assessed by Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0. Results: After 6 weeks of completion of Chemoradiotherapy, we did PET-CT of all three patients; all three patients had a clinically complete response and we advised 6 cycles of consolidative chemotherapy. After completion of consolidative chemotherapy, again PET-CT and sigmoidoscopy, all three patients had complete response on PET-CT and no lesions on sigmoidoscopy and kept all three patients on wait and watch.2 patients had Grade 2 skin toxicities,1 patient had Grade 1 skin toxicity, .2 patients had Grade 2 lower GI toxicities, and 1 patient had Grade lower GI toxicity, both according to RTOG criteria. 3 patients had Grade 2 diarrhea due to capecitabine, and 1 patient had Grade 1 thrombocytopenia due to oxaliplatin assessed by Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0. Conclusion: Sphincter Preservation is possible with this regimen in those who don’t want to opt for surgery or in case of low-lying rectal cancer.

Keywords: locally advanced rectal cancer, sphincter preservation, chemoradiotherapy, consolidative chemotherapy

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Authors: Melikulov A. A., Toshpulotov Sh. G., Akhmedova M. F., Beshimov A. S., Rakhimov M. K. Zokirov N. K.

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Postinfarction ventricular septal defect (PVSD) is a rare but life-threatening complication of acute myocardial infarction. Currently, an alternative direction of minimally invasive treatment of postinfarction ventricular septal defect (PVSD) is being developed - transcatheter closure of the defect using an occluder, but surgical closure of the defect remains the <> correction of post-infarction VSD. Our article presents a case of successful surgical treatment of a patient with a large post-infarction rupture of the interventricular septum (IVS) and post-infarction LV aneurysm under cardiopulmonary bypass and parallel perfusion.

Keywords: echocardiography, myocardial infarction, ventricular septal defect, parallel perfusion

Procedia PDF Downloads 74

Authors: Zoran Herceg, Višnja Stulić, Tomislava Vukušić, Anet Režek Jambrak

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High voltage electrical discharge is a new technology used for inactivation of pathogen microorganisms. Pathogen yeasts can cause diseases in humans if they are ingested. Nowadays new technologies have become the focus of researching all over the world. Rhodotorula is known as yeast that can cause diseases in humans. The aim of this study was to examine whether the high voltage electrical discharge treatment generated in gas phase has an influence on yeast reduction and recovery of Rhodotorula spp 74 in pure culture. Rhodotorula spp. 74 was treated in 200 mL of model solution. Treatment time (5 and 10 min), frequency (60 and 90 Hz) and injected gas (air or argon 99,99%) were changed. Titanium high voltage needle was used as high voltage electrode (positive polarity) through which air or argon was injected at the gas flow of 0.6 L/min. Experimental design and statistical analyses were obtained by Statgraphics Centurion software (StatPoint Technologies, Inc., VA, USA). The best inactivation rate 1.7 log10 reduction was observed after the 10 min of treatment, frequency of 90 Hz and injected air. Also with a longer treatment time inactivation rate was higher. After the 24 h recovery of treated samples was observed. Therefore the further optimization of method is needed to understand the mechanism of yeasts inactivation and cells recovery after the treatment. Acknowledgements: The authors would like to acknowledge the support by Croatian Science Foundation and research project ‘Application of electrical discharge plasma for preservation of liquid foods’.

Keywords: rhodotorula spp. 74, electrical discharge plasma, inactivation, stress response

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Authors: Farida Azzouz-Olden, Arthur G. Hunt, Gloria Degrandi-Hoffman

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Bees are confronting several environmental challenges, including the intermingled effects of malnutrition and disease. Intuitively, pollen is the healthiest nutritional choice; however, commercial substitutes, such as BeePro and MegaBee, are widely used. Herein we examined how feeding natural and artificial diets shapes transcription in the abdomen of the honey bee, and how transcription shifts in combination with Nosema parasitism. Gene ontology enrichment revealed that, compared with poor diet (carbohydrates (C)), bees fed pollen (P > C), BeePro (B > C), and MegaBee (M > C) showed a broad upregulation of metabolic processes, especially lipids; however, pollen feeding promoted more functions and superior proteolysis. The superiority of the pollen diet was also evident through the remarkable overexpression of vitellogenin in bees fed pollen instead of MegaBee or BeePro. Upregulation of bioprocesses under carbohydrates feeding compared to pollen (C > P) provided a clear poor nutritional status, uncovering stark expression changes that were slight or absent relatively to BeePro (C > B) or MegaBee (C > M). Poor diet feeding (C > P) induced starvation response genes and hippo signaling pathway, while it repressed growth through different mechanisms. Carbohydrate feeding (C > P) also elicited ‘adult behavior’, and developmental processes suggesting transition to foraging. Finally, it altered the ‘circadian rhythm’, reflecting the role of this mechanism in the adaptation to nutritional stress in mammals. Nosema-infected bees fed pollen compared to carbohydrates (PN > CN) upheld certain bioprocesses of uninfected bees (P > C). Poor nutritional status was more apparent against pollen (CN > PN) than BeePro (CN > BN) or MegaBee (CN > MN). Nosema accentuated the effects of malnutrition since more starvation-response genes and stress response mechanisms were upregulated in CN > PN compared to C > P. The bioprocess ‘Macromolecular complex assembly’ was also enriched in CN > PN, and involved genes associated with human HIV and/or influenza, thus providing potential candidates for bee-Nosema interactions. Finally, the enzyme Duox emerged as essential for guts defense in bees, similarly to Drosophila. These results provide evidence of the superior nutritional status of bees fed pollen instead of artificial substitutes in terms of overall health, even in the presence of a pathogen.

Keywords: honeybee, immunity, Nosema, nutrition, RNA-seq

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Authors: Sara Matsuzaka

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At the center of emerging policy debates on the rights of transgender individuals in public accommodations is the collision of gender binary views with transgender perspectives that challenge conventional gender norms. The results of such socio-political debates could have significant ramifications for the policies and infrastructures of public and private institutions nationwide, including within the addiction treatment field. Despite having disproportionately high rates of substance use disorder compared to the general population, transgender individuals experience significant barriers to engaging in addiction treatment programs. Inpatient addiction treatment centers were originally designed to treat heterosexual cisgender populations and, as such, feature gender segregated housing, bathrooms, and counseling sessions. Such heteronormative structural barriers, combined with exposures to stigmatic al attitudes, may dissuade transgender populations from benefiting from the addiction treatment they so direly need. A literature review is performed to explore the mechanisms by which gender segregation alienates transgender populations within inpatient addiction treatment. The constituent parts of the current debate on the rights of transgender individuals in public accommodations are situated the context of inpatient addiction treatment facilities. Minority Stress Theory is used as a theoretical framework for understanding substance abuse issues among transgender populations as a maladaptive behavioral response for coping with chronic stressors related to gender minority status and intersecting identities. The findings include that despite having disproportionately high rates of substance use disorder compared to the general population, transgender individuals experience significant barriers to engaging in and benefiting from addiction treatment. These barriers are present in the form of anticipated or real interpersonal stigma and discrimination by service providers and structural stigma in the form of policy and programmatic components in addiction treatment that marginalize transgender populations. Transphobic manifestations within addiction treatment may dissuade transgender individuals from seeking help, if not reinforce a lifetime of stigmatic experience, potentially exacerbating their substance use issues. Conclusive recommendations for social workers and addiction treatment professionals include: (1) dismantling institutional policies around gender segregation that alienate transgender individuals, (2) developing policies that provide full protections for transgender clients against discrimination based on their gender identity, and (3) implementing trans-affirmative cultural competency training requirements for all staff. Directions for future research are provided.

Keywords: addiction treatment, gender segregation, stigma, transgender

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Authors: Janki Shankar, Shu-Ping Chen

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This Canadian study explored the perspectives of recent immigrant workers regarding occupational health and safety (OHS) and workplace conditions that increase workers’ vulnerability to sustaining injury or illness. Using an interpretive research approach and semi structured qualitative interviews, 42 recent immigrant workers from a range of industries operating in two cities in a province in Canada were interviewed. A constant comparative approach was used to identify key themes across the workers’ experiences. The findings revealed that these workers have an incomplete understanding of OHS. In many workplaces, poor job training, little worker support, lack of power in the workplace, and a poor workplace safety culture make it difficult for recent immigrant workers to acquire OHS information and implement safe work practices. This study proposes workplace policies and practices that will improve worker OHS awareness and make workplaces safer for immigrant workers.

Keywords: new immigrant workers, occupational health and safety, workplace challenges, policy, practice

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Authors: Nur Ilya Farhana Md Noh, Zakiah Ahmad

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Heat treatment on timbers is a process of applying heat to modify and equip the timbers with new improvised characteristics. It is environmental friendly compared to the common practice of treating timber by chemical preservatives. Malaysian hardwood timbers; Pauh Kijang and Kapur in green condition were heat treated at 150°C, 170°C, 190°C and 210°C in a specially design electronic furnace in one hour duration. The objectives were to determine the effect of heat treatment on bending strength properties of heat treated Pauh Kijang and Kapur in term of Modulus of Elasticity (MOE) and Modulus of Rupture (MOR) and to examine the significance changes at each temperature levels applied. Untreated samples for each species were used as a control sample. The results indicated that the bending strength properties for both species of timbers were affected by the heat exposure. Both MOE and MOR values for heat treated Pauh Kijang were increased when subjected to the specified temperature levels except at 210°C. The values were dropped compared to the control sample and sample treated at 190°C. Heat treated Kapur shows the same pattern of increment on its MOE and MOR values after exposure to heat at three temperature levels used and the values dropped at 210°C. However, differ to Pauh Kijang, even though there were decrement occurred at 210°C but the value is still higher compared to the control sample. The increments of MOE and MOR values are an indicator that heat treatment had successfully improvised the bending strength properties of these two species of hardwood timber. As the good strength of Malaysian timbers used as structural material is limited in numbers and expensive, heat treating timber with low strength properties is an alternative way to overcome this issue. Heat treatment is an alternative method need to be explored and made available in Malaysia as this country is still practicing chemical preservative treatment on the timbers.

Keywords: bending strength, hardwood timber, heat treatment, modulus of elasticity (MOE), modulus of rupture (MOR)

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Authors: G. L. Devnani, Shishir Sinha

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In the recent years, researchers have drawn their focus on natural fibers reinforced composite materials because of their excellent properties like low cost, lower weight, better tensile and flexural strengths, biodegradability etc. There is little concern however that when these materials are put in moist conditions for long duration, their mechanical properties degrade. Therefore, in order to take maximum advantage of these novel materials, one should have a complete understanding of their moisture or water absorption phenomena. Various fiber surface treatment methods like alkaline treatment, acetylation etc. have also been suggested for reduction in water absorption of these composites. In the present study, a detailed review is done for water absorption behavior of natural fiber reinforced polymer composites, and experiments also have been performed on these composites with varying the parameters like fiber loading etc. for understanding the water absorption kinetics. Various surface treatment methods also performed to reduce the water absorption behavior of these materials and effort is made to develop a proper understanding of water absorption mechanism mathematically and experimentally for full potential utilization of natural fiber reinforced polymer composite materials.

Keywords: alkaline treatment, composites, natural fiber, water absorption

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Authors: Joaquim de Almeida Dultra, Daiana Cristina Pereira Santana, Fátima Karoline Alves Araújo Dultra, Liliane Akemi Kawano Shibasaki, Mariana Machado Mendes de Carvalho, Ieda Margarida Crusoé Rocha Rebello

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Defects originating from mandibular resections can cause significant functional impairment and facial disharmony, and they have complex rehabilitation. The aim of this report is to demonstrate the authors' experience facing challenging rehabilitation after mandibular resection in a patient with ameloblastoma. Clinical and surgical steps are described simultaneously, highlighting the adaptation of the final fixed prosthesis, reported in an unprecedented way in the literature. A 37-year-old male patient was seen after a sports accident, where a pathological fracture in the symphysis and left mandibular body was identified, where a large radiolucent lesion was found. The patient underwent resection, bone graft, distraction osteogenesis, rehabilitation with dental implants, prosthesis, and finally, orofacial harmonization, in an interval of six years. Rehabilitation should consider the patient's needs individually and should have as the main objective to provide similar aesthetics and function to that present before the disease. We also emphasize the importance of interdisciplinary work during the course of rehabilitation.

Keywords: ameloblastoma, mandibular reconstruction, distraction osteogenesis, dental implants. dental prosthesis, implant-supported, treatment outcome

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Authors: Joni Agung Sudarmanto

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The concept of design has historically been elusive and characterized by its fluidity, leading to divergent viewpoints on its fundamental nature. Guy Julier views design as inherent in material culture, while Sanders sees it as a collective endeavor focusing on the outcome. Design's dualistic nature, procedural and outcome-oriented, spans various domains, including objects, individuals, and the environment. This comprehensive view of design challenges the notion that design practice is distinct from research, highlighting their shared exploratory nature. The article explores methodological techniques in design research and the three prevalent approaches: "into design," "through design," and "for design." The contradictory meanings of design arise from its etymology and its duality as both process and result, leading to its integrative nature across objects, humans, and the environment. The parallels between design and research activities, underscoring their exploratory and knowledge-generating nature, are situated within creative research, challenging the perception of design practice as separate from research endeavors. The "into design" approach encourages interdisciplinary collaboration, enriching design research with diverse perspectives. The "through design" approach bridges theory and practice, producing more practical outcomes. The "for design" approach supports specific design solutions, providing designers with valuable guidance.

Keywords: dualistic nature of design, integrative perspectives, methodological approaches, design research

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Authors: Belahmadi M. S. O., Abdessemed A., Benchiheub M., Doukali H., Kaid Kasbah K. M.

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The aim of this study is to evaluate the quality of leachate generated by the Batna landfill site, and to verify the performance of various advanced oxidation processes, in particular the Fenton and Photo-Fenton systems combined with biological treatment to eliminate the recalcitrant organic matter contained in this effluent, and to preserve reverse osmosis membranes used for leachate treatment. The average values obtained are compared with national and international discharge standards. The results of physico-chemical analyses show that the leachate has an alkaline pH =8.26 and a high organic load with a low oxygen content. Mineral pollution is represented by high conductivity (38.3 mS/cm), high Kjeldahl nitrogen content (1266.504 mg/L) and ammoniacal nitrogen (1098.384 mg/L). The average pollution indicator parameters measured were: BOD5 = 1483.333 mg O2 /L, COD = 99790.244 mg O 2/L, TOC = 22400 mg C/L. These parameters exceed Algerian standards. Hence, there is a necessity to treat this effluent before discharging it into the environment. A comparative study was carried out to estimate the efficiency of two oxidation processes. Under optimum reaction conditions, TOC removal efficiencies of 63.43% and 73.4% were achieved for the Fenton and Photo-Fenton processes, respectively. COD removal rates estimated at 88% and 99.5% for the Fenton and Photo- Fenton processes, respectively. In addition, the Photo-Fenton + bacteria + micro- algae hybrid treatment gave removal efficiencies of around 92.24% for TOC and 99.9% for COD; -0.5 for AOS and 0.01 for CN. The results obtained during this study showed that a hybrid approach combining the PhotoFenton process and biological treatment appears to be a highly effective alternative for achieving satisfactory treatment, which aimed at exploiting the advantages of this method in terms of organic pollutant removal.

Keywords: leachate, landfill, advanced oxidation processes, Fenton and Photo-Fenton systems, biological treatment, organic pollutants

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Authors: Adel Ahmadi Hosseini, Fatemeh Tavanaei, Alessandro Navarra, Ferri Hassani

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Mining engineering, as a part of geoscience, must address modern concerns. Traditional mining methods incorporate drill and blast technologies, which are followed by different issues, including excessive noise, vibration, air pollution, and safety hazards. Over the past two decades, mining engineers have sought alternative solutions to move from drill and blast to continuous methods to prevent such issues and improve sustainability in mining. Among the suggested methods, microwave treatment has shown promising results by creating micro/macro cracks in the rock structure prior to the operations. This research utilizes an energy-based analysis methodology to evaluate the efficiency of the microwave treatment in improving mining operations. The data analysis shows that increasing the input microwave energy dosage intensifies the rock damage. However, this approach can decrease the energy efficiency of the method by more than 50% in some cases. In this study, rock samples were treated with three power levels (3 kW, 7 kW, and 12 kW) and two energy dosages (20 kWh/t and 50 kWh/t), resulting in six conditions. To evaluate the impact of microwave treatment on the geomechanical behavior of the rocks, Unconfined Compressive Strength (UCS) tests were conducted on the microwave-treated samples, yielding stress-strain curves. Using the stress-strain curves, the effect of the different powers and energy dosages of microwaves are discussed. This research shows the potential of using microwave treatment to lead the industry to more sustainable mining.

Keywords: microwave treatment, microwave energy dosage, sustainable mining, rock fragmentation

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Authors: Lisa Fox, Jill Aylott

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There is a global need to identify ways to engage doctors in non-clinical matters such as medical leadership, service improvement and health system transformation. Using the core principles of Realistic Evaluation (RE), this study examined what works, for doctors of different grades, specialities and experience in an acute NHS Hospital Trust in the UK. Realistic Evaluation is an alternative to more traditional cause and effect evaluation models and seeks to understand the interdependencies of Context, Mechanism and Outcome proposing that Context (C) + Mechanism (M) = Outcome (O). In this study, the context, mechanism and outcome were examined from within individual medical leaders to determine what enables levels of medical engagement in a specific improvement project to reduce hospital inpatient mortality. Five qualitative case studies were undertaken with consultants who had regularly completed mortality reviews over a six month period. The case studies involved semi-structured interviews to test the theory behind the drivers for medical engagement. The interviews were analysed using a theory-driven thematic analysis to identify CMO configurations to explain what works, for whom and in what circumstances. The findings showed that consultants with a longer length of service became more engaged if there were opportunities to be involved in the beginning of an improvement project, with more opportunities to affect the design. Those that are new to a consultant role were more engaged if they felt able to apply any learning directly into their own settings or if they could use it as an opportunity to understand more about the organisation they are working in. This study concludes that RE is a useful methodology for better understanding the complexities of motivation and consultant engagement in a trust wide service improvement project. The study showed that there should be differentiated and bespoke training programmes to maximise each individual doctor’s propensity for medical engagement. The RE identified that there are different ways to ensure that doctors have the right skills to feel confident in service improvement projects.

Keywords: realistic evaluation, medical leadership, medical engagement, patient safety, service improvement

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Authors: Rui Chen, Jinfeng Zhang, Chun-Sing Lee

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In the past couple of decades, nanoscale metal-organic frameworks (NMOFs) have been highlighted as promising delivery platforms for biomedical applications, which combine many potent features such as high loading capacity, progressive biodegradability and low cytotoxicity. While NMOF has been extensively used as carriers for drugs of different modalities, so far there is no report on exploiting the advantages of NMOF for combination therapy. Herein, we prepared core-shell nanoparticles, where each nanoparticle contains a single graphitic-phase carbon nitride (g-C3N4) nanosheet encapsulated by a zeolitic-imidazolate frameworks-8 (ZIF-8) shell. The g-C3N4 nanosheets are effective visible-light photosensitizer for photodynamic therapy (PDT). When hosting DOX (doxorubicin), the as-synthesized core-shell nanoparticles could realize combinational photo-chemo therapy and provide dual-color fluorescence imaging. Therefore, we expect NMOFs-based core-shell nanoparticles could provide a new way to achieve much-enhanced cancer therapy.

Keywords: carbon nitride, combination therapy, drug delivery, nanoscale metal-organic frameworks

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Authors: Mandy W. M. Chan, Samantha Y. N. Shek, Chi K. Yeung, Taro Kono, Henry H. L. Chan

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Fractional radiofrequency devices have shown to improve skin texture such as smoothness, rhytides, brightness as well as atrophic acne scars by increasing dermal thickness, dermal collagen content and dermal fibrillin content. The objective of the study is to assess the efficacy and adverse effects of this device on Asian patients with skin textural changes. In this study, 20 Chinese patients (ranging from 21-60 years old) with irregularities of skin texture, rhytides and acne scars were recruited. Patients received six treatments at 2-4 week intervals. Treatment was initiated with maximum energy tolerated and was adjustable during treatment if patients felt excessive discomfort. A total of two passes were delivered at each session. Physician assessment and standardized photographs were taken at baseline, all treatment visits and at one, two, and six month after final treatment. As a result, 17 patients were recruited and completed the study according to the study protocol. One patient withdrew after the first treatment due to reaction to local anesthesia and two patients were lost to follow-up. At six months follow-up, 71% of the patients were satisfied and 24% were very satisfied, while treatment physician reported various degrees of improvement based on the global assessment scale in 60% of the subjects. Anticipated side effects including erythema, edema, pinpoint bleeding, scabs formation and flare of acne were recorded, but there were no serious adverse effects noted. Conclude up, the use of fractional radiofrequency improves skin texture and appears to be safe in Asian patients. No long-term serious adverse effect was noted.

Keywords: Asian, fractional radiogrequency, skin, texture

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Authors: Aparajita Mukherjee, D. P. Mukherjee

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This paper critically assessed pollution problems in small and medium enterprises with unique references to foundries and sponge iron industries to survey the adverse impact on human societies and the environment. The objective of this paper was to show how cleaner production concept was implemented in one foundry through improvisation of existing technology in India. Incremental advancement of existing technology minimized environmental issues and resource utilization. This study depicted that poor fiscal help, poor enforcement of government regulations, owners’ attitude and lacking specialized technical workers were the significant hindrances towards cleaner production. The paper explored the possible ways to overcome these hindrances for cleaner production. On a more general level, findings raise important questions regarding the need for a new paradigm for the implementation of cleaner production. Improvisation of existing technology in these enterprises would be cost effective towards sustainable development.

Keywords: SME pollution, ecological crisis, sustainable development, cleaner production, training

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Authors: Aiswarya Gopal, Kamal Bijlani, Vinoth Rengaraj, R. Jayakrishnan

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In the business world, the term “startup” is frequently ringing the bell with the high frequency of young ventures. The main dilemma of startups is the unsuccessful management of the unique risks that have to be confronted in the present world of competition and technology. This research work tried to bring out a game based methodology to improve enough real-world experience among entrepreneurs as well as management students to handle risks and challenges in the field. The game will provide experience to the player to overcome challenges like market problems, running out of cash, poor management, and product problems which can be resolved by a proper strategic approach in the entrepreneurship world. The proposed serious game works on the life cycle of a new software enterprise where the entrepreneur moves from the planning stage to secured financial stage, laying down the basic business structure, and initiates the operations ensuring the increment in confidence level of the player.

Keywords: business model, game based learning, poor management, start up

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Authors: Eriselda Simoni, Leonard Simoni, Endri Paparisto, Laureta Flaga, Silvana Bara, Edit Xhajanka, Arjan Harxhi

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Background: Some pathologies are encountered more often in HIV/ AIDS, such as those with bacterial, fungal, viral, and neoplastic causes, but what has been more noticeable in recent years is the increased and more aggressive manifestation of periodontal disease and oral caries. Our purpose is to investigate the correlation between the HIV/AIDS stage and CD4 level with oral health, dentition, and periodontal status. Materials and Methods: We conducted a prospective observational study that included 35 patients newly diagnosed with HIV/AIDS and underwent an oral examination at the University Dental Clinic in Tirana, Albania, in the period April - July 2024. This study evaluated the basic demographic, laboratory characteristics, oral hygiene, and the presence of oral lesions. The dentition status was assessed with the values DT (decay teeth), FT (filled teeth), and MT (missing teeth) presented as DMFT. The periodontal status was evaluated through a periodontal probe measuring CPI (community periodontal index) and LOA (loss of attachment) as recommended by the WHO Oral Health Assessment Form 2013. The Pearson Correlation Coefficient (r) was used to evaluate the relationship between levels of CD4+ and DMF, CD4+ and CPI, and CD4+ and LOA. The P value ≤ 0.05 was considered statistically significant. Results: 80% of patients included were males with a mean age of 35.8 years. 8.6% of patients were categorized as HIV stage I, 28.6% as stage II, and 62.8% as HIV stage III/AIDS. The mean level value of CD4+ was 266.2 cells/mm3 and the rapport CD4+/ WBC (White Blood Cells) was 15.7%. Most patients (57.2%) used toothbrushes less than 1 time a day. An important negative correlation was found between CD4+ and dentition and periodontal status. A lower level of CD4+ was correlated with a higher DMFT, CPI, and LOA, respectively coefficient (r) for CD4/DMFT = -0.52, p =0.01, (r) for CD4/CPI= - 0.38, p=0.024 and (r) for CD4/LOA= - 0.37, p=0.029. Conclusions: In our study, it was documented that patients with HIV/AIDS had worse oral health, an important negative correlation between CD4+ and dentition and periodontal status. A lower level of CD4+ was correlated with a worse dentition status (higher DMFT), and poor periodontal health (higher CPI and LOA). The monitoring and treatment of oral pathologies can be important in early HIV/AIDS diagnoses and treatment.

Keywords: HIV/AIDS, oral health, dentition, periodontal

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Authors: Burcu Ileri, Deniz Sanliyuksel Yucel, Onder Ayyildiz

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The oxidation of pyrite in water results in the formation of acid mine drainage, which typically forms extremely acid mine lake (AML) in the depression areas of abandoned Etili open-pit coal mine site, Northwest Turkey. Nine acid mine lakes of various sizes have been located in the Etili coal mine site. Hayirtepe AML is one of the oldest lake having a mean pH value of 2.9 and conductivity of 4550 μS/cm, and containing elevated concentrations of Al, B, Ba, Ca, Cd, Co, Cr, Cu, Fe, K, Mg, Mn, Na, Ni, Pb, and Zn. The water quality of the lake has been deteriorated due to its high chemical composition, in particular, increasing heavy metal pollution. In this study, fly ash (FA), a coal combustion by-product from fluidized bed thermal power plant in the northwestern part of Turkey, was used as an adsorbent for the treatment of Hayirtepe AML. The FA is a relatively abundant and cost effective material, but its use in adsorption processes usually require excessive adsorbent doses. To increase adsorption efficiency and lower the adsorbent dose, we modified the FA by means of ultrasonic treatment (20 kHz and 40 kHz). The images of scanning electron microscopy (SEM) have demonstrated that ultrasonic treatment not only decreased the size of ash particles but also created pits and cracks on their surfaces which in turn led to a significant increase in the BET surface area. Both FA and modified fly ash were later tested for the removal of heavy metals from the AML. The effect of various operating parameters such as ultrasonic power, pH, ash dose, and adsorption contact time were examined to obtain the optimum conditions for the treatment process. The results have demonstrated that removal of heavy metals by ultrasound-modified fly ash requires much shorter treatment times and lower adsorbent doses than those attained by the unmodified fly ash. This research was financially supported by the Scientific and Technological Research Council of Turkey (TUBITAK), (Project no: 116Y510).

Keywords: acid mine lake, heavy metal, modified fly ash, ultrasonic treatment

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Authors: Davender Kumar, Virender Singh, Rekha Sharma

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Correction of skeletal deformities in adult patients with orthodontics is limited. In adult severe cases, the combined approach, orthodontic and orthognathic surgery, is always the treatment of choice, and the results obtained usually ensure a better esthetic, functional, and stable results Orthognathic surgery is the best option for cases when camouflage treatment is questionable and growth modulation is not possible. This case report illustrates the benefit of the team approach in correcting mandible retrusion along with class II skeletal deformity with 100% deep bite. Correction was achieved by anterior repositioning of mandible osteotomy along with orthodontic treatment. The patient's facial appearance was markedly improved along with functional and stable occlusion.

Keywords: camouflage, skeletal, orthognathic, dental

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Authors: Sabahattin Comertpay, Sandra Pastorino, Rosanna Mezzapelle, Mika Tanji, Oriana Strianese, Andrea Napolitano, Tracey Weigel, Joseph Friedberg, Paul Sugarbaker, Thomas Krausz, Ena Wang, Amy Powers, Giovanni Gaudino, Harvey I. Pass, Fatmagul Ozcelik, Barbara L. Parsons, Haining Yang, Michele Carbone

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Tumors are thought to be monoclonal in origin. This paradigm arose decades ago, primarily from the study of hematopoietic malignancies and sarcomas. The clonal origin of malignant mesothelioma (MM), a deadly cancer resistant to the current therapies, has not been investigated. Examination of the pleura from patients with MM shows often the presence of multiple pleural nodules, raising the question of whether they represent independent or metastatic growth processes. To investigate the clonality patterns of MM, we used the HUMARA (Human Androgen Receptor) assay to examine 14 sporadic and 2 familial Malignant Mesotheliomas (MM). Of 16 specimens studied, 15 were informative and 14/15 revealed two electrophoretically distinct methylated HUMARA alleles, indicating a polyclonal origin for these tumors. This discovery has important clinical implications, because an accurate assessment of tumor clonality is key to the design of novel molecular strategies for the treatment of MM.

Keywords: malignant mesothelioma, clonal origin, HUMARA, sarcomas

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Authors: Amenah Dhannoon, Ciaran Martin Hurley, Laura Wrafter, Podraic J. Regan

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Introduction: The COVID-19 pandemic continues to present unprecedented challenges for healthcare systems. This has resulted in the pragmatic shift in the practice of plastic surgery units worldwide. During this period, many units reported a significant fall in urgent melanoma referrals, leading to patients presenting with advanced disease requiring more extensive surgery and inferior outcomes. Our objective was to evaluate our unit's experience with both non-invasive and invasive melanoma during the COVID-19 pandemic and characterize our experience and contrast it to that experienced by our neighbors in the UK, mainland Europe and North America. Methods: a retrospective chart review was performed on all patients diagnosed with invasive and non-invasive cutaneous melanoma between March to December of 2019 (control) compared to 2020 (COVID-19 pandemic) in a single plastic surgery unit in Ireland. Patient demographics, referral source, surgical procedures, tumour characteristics, radiological findings, oncological therapies and follow-up were recorded. All data were anonymized and stored in Microsoft Excel. Results: A total of 589 patients were included in the study. Of these, 314 (53%) with invasive melanoma, compared to 275 (47%) with the non-invasive disease. Overall, more patients were diagnosed with both invasive and non-invasive melanoma in 2020 than in 2019 (p<0.05). However, significantly longer waiting times in 2020 (64 days) compared to 2019 (28 days) (p<0.05), with the majority of the referral being from GP in 2019 (83%) compared to 61% in 2020. Positive sentinel lymph node were higher in 2019 at 56% (n=28) compared to 24% (n=22) in 2020. There was no statistically significant difference in the tutor characteristics or metastasis status. Discussion: While other countries have noticed a fall in the melanoma diagnosis. Our units experienced a higher number of disease diagnoses. This can be due to multiple reasons. In Ireland, the government reached an early agreement with the private sector to continue elective surgery on an urgent basis in private hospitals. This allowed access to local anesthetic procedures and local skin cancer cases were triaged to non-COVID-19 provider centers. Our unit also adapted a fast, effective and minimal patient contact strategy for triaging skin cancer based on telemedicine. Thirdly, a skin cancer nurse specialist maintained patient follow-ups and triaging a dedicated email service. Finally, our plastic surgery service continued to maintain a virtual complex skin cancer multidisciplinary team meeting during the pandemic, ensuring local clinical governance has adhered to each clinical case. Conclusion: Our study highlights that with the prompt efficient restructuring of services, we could reserve successful management of skin cancer even in the most devastating times. It is important to reflect on the success during the pandemic and emphasize the importance of preparation for a potentially difficult future

Keywords: malignant melanoma, skin cancer, COVID-19, triage

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Authors: D. A. Onifade

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Kokoro is maize snack which is very popular among poor masses in Nigeria who consume it along with gari(a cassava product) as lunch on a regular basis. In this study, fungal contaminants of kokoro were characterized and its aflatoxin content determined. A total of 30 fungal isolates were obtained from kokoro samples and they belong to 3 different species. Aspergillus flavus had the highest frequency of occurrence of 73.33% while Penicillium species had the lowest (6.66%). Different concentration of aflatoxin B1 was detected in some of the kokoro samples analyzed. Sample D had the highest concentration of 7.25 parts per billion (ppb). The lowest concentration detected was 0.06 ppb in sample P. No aflatoxin G1 and G2 was detected in all the kokoro samples with exception of sample P which contained 2.54 ppb aflatoxin G1.According to international standards some of the kokoro samples are not suitable for human consumption because of high-level aflatoxin which was above the recommended level. Therefore, production of kokoro should be standardized and appropriate packaging materials utilized to prevent the growth of aflatoxigenic fungi. This is to safeguard the health of many poor Nigerians who consume it on a regular basis.

Keywords: kokoro, maize snack, aflatoxin, contamination, mould, Nigeria

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Authors: M. Takhtravanchi, C. Pathirage

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In the construction industry, project members are conveyor of project knowledge which is, often, not managed properly to be used in future projects. As construction projects are temporary and unique, project members are willing to be recruited once a project is completed. Therefore, poor management of knowledge across construction projects will lead to a considerable amount of knowledge loss; the ignoring of which would be detrimental to project performance. This issue is more prominent in projects undertaken through the traditional procurement system, as this system does not incentives project members for integration. Thus, disputes exist between the design and construction phases based on the poor management of knowledge between those two phases. This paper aims to highlight the challenges of the knowledge management that exists within the traditional procurement system. Expert interviews were conducted and challenges were identified and analysed by the Interpretive Structural Modelling (ISM) approach in order to summarise the relationships among them. Two identified key challenges are the Culture of an Organisation and Knowledge Management Policies. A knowledge of the challenges and their relationships will help project manager and stakeholders to have a better understanding of the importance of knowledge management.

Keywords: challenges, construction industry, knowledge management, traditional procurement system

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Authors: Tzu-Ting Hu, Jung-Der Wang, Ming-Yeng Lin, Jin-Luh Chen, Perng-Jy Tsai

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The vinyl chloride monomer (VCM) has been classified as group 1 (human) carcinogen by the IARC. Workers exposed to VCM are known associated with the development of the liver cancer and hence might cause economical and health losses. Particularly, for those work for the petrochemical industry have been seriously concerned in the environmental and occupational health field. Considering assessing workers’ health risks and their resultant economical and health losses requires the establishment of long-term VCM exposure data for any similar exposure group (SEG) of interest, the development of suitable technologies has become an urgent and important issue. In the present study, VCM exposures for petrochemical industry workers were determined firstly based on the database of the 'Workplace Environmental Monitoring Information Systems (WEMIS)' provided by Taiwan OSHA. Considering the existence of miss data, the reconstruction of historical exposure techniques were then used for completing the long-term exposure data for SEGs with routine operations. For SEGs with non-routine operations, exposure modeling techniques, together with their time/activity records, were adopted for determining their long-term exposure concentrations. The Bayesian decision analysis (BDA) was adopted for conducting exposure and health risk assessments for any given SEG in the petrochemical industry. The resultant excessive cancer risk was then used to determine the corresponding loss of quality-adjusted life expectancy (QALE). Results show that low average concentrations can be found for SEGs with routine operations (e.g., VCM rectification 0.0973 ppm, polymerization 0.306 ppm, reaction tank 0.33 ppm, VCM recovery 1.4 ppm, control room 0.14 ppm, VCM storage tanks 0.095 ppm and wastewater treatment 0.390 ppm), and the above values were much lower than that of the permissible exposure limit (PEL; 3 ppm) of VCM promulgated in Taiwan. For non-routine workers, though their high exposure concentrations, their low exposure time and frequencies result in low corresponding health risks. Through the consideration of exposure assessment results, health risk assessment results, and QALE results simultaneously, it is concluded that the proposed method was useful for prioritizing SEGs for conducting exposure abatement measurements. Particularly, the obtained QALE results further indicate the importance of reducing workers’ VCM exposures, though their exposures were low as in comparison with the PEL and the acceptable health risk.

Keywords: exposure assessment, health risk assessment, petrochemical industry, quality-adjusted life years, vinyl chloride monomer

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