Search results for: SOP for reporting and treatment of monitored abnormal events

Authors: Hassan Abo-Salem, Huang Xiaolin

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Background and Purpose: The effectiveness of mirror therapy (MT) has been investigated in acute hemiplegia. The present study examines whether MT, given during chronic stroke, was more effective in promoting motor recovery of the lower extremity and walking speed than standard rehabilitation alone. Methods: The study enrolled 30 patients with chronic stroke. Fifteen patients each were assigned to the treatment group and the control group. All patients received a conventional rehabilitation program for a 4-week period. In addition to this rehabilitation program, patients in the treatment group received mirror therapy for 4 weeks, 5 days a week. Main measures: Passive ankle joint dorsiflexion range of motion, gait speed, Brunnstrom stages of motor recovery, plantarflexor muscle tone by Modified Ashworth Scale. Results: Results: No significant difference was found in the outcome measures among groups before treatment. When compared with standard rehabilitation, mirror therapy improved Ankle ROM, Brunnstrom stages and waking speed (p < 0.05). However, there were no significant differences between two groups on MAS (P > 0.05). Conclusions: Mirror therapy combined with a conventional stroke rehabilitation program enhances lower-extremity motor recovery and walking speed in chronic stroke patients.

Keywords: mirror therapy, stroke, MAS, walking speed

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Authors: Marzieh Khedmati, Shannon L. Bartelt-Hunt

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Vegetative Filter Strips (VFS) are used for controlling the volume of runoff and decreasing contaminant concentrations in runoff before entering water bodies. Many studies have investigated the role of VFS in sediment and nutrient removal, but little is known about their efficiency for the removal of emerging contaminants such as antimicrobial resistance genes (ARGs). Vegetative Filter Strip Modeling System (VFSMOD) was used to simulate the efficiency of VFS in this regard. Several studies demonstrated the ability of VFSMOD to predict reductions in runoff volume and sediment concentration moving through the filters. The objectives of this study were to calibrate the VFSMOD with experimental data and assess the efficiency of the model in simulating the filter behavior in removing ARGs (ermB) and tylosin. The experimental data were obtained from a prior study conducted at the University of Nebraska (UNL) Rogers Memorial Farm. Three treatment factors were tested in the experiments, including manure amendment, narrow grass hedges and rainfall events. Sediment Delivery Ratio (SDR) was defined as the filter efficiency and the related experimental and model values were compared to each other. The VFS Model generally agreed with the experimental results and as a result, the model was used for predicting filter efficiencies when the runoff data are not available. Narrow Grass Hedges (NGH) were shown to be effective in reducing tylosin and ARGs concentration. The simulation showed that the filter efficiency in removing ARGs is different for different soil types and filter lengths. There is an optimum length for the filter strip that produces minimum runoff volume. Based on the model results increasing the length of the filter by 1-meter leads to higher efficiency but widening beyond that decreases the efficiency. The VFSMOD, which was proved to work well in estimation of VFS trapping efficiency, showed confirming results for ARG removal.

Keywords: antimicrobial resistance genes, emerging contaminants, narrow grass hedges, vegetative filter strips, vegetative filter strip modeling system

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Authors: Jakub Kraus, Vladimír Plos, Peter Vittek

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This article deals with a new approach to the airport emergency plans, which are the basic documents and manuals for dealing with events with impact on safety or security. The article describes the identified parts in which the current airport emergency plans do not fulfill their role and which should therefore be considered in the creation of corrective measures. All these issues have been identified at airports in the Czech Republic and confirmed at airports in neighboring countries.

Keywords: airport emergency plan, aviation safety, aviation security, comprehensive management system

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Authors: A. Parra Parra, M. Vlasova, P. A. Marquez, M. Kakazey, M. C. Resendiz Gonzalez

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The work of water treatment plants from various sources of pollution includes a biological treatment stage using activated sludge. Due to the large volume of toxic activated sludge waste (WAS) generated and soil contamination during its storage, WAS disposal technologies are being continuously developed. The most common is the carbonization of WAS. The carbonization products are various forms of ordered and disordered carbon material having different reactivity. The aim of this work was to study the reduction process of Fe₂O₃ mixed with activated sludge waste (WAS). It could be assumed that the simultaneous action of the WAS thermal decomposition process, accompanied by the formation of reactive nano-carbon, with carbothermal reduction of the Fe₂O₃, will permit intensify reduction of metal oxide up to stage of metal and iron carbide formation. The studies showed that the temperature treatment in the region of (800-1000) °C for 1 hour under conditions of oxygen deficiency is accompanied by the occurrence of reactions: Fe₂O₃ → Fe₃O₄ → FeO → Fe, which are typical for the metallurgical process of iron smelting, but less energy-intensive. Depending on the ratio of the WAS - Fe₂O₃ components and the temperature-time regime of reduction of iron oxide, it is possible to distinguish the stages of the predominant formation of ferromagnetic compounds, cast iron, and iron carbide. The results indicated the promise of using WAS as a metals oxide reducing agent and obtaining of ceramic-based on metal carbides.

Keywords: carbothermal reduction, Fe₂O₃, FeₓOᵧ-C, waste activated sludge

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Authors: R. Burahee, B. Chassinat, T. de Laclos, A. Dépée, A. Sastim

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The purpose of this paper is to propose a solution to detect, predict and reconstitute rain drops in real time – during the night – using an embedded material with an infrared camera. To prevent the system from needing too high hardware resources, simple models are considered in a powerful image treatment algorithm reducing considerably calculation time in OpenCV software. Using a smart model – drops will be matched thanks to a process running through two consecutive pictures for implementing a sophisticated tracking system. With this system drops computed trajectory gives information for predicting their future location. Thanks to this technique, treatment part can be reduced. The hardware system composed by a Raspberry Pi is optimized to host efficiently this code for real time execution.

Keywords: reconstitution, prediction, detection, rain drop, real time, raspberry, infrared

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Authors: Sophie Kroeling, Agnetha Schuchardt

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Striving for sustainability brings a lot of challenges for different fields of interest, e. g. security or health concerns. In Germany, civil protection is predominantly carried out by emergency responders who perform essential tasks of civil protection. Based on theoretical concepts of different psychological stress theories this contribution focuses on the question, how the resilience of emergency responders can be improved. The goal is to identify resources and successful coping strategies that help to prevent and reduce negative outcomes during or after stressful events. The paper will present results from a qualitative analysis of semi-structured qualitative interviews with 20 emergency responders. These results provide insights into the complexity of coping processes (e. g. controlling the situation, downplaying perceived personal threats through humor) and show the diversity of stressors (like complexity of the disastrous situation, intrusive press and media, or lack of social support within the organization). Self-efficacy expectation was a very important resource for coping with stressful situations. The results served as a starting point for a quantitative survey (that was conducted in March 2017), the development of education and training tools for emergency responders and the improvement of critical incident stress management processes. First results from the quantitative study with more than 700 participants show that, e. g., the emergency responders use social coping within their private social network and also within their aid organization and that both are correlated to resilience. Moreover, missing information, bureaucratic problems and social conflicts within the organization are events that the majority of the participants considered very onerous. Further results from regression analysis will be presented. The proposed paper will combine findings from the qualitative study with the quantitative results, illustrating figures and correlations with respective statements from the interviews. At the end, suggestions for the improvement of the emergency responder’s resilience are given and it is discussed how this can make a contribution to strive for civil security and furthermore a sustainable development.

Keywords: civil security, emergency responders, stress, resilience, resources

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Authors: Shivdayal Patel, Suhail Ahmad

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Safety assurance and failure prediction of composite material component of an offshore structure due to low velocity impact is essential for associated risk assessment. It is important to incorporate uncertainties associated with material properties and load due to an impact. Likelihood of this hazard causing a chain of failure events plays an important role in risk assessment. The material properties of composites mostly exhibit a scatter due to their in-homogeneity and anisotropic characteristics, brittleness of the matrix and fiber and manufacturing defects. In fact, the probability of occurrence of such a scenario is due to large uncertainties arising in the system. Probabilistic finite element analysis of composite plates due to low-velocity impact is carried out considering uncertainties of material properties and initial impact velocity. Impact-induced damage of composite plate is a probabilistic phenomenon due to a wide range of uncertainties arising in material and loading behavior. A typical failure crack initiates and propagates further into the interface causing de-lamination between dissimilar plies. Since individual crack in the ply is difficult to track. The progressive damage model is implemented in the FE code by a user-defined material subroutine (VUMAT) to overcome these problems. The limit state function is accordingly established while the stresses in the lamina are such that the limit state function (g(x)>0). The Gaussian process response surface method is presently adopted to determine the probability of failure. A comparative study is also carried out for different combination of impactor masses and velocities. The sensitivity based probabilistic design optimization procedure is investigated to achieve better strength and lighter weight of composite structures. Chain of failure events due to different modes of failure is considered to estimate the consequences of failure scenario. Frequencies of occurrence of specific impact hazards yield the expected risk due to economic loss.

Keywords: composites, damage propagation, low velocity impact, probability of failure, uncertainty modeling

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Authors: Priyanka Sharma, Tarkewshwar Dubey, Hemalatha Siva

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Hemorrhoids are one of the most common anorectal diseases around the world. Severalfactors are involved in causing hemorrhoids including irregularbowel function (constipation, diarrhea), exercise, gravity, low fiberdiet, pregnancy, obesity, high abdominal pressure, prolongedsitting, genetic factors, and aging. Pain, bleeding, itching,swelling and anal discharge are the symptoms of the disease. Due to limitedmodern pharmacotherapeutic options available for treatment, theherbal medicines remain the choice of therapy. Blumea lacera (Burm f.) DC. belonging to the Asteraceae family is a common plain land weed of Bangladesh. Traditionally it has been used for treatment of hemorrhoids.Considering the above fact, present study was aimed to validate the ethnomedicinal use of B. lacera leaves on experimental hemorrhoids in rats. The anti-hemorrhoid activity was performed by using croton oil induced rat models. The parameters studied were assessment of TNF-α and IL-6, Evans blue exudation, macroscopic severity score, recto-anal coefficient, histomorphological scores. Also, in vivo antioxidant parameters and histopathological studies were also performed. All paramaters exhibited significant anti-hemorrhoid activity. Moreover ethanolic extract of B. lacera (EBL) leaves 400mg/kg showed ameliorative effect oncroton oil induced hemorrhoids.In conclusion, EBL exhibitedbeneficial effect on croton oil- induced hemorrhoids and validates its ethnomedicinal use in treatment of piles.

Keywords: haemorrhoids, IL-6, piles, TNF-α

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Authors: Adae Amoako, Daniel Montero, Peter Murray, George Pujalte

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We present a case of a 42-year-old, right-handed Caucasian male who presented to a medical orthopedics clinic with left wrist pain. The patient indicated that the pain started two months prior to the visit. He could only remember helping a friend move furniture prior to the onset of pain. Examination of the left wrist showed limited extension compared to the right. There was clicking with flexion and extension of the wrist on the dorsal aspect. Mild tenderness was noticed over the distal radioulnar joint. There was ulnar and radial deviation on provocation. Initial 4-view x-rays of the left wrist showed mild radiocarpal and scapho-trapezium-trapezoid (ST-T) osteoarthritis, with subchondral cysts seen in the lunate and scaphoid, with no obvious fractures. The patient was initially put in a wrist brace and diclofenac topical gel was prescribed for pain control, as a patient could not take non-steroidal anti-inflammatory drugs (NSAIDs) due to gastritis. Despite diclofenac topical gel use and bracing, symptoms remained, and a steroid injection with 1 mL of lidocaine with 10 mg of triamcinolone acetonide was performed under fluoroscopy. He obtained some relief but after 3 months, the injection had to be repeated. On 2-month follow up after the initial evaluation, symptoms persisted. Magnetic resonance imaging (MRI) was obtained which showed an abnormal T1 hypodense signal involving the proximal pole of the scaphoid and articular collapse proximally of the scaphoid, with marked irregularity of the overlying cartilage, suggesting a remote injury, findings consistent with avascular necrosis of the proximal pole of the scaphoid. A month after that, the patient had the left proximal pole of the scaphoid debrided and an intercompartmental supraretinacular artery vascularized. Pedicle bone graft reconstruction of the proximal pole of the left scaphoid was done. A non-vascularized autograft from the left radius was also applied. He was put in a thumb spica cast with the interphalangeal joint free for 6 weeks. On 6-week follow-up after surgery, the patient was healing well and could make a composite fist with his left hand. The diagnosis of Preiser’s disease is primarily based on radiological findings. Due to the fact that necrosis happens over a period of time, most AVNs are diagnosed at the late stages of the disease. There appear to be no specific guidelines on the management AVN of the scaphoid. In the past, immobilization and arthroscopic debridement had been used. Radial osteotomy has also been tried. Vascularized bone grafts have also been used to treat Preiser’s disease. In our patient, we used three of these treatment modalities, starting with conservative management with topical NSAIDS and immobilization, then debridement with vascularized bone grafts.

Keywords: wrist pain, avascular necrosis of the scaphoid, Preiser’s disease, vascularized bone grafts

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Authors: Mohamed Amine Adaour, Mohamed Sadek Bachene, Mosaab Fortassi, Wafaa Siouda

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Foot infections are responsible for a significant number of hospitalizations and amputations in diabetic patients. The objective of our study is to analyze and evaluate the management of diabetic foot in a surgical setting. A retrospective study was conducted based on a selected case of suspected diabetic foot infections of osteitis treated at the Mohamed Boudiaf hospital in Medea. The case was reiterated as a therapeutic charge, consisting of treating first the infection of the soft tissues, then the osteitis: biopsy after at least 15 days of cessation of antibiotic therapy. Successful treatment of osteitis was defined at the end of a follow-up period of complete wound healing, lack of bone resection/amputation surgery at the initial bone site during follow-up , Instead, biopsies are prescribed in the treatment of soft tissue infection. The mean duration of treatment for soft tissue infection was 2-3 weeks, the duration of the antibiotic-free window of therapy prior to bone biopsy was 2-4 weeks. This patient received medical management without surgical resection. The success rate for treating osteitis at one year was 73%, and healing at one year was 88%.It is often limited to a sausage of the foot at the cost of repeated amputations. The best management remains prevention, which necessarily involves setting up a specialized and adapted centre.

Keywords: osteitis, antibiotic therapy, bone biopsy, diabetic foot

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Authors: Sulalit Bandyopadhyay, Muhammad Awais Ashfaq Alvi, Anuvansh Sharma, Wilhelm R. Glomm

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Release of drugs from nanogels and nanogel-based systems can occur under the influence of external stimuli like temperature, pH, magnetic fields and so on. pNIPAm-AAc nanogels respond to the combined action of both temperature and pH, the former being mostly determined by hydrophilic-to-hydrophobic transitions above the volume phase transition temperature (VPTT), while the latter is controlled by the degree of protonation of the carboxylic acid groups. These nanogels based systems are promising candidates in the field of drug delivery. Combining nanogels with magneto-plasmonic nanoparticles (NPs) introduce imaging and targeting modalities along with stimuli-response in one hybrid system, thereby incorporating multifunctionality. Fe@Au core-shell NPs possess optical signature in the visible spectrum owing to localized surface plasmon resonance (LSPR) of the Au shell, and superparamagnetic properties stemming from the Fe core. Although there exist several synthesis methods to control the size and physico-chemical properties of pNIPAm-AAc nanogels, yet, there is no comprehensive study that highlights the dependence of incorporation of one or more layers of NPs to these nanogels. In addition, effective determination of volume phase transition temperature (VPTT) of the nanogels is a challenge which complicates their uses in biological applications. Here, we have modified the swelling-collapse properties of pNIPAm-AAc nanogels, by combining with Fe@Au NPs using different solution based methods. The hydrophilic-hydrophobic transition of the nanogels above the VPTT has been confirmed to be reversible. Further, an analytical method has been developed to deduce the average VPTT which is found to be 37.3°C for the nanogels and 39.3°C for nanogel coated Fe@Au NPs. An opposite swelling –collapse behaviour is observed for the latter where the Fe@Au NPs act as bridge molecules pulling together the gelling units. Thereafter, Cyt C, a model protein drug and L-Dopa, a drug used in the clinical treatment of Parkinson’s disease were loaded separately into the nanogels and nanogel coated Fe@Au NPs, using a modified breathing-in mechanism. This gave high loading and encapsulation efficiencies (L Dopa: ~9% and 70µg/mg of nanogels, Cyt C: ~30% and 10µg/mg of nanogels respectively for both the drugs. The release kinetics of L-Dopa, monitored using UV-vis spectrophotometry was observed to be rather slow (over several hours) with highest release happening under a combination of high temperature (above VPTT) and acidic conditions. However, the release of L-Dopa from nanogel coated Fe@Au NPs was the fastest, accounting for release of almost 87% of the initially loaded drug in ~30 hours. The chemical structure of the drug, drug incorporation method, location of the drug and presence of Fe@Au NPs largely alter the drug release mechanism and the kinetics of these nanogels and Fe@Au NPs coated with nanogels.

Keywords: controlled release, nanogels, volume phase transition temperature, l-dopa

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Authors: Ouahiba Taamallah, Tarek Litim

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The study deals with the burnishing effect of AISI 52100 steel and parameters influence (Py, i and f on surface integrity. The results show that the optimal effects are closely related to the treatment parameters. With a 92% improvement in roughness, SB can be defined as a finishing operation within the machining range. Due to 85% gain in consolidation rate, this treatment constitutes an efficient process for work-hardening of material. In addition, a statistical study based on regression and Taguchi's design has made it possible to develop mathematical models to predict output responses according to the studied burnishing parameters. Response Surface Methodology RSM showed a simultaneous influence of the burnishing parameters and to observe the optimal parameters of the treatment. ANOVA Analysis of results led to validate the prediction model with a determination coefficient R2=94.60% and R2=93.41% for surface roughness and micro-hardness, respectively. Furthermore, a multi-objective optimization allowed to identify a regime characterized by P=20 Kgf, i=5 passes and f=0.08 mm.rev-1, which favors minimum surface roughness and a maximum of micro-hardness. The result was validated by a composite desirability D_i=1 for both surface roughness and microhardness, respectively. Applying optimal parameters, burnishing showed its beneficial effects in fatigue resistance, especially for imposed loading in the low cycle fatigue of the material where the lifespan increased by 90%.

Keywords: AISI 52100 steel, burnishing, Taguchi, fatigue

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Authors: Margarida Matos, João Pereira dos Santos, José Tavares

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Anti-minority discrimination is a persistent phenomenon with long-run effects. While there is a vast literature in economics and psychology that shows that personality and beliefs are not fixed and can be altered by experience, particularly in the so-called impressionable years in early adulthood, less is known about the long-lasting impacts of major events occurring during this time on minority attitudes. In this paper, we study the impact of serving in the military on long-term attitudes towards minorities. For many, military conscription and serving in war are unique life-shaping events. In the context of military service, individuals from different socioeconomic backgrounds interact and learn with each other, potentially changing their views and attitudes in a persistent manner. A prominent theory about the change of attitudes is the contact theory. It suggests that prejudice can be decreased if members of the groups interact with one another. The present paper adds to the literature by providing evidence from a more complicated setting involving the exposure to combat. We study the attitudes of veterans of the Portuguese Colonial War between 1961 and 1974, what was the latest war between African independence movements and Europeans. More than 70 percent of military age Portuguese men were drafted every year and sent to fight in Africa in the widest draft in post-World War II Western Europe. The contact between Portuguese and African soldiers was both cooperative as well as adversarial. Portuguese fought against but also alongside locally recruited African men, who represented half of the Portuguese contingent for substantial periods. We use data from the European Social Survey to identify Portuguese citizens likely to have been drafted and were send to fight in the former Portuguese colonies in Africa. We show that men likely to have fought in African wars are more accepting of immigrants than women of their same cohort, as well as than males from younger and older cohorts. The use of corresponding cohorts from Spain as placebo tests confirms our results. Our findings also hold in a regression discontinuity design setting.

Keywords: attitudes, immigration, war in Africa, veterans, portugal

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Authors: Mohamed Amine Adaour, Mohamed Sadek Bachene, Mosaab Fortassi, Wafaa Siouda

Abstract:

Foot infections are responsible for a significant number of hospitalizations and amputations in diabetic patients. The objective of our study is to analyze and evaluate the management of diabetic foot in a surgical setting. A retrospective study was conducted based on a selected case of suspected diabetic foot infections of osteitis treated at the Mohamed Boudiaf hospital in Medea.The case was reiterated as a therapeutic charge, consisting of treating first the infection of the soft tissues, then the osteitis: biopsy after at least 15 days of cessation of antibiotic therapy. Successful treatment of osteitis was defined at the end of a follow-up period of complete wound healing, lack of bone resection/amputation surgery at the initial bone site during follow-up , Instead, biopsies are prescribed in the treatment of soft tissue infection. The mean duration of treatment for soft tissue infection was 2-3 weeks, the duration of the antibiotic-free window of therapy prior to bone biopsy was 2-4 weeks. This patient received medical management without surgical resection. The success rate for treating osteitis at one year was 73%, and healing at one year was 88%.It is often limited to a sausage of the foot at the cost of repeated amputations. The best management remains prevention, which necessarily involves setting up a specialized and adapted centre.

Keywords: osteitis, antibiotic, biopsy, diabetic foot

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Authors: Vipin Saini, Manish Kumar, Shailendra Bhatt, A. Pandurangan

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The aim of the present study was to fabricate a thermo sensitive gel containing Chlorpheniramine maleate (CPM) loaded nanoparticles following intranasal administration for effective treatment of allergic rhinitis. Chitosan based nanoparticles were prepared by precipitation method followed by the addition of developed NPs within the Poloxamer 407 and carbopol 934P based mucoadhesive thermo-reversible gel. Developed formulations were evaluated for Particle size, PDI, % entrapment efficiency and % cumulative drug permeation. NP3 formulation was found to be optimized on the basis of minimum particle size (143.9 nm), maximum entrapment efficiency (80.10±0.414 %) and highest drug permeation (90.92±0.531 %). The optimized formulation NP3 was then formulated into thermo reversible in situ gel. This intensifies the contact between nasal mucosa and the drug, increases and facilitates the drug absorption which results in increased bioavailability. G4 formulation was selected as the optimize on the basis of gelation ability and mucoadhesive strength. Histology was carried out to examine the damage caused by the optimized G4 formulation. Results revealed no visual signs of tissue damage thus indicated safe nasal delivery of nanoparticulate in situ gel formulation G4. Thus, intranasal CPM NP-loaded in situ gel was found to be a promising formulation for the treatment of allergic rhinitis.

Keywords: chitosan, nanoparticles, in situ gel, chlorpheniramine maleate, poloxamer 407

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Authors: Oliver Mărunţălu, Gheorghe Lăzăroiu, Elena Elisabeta Manea, Dana Andreya Bondrea, Lăcrămioara Diana Robescu

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This paper presents the results obtained by numerical simulation of the pollutants dispersion in the atmosphere coming from the evacuation of combustion gases resulting from the fuel combustion used by electric thermal power plant using the software ANSYS CFX-CFD. The model uses the Navier-Stokes equation to simulate the dispersion of pollutants in the atmosphere. We considered as important factors in elaboration of simulation the atmospheric conditions (pressure, temperature, wind speed, wind direction), the exhaust velocity of the combustion gases, chimney height and the obstacles (buildings). Using the air quality monitoring stations we have measured the concentrations of main pollutants (SO2, NOx and PM). The pollutants were monitored over a period of 3 months, after that we calculated the average concentration, which is used by the software. The concentrations are: 8.915 μg/m3 (NOx), 9.587 μg/m3 (SO2) and 42 μg/m3 (PM). A comparison of test data with simulation results demonstrated that CFX was able to describe the dispersion of the pollutant as well the concentration of this pollutants in the atmosphere.

Keywords: air pollutants, computational fluid dynamics, dispersion, simulation

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Authors: Li Hoon Lim, Nur Farhanah Said, Katie Simmons, Eric Pei Ping Pang, Sharon Mei Mei Wong

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Background and Purpose: Research regarding the sexual impact of breast cancer treatment on Asian women is both sensitive and scarce. This study aims to assess and evaluate the sexual health needs and concerns of breast cancer radiotherapy patients. It is hoped that awareness will be increased and an appropriate intervention can be developed to address the needs of future breast cancer patients. Methods: 110 consecutive unselected breast cancer patients were recruited prospectively. Questionnaires were administered once for patient undergoing radiotherapy to the breast. This study employed an anonymous questionnaire; any breast radiotherapy patient who can read English can voluntarily receive and complete the survey. The questionnaire consisted of items addressing demographics, potential informational needs, and educational preferences. Results: Patients’ interest to address sexual concerns decreases with age (p=0.024). Coherently, sexual concerns of patients are reported to decrease with age (p=0.015) where 70% of all respondents below age 50 [age 20-29 (60%); 30-39 (56.3%); 40-49(55.1%)] have started to have sexual concerns regarding their treatment effects on their sexual health. Patients who underwent breast conservation surgery (42.2%) and reconstruction surgery (83.3%) were more likely to have concerns about sexual health versus patients who underwent mastectomy (36.7%) (p=0.032). 74.2% of patients with sexual concern regardless of age would initiate conversation with their healthcare providers (p < 0.001). Conclusions: The results showed a staggering interest of female patients wanting information on this area which would not only boost their confidence and body image but also address concerns of the effect of breast radiotherapy on sexual health during their treatment.

Keywords: breast cancer, breast radiotherapy, sexual health, sexual impact

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Authors: Maria Angela Bedini, Fabio Bronzini

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The risk of natural disasters affects all the countries of the world, whether it refers to seismic events or tsunamis or hydrogeological disasters. In most cases, the risk can be considered in its three components: hazard, exposure, vulnerability (and urban vulnerability). The aim of this paper is to evaluate how the Italian scientific community has related the contribution of these three components, superimposing the three different maps that summarize the fundamental structure of the risk. Based on the three components considered, the study applies the Regional Planning methodology on the three phases of the risk protection and mitigation process: the prevention phase, the emergency intervention phase, the post-disaster phase. The paper illustrates the Italian experience of the pre-during-post-earthquake intervention. Main results: The study deepens these aspects in the belief that “a historical center” and an “island” can present similar problems at the international level, both in the phase of prevention (earthquake, tsunamis, hydrogeological disasters), in emergency phase (protocols and procedures of intervention) and in the post-disaster phase. The conclusions of the research identify the need to plan in advance how to deal with the post-disaster phase and consider it a priority with respect to the simple reconstruction of destroyed buildings. In fact the main result of the post-disaster intervention must be the return and the social and economic support of the indigenous population, and not only the construction of new housing and equipment. In this sense, the results of the research show that the elderly inhabitants of a historic center can be compared to the indigenous population of an atoll of fishermen, as both constitute the most important resource: the human resource. Their return in conditions of security testifies, with their presence, the culture, customs, and values rooted in the history of a people.

Keywords: post-disaster interventions, risk of natural disasters in Italy and abroad, seismic events in Italy, social and economic protection and support for the native population of historical centers

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Authors: Windy Rakhmawati, Suryani Suryani, Sri Hendrawati, Nenden Nur Asriyani Maryam

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Tuberculosis (TB) is one of the leading causes of death in the world. Fear of COVID-19 has made people reluctant to visit health facilities, leading to disruptions to childhood TB control programs, which may increase household transmission and delay diagnosis and treatment. This study aimed to describe parents' knowledge, attitudes, and health-seeking behaviour towards childhood TB during the COVID-19 pandemic. This cross-sectional study was performed on 392 parents with TB children in three provinces with the highest proportion of TB cases in Indonesia. This study was conducted from February to December 2022. The inclusion criteria of respondents were parents with a child aged 0-14 years old with TB diagnosis who live with their parents. Data were collected using the Knowledge, Attitude, and Practice (KAP) survey guidelines from the World Health Organization and analyzed descriptively, as well as Spearman’s correlation. Overall, 392 parents of children with TB had poor knowledge (51.8%) including about causes, risk factors, transmission, symptoms, treatment, and prevention, which about 52.3%, 55.1%, 61.2%, 69.6%, 100%, 59.2%, respectively. Parents' health service-seeking behaviour towards Child TB was not normally distributed (P < 0.05) with knowledge test results (.000) and Seeking Health Services (.000). Health-seeking behaviour of parents in pediatric TB care was self-medication or self-treatment (86.2%), Traditional health seeking behaviour (4.8%), and modern health seeking behaviour (8.9%). The correlation between knowledge and seeking health services (Sig= .609) means there is no correlation between knowledge about TB and parents' health-seeking behaviour. Furthermore, 60.2% of the respondents would be shocked if their child had TB. More than half of the families in this study have poor knowledge and did self-medication or self-treatment regarding health-seeking behaviour for TB disease. Therefore, health workers, especially nurses, must provide TB-related education and health promotion and emphasize the importance of early detection. Health workers can also optimize their role in caring for and providing care to patients by increasing their trust in health workers, which will impact health-seeking behaviour in the future.

Keywords: attitude, child, health seeking behaviour, knowledge, tuberculosis

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Authors: Mohammed Seyam, Faridah Othman, Ahmed El-Shafie

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The early warning of high stream flow events (HSF) and floods is an important aspect in the management of surface water and rivers systems. This process can be performed using either process-based models or data driven-based models such as artificial intelligence (AI) techniques. The main goal of this study is to develop efficient AI-based model for predicting the real-time hourly stream flow (Q) and apply it as early warning tool of HSF and floods in the downstream area of the Selangor River basin, taken here as a paradigm of humid tropical rivers in Southeast Asia. The performance of AI-based models has been improved through the integration of the lag time (Lt) estimation in the modelling process. A total of 8753 patterns of Q, water level, and rainfall hourly records representing one-year period (2011) were utilized in the modelling process. Six hydrological scenarios have been arranged through hypothetical cases of input variables to investigate how the changes in RF intensity in upstream stations can lead formation of floods. The initial SF was changed for each scenario in order to include wide range of hydrological situations in this study. The performance evaluation of the developed AI-based model shows that high correlation coefficient (R) between the observed and predicted Q is achieved. The AI-based model has been successfully employed in early warning throughout the advance detection of the hydrological conditions that could lead to formations of floods and HSF, where represented by three levels of severity (i.e., alert, warning, and danger). Based on the results of the scenarios, reaching the danger level in the downstream area required high RF intensity in at least two upstream areas. According to results of applications, it can be concluded that AI-based models are beneficial tools to the local authorities for flood control and awareness.

Keywords: floods, stream flow, hydrological modelling, hydrology, artificial intelligence

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Authors: Rui Sousa, Aurora Futuro, António Fiúza

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The exploitation of gold ore deposits is highly dependent on efficient mineral processing methods, although actual perspectives based on life-cycle assessment introduce difficulties that were unforeseen in a very recent past. Cyanidation is the most applied gold processing method, but the potential environmental problems derived from the usage of cyanide as leaching reagent led to a demand for alternative methods. Ammoniacal thiosulfate leaching is one of the most important alternatives to cyanidation. In this article, some experimental studies carried out in order to assess the feasibility of thiosulfate as a leaching agent for the ore from the unexploited Portuguese gold mine of Castromil. It became clear that the process depends on the concentrations of ammonia, thiosulfate and copper. Based on this fact, a few leaching tests were performed in order to assess the best reagent prescription, and also the effects of different combination of these concentrations. Higher thiosulfate concentrations cause the decrease of gold dissolution. Lower concentrations of ammonia require higher thiosulfate concentrations, and higher ammonia concentrations require lower thiosulfate concentrations. The addition of copper increases the gold dissolution ratio. Subsequently, some alternative operatory conditions were tested such as variations in temperature and in the solid/liquid ratio as well as the application of a pre-treatment before the leaching stage. Finally, thiosulfate leaching was compared to cyanidation. Thiosulfate leaching showed to be an important alternative, although a pre-treatment is required to increase the yield of the gold dissolution.

Keywords: gold, leaching, pre-treatment, thiosulfate

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Authors: G. Fitzpatrick, S. O. Chonghaile, D. Harmon

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Objective: Chronic pain patients represent a unique challenge in the Emergency Department. Very little literature has been published regarding this group of patients. Our aim was to determine the attitude of patients with chronic pain to the Emergency Department in order to improve and streamline their future visits. Methods: A two-year survey was carried out on Chronic Pain Patients regarding their Emergency Department Attendances. Patients attending the Pain Clinic in Croom Hospital, Co. Limerick were asked to complete a 20-part questionnaire regarding their experiences of visiting the Emergency Department in the preceding year. 46 questionnaires were completed. Results: Unbearable breakthrough pain was the main reason for visiting the Emergency Department. More than half (54%) of those surveyed were not satisfied with the treatment received. Problems indicated included under-treatment of pain (59%), a sense of being under undue suspicion of drug-seeking behaviour (33%) and a perception that the patient themselves understood their condition better than the treating doctor (76%). Paracetamol, NSAIDs, or time off work comprised 72% of the treatments offered – all of which could have been provided by their General Practitioner. Only 4% were offered a nerve block. 67% felt that the creation of personalised Patient Plans, consisting of an agreed plan between the patient, their pain specialist, and the Emergency Department, would expedite their trip through the Emergency Department. Conclusions: Chronic pain patients generally have a negative experience in the ED. Possible future solutions include increasing our empathy and levels of knowledge, provision of nerve blocks in the ED, and use of personalised “Patient Plans” to streamline the treatment pathway for this group of patients.

Keywords: chronic pain, survey, patients, emergency department

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Authors: Diriba T. Balcha, Boris Kulig, Oliver Hensel, Eyassu Woldesenbet

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Enset fiber is agricultural waste and available in a surplus amount in Ethiopia. However, the hypothesized variation in properties of this fiber due to diversity of its plant source breed, fiber position within plant stem and chemical treatment duration had not proven that its application for the development of composite products is problematic. Currently, limited data are known on the functional properties of the fiber as a potential functional fiber. Thus, an effort is made in this study to narrow the knowledge gaps by characterizing it. The experimental design was conducted using Design-Expert software and the tensile test was conducted on Enset fiber from 10 breeds: Dego, Dirbo, Gishera, Itine, Siskela, Neciho, Yesherkinke, Tuzuma, Ankogena, and Kucharkia. The effects of 5% Na-OH surface treatment duration and fiber location along and across the plant pseudostem was also investigated. The test result shows that the rupture stress variation is not significant among the fibers from 10 Enset breeds. However, strain variation is significant among the fibers from 10 Enset breeds that breed Dego fiber has the highest strain before failure. Surface treated fibers showed improved rupture strength and elastic modulus per 24 hours of treatment duration. Also, the result showed that chemical treatment can deteriorate the load-bearing capacity of the fiber. The raw fiber has the higher load-bearing capacity than the treated fiber. And, it was noted that both the rupture stress and strain increase in the top to bottom gradient, whereas there is no significant variation across the stem. Elastic modulus variation both along and across the stem was insignificant. The rupture stress, elastic modulus, and strain result of Enset fiber are 360.11 ± 181.86 MPa, 12.80 ± 6.85 GPa and 0.04 ± 0.02 mm/mm, respectively. These results show that Enset fiber is comparable to other natural fibers such as abaca, banana, and sisal fibers and can be used as alternatives natural fiber for composites application. Besides, the insignificant variation of properties among breeds and across stem is essential for all breeds and all leaf sheath of the Enset fiber plant for fiber extraction. The use of short natural fiber over the long is preferable to reduce the significant variation of properties along the stem or fiber direction. In conclusion, Enset fiber application for composite product design and development is mechanically feasible.

Keywords: Agricultural waste, Chemical treatment, Fiber characteristics, Natural fiber

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Authors: Aysen Muderrisoglu Esiner

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As an intellectual, scholar, bureaucrat, and statesman, Ahmed Cevdet Pasha (1822-1895) was the prominent figure of “Tanzimat” (reorganization) reforms of the Ottoman State while his daughter Fatma Aliye (1862-1936) was a novelist, columnist, essayist, and women’s rights activist. His father had numerous books on law, grammar, linguistics, logic, and astronomy, moreover, Aliye accepted as the first female novelist in the Turkish literature and the Islamic world. Even if she was better known as a novelist, she also published some works on philosophy, Islam, poetry. In addition, Aliye who was one of the pioneers of the Ottoman women’s movement, also wrote historical works. Her historical works which titled as Tarih-i Osmaninin Bir Devre-i Mühimmesi Kosova Zaferi-Ankara Hezimeti (An Important Era of the Ottoman History: Kosova Victory-Ankara Defeat), and Ahmed Cevdet Paşa ve Zamanı (Ahmed Cevdet Pasha and His Time) have been generally ignored in the literature. However, Aliye’s works in history field are worth being studied in terms of her methodological approach to the Ottoman historiography. On the other hand, written by Ahmed Cevdet Pasha, such as Tarih-i Cevdet (History of Cevdet), Tezâkir (Memoir), Mâruzat (Reports, the events that took place between 1839-1876, 1890), Kısas-ı Enbiya ve Tevârîh-i Hulefa (Retaliation of the Prophets and the History of Calips), Kırım ve Kafkas Tarihçesi (Crimean and Caucasian History) are the most important works in terms of historiography in the 19th century. In contrast to the traditional methodology, Cevdet Pasha brought a new understanding to the Ottoman historiography by making a synthesis between the traditional and modern methods. In this research, the historical works of these two prominent figures of the Ottoman State will be analyzed in terms of their approaches to the Ottoman historiography while evaluating the following questions: to what extent that their use of local and foreign historical sources and their handling of the historical events differ, or if it is possible to talk about a methodological similarities in terms of historiography.

Keywords: Ahmed Cevdet Pasha, Fatma Aliye, historiography, methodology

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Authors: Suang K. Lau, Ismail Goolam, Rafid Al-Asady

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Background: The majority of patients with hepatocellular carcinoma (HCC) are not suitable for curative treatment, in the form of surgical resection or transplantation, due to tumour extent and underlying liver dysfunction. In these non-resectable cases, a variety of non-surgical therapies are available, including microwave ablation (MWA), which has shown increasing popularity due to its low morbidity, low reported complication rate, and the ability to perform multiple ablations simultaneously. Objective: The aim of this study was to evaluate the validity of MWA as a viable treatment option in the management of HCC and hepatic metastatic disease, by assessing its efficacy and complication rate at a tertiary hospital situated in Westmead (Australia). Methods: A retrospective observational study was performed evaluating patients that underwent MWA between 1/1/2017–31/12/2018 at Westmead Hospital, NSW, Australia. Outcome measures, including residual disease, recurrence rates, as well as major and minor complication rates, were retrospectively analysed over a 12-months period following MWA treatment. Excluded patients included those whose lesions were treated on the basis of residual or recurrent disease from previous treatment, which occurred prior to the study window (11 patients) and those who were lost to follow up (2 patients). Results: Following treatment of 106 new hepatic lesions, the complete response rate (CR) was 86% (91/106) at 12 months follow up. 10 patients had the residual disease at post-treatment follow up imaging, corresponding to an incomplete response (ICR) rate of 9.4% (10/106). The local recurrence rate (LRR) was 4.6% (5/106) with follow-up period up to 12 months. The minor complication rate was 9.4% (10/106) including asymptomatic pneumothorax (n=2), asymptomatic pleural effusions (n=2), right lower lobe pneumonia (n=3), pain requiring admission (n=1), hypotension (n=1), cellulitis (n=1) and intraparenchymal hematoma (n=1). There was 1 major complication reported, with pleuro-peritoneal fistula causing recurrent large pleural effusion necessitating repeated thoracocentesis (n=1). There was no statistically significant association between tumour size, location or ablation factors, and risk of recurrence or residual disease. A subset analysis identified 6 segment VIII lesions, which were treated via a trans-pleural approach. This cohort demonstrated an overall complication rate of 33% (2/6), including 1 minor complication of asymptomatic pneumothorax and 1 major complication of pleuro-peritoneal fistula. Conclusions: Microwave ablation therapy is an effective and safe treatment option in cases of non-resectable hepatocellular carcinoma and liver metastases, with good local tumour control and low complication rates. A trans-pleural approach for high segment VIII lesions is associated with a higher complication rate and warrants greater caution.

Keywords: hepatocellular carcinoma, liver metastases, microwave ablation, trans-pleural approach

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Authors: Jae Woong Sull

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Lipid levels are related to the risk of cardiovascular diseases. Cholesterol ester transfer protein (CETP) gene is one of the candidate genes of cardiovascular diseases. A total of 2,304 persons were chosen from a Hospital (N=4,294) in South Korea. Female subjects with the CG/GG genotype had a 2.03 -fold (p=0.0001) higher risk of having abnormal HDL cholesterol levels (<40 mg/dL) than subjects with the CC genotype. Male subjects with the CG/GG genotype had a 1.34 -fold (p=0.0019) higher risk than subjects with the CC genotype. When analyzed by body mass index, the association with CETP was much stronger in male subjects with BMI>=25.69 (OR=1.55, 95% CI: 1.15-2.07, P=0.0037) than in male lean subjects. When analyzed by family history of diabetes, the association with CETP was much stronger in male subjects with positive family history of low physical activity (OR=4.82, 95% CI: 1.86-12.5, P=0.0012) than in male subjects with negative family history of diabetes. This study clearly demonstrates that genetic variants in CETP influence HDL cholesterol levels in Korean adults.

Keywords: CETP, diabetes, obesity, polymorphisms

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Authors: Yimei Huang, Harvey Lui, Jianhua Zhao, Zhenguo Wu, Haishan Zeng

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Conventional laser treatment of skin diseases and cosmetic surgery is based on the principle of one-photon absorption selective photothermolysis which relies strongly on the difference in the light absorption between the therapeutic target and its surrounding tissue. However, when the difference in one-photon absorption is not sufficient, collateral damage would occur due to indiscriminate and nonspecific tissue heating. To overcome this problem, we developed a spatially selective photothermolysis method based on multiphoton absorption in which the heat generation is restricted to the focal point of a tightly focused near-infrared femtosecond laser beam aligned with the target of interest. A multimodal optical microscope with co-registered reflectance confocal imaging (RCM), two-photon fluorescence imaging (TPF), and second harmonic generation imaging (SHG) capabilities was used to perform and monitor the spatially selective photothermolysis. Skin samples excised from the shaved backs of euthanized NODSCID mice were used in this study. Treatments were performed by focusing and scaning the laser beam in the dermis with a 50µm×50µm target area. Treatment power levels of 200 mW to 400 mW and modulated pulse trains of different duration and period were experimented. Different treatment parameters achieved different degrees of spatial confinement of tissue alterations as visualized by 3-D RCM/TPF/SHG imaging. At 200 mW power level, 0.1 s pulse train duration, 4.1 s pulse train period, the tissue damage was found to be restricted precisely to the 50µm×50µm×10µm volume, where the laser focus spot had scanned through. The overlying epidermis/dermis tissue and the underneath dermis tissue were intact although there was light passing through these regions.

Keywords: multiphoton absorption photothermolysis, reflectance confocal microscopy, second harmonic generation microscopy, spatially selective photothermolysis, two-photon fluorescence microscopy

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Authors: Afzaal Gulzar, Shafaq Mubarak, M. Zia-Ur-Rehman

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Industrial waste waters put environmental constrains to the water quality of aqueous reserves. Number of techniques has been used to treat them before disposal to water bodies. In this work a novel green approach is study by using poultry waste eggshells as a low cost efficient adsorbent for the dyes present in industrial effluent of textile and paper industries. The developed technique not only used to treat contaminated waters but also resulted in the utilization of poultry eggshell waste which in turn assists in solid waste management. Batch sorption studies like contact time, adsorbent dose, dye concentration, temp and pH has been conducted to find the optimum adsorption parameters.

Keywords: green technology, solid waste management, industrial effluent, eggshell waste utilization, waste water treatment

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Authors: Han Joo Choe, Soon-Ho Kwon, Jung-Joong Lee

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Tin particles of various size and distribution were self-assembled by plasma treating tin film deposited on silicon oxide substrates. Plasma treatment was conducted using an inductively coupled plasma (ICP) source. A range of ICP power and topographic templated substrates were evaluated to observe changes in particle size and particle distribution. Scanning electron microscopy images of the particles were analyzed using computer software. The evolution of tin film dewetting into particles initiated from the hole nucleation in grain boundaries. Increasing ICP power during plasma treatment produced larger number of particles per area and smaller particle size and particle-size distribution. Topographic templates were also effective in positioning and controlling the size of the particles. By combining the effects of ICP power and topographic templates, particles of similar size and well-ordered distribution were obtained.

Keywords: dewetting, particles, plasma, tin

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Authors: A. Zarei, M. Porkhalili, B. Gholamhosseini

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In this experiment, sixty Hy-Line (W-36) laying hens were selected in 40weeks of age. Experimental diets were consumed for 12 weeks duration by them. The experimental design was completely randomized block included four treatments and each of them with five replications and three sample in each replicate. Treatments were as follow: Basal diet+probiotic, basal diet + prebiotic and basal diet+probiotic+ prebiotic. Performance traits were measured such as: hen production, egg weight, feed intake, feed conversion ratio ,shell thickness, shell strength, shell weight, hough unit, yolk color, and yolk cholesterol. Blood parameters like; Ca, cholesterol, triglyceride, VLDL and antibody titer and so morphological of intestine were determined. At the end of experimental period, after sampling from end of cecum, bacterial colony count was measured. Results showed; shell weight was significantly greater than other treatments in probiotic treatment.Yolk weight in prebiotic treatment was significantly greater than other treatments. The ratio of height of villi to dept of crypt cells in duodenum, jejunum, ileum and secum in prebiotic treatment were significantly greater. Results from the other traits were not significant between treatments, however there were totally good results in other traits with simultaneous usage of probiotic and prebiotic.

Keywords: probiotic, prebiotic, laying hens, performance, blood parameters, intestine morphology

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