Search results for: tertiary treatment

Authors: D. Naresh Yadav, K. Anand Kishore, Bhaskar Bethi, Shirish H. Sonawane, D. Bhagawan

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The untreated industrial wastewater discharged into the environment causes the contamination of soil, water and air. Advanced treatment methods for enhanced wastewater treatment are attracting substantial interest among the currently employed unit processes in wastewater treatment. The textile industry is one of the predominant in wastewater production at current industrialized situation. The refused dyes at textile industry need to be treated in proper manner before its discharge into water bodies. In the present investigation, hybrid treatment process has been developed for the treatment of synthetic mixed dye wastewater. Photocatalysis and ceramic nanoporous membrane are mainly used for process integration to minimize the fouling and increase the flux. Commercial semiconducting powders (TiO2 and ZnO) has used as a nano photocatalyst for the degradation of mixed dye in the hybrid system. Commercial ceramic nanoporous tubular membranes have been used for the rejection of dye and suspended catalysts. Photocatalysis with catalyst has shown the average of 34% of decolorization (RB-32%, BG-34% and CR-36%), whereas ceramic nanofiltration has shown the 56% (RB-54%, BG-56% and CR-58%) of decolorization. Integration of photocatalysis and ceramic nanofiltration has shown 96% (RB-94%, BG-96% and CR-98%) of dye decolorization over 90 min of operation.

Keywords: photocatalysis, ceramic nanoporous membrane, wastewater treatment, advanced oxidation process, process integration

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Authors: Abdelfatah Elsenosy, Mahmoud Ebrahim

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Background: Distal radius fractures are commonly encountered in orthopedic practice, especially in elderly patients. A number of clinical papers have supported the idea that anatomic restoration of the distal end of the radius is essential to gain superior results. Aim and objectives: The aim of the study is to systematically review the literature for the management of distal end radius in elderly persons (conservative treatment versus percutaneous wire fixation) as regards radiological and functional outcomes. Subjects and methods: Studies were identified from the Medline, Cochrane, EMBASE, and Google Scholar databases were searched until 2019 using combinations of the following search terms: distal radius fracture, conservative treatment, non-operative treatment, and nonsurgical treatment, surgical treatment, operative, elderly, and older. Reference lists of relevant studies were manually searched. Results: There was no statistical significance difference between CI and PKF groups’ frequency of complication in all of the selected studies. Based on the results, we recommend more analysis regarding every parameter of the radiographic and functional results and specific complications related to each fixation need to be accomplished, which requires more Randomized controlled trials (RCTs) with high quality. Conclusion: Surgical treatment seems to be more effective distal radius fracture compared with conservative treatment when the radiographic outcomes were analyzed, and no significant differences were detected in the functional outcomes and complication rate.

Keywords: radius, fracture, surgical, RCTs, conservative, radiographic, outcomes, orthopedic

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Authors: D. Schafer, H. Booke, R. Nordmeier

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Patients suffering from chronic musculoskeletal pain ( > 12 months) are a challenging clientele for pain specialists. A multimodal approach, characterized by a two weeks inpatient treatment, often is the ultimate therapeutic attempt. The lasting effects of such a multimodal approach were analyzed, especially since two weeks of inpatient therapy, although very intense, often seem too short to make a difference in patients suffering from chronic pain for years. The study includes 32 consecutive patients suffering from chronic pain over years who underwent a two weeks multimodal inpatient treatment of pain. Twelve months after discharge, each patient was interviewed to objectify any lasting effects. Pain was measured on admission and 12 months after discharge using the numeric rating scale (NRS). For statistics, a paired students' t-test was used. Significance was defined as p < 0.05. The average intensity of pain on admission was 8,6 on the NRS. Twelve months after discharge, the intensity of pain was still reduced by an average of 48% (average NRS 4,4), p < 0.05. Despite this significant improvement in pain severity, two thirds (66%) of the patients still judge their treatment as not sufficient. In conclusion, inpatient treatment of chronic pain has a long-lasting effect on the intensity of pain in patients suffering from chronic musculoskeletal pain for more than 12 months.

Keywords: chronic pain, inpatient treatment, multimodal pain treatment, musculoskeletal pain

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Authors: Ahmed Al Khamisi

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The Disaster Preparedness Standard (DPS) is one of the elements that is evaluated by the Accreditation Canada International (ACI). ACI emphasizes to train and educate all staff, including service providers and senior leaders, on emergency and disaster preparedness upon the orientation and annually thereafter. Lack of awareness and deficit of knowledge among the healthcare providers about DPS have been noticed in a tertiary hospital where ACI standards were implemented. Therefore, this paper aims to introduce a video-based e-learning (VB-EL) module that explains the hospital’s disaster plan in a simple language which will be easily accessible to all healthcare providers through the hospital’s website. The healthcare disaster preparedness coordinator in the targeted hospital will be responsible to ensure that VB-EL is ready by 25 April 2019. This module will be developed based on the Kirkpatrick evaluation method. In fact, VB-EL combines different data forms such as images, motion, sounds, text in a complementary fashion which will suit diverse learning styles and individual learning pace of healthcare providers. Moreover, the module can be adjusted easily than other tools to control the information that healthcare providers receive. It will enable healthcare providers to stop, rewind, fast-forward, and replay content as many times as needed. Some anticipated limitations in the development of this module include challenges of preparing VB-EL content and resistance from healthcare providers.

Keywords: Accreditation Canada International, Disaster Preparedness Standard, Kirkpatrick evaluation method, video-based e-learning

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Authors: Brid Joy

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This paper discusses some major psychological interventions and critiques their effectiveness in relation to the treatment of depression. Links are made between this evidence and the social work profession. This paper reviewed the relevant literature and evidence to ascertain the effectiveness of psychological interventions in the treatment of depression. Evidence suggests that psychological interventions are effective in the treatment of depression. However, a gulf between theory and practice remains and the difficulties in implementing evidence-based practice have been documented within this paper.

Keywords: psychological interventions, social work, depression, evidence based practice

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Authors: R. Sharma, S. Kumar, C. Sharma

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A number of toxic chlorophenolic compounds are formed during pulp bleaching. The nature and concentration of these chlorophenolic compounds largely depends upon the amount and nature of bleaching chemicals used. These compounds are highly recalcitrant and difficult to remove but are partially removed by the biochemical treatment processes adopted by the paper industry. Identification and estimation of these chlorophenolic compounds has been carried out in the primary and secondary clarified effluents from the paper mill by GCMS. Twenty-six chorophenolic compounds have been identified and estimated in paper mill waste waters. Electrochemical treatment is an efficient method for oxidation of pollutants and has successfully been used to treat textile and oil waste water. Electrochemical treatment using less expensive anode material, stainless steel electrodes has been tried to study their removal. The electrochemical assembly comprised a DC power supply, a magnetic stirrer and stainless steel (316 L) electrode. The optimization of operating conditions has been carried out and treatment has been performed under optimized treatment conditions. Results indicate that 68.7% and 83.8% of cholorphenolic compounds are removed during 2 h of electrochemical treatment from primary and secondary clarified effluent respectively. Further, there is a reduction of 65.1, 60 and 92.6% of COD, AOX and color, respectively for primary clarified and 83.8%, 75.9% and 96.8% of COD, AOX and color, respectively for secondary clarified effluent. EC treatment has also been found to increase significantly the biodegradability index of wastewater because of conversion of non- biodegradable fraction into biodegradable fraction. Thus, electrochemical treatment is an efficient method for the degradation of cholorophenolic compounds, removal of color, AOX and other recalcitrant organic matter present in paper mill waste water.

Keywords: chlorophenolics, effluent, electrochemical treatment, wastewater

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Authors: Praveen Adusumilli, Meher Lakshmi Konatam, Sadashivudu Gundeti, Stalin Bala

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The invention of trastuzumab has changed the treatment of breast cancer and lives of many patients all over the world. Despite many patients getting benefitted from the drug, it is out of reach for most of the patients. There is very limited real world data regarding the epidemiology and clinical outcome of Her2neu positive breast cancer patients. Materials and Methods: This is a retrospective analysis of breast cancer patients presenting to a tertiary care cancer centre in Southern India from 2007 to2013. All early and locally advanced breast cancer patients, who were Her2neu 3+ on IHC are included in the study and evaluated in terms of epidemiology, 3-year disease free survival (DFS)and 5-year overall survival(OS). Chemotherapy regimens used were-FAC 6 cycles or AC 4 cycles followed by 12 cycles of weekly paclitaxel . Trastuzumab was given after 6 cycles of FAC or weekly with paclitaxel followed by 3weekly maintenance until 1 year. Results: Over the period of this study there were 885 newly diagnosed cases of carcinoma breast, of which 242 (27%) were Her2neu positive, 360(40%) were hormone receptor positive, and 212(24%) were triple negative. A total of 71(8%) were Her2neu equivocal of which only 10 patients got FISH test done. Of the 212 newly diagnosed patients, only 74 (29%) opted to have standard of care therapy with trastuzumab at our centre, out of which 52(24%), 8(3%), received under insurance, paying basis respectively. 14(9%) patients received the care as part of clinical trial program (ALTTO trial). 7 (9.72%) patients developed decrease of ejection fraction by greater than 10%, requiring stoppage of trastuzumab out of which 5 were restarted in 2 months. Patients receiving trastuzumab along with chemotherapy had longer 3year DFS 92% vs. 60% (p value<0.0001) when compared to chemotherapy alone. 5 year OS was 87% vs 44% (p-value <0.0001) compared to chemotherapy alone. Conclusion: Trastuzumab with chemotherapy improves the DFS and OS in Her2neu positive patients. The biggest constraint is the cost of the treatment and absence of universal health security net to treat all patients with this diagnosis.

Keywords: breast cancer, Her 2 neu positive, real world data, Trastuzumab

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Authors: Jacklyn Yek, Clara Tong, Shin Yuet Chong, Yee Yian Ong

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Background: While emergency manuals and cognitive aids (CA) have been used in high-hazard industries for decades, this has been a nascent field in healthcare. CAs can potentially offset the large cognitive load involved in crisis resource management and possibly facilitate the efficient performance of key steps in treatment. A crisis manual was developed based on local guidelines and the latest evidence-based information and introduced to a tertiary hospital setting in Singapore. Hence, the objective of this study is to evaluate the effectiveness of the crisis manual in guiding response and management of critical events. Methods: 7 surgical teams were recruited to participate in a series of simulated emergencies in high-fidelity operating room simulator over the period of April to June 2018. All teams consisted of a surgical consultant and medical officer/registrar, anesthesia consultant and medical officer/registrar; as well as a circulating, scrub and anesthetic nurse. Each team performed a simulated operation in which 1 or more of the crisis events occurred. The teams were randomly assigned to a scenario of the crisis manual and all teams were deemed to be equal in experience and knowledge. Before the simulation, teams were instructed on proper checklist use but the use of the checklist was optional. Results: 7 simulation sessions were performed, consisting of the following scenarios: Airway fire, Massive Transfusion Protocol, Malignant Hyperthermia, Eclampsia, and Difficult Airway. Out of the 7 surgical teams, 2 teams made use of the crisis manual – of which both teams had encountered a ‘Malignant Hyperthermia’ scenario. These team members reflected that the crisis manual assisted allowed them to work in a team, especially being able to involve the surgical doctors who were unfamiliar with the condition and management. A run chart plotted showed a possible upward trend, suggesting that with increasing awareness and training, staff would become more likely to initiate the use of the crisis manual. Conclusion: Despite the high volume load in this tertiary hospital, certain crises remain rare and clinicians are often caught unprepared. A crisis manual is an effective tool and easy-to-use repository that can improve patient outcome and encourage teamwork. With training, familiarity would allow clinicians to be increasingly comfortable with reaching out for the crisis manual. More simulation training would need to be conducted to determine its effectiveness.

Keywords: crisis resource management, high fidelity simulation training, medical errors, visual aids

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Authors: Jemini Vyas, Oluwatobi Adeyoe, Jenny Branagan, Chandran Tanabalan, John Beatty, Aakash Pai

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Introduction: The development of robotic surgery has accelerated centralisation to tertiary centres, where robotic radical prostatectomy (RP) is offered. The purpose of concentrating treatment in high volume specialist centres is to improve the quality of care and patient outcomes. The aim of this study was to assess the impact on clinical outcomes of centralisation for locally diagnosed patients undergoing RP. Methods: Clinical outcomes for 169 consecutive laparoscopic & open RP pre-centralisation were retrospectively compared with 50 consecutive robotic RP conducted over a similar period post-centralisation. Preoperative risk stratification and time to surgery were collected. Perioperative outcomes, including length of stay (LOS) and complications, were collated. Post-operative outcomes, including erectile dysfunction (ED), biochemical recurrence (BCR), and urinary continence, were assessed. Results: Preoperative risk stratification showed no difference between the two groups. The median time from diagnosis to treatment was similar between the two groups (pre-centralisation, 121 days, post-centralisation, 117 days). The mean length of stay (pre-centralisation, 2.1 days, post-centralisation, 1.6 days) showed no significant difference (p=0.073). Proportion of overall complications (pre-centralisation, 11.4%, post-centralisation, 8.7%) and complications, above Clavien-Dindo 2, were similar between the two groups (pre-centralisation1.2%, post-centralisation 2.2%). Post operative functional parameters, including continence and ED, were comparable. Five-year BCR free rate was 78% for the pre-centralisation group and 79% for the post centralisation group. Conclusion: For our cohort of patients, clinical outcomes have remained static during centralisation. It is imperative that centralisation is accompanied by increased capacity, streamlining of pathways, and training to ensure that improved quality of care is achieved. Our institution has newly acquired a robot, and prospectively studying this data may support the reversal of centralisation for RP surgery.

Keywords: prostate, cancer, prostatectomy, clinical

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Authors: J. S. S. Neto, R. A. A. Lima, D. K. K. Cavalcanti, J. P. B. Souza, R. A. A. Aguiar, M. D. Banea

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In the last decade, investments in sustainable processes and products have gained space in several segments, such as in the civil, automobile, textile and other industries. In addition to increasing concern about the development of environmentally friendly materials that reduce, energy costs and reduces environmental impact in the production of these products, as well as reducing CO2 emissions. Natural fibers offer a great alternative to replace synthetic fibers, totally or partially, because of their low cost and their renewable source. The purpose of this research is to study the effect of surface chemical treatment on the thermal properties of hybrid fiber reinforced natural fibers (NFRC), jute + ramie, jute + sisal, jute + curauá, and jute fiber in polymer matrices. Two types of chemical treatment: alkalinization and silanization were employed, besides the condition without treatment. Differential scanning calorimetry (DSC), thermogravimetry (TG) and dynamic-mechanical analysis (DMA) were performed to explore the thermal stability and weight loss in the natural fiber reinforced composite as a function of chemical treatment.

Keywords: chemical treatment, hybrid composite, jute, thermal

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Authors: D. Hephzibah, P. Kumaran, N. M. Saifuddin

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Anaerobic digestion is a well-known technique for sustainable energy recovery from sewage sludge. However, sewage sludge digestion is restricted due to certain factors. Pre-treatment methods have been established in various publications as a promising technique to improve the digestibility of the sewage sludge and to enhance the biogas generated which can be used for energy recovery. In this study, continuous flow microwave (MW) pre-treatment with different intensities were compared by using 5 L semi-continuous digesters at a hydraulic retention time of 27 days. We focused on the effects of MW at different intensities on the sludge solubilization, sludge digestibility, and biogas production of the untreated and MW pre-treated sludge. The MW pre-treatment demonstrated an increase in the ratio of soluble chemical oxygen demand to total chemical oxygen demand (sCOD/tCOD) and volatile fatty acid (VFA) concentration. Besides that, the total volatile solid (TVS) removal efficiency and tCOD removal efficiency also increased during the digestion of the MW pre-treated sewage sludge compared to the untreated sewage sludge. Furthermore, the biogas yield also subsequently increases due to the pre-treatment effect. A higher MW power level and irradiation time generally enhanced the biogas generation which has potential for sustainable energy recovery from sewage treatment plant. However, the net energy balance tabulation shows that the MW pre-treatment leads to negative net energy production.

Keywords: anaerobic digestion, biogas, microwave pre-treatment, sewage sludge

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Authors: Kebede Mairie, Getahun Belete, Mitike Abeba

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Background: Leishmania aethiopica is a peculiar parasite causing cutaneous leishmaniasis in Ethiopia and its mainstay treatment is Sodium Stibogluconate. However, its treatment outcome in Ethiopia is not well documented. Objectives: To determine the treatment outcome of admitted cutaneous leishmaniasis patients and its associated factors in Addis Ababa, Ethiopia. Methods: A retrospective study was conducted from 1st November 2021 to 30th March 2022. Medical records of all cutaneous leishmaniasis-diagnosed and admitted patients who received parenteral sodium stibogluconate at All Africa Leprosy Rehabilitation and Training Center (ALERT) hospital, the main Leishmania treatment center in Ethiopia from July 2011 to September 2021 were reviewed. Results: A total of 827 charts of admitted cases from July 2011 to September 2021 were retrieved, but 667 (80.65%) were reviewed. Improvement in the treatment outcome was recorded in 93.36 % in the first course of SSG treatment and 96.23%, 94.62%, and 96.97% subsequently in the second, third and fourth treatment courses, respectively. Female gender and diffuse cutaneous leishmaniasis were the two predictive determinants in the treatment of cutaneous leishmaniasis. Conclusion: The study shows that parenteral sodium stibogluconate therapy treats hospitalized cutaneous leishmaniasis patients well, with female gender and diffuse cutaneous leishmaniasis having poor outcomes suggesting the need for a different approach for diffuse cutaneous leishmaniasis patients.

Keywords: cutaneous leishmaniasis, leishmania aethiopica, sodium stibogluconate, diffuse cutaneous leishmaniasis, pentostam

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Authors: Keden Montgomery, Kathie Ardzejewska, Alison Casey, Rosemarie Hogan

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Research was undertaken to explore the question “what is known about the experiences of regional, rural and remote Australian women undertaking a Bachelor of Nursing program delivered online?”. The findings will support future research aimed at improving the retention and completion rates of women studying nursing in regional, rural and remote areas.  There is a critical shortage of nurses working in regional, rural and remote (RRR) Australia. It is well supported that this shortage of nurses is most likely to be addressed by nursing students who are completing their studies in RRR areas. Despite this, students from RRR Australia remain an equity group and experience poorer outcomes than their metropolitan counterparts. Completion rates for RRR students who enrol in tertiary education courses are much less than students from metropolitan areas. In addition to this, RRR students are less likely than students from metropolitan areas to gain a tertiary level qualification at all, and even less likely to gain a Bachelor level degree which is required for Registered Nurses. Supporting students to remain in regional, rural and remote areas while they study reduces the need for students to relocate to metropolitan areas and to continue living and working in RRR areas after graduation. This research holds implications for workforce shortages internationally.

Keywords: nurse education, online education, regional, rural, remote, workforce

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Authors: Tshilenge Kabongo, John Kabuba

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The distillery wastewater has become major issues in sanitation sectors. One of the solutions to overcome this sewage is to install the Wastewater Treatment Plant. Economic analysis is fundamentally required for its viability. Integrated anaerobic digestion and advanced oxidation (AD-AOP) in the treatment of distillery wastewater (DWW), anaerobic digestion achieved sufficient biochemical oxygen demand (BOD) and chemical oxygen demand (COD) removals of 95% and 75%, respectively, and methane production of 0.292 L/g COD removed at an organic loading rate of 15 kg COD/m3/d. However, a considerable amount of biorecalcitrant compounds still existed in the anaerobically treated effluent, contributing to a residual COD of 4.5 g/L and an intense dark brown color. To remove the biorecalcitrant color and COD, ozonation, which is an AOP, was introduced as a post-treatment method to AD. Ozonation is a highly competitive treatment technique that can be easily applied to remove the biorecalcitrant compounds, including color, and turbidity. In the ozonation process carried out for an hour, more than 80% of the color was removed at an ozone dose of 45 mg O3/L/min (corresponding to 1.8 g O3/g COD). Thus, integrating AD with the AOP can be effective for organic load and color reductions during the treatment of DWW. The deliverable established the best configuration of the AD-AOP system, where DWW is first subjected to AD followed by AOP post-treatment. However, for establishing the feasibility of the industrial application of the integrated system, it is necessary to carry out the economic analysis. This may help the starting point of the wastewater treatment plant construction and its operation and maintenance costs.

Keywords: distillery wastewater, economic analysis, integrated anaerobic digestion, ozonolysis, treatment

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Authors: Hebah M. Musalem, Jeylan El-Mansoury, Lin M. Tuleimat, Selwa Alhazza, Abdul-Aziz A. Al Zoba

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Background: Amblyopia is a condition that affects the visual system triggering a decrease in visual acuity without a known underlying pathology. It is due to abnormal vision development in childhood or infancy. Most importantly, vision loss is preventable or reversible with the right kind of intervention in most of the cases. Strabismus, sensory defects, and anisometropia are all well-known causes of amblyopia. However, ocular misalignment in Strabismus is considered the most common form of amblyopia worldwide. The risk of developing amblyopia increases in premature children, developmentally delayed or children who had brain lesions affecting the visual pathway. The prevalence of amblyopia varies between 2 to 5 % in the world according to the literature. Objective: To determine the different causes of Amblyopia in pediatric patients seen in ophthalmology clinic of a tertiary care center, i.e. King Faisal Specialist Hospital and Research Center (KFSH&RC). Methods: This is a hospital based, random retrospective, based on reviewing patient’s files in the Ophthalmology Department of KFSH&RC in Riyadh city, Kingdom of Saudi Arabia. Inclusion criteria: amblyopic pediatric patients who attended the clinic from 2015 to 2016, who are between 6 months and 18 years old. Exclusion Criteria: patients above 18 years of age and any patient who is uncooperative to obtain an accurate vision or a proper refraction. Detailed ocular and medical history are recorded. The examination protocol includes a full ocular exam, full cycloplegic refraction, visual acuity measurement, ocular motility and strabismus evaluation. All data were organized in tables and graphs and analyzed by statistician. Results: Our preliminary results will be discussed on spot by our corresponding author. Conclusions: We focused on this study on utilizing various examination techniques which enhanced our results and highlighted a distinguished correlation between amblyopia and its’ causes. This paper recommendation emphasizes on critical testing protocols to be followed among amblyopic patient, especially in tertiary care centers.

Keywords: amblyopia, amblyopia causes, amblyopia diagnostic criterion, amblyopia prevalence, Saudi Arabia

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Authors: S. Buloyan, V. Mamikonyan, H. Hakobyan, H. Harutyunyan, H. Gasparyan

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The liver is the strongest regenerating organ of the organism, and even with 2/3 surgically removed, it can regenerate completely. Hence, liver cirrhosis may only develop when the regenerating system is off. We present the results of a comparative study of structural and functional characteristics of rat liver tissue under the conditions of toxic liver cirrhosis development, induced by carbon tetrachloride, and its prevention/treatment by natural compounds with antioxidant and immune stimulating action. Studies were made on Wister rats, weighing 120~140 g. Grape seeds extracts, separately and in combination with well known anticirrhotic drug ursodeoxycholic acid (ursodiol) have demonstrated effectiveness in prevention of liver cirrhosis development and its treatment.

Keywords: carbon tetrachloride, GSE, liver cirrhosis, prevention, treatment

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Authors: Esther Kelechi Soyele

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Job satisfaction is the expression of an organisation's fulfillment of work output. In order to achieve effective job satisfaction, the motivation of employees is very essential in stimulating their obligation towards their work. The study examined the motivational strategies, job satisfaction as a correlation of library service delivery in some selected tertiary institutions in southwest Nigeria. The study adopted a descriptive survey research design. A simple random sampling method was employed to select 200 library staff consisting of both library professionals and para-professionals. Two hundred (200) questionnaires were given out, but only one hundred and twenty-nine 129 (96% response rate) were used for the study. Both simple percentage and one and two way ANOVA was used for data analysis. Findings revealed that 60.4% of the respondents were males while 39.6% were female; most of the respondents’ relatively belong to the age group of 31-40 and 41-50, 93.3% were within the age range of 21-50 years, and 43.2 % were M.Sc degree holders. The result revealed a (p < 0.05) significant relationship between work motivational strategies and library service delivery. The results also revealed that motivational development program strategies and job satisfaction have (p < 0.05) a positive significant relationship with library service delivery. It was concluded that work motivation strategies are essential for job satisfaction which is very important in any organization in the attainment of its goals and objectives and helps in maintaining a high standard. The study recommended that more incentive plans that will enhance job satisfaction should be put in place to encourage employees to be more active in carrying out their job effectively.

Keywords: job satisfaction, library, library services, motivational strategies

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Authors: Sat Sharma, Antonella Conflitti, Hilary Reiter

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Introduction: The study's purpose was to assess the efficacy of the oral appliance device O2Vent Optima + ExVent as compared to Optima in the treatment of OSA. Methods: A prospective, open-label study conducted at 3 sites included subjects with mild to moderate OSA (AHI ≥ 5 and ≤ 30). Screening Phase: A diagnostic in-lab PSG study was performed to confirm a diagnosis of mild to moderate OSA. Treatment I: Subjects used O2Vent Optima for 6 weeks and underwent an in-lab PSG sleep night while using the O2Vent Optima. Treatment II: Subjects used O2Vent Optima + ExVent for 6 weeks and underwent an in-lab PSG sleep night while using the O2Vent Optima + ExVent Primary Effectiveness Measure: Change in AHI between baseline vs. O2Vent Optima MAD vs. O2Vent Optima + ExVent. Results: Treatment with Optima, Optima + ExVent reduced AHI from 22.5±6.4/hr to 12.6±4.5/hr to 5.9±2.7 (p< 0.005 baseline vs. Optima and Optima + ExVent; p<0.05 Optima MAD vs. Optima + ExVent). The average reduction in AHI with Optima was 43%, and with Optima + ExVent was 72%. The lowest oxygen during sleep increased from 84.6±2.7% to 88.6±2.9% to 91.6±3.2% (p< 0.005 baseline vs. Optima and Optima + ExVent; p<0.05 Optima vs. Optima + ExVent). During the trial, patients on treatment with Optima and Optima + ExVent demonstrated no excessive adverse events or device malfunction. Conclusion: Treatment with O2Vent Optima and O2Vent Optima + ExVent significantly improved OSA compared to the baseline. An even greater benefit was observed with the addition of ExVent to the Optima in mild to moderate OSA.

Keywords: oral appliance, O2Vent, sleep dentistry, sleep apnea

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Authors: Alejandro Salicrup, Riacrdo Gelhman, Geetha Gopalakrishna

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The main aim of this session is to have a panel to discuss specific steps for the integration of traditional, complementary and alternative medicine (TCAM) with conventional oncology for enhancing treatment practices at the global level, specifically in low-and-middle-income-countries (LMICs). Concrete current and required programs for strengthening Integrative Oncology research in LMICs will also be discussed. Case Studies from Latin America, Asia, Europe and Africa will discuss and highlight 1) What is working regarding treatment practices in integrative oncology in their countries/regions providing concrete examples 2) What is not working on this integration for cancer treatment in their countries/regions with concrete examples and 3) What are the challenges and opportunities for research related to integrative oncology treatment. Discussion will include potential next steps and potential mechanisms to enhance global integrative oncology research aimed to enhance the use of TCAM therapies and strengthening cancer treatment in LMICs.

Keywords: global cancer treatment, integrative oncology research, low and middle income countries, traditional, complementary and alternative medicines

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Authors: Ilirian Laçi, Alketa Spahiu

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Ageing causes an increase in the number of patients with spinal canal stenosis. Most of the patients have back pain, leg pain, numbness of the legs, as well as urinary incontinence as a very common symptoms. Urinary incontinence impairs the quality of life. Correction of the symptom of urinary incontinence is possible in the early and adequate treatment of spinal stenosis. Methods: This study observed patients with urinary incontinence and spinal canal stenosis. These patients underwent mechanical decompression of the spinal stenosis through surgery. At the same time, these patients were observed clinically with clinical consultations. Cystoscopy and urodynamic tests were conducted at intervals of 2 and 6 months. As a result of treatment, 60% of patients did recover. The patients in this group who benefit from treatment were the patients who were early diagnosed and treated. Conclusions: An important factor in the prognosis of this pathology is the early diagnosis and treatment. The proper treatment of this pathology makes it curable in most cases. An important role in this pathology is played by the neurosurgeon. Surgery accompanied by laminotomy and mechanical decompression is the best way of treatment. Other factors that played a role in this pathology are also a large number of childbirths for women, obesity, etc.

Keywords: urinary incontinence, quality of life, spinal canal stenosis, early diagnosis, treatment

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Authors: Jungkyun Na, Jaesang Lee, Yang Mo Koo

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In this study to find a replacement for expensive secondary recrystallization in GO electrical steel production, effect of heat treatment on the formation of columnar grain and Goss texture is investigated. The composition of the sample is Fe-2.0Si-0.2C. This process involves repeating of cold rolling and decarburization as a replacement for secondary recrystallization. By cold-rolling shear band is made and Goss grain grows from shear band by decarburization. By doing another cold rolling, some Goss texture is newly formed from the shear band, and some Goss texture is retained in microbands. To determine whether additional heat treatment with H2 atmosphere is needed on decarburization process for growth of Goss texture, comparing between decarburization and heat treatment with H2 atmosphere is performed. Also, to find optimum condition for heat treatment, heat treatment with various time and temperature is performed. It was found that increase in the number of cold rolling and heat treatment increases Goss texture. Both high Goss texture and good columnar structure is achieved at 900℃, and this temperature is within a+r phase region. Heat treatment at a temperature higher than a+r phase region caused carbon diffusion and this made layer with Goss grain decrease.

Keywords: electrical steel, Goss texture, columnar structure, normal grain growth

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Authors: Niall Fennessy, Charlotte Yin, Vineet Gorolay, Michael Chan, Ilias Drivas

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Background: The aim of this study was to evaluate the effect of manual aspiration of air from the pleural cavity in mitigating the need for chest drain placement after a CT-guided lung biopsy. Method: This is a single institution retrospective review of CT-guided lung biopsies performed on 799 patients between September 2013 and May 2021 in a major tertiary hospital. Percutaneous manual aspiration of air was performed in 104/306 patients (34%) with pneumothoraxes as a preventative measure. Simple and multivariate analysis was performed to identify independent risk factors (modifiable and nonmodifiable) for the success of manual aspiration in mitigating the need for chest drain insertion. Results: The overall incidence of pneumothorax was 37% (295/799). Chest drains were inserted for 81/295 (27%) of the pneumothoraxes, representing 81/799 (10%) of all CT-guided lung biopsies. Of patients with pneumothoraces, 104 (36%) underwent percutaneous aspiration via either the coaxial guide needle or an 18 or 20G intravenous catheter attached to a three-way stopcock and syringe. Amongst this group, 13 patients (13%) subsequently required chest drain insertion. The success of percutaneous aspiration in avoiding subsequent pleural drain insertion decreased with aspiration volume >500mL, radial pneumothorax depth >3cm, increased subpleural depth of the lesion, and the presence of background emphysema.

Keywords: computed tomography, lung biopsy, pneumothorax, manual aspiration, chest drainage

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Authors: Lima Priscila, Gianotto Raiza, Arruda Leonan, Magalhães Filho Fernando

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Industrialization and especially the accentuated population growth in developing countries and the lack of drainage, public cleaning, water and sanitation services has caused concern about the need for expansion of water treatment units and sewage. However, these units have been generating by-products, such as the sludge. This paper aims to investigate aspects of operation and maintenance of sludge from a wastewater treatment plant (WWTP - 90 L.s-1) and two water treatment plants (WTPs; 1.4 m3.s-1 and 0.5 m3.s-1) for the purpose of proper disposal and reuse, evaluating their qualitative and quantitative characteristics, the Brazilian legislation and standards. It was concluded that the sludge from the water treatment plants is directly related to the quality of raw water collected, and it becomes feasible for use in construction materials, and to dispose it in the sewage system, improving the efficiency of the WWTP regarding precipitation of phosphorus (35% of removal). The WTP Lageado had 55,726 kg/month of sludge production, more than WTP Guariroba (29,336 kg/month), even though the flow of WTP Guariroba is 1,400 L.s-1 and the WTP Lagedo 500 L.s-1, being explained by the quality that influences more than the flow. The WWTP sludge have higher concentrations of organic materials due to their origin and could be used to improve the fertility of the soil, crop production and recovery of degraded areas. The volume of sludge generated at the WWTP was 1,760 ton/month, with 5.6% of solid content in the raw sludge and in the dewatered sludge it increased its content to 23%.

Keywords: disposal, sludge, water treatment, wastewater treatment

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Authors: Ben Clapperton, Daniel Stahl, Kimberley Goldsmith, Trudie Chalder

Abstract:

Chronic fatigue syndrome (CFS) is a condition characterised by chronic disabling fatigue and other symptoms that currently can't be explained by any underlying medical condition. Although clinical trials support the effectiveness of cognitive behaviour therapy (CBT), the success rate for individual patients is modest. Patients vary in their response and little is known which factors predict or moderate treatment outcomes. The aim of the project is to develop a prediction model from baseline characteristics of patients, such as demographics, clinical and psychological variables, which may predict likely treatment outcome and provide guidance for clinical decision making and help clinicians to recommend the best treatment. The project is aimed at identifying subgroups of patients with similar baseline characteristics that are predictive of treatment effects using modern cluster analyses and data mining machine learning algorithms. The characteristics of these groups will then be used to inform the types of individuals who benefit from a specific treatment. In addition, results will provide a better understanding of for whom the treatment works. The suitability of different clustering methods to identify subgroups and their response to different treatments of CFS patients is compared.

Keywords: chronic fatigue syndrome, latent class analysis, prediction modelling, self-organizing maps

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Authors: Marco Correa

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The increasing reduction of the volumes of surface water sources supplying most municipalities, as well as the rising demand for treated water, combined with the disposal of effluents from washing of decanters and filters of water treatment plants generates a continuous search for correct environmentally solutions to these problems. The effluents generated by the water treatment industry need to be suitably processed for return to the environment or re-use. This article shows alternatives for sludge dehydration from the water treatment plants (WTP) and eventual disposal of sludge drained. Using the simple design methodology, it is presented a case study for drainage in tanks geotextile, full-scale, which involve five sledge drainage tanks from WTP of the city of Rio Verde. Aiming to the reutilization of drained water from the sledge and enabling its reuse both at the beginning of the treatment process at the WTP and in less noble services as for watering the gardens of the local town hall. The sludge will be used to in the production of building materials.

Keywords: dehydration, effluent discharges, re-use, sludge, WTP sludge

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Authors: Bae Yu been, Choi Sung won, Lee Ju yeon, Yang Dan Bi

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The purpose of this study is to develop a self-help therapy program for bipolar disorder (BD). Psychosocial treatment is adjunct to pharmacotherapy for BD, however, it is limited and they demand high costs. Therefore, the objective of the study is to overcome these limitations by developing the self-treatment for BD. The study was examined the efficacy of the self-treatment program for BD. A randomized controlled trial compared the self-help therapy (ST) intervention with a treatment as usual (TAU) group. ST group has conducted the program for 8 weeks (16 sessions). Mood chart, Quality of Life in Bipolar Disorder Questionnaire, Attitudes toward seeking professional help Scale, BIS, CERQ, YMRS, MADRS were used by pre, post, and follow up. The efficacy of the self-help therapy was analyzed by using mixed ANOVAs. There were significant differences in the rate of occurrence of mania or depression between the two groups. ST group reported stable moods on mood chart, and reductions in mood symptoms and improvements in quality of life and treatment adherence. This study was confirmed applicable to BD to the self-help therapy for patients with BD conducted first in Korea.

Keywords: self help therapy, bipolar disorder, self help, self therapy

Procedia PDF Downloads 677

Authors: Thandie Veronicah Sima, Moatlhodi Wiseman Letshwenyo

Abstract:

Discharge of wastewater is one of the major sources of phosphorus entering streams, lakes and other water bodies causing undesired environmental problem such as eutrophication. This condition not only puts the ecosystem at risk but also causes severe economic damages. Stringent laws have been developed globally by different bodies to control the level of phosphorus concentrations into receiving environments. In order to satisfy the constraints, a high degree of tertiary treatment or at least a significant reduction of phosphorus concentration is obligatory. This comprehensive review summarizes phosphorus removal technologies, from the most commonly used conventional technologies such as chemical precipitation through metal addition, membrane filtration, reverse osmosis and enhanced biological phosphorus removal using activated sludge system to passive systems such as constructed wetlands and filtration systems. Trends, perspectives and scientific procedures conducted by different researchers have been presented. This review critically evaluates the advantages and limitations behind each of the technologies. Enhancement of passive systems using reactive media such as industrial wastes to provide additional uptake through adsorption or precipitation is also discussed in this article.

Keywords: adsorption, chemical precipitation, enhanced biological phosphorus removal, phosphorus removal

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Authors: Amin Mojiri, Hamidi Abdul Aziz

Abstract:

Leachate is created while water penetrates through the waste in a landfill, carrying some forms of pollutants. In literature, for treatment of wastewater and leachate, different ways of biological treatment were used. Sequencing batch reactor (SBR) is a kind of biological treatment. This study investigated the co-treatment of landfill leachate and domestic waste water by SBR and powdered activated carbon augmented (PAC) SBR process. The response surface methodology (RSM) and central composite design (CCD) were employed. The independent variables were aeration rate (L/min), contact time (h), and the ratio of leachate to wastewater mixture (%; v/v)). To perform an adequate analysis of the aerobic process, three dependent parameters, i.e. COD, color, and ammonia-nitrogen (NH3-N or NH4-N) were measured as responses. The findings of the study indicated that the PAC-SBR showed a higher performance in elimination of certain pollutants, in comparison with SBR. With the optimal conditions of aeration rate (0.6 L/min), leachate to waste water ratio (20%), and contact time (10.8 h) for the PAC-SBR, the removal efficiencies for color, NH3-N, and COD were 72.8%, 98.5%, and 65.2%, respectively.

Keywords: co-treatment, landfill Leachate, wastewater, sequencing batch reactor, activate carbon

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Authors: Margarita A. Belousova, Sergey N. Ermoliev, Nina K. Loginova

Abstract:

The method of intraoral ultrasound densitometry developed to diagnose mineral density of alveolar bone jaws during retention period of orthodontic treatment (Patent of Russian Federation № 2541038). It was revealed significant decrease of the ultrasonic wave speed and bone mineral density in patients with relapses dentition anomalies during retention period of orthodontic treatment.

Keywords: intraoral ultrasonic densitometry, speed of sound, alveolar jaw bone, relapses of dentition anomalies, retention period of orthodontic treatment

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Authors: A. Benhadji, M. Taleb Ahmed

Abstract:

Among the various methods of treatment, advanced oxidation processes (AOP) are the most promising ones. In this study, Peroxi Electrocoagulation Process (PEP) was investigated for the treatment of detergent wastewater. The process was compared with electrooxidation treatment. The results showed that chemical oxygen demand (COD) was high 7584 mgO₂.L^-1, while the biochemical oxygen demand was low (250 mgO₂.L^-1). This wastewater was hardly biodegradable. Electrochemical process was carried out for the removal of detergent using a glass reactor with a volume of 1 L and fitted with three electrodes. A direct current (DC) supply was used. Samples were taken at various current density (0.0227 A/cm² to 0.0378 A/cm²) and reaction time (1-2-3-4 and 5 hour). Finally, the COD was determined. The results indicated that COD removal efficiency of PEP was observed to increase with current intensity and reached to 77% after 5 h. The highest removal efficiency was observed after 5 h of treatment.

Keywords: AOP, COD, detergent, PEP, wastewater

Procedia PDF Downloads 119