Search results for: surgical removal

Authors: Zahra Akbari, Farzin Zokaee, Talat Ghomashchi

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Whey is a by-product of the dairy industry whose major components are lactose (44–52 g/L), proteins (6–8 g/L) and mineral salts (4–9 g/L). Approximately 50% of 121 million tons of whey produced in the world in 1993 were disposed into rivers, lakes or other water bodies, treated in wastewater treatment plants or loaded onto land. This represents a significant loss of resources and causes serious pollution problems since whey is a heavy organic pollutant with high COD and BOD values, 40–60 g/L and 50–80 g/L, respectively. The removal of cheese whey proteins and minerals represent an important task both in environmental and in food sciences. The most important treatments which are considered in this study, have been done by using lime, Al2O3, FeCl3 and AlCl3 along with heating and also acidic-alkaline method. Results show that the best way for removal of protein is accomplished with adding HCl to decrease pH from 6 to 4, boiling for 20 min, and filtering protein aggregates. Also partial demineralization in whey solution for reducing ash is accomplished by adding NaOH to increase pH to 7.2 and heating solution for 20 min.

Keywords: whey treatment, dairy industry, precipitation, protein, mineral

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Authors: Sharon Baoas, Toni Beninato, Michael Zenilman, Gokhan Ozuner

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Background An enhanced recovery after surgery (ERAS) protocol was implemented to improve quality and cost effectiveness of surgical care in elective colorectal procedures. Results A total of 109 patients, 55 (pre-ERAS) and 54 (post-ERAS) are included in the final analysis. There were no differences in complications were recorded (p = 0.37) and 30-day readmissions (p = 0.785). The mean hospital stay was 5.89 ± 2.62 days in pre-ERAS and 4.94 ± 2.27 days in post-ERAS group which was statistically significant (p = 0.047). Conclusions An ERAS protocol for colorectal surgery harmonised perioperative care and decreased length of stay.

Keywords: 30-day readmission, lenght of stay, Enhanced Recovery after surgery, Surgical site infection

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Authors: Abhijeet Kumar, Palaniswamy N. K.

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Heavy metal contamination in water sources endangers both the environment and human health. Various water filtration techniques have been employed till now for purification and removal of hazardous metals from water. Among all the existing methods, nanofibres have emerged as a viable alternative for effective heavy metal removal in recent years because of their unique qualities, such as large surface area, interconnected porous structure, and customizable surface chemistry. Among the numerous manufacturing techniques, solution blow spinning has gained popularity as a versatile process for producing nanofibers with customized properties. This paper seeks to offer a complete overview of the use of nanofibers for heavy metal filtration, particularly those produced using solution blow spinning. The review discusses current advances in nanofiber materials, production processes, and heavy metal removal performance. Furthermore, the field's difficulties and future opportunities are examined in order to direct future research and development activities.

Keywords: heavy metals, nanofiber composite, filter membranes, adsorption, impaction

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Authors: Waddah Abdullah, Saleh Al-Sarem

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Electrokinetic remediation was undoubtedly proven to be one of the most efficient techniques used to clean up soils contaminated with polar charged contaminants (such as heavy metals) and non-polar organic contaminants. It can be efficiently used to clean up low permeability mud, wastewater, electroplating wastes, sludge, and marine dredging. This study presented and discussed the results of electrokinetic remediation processes to clean up soils contaminated with nickel. Two types of electrokinetics cells were used: an open cell and an advanced cylindrical cell. Two types of soils were used for this investigation; the Azraq green clay which has very low permeability taken from the eastern part of Jordan (city of Azraq) and a sandy soil having, relatively, very high permeability. The clayey soil was spiked with 500 ppm of nickel, and the sandy soil was spiked with 1500 ppm of nickel. Fully saturated and partially saturated clayey soils were used for the clean-up process. Clayey soils were tested under a direct current of 80 mA and 50 mA to study the effect of the electrical current on the remediation process. Chelating agent (Na-EDTA), disodium ethylene diamine tetraacetatic acid, was used in both types of soils to enhance the electroremediation process. The effect of carbonates presence in the contaminated soils, also, was investigated by use of sodium carbonate and calcium carbonate. pH changes in the anode and the cathode compartments were controlled by use of buffer solutions. The results of the investigation showed that for the fully saturated clayey soil spiked with nickel had an average removal efficiency of 64%, and the average removal efficiency was 46% for the unsaturated clayey soil. For the sandy soil, the average removal efficiency of Nickel was 90%. Test results showed that presence of carbonates in the remediated soils retarded the clean-up process of nickel-contaminated soils (removal efficiency was reduced from 90% to 60%). EDTA enhanced decontamination of nickel contaminated clayey and sandy soils with carbonates was studied. The average removal efficiency increased from 60% (prior to using EDTA) to more than 90% after using EDTA.

Keywords: buffer solution, EDTA, electroremediation, nickel removal efficiency

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Authors: M. Jerold, V. Sivasubramanian

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In this study, nano zero valent iron Sargassum swartzii (nZVI-SS) biocomposite a marine algal based biosorbent was used for the removal of simulated crystal violet (CV) in batch and continuous fixed bed operation. The Box-Behnen design (BBD) experimental results revealed the biosoprtion was maximum at pH 7.5, biosorbent dosage 0.1 g/L and initial CV concentration of 100 mg/L. The effect of various column parameters like bed depth (3, 6 and 9 cm), flow rate (5, 10 and 15 mL/min) and influent CV concentration (5, 10 and 15 mg/L) were investigated. The exhaustion time increased with increase of bed depth, influent CV concentration and decrease of flow rate. Adam-Bohart, Thomas and Yoon-Nelson models were used to predict the breakthrough curve and to evaluate the model parameters. Out of these models, Thomas and Yoon-Nelson models well described the experimental data. Therefore, the result implies that nZVI-SS biocomposite is a cheap and most promising biosorbent for the removal of CV from wastewater.

Keywords: algae, biosorption, zero-valent, dye, wastewater

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Authors: Pritam Kumar Ghosh

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The phenomenon of inter-country parental child removal and the protection of children against removal from lawful custody by their own parents has been a major issue over the last five decades. This occurs when parents take away their children during pending divorce and custody proceedings or in violation of pre-existing foreign or Indian custody orders through which they may have obtained visitation rights only after divorce but not permanent custody. Even though considerable efforts have been made by the Indian judiciary to resolve the issue, a lot is still left to be desired. A study of the spate of judicial decisions on the issue since 1970 reveals that judges have attempted to resolve the issue mainly through the application of the existing personal law regime and the principle of the best interest of the child. This has made the position of law extremely confusing. The existing precedential jurisprudence contains a wide variety of custody orders in the name of enforcement of the paramount consideration of the best interest and welfare of children. The problem is aggravated by the fact that India has decided not to accede to the Hague Abduction Convention of 1980, which is the main international instrument combating the issue. In this context, the paper discusses the reasons behind the rising instances of inter-country parental child removals. It then goes on to analyze the existing jurisprudence of international child custody disputes in India, which have come before courts post-removal of children from lawful custody. The paper concludes by suggesting essential reforms in the existing Indian legal framework governing the issue. In the process, the paper proposes new legislation for India governing inter-country parental child removals and subsequent custody disputes. The possible structure and content of this new law shall also be outlined as a part of the paper.

Keywords: custody, dispute, child removal, Hague convention

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Authors: Prangya Ranjan Rout, Rajesh Roshan Dash, Puspendu Bhunia

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With the aim of enhancing the nutrient (ammonium and phosphate) removal from eutrophic wastewater with reduced cost, a novel media based multistage bio filter with drop aeration facility was developed in this work. The bio filter was packed with a discarded sponge iron industry by product, ‘dolochar’ primarily to remove phosphate via physicochemical approach. In the multi stage bio-filter drop, aeration was achieved by the process of percolation of the gravity-fed wastewater through the filter media and dropping down of wastewater from stage to stage. Ammonium present in wastewater got adsorbed by the filter media and biomass grown on the filter media and subsequently, got converted to nitrate through biological nitrification in the aerobic condition, as realized by drop aeration. The performance of the bio-filter in treating real eutrophic wastewater was monitored for a period of about 2 months. The influent phosphate concentration was in the range of 16-19 mg/L, and ammonium concentration was in the range of 65-78 mg/L. The average nutrient removal efficiency observed during the study period were 95.2% for phosphate and 88.7% for ammonium, with mean final effluent concentration of 0.91, and 8.74 mg/L, respectively. Furthermore, the subsequent release of nutrient from the saturated filter media, after completion of treatment process has been undertaken in this study and thin layer funnel analytical test results reveal the slow nutrient release nature of spent dolochar, thereby, recommending its potential agricultural application. Thus, the bio-filter displays immense prospective for treating real eutrophic wastewater, significantly decreasing the level of nutrients and keeping the effluent nutrient concentrations at par with the permissible limit and more importantly, facilitating the conversion of the waste materials into usable ones.

Keywords: ammonium removal, phosphate removal, multi-stage bio-filter, dolochar

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Authors: C. M. Williams, R. English, P. King, I. M. Brown

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Introduction: Pseudoangiomatous Stromal Hyperplasia (PASH) is a benign fibrous proliferation of breast stroma affecting predominantly premenopausal women with no significant increased risk of breast cancer. Informal recommendations for management have continued to evolve over recent years from surgical excision to observation, although there are no specific national guidelines. This study assesses the safety of a non-surgical approach to PASH management by review of cases at a single centre. Methods: Retrospective case series review (January 2011 – August 2016) was conducted on consecutive PASH cases. Diagnostic classification (clinical, radiological and histological), management outcomes, and breast cancer incidence were recorded. Results: 43 patients were followed up for median of 25 months (3-64) with 75% symptomatic at presentation. 12% of cases (n=5) had a radiological score (BIRADS MMG or US) ≥ 4 of which 3 were confirmed malignant. One further malignancy was detected and proven radiologically occult and contralateral. No patients were diagnosed with a malignancy during follow-up. Treatment evolved from 67% surgical in 2011 to 33% in 2016. Conclusions: The management of PASH has transitioned in line with other published experience. The preliminary findings suggest this appears safe with no evidence of missed malignancies; however, longer follow up is required to confirm long-term safety. Recommendations: PASH with suspicious radiological findings ( ≥ U4/R4) warrants multidisciplinary discussion for excision. In the absence of histological or radiological suspicion of malignancy, PASH can be safely managed without surgery.

Keywords: benign breast disease, conservative management, malignancy, pseudoangiomatous stromal hyperplasia, surgical excision

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Authors: Soheila Zhaeentan, Anders Von Heijne, Elisabet Hagert, André Stark, Björn Salomonsson

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Recommended treatment for traumatic rotator cuff tear (TRCT) is surgery within a few weeks after injury if the diagnosis is made early, especially if a functional impairment of the shoulder exists. This may lead to the assumption that a poor outcome then can be expected in delayed surgical treatment, when the patient is diagnosed at a later stage. The aim of this study was to investigate if a surgical repair later than three months after injury may result in successful outcomes and patient satisfaction. There is evidence in literature that good results of treatment can be expected up to three months after the injury, but little is known of later treatment with cuff repair. 73 patients (75 shoulders), 58 males/17 females, mean age 59 (range 34-­‐72), who had undergone surgical intervention for TRCT between January 1999 to December 2011 at our clinic, were included in this study. Patients were assessed by MRI investigation, clinical examination, Western Ontario Rotator Cuff index (WORC), Oxford Shoulder Score, Constant-­‐Murley Score, EQ-­‐5D and patient subjective satisfaction at follow-­‐up. The patients treated surgically within three months ( < 12 weeks) after injury (39 cases) were compared with patients treated more than three months ( ≥ 12 weeks) after injury (36 cases). WORC was used as the primary outcome measure and the other variables as secondary. A senior consultant radiologist, blinded to patient category and clinical outcome, evaluated all MRI-­‐images. Rotator cuff integrity, presence of arthritis, fatty degeneration and muscle atrophy was evaluated in all cases. The average follow-­‐up time was 56 months (range 14-­‐149) and the average time from injury to repair was 16 weeks (range 3-­‐104). No statistically significant differences were found for any of the assessed parameters or scores between the two groups. The mean WORC score was 77 (early group, range 25-­‐ 100 and late group, range 27-­‐100) for both groups (p= 0.86), Constant-­‐Murley Score (p= 0.91), Oxford Shoulder Score (p= 0.79), EQ-­‐5D index (p= 0.86). Re-­‐tear frequency was 24% for both groups, and the patients with re-­‐tear reported less satisfaction with outcome. Discussion and conclusion: This study shows that surgical repair of TRCT performed later than three months after injury may result in good functional outcomes and patient satisfaction. However, this does not motivate an intentional delay in surgery when there is an indication for surgical repair as that delay may adversely affect the possibility to perform a repair. Our results show that surgeons may safely consider surgical repair even if a delay in diagnosis has occurred. A retrospective cohort study on 75 shoulders shows good functional result after traumatic rotator cuff tear (TRCT) treated surgically up to one year after the injury.

Keywords: traumatic rotator cuff injury, time to surgery, surgical outcome, retrospective cohort study

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Authors: Shammael Selorfia

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The Quality improvement project aimed to improve junior doctors and nurses’ knowledge and confidence in diagnosing and managing delirium on inpatient surgical wards in a tertiary hospital. The study aimed to develop a standardised assessment and management checklist for all staff working with patients who were presenting with signs of delirium. The aim of the study was to increase confidence of staff at dealing with delirium and improve the quality of referrals that were being sent to the Mental Health Liaison team over a 6-month period. A significant proportion of time was being spent by the Mental Health Liaison triage nurses on referrals for delirium. Data showed 28% of all delirium referrals from surgical teams were being closed at triage reflecting a poor standard of quality of those referrals. A qualitative survey of junior doctors in 6 surgical specialties in a UK tertiary hospital was conducted. These specialties include general surgery, vascular, plastic, urology, neurosurgery, and orthopaedics. The standardised checklist was distributed to all surgical wards. A comparison was made between the Mental health team caseload of delirium before intervention was compared and after. A Qualitative survey at end of 3-month cycle and compare overall caseload on Mental Health Liaison team to pre-QIP data with aim to improve quality of referrals and reduce workload on Mental Health Liaison team. At the end of the project cycle, we demonstrated an improvement in the quality of referrals with a decrease in the percentage of referrals being closed at triage by 8%. Our surveys also indicated an increase in the knowledge of official trust delirium guidelines and confidence at managing the patients. This project highlights that a new approach to delirium using multi-component interventions is needed, where the diagnosis of delirium is shared amongst medical and nursing staff, and everyone plays role in management. The key is improving awareness of delirium and encouraging the use of recognized diagnostic tools and official guidelines. Recommendations were made to the trust on how to implement a long-lasting change.

Keywords: delirium, surgery, quality, improvement

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Authors: Kalyani Mer

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Hydrogen peroxide (H₂O₂) is one of the most efficient and commonly used oxidants in in-situ chemical oxidation (ISCO) of organic contaminants. In the present study, we investigated the activation of H₂O₂ by heavy metal (nickel and lead metal ions) loaded biochar for phenol degradation in an aqueous solution (concentration = 100 mg/L). It was found that H₂O₂ can be effectively activated by biochar, which produces hydroxyl (•OH) radicals owing to an increase in the formation of persistent free radicals (PFRs) on biochar surface. Ultrasound treated (30s duration) biochar, chemically activated by 30% phosphoric acid and functionalized by diethanolamine (DEA) was used for the adsorption of heavy metal ions from aqueous solutions. It was found that modified biochar could remove almost 60% of nickel in eight hours; however, for lead, the removal efficiency reached up to 95% for the same time duration. The heavy metal loaded biochar was further used for the degradation of phenol in the absence and presence of H₂O₂ (20 mM), within 4 hours of reaction time. The removal efficiency values for phenol in the presence of H₂O₂ were 80.3% and 61.9%, respectively, by modified biochar loaded with nickel and lead metal ions. These results suggested that the biochar loaded with nickel exhibits a better removal capacity towards phenol than the lead loaded biochar when used in H₂O₂ based oxidation systems. Meanwhile, control experiments were set in the absence of any activating biochar, and the removal efficiency was found to be 19.1% when only H₂O₂ was added in the reaction solution. Overall, the proposed approach serves a dual purpose of using biochar for heavy metal ion removal and treatment of organic contaminants by further using the metal loaded biochar for H₂O₂ activation in ISCO processes.

Keywords: biochar, ultrasound, heavy metals, in-situ chemical oxidation, chemical activation

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Authors: Inba Blesso P., Senthil Kumar P.

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The main consideration of any tire manufacturing process is wear resistance. One of the factors that cause tire wear is improper removal of vent and flash from the tire surface. The contact point between tyre surface and vent is highly supposed to wear. When the vehicle running at higher speed with heavy load, the tire vent and flash is wearing initially and it makes few of the tire surface material to wear along with it. Hence, provision must be given to efficient removal vent and flash thereby tire wear. Human efforts in trimming of tire vent results in time consuming and inaccurate output. Hence, this lead to the reduction in production rate and profit. Thus, the development of automated system can helps to attain minimum time consumption and provide a possible way to get the profitable production. Semi-automated system that employs Pneumatic actuators and sequencing circuits are focused in this study. By implementing this, one can achieve the accurate results with reduction in time and profitable output.

Keywords: tire manufacturing, pneumatic system, vent and flash removal, engineering and technology

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Authors: E. Marei, A. Hammad, S. Ismail, A. El-Gindy

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This study aims to investigate the ability of different formula of mixed bacteria as a biological treatments of wastewater after primary treatment as a bio-treatment and bio-removal and bio-adsorbent of different heavy metals in natural circumstances. The wastewater was collected from Sarpium forest site-Ismailia Governorate, Egypt. These treatments were mixture of free cells and mixture of immobilized cells of different bacteria. These different formulas of mixed bacteria were prepared under Lab. condition. The obtained data indicated that, as a result of wastewater bio-treatment, the removal rate was found to be 76.92 and 76.70% for biological oxygen demand, 79.78 and 71.07% for chemical oxygen demand, 32.45 and 36.84 % for ammonia nitrogen as well as 91.67 and 50.0% for phosphate after 24 and 28 hrs with mixed free cells and mixed immobilized cells, respectively. Moreover, the bio-removals of different heavy metals were found to reach 90.0 and 50. 0% for Cu ion, 98.0 and 98.5% for Fe ion, 97.0 and 99.3% for Mn ion, 90.0 and 90.0% Pb, 80.0% and 75.0% for Zn ion after 24 and 28 hrs with mixed free cells and mixed immobilized cells, respectively. The results indicated that 13.86 and 17.43% of removal efficiency and reduction of total dissolved solids were achieved after 24 and 28 hrs with mixed free cells and mixed immobilized cells, respectively.

Keywords: wastewater bio-treatment , bio-sorption heavy metals, biological desalination, immobilized bacteria, free cell bacteria

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Authors: Saidasanov Saidazal Shokhmurodovich, Topolnickiy Orest Zinovyevich, Afaunova Olga Arturovna

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Relevance: Bilateral congenital cleft is one of the most complex forms of all clefts, which makes it difficult to choose a surgical method of treatment. During primary operations to close the hard and soft palate, there is a shortage of soft tissues and their lack during standard uranoplasty, and these factors aggravate the period of rehabilitation of patients. Materials and methods: The results of surgical treatment of children with bilateral cleft, who underwent uranoplasty using a flap from the tongue, were analyzed. The study used methods: clinical and statistical, which allowed us to solve the tasks, based on the principles of evidence-based medicine. Results and discussion: in our study, 15 patients were studied, who underwent surgical treatment in the following volume: uranoplasty using a flap from the tongue in two stages. Of these, 9 boys and 6 girls aged 2.5 to 6 years. The first stage was surgical treatment in the volume: veloplasty. The second stage was a surgical intervention in volume: uranoplasty using a flap from the tongue. In all patients, the width of the cleft ranged from 1.6-2.8 cm. All patients in this group were orthodontically prepared. Using this method, the surgeon can achieve the following results: maximum narrowing of the palatopharyngeal ring, long soft palate, complete closure of the hard palate, alveolar process, and the mucous membrane of the nasal cavity is also sutured, which creates good conditions for the next stage of osteoplastic surgery. Based on the result obtained, patients have positive results of working with a speech therapist. In all patients, the dynamics were positive without complications. Conclusions: Based on our observation, tongue flap uranoplasty is one of the effective techniques for patients with wide clefts of the hard and soft palate. The use of a flap from the tongue makes it possible to reduce the number of repeated reoperations and improve the quality of social adaptation of this group of patients, which is one of the important stages of rehabilitation. Upon completion of the stages of rehabilitation, all patients had the maximum improvement in functional, anatomical and social indicators.

Keywords: congenital cleft lips and palate, bilateral cleft, child surgery, maxillofacial surgery

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Authors: Prem Mohan, Namrata Jariwala

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In recent years 10000 dyes are approximately used by dying industry which makes dyeing wastewater more complex in nature. It is very difficult to treat dyeing wastewater by conventional methods. Here an attempt has been made to treat dyeing wastewater by the conventional and advanced method for removal of COD. Fenton process is the advanced method and activated carbon treatment is the conventional method. Experiments have been done on synthetic wastewater prepared from three different dyes; acidic, disperse and reactive. Experiments have also been conducted on real effluent obtained from industry. The optimum dose of catalyst and hydrogen peroxide in Fenton process and optimum activated carbon dose for each of these wastewaters were obtained. In Fenton treatment, COD removal was obtained up to 95% whereas 70% removal was obtained with activated carbon treatment.

Keywords: activated carbon, advanced oxidation process, dyeing waste water, fenton oxidation process

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Authors: M. M. Akhmediev, J. R. Ashrapov, T. M. Akhmediev

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Hydrocephalus frequently occurs with spina bifida, and up to 80% of such patients need to be shunted. Objective: It’s sought to improve the results of the surgical treatment of hydrocephalus in children with spina bifida. Methods: We have analyzed the results of the surgical treatment of 80 patients aged between 1 month and 1,5-year-old with hydrocephalus and myelomeningocele. All patients underwent surgery in the period of 2013-2018. Results: In all patients, spina bifida was associated with hydrocephalus with a predominant extension of the posterior horns of the lateral ventricles in the form of colpocephaly, Chiari malformation type 2. Based on the method “Choose right shunt” the determination of the point of critical deformation of the ventricular system was established, 47 (58.8%) patients for the 1st stage underwent ventriculoperitoneal (VP) shunt surgery with a low-pressure valve, 28 (35.0%) patients with medium pressure and 5 (6.2%) with high-pressure valve. Under or over drainage complications were not observed in the postoperative period. The 2nd stage of surgery for myelomeningocele repair was planned in 1-2 months with the follow-up head ultrasonography and electromyography study. Conclusion: The implantable shunt systems parameters chosen before surgery in the surgical management of hydrocephalus in children with myelomeningocele are important in the causes of under or over drainage states, cerebrospinal fluid leakage from the myelomeningocele sac. Management of hydrocephalus should be performed by considering myelomeningocele affecting craniospinal compliance.

Keywords: hydrocephalus, spina bifida, myelomeningocele, ventriculoperitoneal (VP) shunt

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Authors: Sneha Noble, Rahul Krishnan, Uma G., D. K. Vijaykumar

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Breast-Cancer related Lymphedema is a major problem that affects many women. Lymphedema is the swelling that generally occurs in the arms or legs caused by the removal of or damage to lymph nodes as a part of cancer treatment. Treating it at the earliest possible stage is the best way to manage the condition and prevent it from leading to pain, recurrent infection, reduced mobility, and impaired function. So, this project aims to focus on the multi-modal approaches to identify the risks of Lymphedema in post-surgical oncology patients and prevent it at the earliest. The Kinect IR Sensor is utilized to capture the images of the body and after image processing techniques, the region of interest is obtained. Then, performing the voxelization method will provide volume measurements in pre-operative and post-operative periods in patients. The formation of a mathematical model will help in the comparison of values. Clinical pathological data of patients will be investigated to assess the factors responsible for the development of lymphedema and its risks.

Keywords: Kinect IR sensor, Lymphedema, voxelization, lymph nodes

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Authors: Kalu Uka Orji, Nasiman Sapari, Khamaruzaman W. Yusof

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Exposure of galena (PbS), tealite (PbSnS2), and other associated minerals during mining activities release lead (Pb) and other heavy metals into the mining water through oxidation and dissolution. Heavy metal pollution has become an environmental challenge. Lead, for instance, can cause toxic effects to human health, including brain damage. Ex-mining pond water was reported to contain lead as high as 69.46 mg/L. Conventional treatment does not easily remove lead from water. A promising and emerging treatment technology for lead removal is the application of the electrocoagulation (EC) process. However, some of the problems associated with EC are systematic reactor design, selection of maximum EC operating parameters, scale-up, among others. This study investigated an EC process for the removal of lead from synthetic ex-mining pond water using a batch reactor and Fe electrodes. The effects of various operating parameters on lead removal efficiency were examined. The results obtained indicated that the maximum removal efficiency of 98.6% was achieved at an initial PH of 9, the current density of 15mA/cm2, electrode spacing of 0.3cm, treatment time of 60 minutes, Liquid Motion of Magnetic Stirring (LM-MS), and electrode arrangement = BP-S. The above experimental data were further modeled and optimized using a 2-Level 4-Factor Full Factorial design, a Response Surface Methodology (RSM). The four factors optimized were the current density, electrode spacing, electrode arrangements, and Liquid Motion Driving Mode (LM). Based on the regression model and the analysis of variance (ANOVA) at 0.01%, the results showed that an increase in current density and LM-MS increased the removal efficiency while the reverse was the case for electrode spacing. The model predicted the optimal lead removal efficiency of 99.962% with an electrode spacing of 0.38 cm alongside others. Applying the predicted parameters, the lead removal efficiency of 100% was actualized. The electrode and energy consumptions were 0.192kg/m3 and 2.56 kWh/m3 respectively. Meanwhile, the adsorption kinetic studies indicated that the overall lead adsorption system belongs to the pseudo-second-order kinetic model. The adsorption dynamics were also random, spontaneous, and endothermic. The higher temperature of the process enhances adsorption capacity. Furthermore, the adsorption isotherm fitted the Freundlish model more than the Langmuir model; describing the adsorption on a heterogeneous surface and showed good adsorption efficiency by the Fe electrodes. Adsorption of Pb2+ onto the Fe electrodes was a complex reaction, involving more than one mechanism. The overall results proved that EC is an efficient technique for lead removal from synthetic mining pond water. The findings of this study would have application in the scale-up of EC reactor and in the design of water treatment plants for feed-water sources that contain lead using the electrocoagulation method.

Keywords: ex-mining water, electrocoagulation, lead, adsorption kinetics

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Authors: Neal Rupani

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Background: A surgical trainee has limited learning opportunities in the operating room in order to gain an ever-increasing standard of surgical skill, competency, and proficiency. These opportunities continue to decline due to numerous factors such as the European Working Time Directive and increasing requirement for service provision. It is therefore imperative to obtain the highest educational value from each educational opportunity. A measure that has yet to be validated in England on surgical trainees called the Operating Room Educational Environment Measure (OREEM) has been developed to identify and evaluate each component of the educational environment with a view to steer future change in optimising educational events in theatre. Aims: The aims of the study are to assess the reliability of the OREEM within England and to evaluate the surgical trainee’s objective perspective of the current operating room educational environment within one region within England. Methods: Using a quantitative study approach, data was collected over one month from surgical trainees within Health Education Thames Valley (Oxford) using an online questionnaire consisting of demographic data, the OREEM, a global satisfaction score. Results: 140 surgical trainees were invited to the study, with an online response of 54 participants (response rate = 38.6%). The OREEM was shown to have good internal consistency (α = 0.906, variables = 40) and unidimensionality, along with all four of its subgroups. The mean OREEM score was 79.16%. The areas highlighted for improvement predominantly focused on improving learning opportunities (average subscale score = 72.9%) and conducting pre- and post-operative teaching (average score = 70.4%). The trainee perception is most satisfactory for the level of supervision and workload (average subscale score = 82.87%). There was no differences found between gender (U = 191.5, p = 0.535) or type of hospital (U = 258.0, p = 0.099), but the learning environment was favoured towards senior trainees (U = 223.5, p = 0.017). There was strong correlation between OREEM and the global satisfaction score (r = 0.755, p<0.001). Conclusions: The OREEM was shown to be reliable in measuring the educational environment in the operating room. This can be used to identify potentially modifiable components for improvement and as an audit tool to ensure high standards are being met. The current perception of the education environment in Health Education Thames Valley is satisfactory, and modifiable internal and external factors such as reducing service provision requirements, empowering trainees to plan lists, creating a team-working ethic between all personnel, and using tools that maximise learning from each operation have been identified to improve learning in the future. There is a favourable attitude to use of such improvement tools, especially for those currently dissatisfied.

Keywords: education environment, surgery, post-graduate education, OREEM

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Authors: Seval Yilmaz, Filiz Bayrakci Karel, Ali Savas Koparal

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Textile products produced by leather have been indispensable for human consumption. Various chemicals are used to enhance the durability of end-products in the processing of leather products. The wastewaters from the leather industry which contain these chemicals exhibit toxic effects on the receiving environment and threaten the natural ecosystem. In this study, leather industry wastewater (LIW), which has high loads of contaminants, was treated using advanced treatment techniques instead of conventional methods. During the experiments, the performance of electrochemical methods was investigated. During the electrochemical experiments, the performance of batch electrooxidation (EO) using boron-doped diamond (BDD) electrodes with monopolar configuration for removal of chemical oxygen demand (COD) from LIW were investigated. The influences of electrolysis time, current density (which varies as 5 mA/cm², 10 mA/cm², 20 mA/cm², 30 mA/cm², 50 mA/cm²) and initial pH (which varies as 3,80 (natural pH of LIW), 7, 9) on removal efficiency were investigated in a batch stirred cell to determine the best treatment conditions. The current density applied to the electrochemical reactors is directly proportional to the consumption of electric energy, so electrical energy consumption was monitored during the experiment. The best experimental conditions obtained in electrochemical studies were as follows: electrolysis time = 60 min, current density = 30.0 mA/cm², pH 7. Using these parameters, 53.59% COD removal rates for LIW was achieved and total energy consumption was obtained as 13.03 kWh/m³. It is concluded that electrooxidation process constitutes a plausible and developable method for the treatment of LIW.

Keywords: BDD electrodes, COD removal, electrochemical treatment, leather industry wastewater

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Authors: G. Anusha, J. Raja Murugadoss

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In recent years, the problem of water contaminant is drastically increasing due to the disposal of industrial wastewater containing iron, fluoride, mercury, lead, cadmium, phosphorus, silver etc. into water bodies. The non-biodegradable heavy metals could accumulate in the human system through food chain and cause various dreadful diseases and permanent disabilities and in worst cases it leads to casual losses. Further, the presence of the excess quantity of such heavy metals viz. Lead, Cadmium, Chromium, Nickel, Zinc, Copper, Iron etc. seriously affect the natural quality of potable water and necessitates the treatment process for removal. Though there are dozens of standard procedures available for the removal of heavy metals, their cost keeps the industrialists away from adopting such technologies. In the present work, an attempt has been made to remove such contaminants particularly fluoride and to study the efficiency of the removal of fluoride by adsorption using a new agro-based materials namely Limonia acidissima and Emblica officinalis which is commonly referred as wood apple and gooseberry respectively. Accordingly a set of experiments has been conducted using batch and column processes, with the help of activated carbon prepared from the shell of wood apple and seeds of gooseberries. Experiments reveal that the adsorption capacity of the shell of wood apple is significant to yield promising solutions.

Keywords: adsorption, fluoride, agro-based waste materials, Limonia acidissima, Emblica officinalis

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Authors: T. Abbas, J. McEvoy, E. Khan

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Pesticide contamination in water supply is a common environmental problem in rural agricultural communities. Advanced water treatment processes such as membrane filtration and adsorption on activated carbon only remove pesticides from water without degrading them into less toxic/easily degradable compounds leaving behind contaminated brine and activated carbon that need to be managed. Rural communities which normally cannot afford expensive water treatment technologies need an economical and sustainable filter which not only treats pesticides from water but also degrades them into benign products. In this study, iron turning waste experimented as potential point-of-use filtration media for the removal/degradation of a mixture of six chlorinated pesticides (lindane, heptachlor, endosulfan, dieldrin, endrin, and DDT) in water. As a common and traditional medium for water filtration, sand was also tested along with iron turning waste. Iron turning waste was characterized using scanning electron microscopy and energy dispersive X-Ray analyzer. Four glass columns with different filter media layer configurations were set up: (1) only sand, (2) only iron turning, (3) sand and iron turning (two separate layers), and (4) sand, iron turning and sand (three separate layers). The initial pesticide concentration and flow rate were 2 μg/L and 10 mL/min. Results indicate that sand filtration was effective only for the removal of DDT (100%) and endosulfan (94-96%). Iron turning filtration column effectively removed endosulfan, endrin, and dieldrin (85-95%) whereas the lindane and DDT removal were 79-85% and 39-56%, respectively. The removal efficiencies for heptachlor, endosulfan, endrin, dieldrin, and DDT were 90-100% when sand and iron turning waste (two separate layers) were used. However, better removal efficiencies (93-100%) for five out of six pesticides were achieved, when sand, iron turning and sand (three separate layers) were used as filtration media. Moreover, the effects of water pH, amounts of media, and minerals present in water such as magnesium, sodium, calcium, and nitrate on the removal of pesticides were examined. Results demonstrate that iron turning waste efficiently removed all the pesticides under studied parameters. Also, it completely de-chlorinated all the pesticides studied and based on the detection of by-products, the degradation mechanisms for all six pesticides were proposed.

Keywords: pesticide contamination, rural communities, iron turning waste, filtration

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Authors: Tomaz Oliveira, Rui Medeiros, André Lacerda

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Introduction: Cleft lip and/or palate are the most frequent forms of congenital craniofacial anomalies, affecting mainly the middle third of the face and manifesting by functional and aesthetic changes. Bilateral cleft lip represents a reconstructive surgical challenge, not only for the labial component but also for the associated nasal deformation. Recently, the paradigm of the approach to this pathology has changed, placing the focus on muscle reconstruction and anatomical repositioning of the nasal cartilages in order to obtain the best aesthetic and functional results. The aim of this study is to carry out a systematic review of the surgical approach to bilateral cleft lip, retrospectively analyzing the case series of Plastic Surgery Service at Hospital Santa Maria (Lisbon, Portugal) regarding this pathology, the global assessment of the characteristics of the operated patients and the study of the different surgical approaches and their complications in the last 20 years. Methods: The present work demonstrates a retrospective and descriptive study of patients who underwent at least one reconstructive surgery for cleft lip and/or palate, in the CPRE service of the HSM, in the period between January 1 of 1997 and December 31 of 2017, in which the data relating to 361 individuals were analyzed who, after applying the exclusion criteria, constituted a sample of 212 participants. The variables analyzed were the year of the first surgery, gender, age, type of orofacial cleft, surgical approach, and its complications. Results: There was a higher overall prevalence in males, with cleft lip and cleft palate occurring in greater proportion in males, with the cleft palate being more common in females. The most frequently recorded malformation was cleft lip and palate, which is complete in most cases. Regarding laterality, alterations with a unilateral labial component were the most commonly observed, with the left lip being described as the most affected. It was found that the vast majority of patients underwent primary intervention up to 12 months of age. The surgical techniques used in the approach to this pathology showed an important chronological variation over the years. Discussion: Cleft lip and/or palate is a medical condition associated with high aesthetic and functional morbidity, which requires early treatment in order to optimize the long-term outcome. The existence of a nasolabial component and its respective surgical correction plays a central role in the treatment of this pathology. The high rates of post-surgical complications and unconvincing aesthetic results have motivated an evolution of the surgical technique, increasingly evident in recent years, allowing today to achieve satisfactory aesthetic results, even in bilateral cleft lip with high deformation complexity. The introduction of techniques that favor nasolabial reconstruction based on anatomical principles has been producing increasingly convincing results. The analyzed sample shows that most of the results obtained in this study are, in general, compatible with the results published in the literature. Conclusion: This work showed that the existence of small variations in the surgical technique can bring significant improvements in the functional and aesthetic results in the treatment of bilateral cleft lip.

Keywords: cleft lip, palate lip, congenital abnormalities, cranofacial malformations

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Authors: Amandeep Kaur

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Digital Image processing is a fundamental tool to perform various operations on the digital images for pattern recognition, noise removal and feature extraction. In this paper noise removal technique has been described for various types of noises. This paper comprises discussion about various noises available in the image due to different environmental, accidental factors. In this paper, various de-noising approaches have been discussed that utilize different wavelets and filters for de-noising. By analyzing various papers on image de-noising we extract that wavelet based de-noise approaches are much effective as compared to others.

Keywords: de-noising techniques, edges, image, image processing

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Authors: Hamida Y. Mostafa, Ghada E. Khedr, Dina M. Abd El-Aty

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Sulfur compound removal from petroleum fractions is a critical component of environmental protection demands. Solvent extraction, oxidative desulfurization, or hydro-treatment techniques have traditionally been used as the removal processes. While all methods were capable of eliminating sulfur compounds at moderate rates, they had some limitations. A major problem with these routes is their high running expenses, which are caused by their prolonged operation times and high energy consumption. Therefore, new methods for removing sulfur are still necessary. In the current study, a simple assisted desulfurization system for gas oil fraction has been successfully developed using acetonitrile and methanol as a solvent under microwave irradiation. The key variables affecting sulfur removal have been studied, including microwave power, irradiation time, and solvent to gas oil volume ratio. At the conclusion of the research that is being presented, promising results have been found. The results show that a microwave-assisted extractive desulfurization method had remove sulfur with a high degree of efficiency under the suitable conditions.

Keywords: extractive desulfurization, microwave assisted extraction, petroleum fractions, acetonitrile and methanol

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Authors: Yongjun Ahn, Sung Gyu Choi, Seung-Yeop Kwak

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Selective removal of free fatty acid (FFA) and chlorophyll in extra virgin olive oil (EVOO) is necessary to enhance the thermal stability in the condition of the deep frying. In this work, we demonstrated improving the thermal stability of EVOO by selective removal of free fatty acid and chlorophyll using (3-Aminopropyl)trimethoxysilane (APTMS) functionalized mesoporous silica with controlled pore size. The adsorption kinetics of free fatty acid and chlorophyll into the mesoporous silica were quantitatively analyzed by Freundlich and Langmuir model. The highest chlorophyll adsorption efficiency was shown in the pore size at 5 nm, suggesting that the interaction between the silica and the chlorophyll could be optimized at this point. The amino-functionalized mesoporous silica showed drastically improved removal efficiency of FFA than the bare silica. Moreover, beneficial compounds like tocopherol and phenolic compounds maintained even after adsorptive removal. Extra virgin olive oil treated by aminopropyl-functionalized silica had a smoke point high enough to be used as commercial frying oil. Based on these results, it is expected to attract the considerable amount of interest toward facile adsorptive refining process of EVOO using pore size controlled and amino-functionalized mesoporous silica.

Keywords: mesoporous silica, extra virgin olive oil, selective adsorption, thermal stability

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Authors: Lina Wu

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The excessive discharge of nitrogen in sewage greatly intensifies the eutrophication of water bodies and poses a threat to water quality. Nitrogen pollution control has become a global concern. Currently, the problem of water pollution in China is still not optimistic. As a typical high ammonia nitrogen organic wastewater, landfill leachate is more difficult to treat than domestic sewage because of its complex water quality, high toxicity, and high concentration.Many studies have shown that the autotrophic anammox bacteria in nature can combine nitrous and ammonia nitrogen without carbon source through functional genes to achieve total nitrogen removal, which is very suitable for the removal of nitrogen from leachate. In addition, the process also saves a lot of aeration energy consumption than the traditional nitrogen removal process. Therefore, anammox plays an important role in nitrogen conversion and energy saving. The process composed of short-range nitrification and denitrification coupled an ammo ensures the removal of total nitrogen and improves the removal efficiency, meeting the needs of the society for an ecologically friendly and cost-effective nutrient removal treatment technology. Continuous flow process for treating late leachate [an up-flow anaerobic sludge blanket reactor (UASB), anoxic/oxic (A/O)–anaerobic ammonia oxidation reactor (ANAOR or anammox reactor)] has been developed to achieve autotrophic deep nitrogen removal. In this process, the optimal process parameters such as hydraulic retention time and nitrification flow rate have been obtained, and have been applied to the rapid start-up and stable operation of the process system and high removal efficiency. Besides, finding the characteristics of microbial community during the start-up of anammox process system and analyzing its microbial ecological mechanism provide a basis for the enrichment of anammox microbial community under high environmental stress. One research developed partial nitrification-Anammox (PN/A) using an internal circulation (IC) system and a biological aerated filter (BAF) biofilm reactor (IBBR), where the amount of water treated is closer to that of landfill leachate. However, new high-throughput sequencing technology is still required to be utilized to analyze the changes of microbial diversity of this system, related functional genera and functional genes under optimal conditions, providing theoretical and further practical basis for the engineering application of novel anammox system in biogas slurry treatment and resource utilization.

Keywords: nutrient removal and recovery, leachate, anammox, partial nitrification

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Authors: Vaikunthan Rajaratnam

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Intro: Motor imagery (MI) and mental practice (MP) can be an alternative to acquire mastery of surgical skills. One component of using this technique is the use of a mental script. The aim of this study was to design and develop a mental script for basic micro suturing training for skill acquisition using a low-fidelity rubber glove model and to describe the detailed methodology for this process. Methods: This study was based on a design and development research framework. The mental script was developed with 5 expert surgeons performing a cognitive walkthrough of the repair of a vertical opening in a rubber glove model using 8/0 nylon. This was followed by a hierarchal task analysis. A draft script was created, and face and content validity assessed with a checking-back process. The final script was validated with the recruitment of 28 participants, assessed using the Mental Imagery Questionnaire (MIQ). Results: The creation of the mental script is detailed in the full text. After assessment by the expert panel, the mental script had good face and content validity. The average overall MIQ score was 5.2 ± 1.1, demonstrating the validity of generating mental imagery from the mental script developed in this study for micro suturing in the rubber glove model. Conclusion: The methodological approach described in this study is based on an instructional design framework to teach surgical skills. This MP model is inexpensive and easily accessible, addressing the challenge of reduced opportunities to practice surgical skills. However, while motor skills are important, other non-technical expertise required by the surgeon is not addressed with this model. Thus, this model should act a surgical training augment, but not replace it.

Keywords: mental script, motor imagery, cognitive walkthrough, verbal protocol analysis, hierarchical task analysis

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Authors: Bessaha Hassiba, Bouraada Mohamed

Abstract:

Layered double hydroxide with Zn/(Al+Fe) molar ratio of 3:1 was synthesized by co-precipitation method and their calcined product was obtained by heating treatment of ZAF-HT at 500°C. The calcined and uncalcined materials were used to remove weak acid dyes: indigo carmine (IC) and green bezanyl-F2B (F2B) in aqueous solution. The synthesized materials were characterized by XRD, SEM, FTIR and TG/DTA analysis confirming the formation of pure layered structure of ZAF-HT, the destruction of the original structure after calcination and the intercalation of the dyes molecules. Moreover, the interlayer distance increases from 7.645 Å in ZAF-HT to 19.102 Å after the dyes sorption. The dose of the adsorbents was chosen 0.5 g/l while the initial concentrations were 250 and 750 mg/l for indigo carmine and green bezanyl-F2B respectively. The sorption experiments were carried out at ambient temperature and without adjusting the initial solution pH (pHi = 6.10 for IC and pHi = 5.01 for F2B). In addition, the maximum adsorption capacities obtained by ZAF-HT and CZAF for both dyes followed the order: CZAF-F2B (1501.4 mg.g-1) > CZAF-IC (617.3 mg.g-1) > ZAF-HT-IC (41.4 mg.g-1) > ZAF-HT-F2B (28.9 mg.g-1). The removal of indigo carmine and green bezanyl-F2B by ZAF-HT was due to the anion exchange and/or the adsorption on the surface. By using the calcined material (CZAF), the removal of the dyes was based on a particular property, called ‘memory effect’. CZAF recover the pristine structure in the presence anionic molecules such as acid dyes where they occupy the interlayer space. The sorption process was spontaneous in nature and followed pseudo-second-order. The isotherms showed that the removal of IC and F2B by ZAF-HT and CZAF were consistent with Langmiur model.

Keywords: acid dyes, adsorption, calcination, layered double hydroxides

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Authors: K. V. Kalinichenko, G. N. Nikovskaya

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The efficiency of heavy metals removal from sewage sludge in bioleaching with heterotrophic, chemoautotrophic (sulphur-oxidizing) sludge cenoses and chemical leaching (in distilled water, weakly acidic or alkaline medium) was compared. The efficacy of heavy metals removal from sewage sludge varied from 83 % (Zn) up to 14 % (Cr) and followed the order: Zn > Mn > Cu > Ni > Co > Pb > Cr. The advantages of metals bioleaching process at heterotrophic metabolism was shown. A new process for bioconversation of sewage sludge into fertilizer at middle temperature after partial heavy metals removal was developed. This process is based on enhancing vital ability of heterotrophic microorganisms by adding easily metabolized nutrients and synthesis of metabolites by growing sludge cenoses. These metabolites possess the properties of heavy metals extractants and flocculants which provide sludge flocks sedimentation and concentration. The process results in biomineral fertilizer with immobilized sludge bioelements with prolonged action. The fertilizer obtained satisfied the EU limits for the sewage sludge of agricultural utilization. High efficiency of the biomineral fertilizers obtained has been demonstrated in vegetation experiments.

Keywords: fertilizer, heavy metals, leaching, sewage sludge

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