Identifying and ranking of the main organizational resilience indicators in the hospital during the COVID-19 pandemic: A study using fuzzy Delphi technique (FDT) and fuzzy analytical hierarchy process (FAHP).

Resilience in a hospital is referred to as the capability to withstand and respond to disasters while maintaining critical functions. The current study aims to identify and prioritize the defining indicators of organizational resilience in dealing with the critical conditions of the COVID-19 pandemic. First, a literature review and semi-structured interviews with experts were performed for the identification of the primary indicators affecting the hospital's organizational resilience in critical conditions caused by the COVID-19 disease. Next, the fuzzy Delphi technique (FDT) was used to determine the effective and final indicators with a 70% agreement level. Finally, the indicators were weighted and prioritized using the FAHP method. The results shows that three indicators of leadership and management (NW = 0.092), preparedness (NW = 0.080), and learning from previous experiences (NW = 0.078) had the greatest impact on the organizational resilience of the hospital, respectively. Three indicators of logistics support, fallibility culture, creativity, and innovation with the final weights of 0.56, 0.054, and 0.053 gained the least importance, respectively. It can be concluded that a higher level of leadership and management, preparedness, and learning from previous experiences in the conditions of the COVID-19 pandemic can help control this crisis.

Determination and prioritization of factors affecting the occurrence of needle stick injuries among healthcare workers using techniques of Delphi and fuzzy analytical hierarchy process (FAHP).

INTRODUCTION: Needlestick injuries (NSIs) are a major hazard in the workplace for healthcare workers. To prevent these injuries, it is essential to determine the important factors affecting the occurrence of them. This study aimed to identify, classify and prioritize these factors using techniques of Delphi and fuzzy analytical hierarchy process (FAHP). METHODS: This descriptive-analytical study was conducted in 2022. Firstly, the factors affecting the occurrence of needlestick injuries were identified by the literature review. Moreover, the Delphi technique was used to identify the factors. 20 experts (physicians, nurses, and occupational health experts) participated in the steps of the Delphi method. Then, these factors were grouped into six groups. In the next step, the fuzzy analytical hierarchy process (FAHP) was applied to prioritize the factors. For this purpose, the pairwise comparison questionnaire was designed and filled out by 20 experts. Finally, data were analyzed using MATLAB software (version 2018a). RESULTS: 42 factors (31 factors extracted from the literature review and 11 factors obtained from the Delphi technique) were identified in this study. These factors were categorized into six groups. Based on the results, the relative weight of non-demographic personal factors, tool and technology factors, job factors, organizational factors, demographic personal factors, and environmental factors were computed by 0.200, 0.185, 0.184, 0.157, 0.142, and 0.133, respectively. CONCLUSION: These results determined the importance of the factors affecting the occurrence of needlestick injuries. These findings can be useful for planning preventive measures.

Determining the effect of selected mental factors on turnover intention through two modulators - stress and resilience over COVID-19 period.

INTRODUCTION: Turnover intention among nurses has risen in an alarming rate since the onset of the pandemic. There are various underlying factors to turnover intention. The present study aims to determine the effect of a number of mental factors on nurses' professional-turnover intention through two modulators of stress and resilience over COVID-19 period. METHODS: The current cross-sectional study was conducted at three hospitals in Khuzestan Province, southern Iran, during the winter of 2021. To collect the data, given the restrictions in place during COVID-19 period, the web link of electronic self-reported questionnaires (including general health, mental workload, work-family conflict, resilience, job stress, corona fear, and turnover intention) were sent to 350 nurses through e-mail and other social media (WhatsApp and Telegram). Accordingly, they were asked to complete the questionnaire during rest periods within two weeks. Totally, 300 people (85% participation) filled out the questionnaires. Finally, a model was constructed in the Amos software. RESULTS: The results showed that the four independent parameters of decreasing general health, increasing mental workload, increasing WFCs and fear of COVID-19 can indirectly increase nurses' turnover intention by increasing job stress. Among these variables, the highest indirect effect coefficient on turnover intention was related to the general health parameter (-0.141). The results also demonstrated a negative correlation between job stress and resilience, with lower resilience raising job stress and, consequently, increasing intention to quit the job. CONCLUSION: Mental factors affecting turnover intension were identified in this study through path analysis. Therefore, it is recommended that the required resilience-enhancing measures to be taken by hospitals and nursing administrations to reduce psychological pressures caused by mentioned variables with the aim of minimizing job-related stress and fostering nurse retention.

Nitrogen-Doped Porous Nickel Molybdenum Phosphide Sheets for Efficient Seawater Splitting.

Hydrogen is emerging as an alternative clean fuel; however, its dependency on freshwater will be a threat to a sustainable environment. Seawater, an unlimited source, can be an alternative, but its salt-rich nature causes corrosion and introduces several competing reactions, hindering its use. To overcome these, a unique catalyst composed of porous sheets of nitrogen-doped NiMo3 P (N-NiMo3 P) having a sheet size of several microns is designed. The presence of large homogenous pores in the basal plane of these sheets makes them catalytically more active and ensures faster mass transfer. The introduction of N and Ni into MoP significantly tunes the electronic density of Mo, surface chemistry, and metal-non-metal bond lengths, optimizing surface energies, creating new active sites, and increasing electrical conductivity. The presence of metal-nitrogen bonds and surface polyanions increases the stability and improves anti-corrosive properties against chlorine chemistry. Ultimately, the N-NiMo3 P sheets show remarkable performance as it only requires overpotentials of 23 and 35 mV for hydrogen evolution reaction, and it catalyzes full water splitting at 1.52 and 1.55 V to achieve 10 mA cm-2 in 1 m KOH and seawater, respectively. Hence, structural and compositional control can make catalysts effective in realizing low-cost hydrogen directly from seawater.

Investigation of electroencephalography variations of mental workload in the exposure of the psychoacoustic in both male and female groups.

Most studies have examined the effect of the physical aspects of noise while the effect of exposure to psychoacoustic parameters at different task difficulty levels has been less evaluated. Therefore, this study was performed with the aim of investigating the brainwave in the face of psychoacoustic and the change of difficulty level of task. 120 persons were exposed to 16 psychoacoustic parameters (loudness, sharpness, roughness and fluctuation strength). Each person was asked to complete the three N-Back task difficulty levels. At the same time, brain waves were recorded and the subject completed the NASA-TLX questionnaire. Finally, brain indices including alpha1, alpha2, PrTeta, PrAlpha and EI were examined. With increasing loudness, sharpness and fluctuation, the alpha-1 and alpha-2 index (mental fatigue (increased. Loudness and roughness also increased the PrTeta and PrAlpha (annoyance). For the EI (Engagement Index), increasing fluctuation caused a decrease in the level of consciousness and engagement. In addition, exposure to psychoacoustic parameters at high and medium difficulty levels caused a greater effect on alpha, alpha2, PrTeta and PrAlpha indices. High level of difficulty task reduce the accuracy rate and increase the reaction time to stimuli in the N-Back task, and increase the mean of dimensions of the NASA-TLX questionnaire in the exposure of all psychoacoustic aspect.With increasing loudness, sharpness and fluctuation, the alpha-1 and alpha-2 index (mental fatigue (increased. Loudness and roughness also increased the PrTeta and PrAlpha (annoyance). For the EI (Engagement Index), increasing fluctuation caused a decrease in the level of consciousness and engagement. In addition, exposure to psychoacoustic parameters at high and medium difficulty levels caused a greater effect on alpha, alpha2, PrTeta and PrAlpha indices. High level of difficulty task reduce the accuracy rate and increase the reaction time to stimuli in the N-Back task, and increase the mean of dimensions of the NASA-TLX questionnaire in the exposure of all psychoacoustic aspect. Considering the effect of psychoacoustic at different levels of task difficulty on the mental load and cognitive function is essential to prevent damage to the person and his performance.

Effect of tonal noise and task difficulty on electroencephalography and cognitive performance.

Objectives. The present study aimed to investigate the effect of tonal noise and task difficulty on electroencephalography (EEG) and cognitive performance. Methods. Twelve healthy volunteers participated in the present study. Four noise signals were generated by four prominence tone levels (0, 2, 5 and 9) at background noise levels of 55 dBA and frequency of 500 Hz using the Test Tone Generator from Esser Audio (USA). The participants were asked to perform the tasks with low, moderate and high levels of difficulty while exposed to the noises in an acoustics laboratory. The values of reaction time, correct rate and missed numbers were recorded during each step. Moreover, the EEG signals were measured. Results. The results showed that higher tone level and more task difficulty significantly decreased the correct rate, and increased the miss numbers. However, no significant effect was observed on reaction times. Furthermore, tone level and task difficulty significantly increased activity of the θ and ß bands and decreased activity of the α band. Conclusion. Task difficulty and tone level could significantly affect the parameters of performance and the activity of EEG bands. Therefore, noise control can help sustain appropriate performance.

Fixing ulnar Styloid Fracture with Stable Distal Radioulnar Joint: A Randomized Clinical Trial.

BACKGROUND: The association between ulnar styloid fracture and distal radius fracture is common while the necessity of ulnar styloid fixation is still controversial. We have aimed to elucidate the effect of ulnar styloid fracture fixation on final outcome of distal radius fracture treatment. METHODS: In a two-arm randomized clinical trial, patients with Fernandez type I distal radius fracture associated with ulnar styloid fracture in the base were divided into two groups of fixed (group A) and unfixed (group B) ulnar styloid fracture. They were followed up for 12 months using pain visual analogue scale (VAS), quick form of the Disabilities of the Arm, Shoulder, and Hand (DASH) score questionnaire, and Mayo performance score as well as wrist range of motion and grip strength evaluation. RESULTS: Quick DASH score was 35.4±14.0 in group A and 30.5±5.82 in group B (P=0.027) at 3-month follow-up and 29.8±18.2 in group A and 18.3±8.40 in group B At 6-month follow-up (P= 0.001). VAS score for pain was declined 4.46±2.17 and 3.64±0.96 after 6 months (P= 0.339) and 4.00±1.73 and 2.50±0.81 after 12 months (P= 0.352) in groups A and B, respectively. The mean Mayo wrist scores were measured as 59.3 and 57.8 in group A and B three months after the fracture, respectively (P= 0.504). We found no significant difference in the wrist range of motion and grip strength between two groups after three months (P>0.05). CONCLUSION: According to our findings, ulnar styloid fixation using pin and wire have an adverse effect on distal radius fixation outcomes.

The contribution of hypochondria resulting from Corona virus on the occupational productivity loss through increased job stress and decreased resilience in the central workshop of an oil refinery: A path analysis.

The prevalence of contagious viral-infectious diseases such as COVID19 cause the economic problems in addition to harmful effect on the people health. The present study was aimed to determine the contribution of hypochondria resulting from Corona virus on the occupational productivity loss through increased job stress and decreased resilience in the central workshop of an oil refinery. This cross-sectional study was conducted on 275 subjects in the spring of 2020 in one of the oil and gas industries in southern Iran. To collect the data, the demographic, standard hypochondria, CD-RSC resilience, job stress, productivity questionnaires were sent electronically along with a guide to completing them, as well as study objectives. People were given two weeks to complete the questionnaires and send them electronically to the research team. Participation rate was 80%. Finally, a model based on the defaults was developed in AMOS software and the relationships between the variables were examined. The results showed that corona hypochondria could affect productivity in two ways. In the first place, hypochondria significantly increases job stress, thereby reducing productivity. The indirect effect of hypochondria on productivity in this direction was -0.09. In another way, hypochondria significantly reduces resilience and thus lowers productivity. The effect of hypochondria on productivity was equal to -0.04. Based on the results, the fit of the drawn model was confirmed. The results of the study generally suggested that coronavirus disease has caused the spread of hypochondria mental disorder. Hypochondria could reduce the productivity of workers through two ways of increasing job stress and reducing workers' resilience.

The role of individual factors on corona-induced hypochondriasis and job stress: A case study in workplace.

Background: Given the importance of maintaining the mental health of workers, the present study was conducted to determine the effect of the individual factors on hypochondriasis and job stress under the corona epidemic condition in a company. Methods: This cross-sectional study was performed on 275 workers in 2020 in one of the industries in southern Iran. To gather the data, demographic, researcher-made, standard hypochondria, and job stress questionnaires were sent electronically along with a guide and study objectives. The participants completed the questionnaires during 2 weeks and send them electronically to the research team. Finally, data were analyzed using tests of one-way ANOVA and linear regression in SPSS software version 22. Results: The results showed that the mean score of hypochondriasis in different groups of variables, including age, work experience, use of personal protective equipment, corona experience, and attention to preventive measures was significantly different (p<0.05). Based on the results, the mean score of job stress significantly differed in different groups of variables of personal protective equipment use, corona experience, and awareness on corona (p<0.05). Moreover, based on the regression relationships, hypochondriasis could be predicted by variables of personal protective equipment, corona experience, awareness on corona, and attention to preventive measures; and job stress could be predicted by variables of awareness on corona and attention to preventive measures. Conclusion: Regarding the importance of providing the physical and mental health of employees, the implementation of measures to reduce stress and hypochondriasis of employees, particularly in identified groups, is helpful.

Protective effects of Lavandula stoechas L. methanol extract against 6-OHDA-induced apoptosis in PC12 cells.

ETHNOPHARMACOLOGICAL RELEVANCE: Parkinson's disease (PD) is a neurodegenerative disorder associated with oxidative stress-induced neuronal damage and death. In European and Persian Traditional Medicine, aerial parts (leaves, stems, and flowers) of Lavandula stoechas L. have been widely used for treating neurodegenerative disorders including PD. AIM OF THE STUDY: Herein, the protective effects of L. stoechas methanol extract were investigated on 6-hydroxydopamine (6-OHDA)-induced cytotoxicity and oxidative damage in PC12 cells. MATERIALS AND METHODS: The cells were pretreated with a standardized L. stoechas methanol extract (2.5-20 µg/mL) for 24 h and exposed to 6-OHDA (200 µM) thereafter. The cell viability percentage was determined by AlamarBlue test. Intracellular reactive oxygen species (ROS) production was determined by a fluorimetric method using 2',7'-dichlorodihydrofluorescein diacetate and cellular apoptosis was assessed by the fluorescent probe propidium iodide test. Finally, the expression of proteins involved in apoptosis pathway (Phospho SAPK/JNK, SAPK/JNK, p44/42 MAPK (ERK1/2) and Poly ADP ribose polymerase (PARP)) was measured via Western blot analysis. RESULTS: Treatment of PC12 cells with 6-OHDA could significantly increase cytotoxicity, ROS level, and cell apoptosis. Pretreatment of PC12 cells with the extract could significantly decrease 6-OHDA cytotoxicity, ROS production, (2.5 and 5 µg/mL) and cell apoptosis (5 µg/mL). Western blot analysis showed that 6-OHDA exposure could increase the expression of proteins involved in apoptosis signaling, while pretreatment with L. stoechas (5 µg/mL) reduced apoptotic proteins. CONCLUSIONS: The present study demonstrated that L. stoechas, which has been traditionally used in Persian Medicine for treating CNS diseases, is a valuable source of active compounds with neuroprotective, anti-oxidant, and anti-apoptotic activity.

CFD Modeling of Methanol to Light Olefins in a Sodalite Membrane Reactor using SAPO-34 Catalyst with In Situ Steam Removal.

AIMS AND OBJECTIVE: In this work, the performance of a sodalite membrane reactor (MR) in the conversion of methanol to olefins (MTO process) was evaluated for ethylene and propylene production with in situ steam removal using 3-dimensional CFD (computational fluid dynamic) technique. METHODS: Numerical simulation was performed using the commercial CFD package COMSOL Multiphysics 5.3. The finite element method was used to solve the governing equations in the 3- dimensional CFD model for the present work. In the sodalite MR model, a commercial SAPO-34 catalyst in the reaction zone was considered. The influence of key operation parameters, including pressure and temperature on methanol conversion, water recovery, and yields of ethylene, propylene, and water was studied to evaluate the performance of sodalite MR. RESULTS: The local information of component concentration for methanol, ethylene, propylene, and water was obtained by the proposed CFD model. Literature data were applied to validate model results, and a good agreement was attained between the experimental data and predicted results using CFD model. Permeation flux through the sodalite membrane was increased by an increase of reaction temperature, which led to the enhancement of water stream recovered in the permeate side. CONCLUSION: The CFD modeling results showed that the sodalite MR in the MTO process had higher performance in methanol conversion compared to the fixed-bed reactor (methanol conversion of 97% and 89% at 733 K for sodalite MR and fixed-bed reactor, respectively).

Modeling and optimization of V2O5/TiO2 nanocatalysts for NH3-Selective catalytic reduction (SCR) of NOx by RSM and ANN techniques.

In the present study, two statistical methods including the response surface method (RSM) and artificial neural network (ANN), were employed for modeling and optimization of selective catalytic reduction of NOx with NH3 (NH3-SCR) over V2O5/TiO2 nanocatalysts. The relationship between catalyst preparation variables, such as metal loading, impregnation temperature, and calcination temperature on NO conversion were investigated. The R2 value of 0.9898 was obtained for quadratic a RSM model, which proves the high agreement of the model with the experimental data. The results of Pareto analysis revealed that three factors including calcination temperature, V loading, and impregnation temperature have a considerable impact on the response. Deduced from the established RSM model, the order of influence on the NO conversion was as follows: calcination followed by V loading and impregnation temperature. The optimum condition of catalyst preparation for maximum NO conversion over V2O5/TiO2 nanocatalysts was predicted to be at 0.0051 mol of V loading, an impregnation temperature of 50 °C and a calcination temperature of 491 °C. Moreover, an ANN model was created by a feed-forward back propagation network (with the topology 4, 12 and 1) to model the relation between the selected catalyst preparation variables and NH3-SCR process temperature. The R2 values for training, validation as well as test sets, were 0.99, 0.9810 and 0.9733. These high values proved the accuracy of the AAN model in modeling and estimating the NO conversion over V2O5/TiO2 nanocatalysts. According to the ANN model, the relative significance of each variable on NO conversion is calcination temperature, process temperature loading, and impregnation temperature from high to low importance, respectively, corroborating the obtained results from RSM.

Effect of the preparation method on activity of Cu-ZSM-5 nanocatalyst for the selective reduction of NO by NH3.

The selective catalytic reduction of NO with ammonia (NH3-SCR) was studied over Cu-ZSM-5 nanocatalysts which were prepared by several methods, including conventional ion-exchange (IE), conventional impregnation (IM), ultrasound-enhanced impregnation (UIM), and conventional deposition-precipitation (DP) using NaOH and homogeneous deposition-precipitation (HDP) using urea. The nanocatalysts were subsequently characterized by Fourier transform infrared spectroscopy, temperature-programmed reduction with hydrogen (H2-TPR), ammonia temperature-programmed desorption (NH3-TPD), X-ray photoelectron spectroscopy, X-ray diffraction, transmission electron microscope, and Brunauer-Emmett-Teller. The catalytic activity of the Cu-ZSM-5 nanocatalysts for NO removal decreased in the following order: Cu-ZSM-5 (HDP) > Cu-ZSM-5 (UIM) > Cu-ZSM-5 (IM) > Cu-ZSM-5 (IE) > Cu-ZSM-5 (DP). The effect of various preparation methods for Cu-ZSM-5 on the activity of NO conversion was compared and catalytic experiments revealed a strong correlation between the acid sites' strength and easily reducible isolated Cu2+ with NO conversion. Catalyst (HDP) (which showed excellent deNO activity) mainly contains easy reducibility of isolated Cu2+ ions, more strong acid sites, and higher specific surface area when compared with other catalysts.

Individual Factors of Social Acceptance in Patients Infected With Human Immunodeficiency Virus (HIV) at the Yazd Behavioral Consultation Center in Iran.

BACKGROUND: A considerable number of patients infected with HIV also have mental health problems. Individual psychotherapy is an effective way to treat these issues. Lack of social acceptance is a barrier to patients receiving proper medication and emotional/psychological support. OBJECTIVES: The purpose of this study was to examine the individual factors of social acceptance in patients infected with human immunodeficiency virus. PATIENTS AND METHODS: Fifty HIV-infected patients who were registered in the Behavioral Consultation Center entered the study. Each of them filled out a questionnaire based on the Crown-Marlow social acceptance scale. Their answers were evaluated according to the questionnaire key. RESULTS: Forty-five patients (90%) were male and five (10%) were female. Their ages ranged between 28 and 52 years old. Other variables researched in this study include patients' age, sex, education, occupation, place of living, marital status, family history of HIV, and family history of psychological disorders. Employed patients experienced more social acceptance than housewives and people who were unemployed or retired. CONCLUSIONS: This study showed that HIV-infected patients with jobs enjoy a great deal of acceptance from the people around them and a higher quality of life in general. It also led to suggestions for further study with the purpose of finding more effective solutions for HIV prevention and better strategies for dealing with psychological disorders. Such research could also help in providing an enhanced understanding of the potential psychological impact that AIDS has on patients in Iran.

Ultrasound-assistant preparation of Cu-SAPO-34 nanocatalyst for selective catalytic reduction of NO by NH3.

The influence of the various preparation methods of Cu-SAPO-34 nanocatalysts on the selective catalytic reduction of NO with NH3 under excess oxygen was studied. Cu-SAPO-34 nanocatalysts were prepared by using four techniques: conventional impregnation (IM), ultrasound-enhanced impregnation (UIM), conventional deposition precipitation (DP) using NaOH and homogeneous deposition precipitation (HDP) using urea. These catalysts were characterized in detail by various techniques such as N2-sorption, XRD, TEM, H2-TPR, NH3-TPD and XPS to understand the catalyst structure, the nature and the dispersed state of the copper species, and the acid sites for NH3 adsorption. All of the nanocatalysts showed high activities for NO removal. However, the activities were different and followed the sequence of Cu-SAPO-34 (UIM)>Cu-SAPO-34 (HDP)>Cu-SAPO-34 (IM)>Cu-SAPO-34 (DP). Based on the obtained results, it was concluded that the NO conversion on Cu-SAPO-34 nanocatalysts was mainly related to the high reducibility of the isolated Cu(2+) ions and CuO species, the number of the acid sites and the dispersion of CuO species on SAPO-34.

Total ureteral avulsion leading to early nephrectomy as a rare complication of simple lumbar discectomy; a case report.

INTRODUCTION: Lumbar discectomy constitutes the most common and probably easiest spine surgery but it is not without complications. The aim of this work is to report a case with total ureteral avulsion during lumbar discectomy due to careless advancement of the pituitary rongeur. METHODS: A 59-year-old male presented with refractory left L5-S1 lumbar disc herniation. During the surgery, left sided total ureteral avulsion occurred. Early postoperative progressive abdominal pain was the main clue for further investigation and diagnostic work-up. RESULTS: Abdominal ultrasonography, intravenous pyelography, and abdominal contrast-enhanced computed tomography (CT) detected a left ureteral injury. Although the injury was detected early, ureteral repair or renal autotransplantation was not possible and nephrectomy was finally indicated, due to a significant ureteral loss. DISCUSSION: Careful use of discectomy instruments, avoidance of excessive advancement of pituitary rongeurs (more than 3 cm), and thorough knowledge of the relevant anatomy are critical in preventing ureteral injury.

A modelling study and optimization of catalytic reduction of NO over CeO2-MnOx (0.25)-Ba mixed oxide catalyst using design of experiments.

In this study, the effects of operation variables on catalytic performance of CeO2-MnOx (0.25)-Ba mixed oxide in catalytic reduction of NO with ammonia are investigated by using design of experiments. A response surface methodology (RSM) combined with the central composite design (CCD) is used to model and optimize the process variables, including concentration of 02 (vol.%), NH3/NO ratio in the gas feed, gas hourly space velocity (GHSV) and reaction temperature (degrees C) on the NO conversion and N2 selectivity as responses. The R2 values for both generated models were greater than 0.9, confirming the capability of quadratic RSM model in fitting the obtained experimental data. According to the results, GHSV had the largest and negative effect on the NO conversion, while it was an insignificant parameter on the N2 selectivity in the design space. Also, NH3/NO ratio was the most effective parameter on the N2 selectivity. Under the optimum conditions: 4.75 vol.% O2, NH3/NO ratio of 0.9, GHSV of 12,000 h(-1) and 197.5 degrees C, the predicted values for NO conversion and N2 selectivity were 96.47% and 93.96%, respectively. The obtained experimental values in optimum condition agreed with those predicted, indicating suitability of the RSM model to estimate the values of the responses.

Modelling and optimization of Mn/activate carbon nanocatalysts for NO reduction: comparison of RSM and ANN techniques.

A response surface methodology (RSM) involving a central composite design was applied to the modelling and optimization of a preparation of Mn/active carbon nanocatalysts in NH3-SCR of NO at 250 degrees C and the results were compared with the artificial neural network (ANN) predicted values. The catalyst preparation parameters, including metal loading (wt%), calcination temperature and pre-oxidization degree (v/v% HNO3) were selected as influence factors on catalyst efficiency. In the RSM model, the predicted values of NO conversion were found to be in good agreement with the experimental values. Pareto graphic analysis showed that all the chosen parameters and some of the interactions were effective on response. The optimization results showed that maximum NO conversion was achieved at the optimum conditions: 10.2 v/v% HNO3, 6.1 wt% Mn loading and calcination at 480 degrees C. The ANN model was developed by a feed-forward back propagation network with the topology 3, 8 and 1 and a Levenberg-Marquardt training algorithm. The mean square error for the ANN and RSM models were 0.339 and 1.176, respectively, and the R2 values were 0.991 and 0.972, respectively, indicating the superiority of ANN in capturing the nonlinear behaviour of the system and being accurate in estimating the values of the NO conversion.

Optimization of Cu/activated carbon catalyst in low temperature selective catalytic reduction of NO process using response surface methodology.

Preparation of Cu/Activated Carbon (Cu/AC) catalyst was optimized for low temperature selective catalytic reduction of NO by using response surface methodology. A central composite design (CCD) was used to investigate the effects of three independent variables, namely pre-oxidization degree (HNO3%), Cu loading (wt.%) and calcination temperature on NO conversion efficiency. The CCD was consisted of 20 different preparation conditions of Cu/AC catalysts. The prepared catalysts were characterized by XRD and SEM techniques. Predicting NO conversion was carried out using a second order model obtained from designed experiments and statistical software Minitab 14. Regression and Pareto graphic analysis showed that all of the chosen parameters and some interactions were effective on the NO conversion. The optimal values were pre-oxidization in 10.2% HNO3, 6.1 wt.% Cu loading and 480°C for calcination temperature. Under the optimum condition, NO conversion (94.3%) was in a good agreement with predicted value (96.12%).

Ethics of palliative surgery in esophageal cancer.

BACKGROUND: Surgery is one of the important palliative methods for patients withesophageal cancer. In addition to concerns related to clinical decision making, various moral challenges are encountered in palliative surgery. Some of them are related to patients and their illness, others to surgeons, their attitudes, skills and knowledge base. METHODS: Pertinent moral challenges are addressed and analyzed with respect to prevailing perspectives in normative ethics (Ross style pluralism). Demandsregarding sensibility and precaution in this clinical setting represent substantial challenges with regard to the beneficence, non-maleficence, justice, autonomy and proper patient information. RESULTS: Moreover, variations in definition of palliative surgery as well as limited scientific evidence in efficacy, effectiveness and efficiency pose methodological and moral problems. We have shown that ethical principles (beneficence, non-maleficence, and justice) in all procedures and treatments in esophageal cancer, including psychological problems of the patients are effective in improving their quality of life. CONCLUSION: Both surgical skills and moral sensibility are required to improve surgical palliative care in esophageal cancer, and should be taken into account not only in clinical practice but also in education and research.