A case report of chyle leakage after axillary node clearance in a patient with breast cancer.

Key Clinical Message: Chyle leakage is a rare postoperative complication of breast cancer, and conservative treatments should be prioritized, with careful monitoring of drainage volume and timely surgical intervention when conservative treatments are ineffective. Abstract: Chyle leaks following surgery for breast cancer are seldom encountered. Management varies with no consensus in the literature. This paper reports a case of a chylous leak after axillary dissection in a patient with breast cancer eventually cured with conservative treatment and discusses management options varied with both conservative and surgical options available to clinicians.

Cadmium immobilization in soil using phosphate modified biochar derived from wheat straw.

The phosphate-modified biochar (BC) immobilizes cadmium (Cd), yet little is known about how phosphate species affect Cd detoxification in contaminated soils. We developed phosphate-modified biochar through the pyrolysis of wheat straw impregnated with three types of phosphate: mono­potassium phosphate (MKP), dipotassium hydrogen phosphate (DKP), and tripotassium phosphate (TKP). The Cd adsorption mechanism of modified biochar was investigated by biochar characterization, adsorption performance evaluation, and soil incubation tests. The results demonstrated that the efficiency of biochar in immobilizing Cd2+ followed the order: TKP-BC > DKP-BC > MKP-BC. The TKP-BC had the highest orthophosphate content, the fastest adsorption rate, and the largest adsorption capacity (Langmuir) of 257.28 mg/g, which is 6.31 times higher than that of the unmodified BC (CK). In contrast, pyrophosphate was predominant in MKP-BC and DKP-BC. The primary adsorption mechanism for Cd2+ was precipitation, followed by cation exchange, as evidenced by the formation of CdP minerals on the BC surface, and an increase of K+ in solution (compared to water-soluble K+) and a decrease of K+ in the biochar during adsorption. Desorption of Cd from the TKP-BC after adsorption was 9.77 %-12.39 % at a pH of 5-9, much lower than that of CK. The soil incubation test showed the diethylenetriaminepentaacetic acid extracted Cd of TKP-BC, MKP-BC, and DKP-BC was reduced by 67.93 %, 18.41 % and 31.30 % over CK, respectively. Using the planar optodes technique, we also found that TKP-BC had the longest effect enhancing in situ soil pH. This study provides a theoretical basis for developing heavy metal pollution control technology using green remediation materials and offers insights into the remediation mechanisms.

Skin cancer diagnosis (SCD) using Artificial Neural Network (ANN) and Improved Gray Wolf Optimization (IGWO).

Skin Cancer (SC) is one of the most dangerous types of cancer and if not treated in time, it can threaten the patient's life. With early diagnosis of this disease, treatment methods can be used more effectively and the progression of the disease can be prevented. Machine Learning (ML) techniques can be utilized as a useful and efficient tool for SCD. So far, various methods for automatic SCD based on ML techniques have been presented; However, this research field still requires the application of optimal and efficient models to increase the accuracy of SCD. Therefore, in this article, a new method for SCD using a combination of optimization techniques and Artificial Neural Networks (ANNs) is presented. The proposed method includes four steps: pre-processing, segmentation, feature extraction, and classification. Image segmentation for identifying the lesion region is performed using a Kohonen neural network, where the identified region of interest (ROI) is enhanced using the Greedy Search Algorithm (GSA). The proposed method, uses a Convolutional Neural Network (CNN) for extracting features from ROIs. Also, to classify features, an ANN is used, and by the Improved Gray Wolf Optimization (IGWO) algorithm, the number of neurons and weight vector are adjusted. In this method, a probabilistic model is used to improve the convergence speed of the GWO algorithm. Based on the evaluation results, using the IGWO model to optimize the structure and weight vector of the ANN can be effective in increasing the diagnosis accuracy by at least 5%. The results of implementing the proposed method and comparing its performance with previous methods also show that this method can diagnose SC in the ISIC-2016 and ISIC-2017 databases with an average accuracy of 97.09 and 95.17%, respectively; which improves accuracy by at least 0.5% compared to other methods.

Metolachlor adsorption using walnut shell biochar modified by soil minerals.

The removal of pesticide residues in soil is a research hotspot. The metolachlor (MET) adsorption by walnut shell biochar (BC) modified with montmorillonite (MBC), illite (IBC), and kaolinite (KBC), as well as the original BC (OBC) was investigated. The characteristics of samples were studied by scanning electron microscopy and mapping analysis, Fourier transform infrared spectroscopy, X-ray diffraction, thermogravimetry, and chemical stability analysis. The effects of the dosage, ionic strength, and pH, and determined the adsorption kinetics and isotherms for MET with the BCs were analyzed. In addition, response surface methodology regression model analysis was conducted and the adsorption mechanisms were investigated. The results showed that the thermal stability and chemical stability of MBC, IBC, and KBC were higher than those of OBC, and MBC had the greatest stability. The MET adsorption rates of OBC, MBC, IBC, and KBC were 62.15%, 92.47%, 87.97%, and 83.31%, respectively. The kinetic fitting results and adsorption mechanisms showed that the modification of BC with minerals enhanced the physical adsorption of MET. The maximum MET adsorption capacities by OBC, MBC, IBC, and KBC were 39.68 mg g-1, 68.49 mg g-1, 65.79 mg g-1, and 65.36 mg g-1, respectively. Hydrogen bonds, π-π bonds, coordination bonds, and hydrophobic interactions were the key adsorption mechanisms. Therefore, the mineral-modified BCs were characterized by high adsorption rates and stability. This approach can make BC more efficient, with higher performance as a low cost soil amendment.

Adsorption of metolachlor by a novel magnetic illite-biochar and recovery from soil.

In this study, we investigated a highly efficient adsorbent that can be recycled from the soil. Walnut shells were used as raw materials to prepare original ecological biochar (OBC), illite modified biochar (IBC), FeCl3 modified biochar (magnetic biochar; MBC), and illite and FeCl3 modified biochar (IMBC), which were tested as low-cost adsorbents. The agents were used to remove metolachlor (MET) from soil. Scanning electron microscopy, Fourier transform infrared spectroscopy, X-ray diffraction, magnetic sensitivity curve analysis, and a series of adsorption experiments were conducted to study the interaction between illite and MBC, and the effect on MET adsorption. Compared with OBC, IMBC had more adsorption sites on the surface. IMBC improved the hole filling effect during the adsorption process. IMBC had more oxygen-containing functional groups and it performed better at removing organic matter through π-π interactions. According to the Langmuir model, the Q0 values for IBC, MBC, and IMBC were 91.74 mg g-1, 107.53 mg g-1, and 129.87 mg g-1, respectively, which were significantly higher than that for OBC (72.99 mg g-1). The response surface model was used to explore the optimal adsorption conditions for IMBC. After three regeneration cycles, the MET adsorption rate with IMBC was still 81.38% and the MET recovery rate was 98.12%. Therefore, IMBC was characterized as an adsorbent with high efficiency, low cost, and good recyclability. In addition, we propose a suitable agricultural system for recovering MBC on site in the field.