Municipal sewage sludge dewatering performance enhancement by ultrasonic cavitation and advanced oxidation: A case study.

The number of published literature on the effect of ultrasonic cavitation and advanced oxidation pretreatment on the dewatering performance of anaerobically digested sludge is very limited. This study aims at determining the optimum operating conditions of large-scale filtering centrifuges in wastewater treatment plants. The optimum dose of hydrogen peroxide, ultrasonic power, ultrasonic duration, ultrasonic pulse and particle size distribution for improved dewatering performance were determined in this study. In addition, shear stress-shear rate and viscosity-shear rate rheograms were developed to show the rheological flow properties for varying ultrasonic power and treatment duration. Optimum sonication power, time, pulse and amplitude were determined to be 14 W, 1 min, 55/5 and 20%, respectively. At a pH of 6.8, the optimum concentration of hydrogen peroxide was found to be 43.5 g/L. The optimum hydrogen peroxide dose in the combined conditioning experiments was determined to be 500 mg/L at a pH of 3. Under these optimum conditions, capillary suction time was reduced significantly by 71.1%. This study helps to reduce polymer consumption and provides the optimum pretreatment and dewatering operating conditions, and better monitoring and control in the dewatering unit has significant impact in the overall economy of wastewater treatment plants.

The Effect of Expert Patient Simulation on Clinical Judgment: A Quasi-Experimental Study.

Background: Worldwide, quality education is one of the important tools to improve healthcare quality. Healthcare practitioners must be competent in their clinical judgement to meet clients' need. However, poor clinical judgment skill accounts for almost one-third of all patient problems in health care. Expert patient simulation has been used as a training method for clinical judgement skill. However, according to empirical studies, using expert patients to develop clinical judgement skill is unclear. The method is effective in one situation but not in another. Objective: To examine the effect of expert patient simulation on the clinical judgment skill of health science students of Mizan-Tepi University. Methods: A pre-test/post-test quasi-experimental design was used on 92 randomly selected samples from the graduating cohort of midwifery students. The research subjects who took part in the experiment were picked at random. Tools included the Creighton Competency Evaluation Instrument (C-CEI®), the Learning Satisfaction and Self-Confidence Questionnaire, and the Kolb Learning Style Inventory (LSI). The Wilcoxon-signed rank test was utilized to compare the self-confidence scores among intervention and control group of students, and the paired sample test was used to compare clinical judgment scores. Cohen's d was used to assess the effect size, and Spearman correlation was used to explore the association. Results: Clinical decision-making ability and self-confidence measures revealed statistical and practical differences between before and after simulation. There was a mean difference of 2.28 (95% CI, 1.78, 2.79), t (45)=9.13, p 0.001, and an effect size of 1.3, p 0.001. A pre-and post-simulation self-confidence measure showed statistically significant improvement after simulation (W = 1, Z = -3.57, P 0.001). A moderately significant positive connection (r = 0.419, p 0.004) was also discovered. Conclusion: The study found that human expert patient simulation is a tremendous clinical training technique for improving students' clinical decision-making skill competency and self-confidence.

Prevention of Occupational Hazards Among Sanitary Workers: Knowledge, Attitude, and Practice Survey in Bulehora, West Guji Zone, Oromia, Ethiopia.

INTRODUCTION: The production of waste is due to the result of commercial activities, consumption, and utilization of products or materials. It is further believed that mainly solid waste includes non-harmful waste which may be from households, mainly kitchens, and even from organizations and institutions, shops and various types of markets, and manufacturing industries. Solid waste handling, management, and accurate and appropriate disposal is a hot topic relating to public and environmental health concerns. METHODS: A cross-sectional quantitative study design was incorporated to assess knowledge, attitude, and practice and associated factors regarding prevention of occupational risks and health hazards among sanitary workers in Bulehora University, a government organization in West Guji Zone, Ethiopia. One hundred and ninety-one solid waste handlers found to be working in this institution were included in the study. RESULTS: The response rate of samples in the present study was found to be 94.4%, of which the majority were females, which accounted for 79.7%. The median age of the study samples was 29 years. It was found that 64% of study samples stated good knowledge of the prevention of occupational health risks. About 76.4% of solid waste collectors had a good attitude and only 8.9% showed good practice regarding prevention of occupational health hazards. Job dissatisfaction was found to be a statistically significant factor along with the use of personal protective equipment (PPE) in implementing good practice work patterns among sanitation workers, even though they had been provided with basic personal protective equipment. CONCLUSION: The study concluded that there is a need for development of plans on implementation of basic occupational health services while enforcing the provision of personal protective equipment and supervising solid waste collectors.

Factors Affecting the Outcome of Extracorporeal Shockwave Lithotripsy in Urinary Stone Treatment.

OBJECTIVES: We sought to evaluate the factors affecting the outcome of extracorporeal shockwave lithotripsy (ESWL) in urinary stone treatment. METHODS: We conducted a retrospective review of 235 adult patients treated with ESWL, for radiopaque renal or ureteric stones between January 2015 and December 2016. Patient's age, sex, stone size, laterality, location, density, skin-to-stone distance (SSD), and presence of double J stent were studied as potential predictors. At the end of three months, the patients were divided into success and failure groups and the significance was determined. RESULTS: Of the 235 patients (188 males and 47 females) analyzed, ESWL was successful in 79.1%. Univariate analysis of both groups revealed no significant difference in patient's age and stone laterality. Statistically significant differences in gender, stone size, stone site, stone density, SSD, and patients with stents were observed. Statistically significant factors in multivariate logistic regression analysis were sex and stent. Females had three-times higher risk for ESWL failure than males (odds ratio (OR) = 3.213; 95% confidence interval (CI): 1.194-8.645; p = 0.021) and a higher failure rate when a stent was used (OR = 6.358; 95% CI: 2.228-18.143; p = 0.001). CONCLUSIONS: This study revealed that ESWL can treat renal and ureteric stones successfully with an inverse association between outcome and predictors such as stone size and density, SSD, and stent presence. These factors can help us in improving patient selection and ensure better results at lower cost.

Dosimetry and radiobiological studies of automated alpha-particle irradiator.

Understanding the effect of alpha radiation on biological systems is an important component of radiation risk assessment and associated health consequences. However, due to the short path length of alpha radiation in the atmosphere, in vitro radiobiological experiments cannot be performed with accuracy in terms of dose and specified exposure time. The present paper describes the design and dosimetry of an automated alpha-particle irradiator named 'BARC BioAlpha', which is suitable for in vitro radiobiological studies. Compared to alpha irradiators developed in other laboratories, BARC BioAlpha has integrated computer-controlled movement of the alpha-particle source, collimator, and electronic shutter. The diaphragm blades of the electronic shutter can control the area (diameter) of irradiation without any additional shielding, which is suitable for radiobiological bystander studies. To avoid irradiation with incorrect parameters, a software interlock is provided to prevent shutter opening, unless the user-specified speed of the source and collimator are achieved. The dosimetry of the alpha irradiator using CR-39 and silicon surface barrier detectors showed that ~4 MeV energy of the alpha particle reached the cells on the irradiation dish. The alpha irradiation was also demonstrated by the evaluation of DNA double-strand breaks in human cells. In conclusion, 'BARC BioAlpha' provides a user-friendly alpha irradiation system for radiobiological experiments with a novel automation mechanism for better accuracy of dose and exposure time.

Mixed malignant tumor of the submandibular gland.

A 70-year-old woman presented with chief complaints of swelling in the right side of her neck for 20 years, mainly in the submandibular region, with an increase in size 2 months prior, discharge of foul-smelling pus, ulceration of the overlying skin, and pain in the swelling for 15 days. Immunohistochemical studies reported the tumor to be a mixed malignant tumor arising from the submandibular gland. Wide excision of the tumor with deltopectoral flap was done.

Eosinophilic enteritis presenting as a rare cause for ileo-ileal intussusception.

Eosinophilic enteritis, a relatively rare entity, usually involves gastric antrum or proximal small bowel. Our case is rarer in its involvement of the distal small bowel and presents unusually as intussusception. The disease if diagnosed in the initial stages responds well to medical treatment but if associated with complications or misdiagnosed, surgical modality is the treatment of choice. In our case, the patient presented with acute intestinal obstruction due to intussusception and emergency laparotomy with ileoileal anastomosis was done. Histopathology confirmed the diagnosis as eosinophilic enteritis. This case with such a presentation is discussed here.