Treatment Techniques Research Articles

Post-intubation tracheal rupture treated surgically using a muscle graft from the Latissimus Dorsi: A rare disorder and review of literature

Introduction: Postintubation tracheal rupture (PiTR) is an extremely uncommon disorder. Pneumothorax, pneumomediastinum, hemorrhage, cutaneous emphysema and sepsis are common clinical presentations that eventually result in organ failure and mediastinitis. Endoscopy and computed tomography (CT) are considered the gold standards for assessment and diagnosis. Case Presentation: Here we present a 96-year-old woman with asthma and ischemic heart disease presented to the Emergency Department with dyspnea following viral pneumonia. Despite initial treatment, her condition worsened, requiring tracheal intubation. Subsequent complications led to a diagnosis of tracheal rupture, requiring surgical repair. The procedure involved using a muscle graft from the Latissimus Dorsi muscle: which is a novel Surgical Technique as we have conducted a literature review. Discussion: Upon scrutinizing analogous cases delineated within the medical literature, it becomes evident that our patient manifests four distinct risk factors. These factors include gender, advanced age, asthma, and prolonged steroid use. While the clinical manifestation and diagnostic methods for tracheal rupture are frequently consistent throughout cases, there is a significant variation in the surgical treatments used to treat the condition. Conclusion: More research should be conducted to investigate the use of muscle grafts as a treatment technique for tracheal rupture in the future.

Full robotic versus open ALPPS: a bi-institutional comparison of perioperative outcomes.

In primarily unresectable liver tumors, ALPPS (Associating Liver Partition and Portal Vein Ligation for Staged hepatectomy) may offer curative two-stage hepatectomy trough a fast and extensive hypertrophy. However, concerns have been raised about the invasiveness of the procedure. Full robotic ALPPS has the potential to reduce the postoperative morbidity trough a less invasive access. The aim of this study was to compare the perioperative outcomes of open and full robotic ALPPS. The bicentric study included open ALPPS cases from the University Hospital Zurich, Switzerland and robotic ALPPS cases from the University of Modena and Reggio Emilia, Italy from 01/2015 to 07/2022. Main outcomes were intraoperative parameters and overall complications. Open and full robotic ALPPS were performed in 36 and 7 cases. Robotic ALPPS was associated with less blood loss after both stages (418 ± 237ml vs. 319 ± 197ml; P = 0.04 and 631 ± 354ml vs. 258 ± 53ml; P = 0.01) as well as a higher rate of interstage discharge (86% vs. 37%; P = 0.02). OT was longer with robotic ALPPS after both stages (371 ± 70min vs. 449 ± 81min; P = 0.01 and 282 ± 87min vs. 373 ± 90min; P = 0.02). After ALPPS stage 2, there was no difference for overall complications (86% vs. 86%; P = 1.00) and major complications (43% vs. 39%; P = 0.86). The total length of hospital stay was similar (23 ± 17days vs. 26 ± 13; P = 0.56). Robotic ALPPS was safely implemented and showed potential for improved perioperative outcomes compared to open ALPPS in an experienced robotic center. The robotic approach might bring the perioperative risk profile of ALPPS closer to interventional techniques of portal vein embolization/liver venous deprivation.

Factors predicting the outcome of arthroscopic debridement and microfracture technique in treatment of osteochondral lesions of talus

Aims and Scope: Osteochondral lesions of the talus (OLT) are common injuries that occur following ankle sprains and fractures. Surgical management, either through open or arthroscopic technique, is required to eliminate the pain and restore the ankle’s function. This study aims to evaluate the prognostic significance of demographic variables and lesion’s characteristics. Method and Techniques: In this study, 40 ankle (40 patients), who underwent arthroscopic debridement and microfracture technique to treat osteochondral lesion of the talus, were evaluated retrospectively after two years. The functional outcome of the ankle joint was assessed by using foot – ankle disability score, (FADS), pain analysing scale score (PASS), American orthopaedic foot and ankle society (AOFAS) score, and Ogilvie-Harris scaling system. Then the association between patients’ age and gender, and the lesions’ characteristics, including size, grade, and location, were evaluated. Results: Outcome results varied according to the scoring system, but all patients achieved satisfied outcome and pain relieve. Younger patients with smaller lesions achieved a better clinical result. All measures including PASS, AOFAS, Ogilvie-Harris, FADS appeared to be significantly better in smaller lesions. (P-value <0.05) PASS and Ogilvie-Harris scales showed better results in younger patients. Ogilvie-Harris test result was notably superior in the lateral lesions. Conclusion: The patient’s age and size of the lesion are two prognostic factors of arthroscopic debridement and microfracture of OLTs. We believe arthroscopic management can be associated with a better outcome in lesions smaller than 1.5 cm in diameter and patients younger than 40-years-old. Level of Clinical Evidence: Level 2 – prognostic study

A Systematic Review of Loco-Sedative Anesthesia for Urologic Surgery

ObjectiveTo perform a systematic review of the characteristics and outcomes of conscious sedation and local anesthesia for various urologic procedures. Urologic care has much to gain from the routine integration of ambulatory surgery via loco-sedative anesthetic techniques for both surgeon and patient. MethodsA comprehensive systematic literature search was conducted on PubMed, and Scopus databases following PRISMA criteria from June to August 2021. Articles were included if they were English, prospective, randomized, or non-randomized controlled trials that used local anesthetic or conscious sedation for urologic interventions in adult patients. Additionally, included studies provided primary data on the use loco-sedative anesthesia and the efficacy and complications. All studies included were further reviewed to assess the biases and conflicts of interests. Results32 studies with 6897 patients were included in the review. Mean patient age was 46.4 years. The most common anesthetic and analgesic relief was the use of local anesthetic with 1% lidocaine. The majority used lidocaine as an injection, whereas the second most common route of administration was a topical cream. However, there was significant heterogeneity in the type of local or conscious sedation method and whether a combination was used. 44.4% of the studies used the visual analog scale as their primary endpoint. All the studies reported an 83% to 100% successful procedure rate without note of significant sedation-related complications. ConclusionsGiven the high efficacy rates, loco-sedative anesthesia is a promising technique for urologic interventions and should be further investigated to determine whether it may become be the standard of care.

Ultrafiltration of anaerobically digested sludge centrate as key process for a further nitrogen recovery process

In a wastewater treatment plant, the centrate generated in the dehydration process of the anaerobically digested sludge has a high potential for nutrients recovery because of its high nutrients concentration (specifically nitrogen and phosphorous). However, the high organic matter and solids content may make difficult its management. Membrane fouling is the most significant challenge limiting the application of membrane techniques for wastewater treatment. Results in this article highlight the potential of conventional filtration followed by ultrafiltration as pretreatment for further nutrients recovery using emerging membrane technologies (as membrane contactor, membrane distillation or forward osmosis). Thus, a conventional filtration (with 1, 5 and 60 μm filters) followed by an ultrafiltration process were tested. The UF membranes studied were two PES membranes (5kDa and 0.01 μm) and one PVDF membranes (100kDa). Results demonstrated that a conventional filtration with a cartridge filter of 60 μm and a subsequent UF process with a 0.01 μm RAY100 membrane (Orelis, France) achieved the best results in terms of the maximum organic matter (66% COD removal) and solids (over 97% suspended solids removal) separation, hardly varying nutrients concentration (13% NH4+ removal). Concerning membrane fouling, FESEM-EDX confirmed salt precipitation on the membrane surface, which has to be controlled to avoid loss of performance.

Effects of different irrigation activation methods on root canal treatment of primary teeth.

There is currently a lack of research on the application of newly developed irrigation techniques in root canal treatment of primary teeth. This study aimed to evaluate the effects of various irrigation activation techniques on two key parameters: apical debris extrusion (ADE) and dentinal tubule penetration depth (DTPD) of the root canal filling material. A total of 96 primary mandibular second molars were randomly divided into 4 groups: Group 1-Conventional Needle Irrigation (CNI), Group 2-XP-Endo Finisher (XPF), Group 3-EndoActivator (EA), and Group 4-Passive Ultrasonic Irrigation (PUI). In all groups, the One Reci single-file system was used for root canal preparation. For ADE measurement, each group was rinsed with distilled water. For DTPD assessment, sodium hypochlorite (NaOCl) was applied. ADE quantification was performed by collecting debris in pre-weighed Eppendorf tubes. A combination of fluorescent dye and root canal filling material (DiaPex Plus) was used for root canal filling. In order to examine DTPD, horizontal cross-sections of the coronal and apical regions of the teeth were taken with a thickness of 1 mm. The maximum and mean DTPD was examined by confocal laser scanning microscopy. Data were analyzed using the Kruskal-Wallis, One-way ANOVA, and Mann-Whitney U tests (p = 0.05). As a result, PUI had the highest mean ADE and CNI had the lowest mean ADE, while CNI had the highest mean DTPD in both the coronal and apical regions, whereas PUI had the lowest mean DTPD in the coronal region, and EA had the lowest mean DTPD in the apical region. There were no statistically significant differences in DTPD and ADE among the four groups. Comparing intragroup maximum DTPD across all groups, it was significantly higher in the coronal region than in the apical region (p < 0.05). ADE and DTPD of root canal filling materials in primary teeth did not differ significantly among CNI, XPF, EA and PUI irrigation activation techniques.

Utilizing magnetic nanoparticles embedded into polyvinyl alcohol and sodium alginate for the absorption of arsenic

Arsenic is an extremely toxic metalloid. The majority of arsenic water pollution originates from industrial activities such as mining, smelting, and utilization of arsenic compounds in glass, pigment, semiconductor, and other industries. Arsenic-containing wastewater poses a threat to groundwater, freshwater, seawater, and soil. Bioaccumulation of arsenic as a result of accidental ingestion may have a harmful effect on the skin and cardiovascular, respiratory, and nervous systems, thereby posing a major health risk. Chemical coagulation, membrane filtration, and adsorption can be used to treat arsenic-containing wastewater. However, chemical coagulation produces a large amount of waste sludge, which is harmful and incurs high processing costs. Membrane filtration is difficult to adopt because of its high operation and maintenance costs. Adsorption is an inexpensive, easy-to-use, sludge-free water treatment method that enables adsorbent recycling. These characteristics make adsorption an economically feasible technique for water treatment. Magnetic nanoparticles (MNPs) are small particles with a high surface area to volume ratio. Their strong magnetic properties enable them to absorb specific water pollutants. MNPs are currently used as water treatment adsorbents. However, they have several drawbacks, including low acid and alkali buffer capacity and water oxidation. In this study, MNPs immobilized with polyvinyl alcohol (PVA) and sodium alginate (SA) were used to enhance the efficacy of wastewater treatment with magnetic materials. These modified MNPs exhibited magnetic characteristics and improved acid resistance. When 100 g/L PVA/SA-MNPs (pH 1–6) were stirred at 120 rpm for 30 min, the resulting iron concentration of the water was 16 mg/L. By contrast, the MNPs released iron in levels ranging from 18 to 4045 mg/L. The PVA/SA–MNPs efficiently adsorbed arsenic in the pH range 3–6, with a high removal efficiency of 76%–82%. At pH 5, the average adsorption capacity was 382 ± 27 μg/g. To recover the MNPs, they were rinsed with deionized water and immersed in acid three times, after which their adsorption capacity was 300 μg/g or higher. By contrast, the PVA/SA-MNPs could be recovered through spontaneous sedimentation, eliminating the need for a magnetic field and simplifying the collection process. In addition, iron dissolution in acidic solutions was minimized for the PVA/SA-MNPs, contributing to environmental protection.

Effectiveness and safety of a ventricular septal occluder device for the treatment of Gastro-tracheal fistula

BackgroundGastro-tracheal fistula (GTF) is one of the most serious complications after esophagogastrostomy and radiothrapy, with very high disability and mortality rates. To evaluate the effectiveness and safety of ventricular septal occluder devices (VSOD) for the treatment of Gastro-tracheal fistula (GTF). MethodsFrom January 2020 to May 2022, 14 patients with GTF underwent VSOD under real-time fluoroscopy. The technical/clinical success, compliations, quality of life (QoL), Eastern Cooperative Oncology Group (ECOG) score, Karnofsky score and median overall survival (mOS) were recorded and analyzed. ResultsTechnical success, clinical success and major complication rates were 100%, 71.4% and 14.3%, respectively. Both the ECOG and the Karnofsky score showed significant improvement at the 2-month evaluation compared with the pretreatment value (p<0.05). For QoL, general health, physical function, vitality, role physical, and social function all improved at the 2-month evaluation (p<0.05), but bodily pain, role emotion and mental health showed no significant difference (P>0.05). During the mean follow-up of 9.6 months, eight patients were alive, and the mOS was 11.4 months (95% CI, 8.5-14.3). ConclusionVSOD is a simple and safe technique for GTF treatment, but long-term observation is needed at multiple centers to confirm our findings.

A novel technique of percutaneous transhepatic treatment of biliary-enteric anastomotic occlusive strictures with compliant balloon-occluded distal cholangiography and large-bore catheter: a retrospective case series.

Endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous transhepatic biliary balloon dilatation (PTBD) is a challenge in resolving biliary-enteric anastomotic occlusive strictures (BEAOS) and/or coexisting stones. The biliary-enteric anastomosis (BEA) often cannot be seen because of the surgically altered gastrointestinal anatomy. Here, a technique that combined percutaneous compliant-occluded distal cholangiography and the maintenance of a large-bore catheter is described to resolve this issue. A retrospective review of 10 patients who presented with BEAOS with/without coexisting stones who were treated with percutaneous compliant balloon-occluded distal cholangiography, bile duct stone removal, and the maintenance of a large-bore catheter between February 2017 and January 2021 was performed. Treatment response, laboratory examinations, including hepatic function tests, routine blood tests, and blood electrolytes, complications, and imaging data were evaluated. Paired t-tests were used to investigate the difference of laboratory examinations before and after the procedure. All 10 cases were technically successful. A total of 9 stones in 6 patients were successfully removed by the compliant balloon. All catheters were removed after the patency of the stricture was confirmed by percutaneous transhepatic cholangiography (PTHC) 6 months later. No severe adverse events occurred during the perioperative period. There were 2 patients who experienced episodes of cholangitis during the follow-up period (mean, 17 months; range, 4-24 months), and neither BEAOS nor bile duct stones recurred within 2 years after the procedure. White blood cells (WBC), total bilirubin (TB), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) were (6.0±1.4)×109/L and (6.0±1.6)×109/L (P=0.91), 31.4±15.7 and 29.6±10.3 µmol/L (P=0.74), 50.8±20.0 and 85.8±67.0 U/L (P=0.16), and 42.6±15.2 and 71.8±44.9 U/L (P=0.09) pre and postintervention, respectively. Percutaneous transhepatic compliant balloon-occluded distal cholangiography and the maintenance of a large-bore catheter probably provide an effective and safe alternative method for resolving BEAOS and/or coexisting stones.

Maintenance treatment of immunotherapy after microwave ablation plus drug-eluting bead bronchial arterial chemoembolization for advanced non-small cell lung cancer: a retrospective single-center cohort study.

The combination therapy of immunotherapy and drug-eluting bead bronchial artery chemoembolization (DEB-BACE) or microwave ablation (MWA) has been attempted as an effective and safe approach for advanced non-small cell lung cancer (NSCLC). However, the outcomes of immunotherapy plus multiple interventional techniques for advanced NSCLC remain unclear. This retrospective study thus aimed to investigate the effectiveness and safety of the maintenance treatment of programmed cell death protein 1 (PD-1) blockade after MWA plus DEB-BACE for advanced NSCLC. This retrospective cohort study consists of 95 patients with advanced NSCLC who were treated with DEB-BACE between April 2017 and October 2022 and who were allocated to three groups: group A (MWA + DEB-BACE + PD-1 blockade; n=15), group B (MWA + DEB-BACE; n=25), and group C (DEB-BACE alone; n=55). The adverse events (AEs) were compared between the three groups. The outcomes were compared via Kaplan-Meier methods, including median progression-free survival (PFS) and overall survival (OS). Survival analyses were performed via the univariate and multivariate analyses to investigate the prognostic predictors. The overall incidence of AEs in the groups A-C was 53.3% (8/15), 36.0% (9/25), and 32.7% (18/55), respectively, which did not represent a significant difference (P=0.42). No severe AEs (SAEs) occurred. Group A, compared with group B and group C, had a significantly longer estimated median PFS (33.0 vs. 7.0 vs. 3.0 months; P<0.001) and OS (33.0 vs. 13.0 vs. 6.0 months; P=0.002). PD-1 blockade (P=0.006), tumor number (P=0.01), and DEB-BACE/bronchial artery infusion (BAI) chemotherapy cycles (P=0.04) were identified as the predictors of PFS, while the predictors of OS were PD-1 blockade (P<0.001), number of metastases (P<0.001), tumor diameter (P<0.001), and DEB-BACE/BAI cycles (P=0.02). Compared with that of advanced NSCLC treated with MWA plus DEB-BACE or DEB-BACE alone, the maintenance treatment of immunotherapy after MWA plus DEB-BACE might provide a superior prognosis without increasing the risk of AEs.

Measurement of laser shock peening induced residual stress by nanoindentation and comparison with XRD technique

Laser shock peening (LSP) is an innovative surface treatment technique successfully used to improve fatigue performance of metallic components. It is based on the application of high intensity laser and suitable overlays with the aim to generate high pressure shock waves on the surface of the mechanical part to be treated. Shock waves generate severe plastic deformations and, consequently, compressive residual stresses (RS). An accurate measurement of these latter is crucial for predicting the resistance of treated parts under service loads and to assess the effectiveness of LSP process.In this paper, a non-destructive method, based on the nanoindentation technique and finite element analysis (FEA), was developed to measure the RS generated by LSP process on AA-7050-T451 samples. In particular, the methodology is based on the analysis of the nanoindentation peak load variation generated by the presence of residual stresses on a component. Obtained results were compared, for validation, with the measurements carried out by the most consolidated X-ray diffractometer (XRD) technique. The results showed a satisfactory agreement between the two techniques, revealing nanoindentation as a promising and reliable method for characterizing RS induced by LSP.

Occurrence, fate and potential risks of pharmaceuticals and personal care products (PPCPs) in Elbe river water during water treatment in Dresden, Germany

Pharmaceuticals and personal care products (PPCPs) are found in most rivers facing sewage input worldwide. This study investigated the occurence of 116 PPCPs in the Elbe river in Dresden, Germany, as well as the removal efficiency at a riverbank filtration (RBF) site. The data obtained were compared with data from two additional surface water monitoring stations along the Elbe river operated by a state environmental agency. 21 PPCPs were frequently detected in all water samples with concentrations up to 1270 ng/L. Spatial occurrence and sociodemographic aspects are discussed. According to the European Guideline for Environmental Risk Assessment, carbamazepine, diclofenac, iomeprol and venlafaxine indicate a suspected risk for the aquatic environment but not for drinking water quality in the Dresden region. Water treatment using a combination of natural treatment techniques and post-treatment using activated carbon filtration and disinfection proved to be an efficient barrier to drinking water pollution by PPCPs.

Treatment Related Acute Toxicities Between Treatment with 3D-CRT and IMRT in Localised Prostate Cancer.

To compare the acute toxicities of two radiation treatment techniques, intensity modulated radiation therapy (IMRT), and 3-dimensional conformal radiation therapy (3D-CRT) in localised prostate adenocarcinoma. Descriptive study. Place and Duration of the Study:Department of Oncology, Dr. Ziauddin Hospital, Karachi, Pakistan, from July 2016 to June 2022. Patients with localised prostate adenocarcinoma who underwent treatment using two different advanced radiotherapy techniques i.e., IMRT and 3D-CRT were recruited during the study period. They were followed up for six months for acute gastrointestinal (GI) and genitourinary (GU) adverse events (acute toxicities) related to both treatment modalities according to Modified radiation therapy oncology group (RTOG) criteria. The acute toxicities were assessed at the 2nd, 4th, and 6th week during treatment and at the 3rd and 6th month after treatment. There were 78 patients, with 39 patients in each group. The mean age was 68 ± 10 years in the 3D-CRT and 68 ± 07 years in the IMRT group. Patients in the IMRT group exhibited markedly lower treatment-related acute GI and GU effects at the end of 4th and 6th weeks for anorectal pain (p = 0.04) and (p = 0.01) and burning micturition (p = 0.003) and (p = 0.01), respectively. Furthermore, at 3 months anorectal pain (p = 0.02), loose stools (p = 0.005), and burning micturition (p = 0.01) were present and at 6 months anorectal pain was (p = 0.01) still present. Radiation therapy modalities 3D-CRT and IMRT both showed acceptable toxicity profile in the management of localised prostate cancer, while IMRT group exhibited significantly lower treatment-related acute GI and GU effects. 3D-CRT (3-Dimensional Conformal Radiation Therapy), IMRT (Intensity-Modulated Radiation Therapy), Radiation toxicity.

Non-invasive treatments improve patient outcomes in chronic tinnitus: a systematic review and network meta-analysis

ObjectiveTo investigate the relative effectiveness of various Non-Invasive Treatment Techniques (NITs) in chronic tinnitus management. MethodsWe searched PubMed, Embase and Cochrane Library databases from the time of data construction to December 31, 2022. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, NITs were evaluated, including Aacceptance and commitment therapy (A), Cognitive behavioral therapy (C), Sound therapy (S), Transcranial magnetic stimulation (T), Electrical stimulation therapy (E), Virtual reality therapy (V), tinnitus Retraining therapy (R), general psychotherapy (D), and Placebo (P). The outcome indicators included the Tinnitus Handicap Inventory (THI), Tinnitus Questionnaire (TQ), Hospital Anxiety and Depression Scale-anxiety-Depression (HADS-D), Insomnia Severity Index (ISI), Visual Analogue Scales-Loudness (VAS-L), and Visual Analogue Scales-Distress (VAS-D). Statistical analysis was performed using Stata 14.0 for NMA. ResultsThis systematic review and meta-analysis included 22 randomized controlled trials comprising 2,354 patients. The treatment effects varied on each scale. For THI, S (86.9%) was the most effective, whereas P (6.5%) was the worst. For TQ, C (89.5%) was the most effective, whereas D (25.4%) was the worst. For HADS-D, A (82.4%) was the most effective, whereas D (9.47%) was the worst. For ISI, A (83.2%) was the most effective, whereas R (20.6%) was the worst. For VAS-L, S (73.5%) was the most effective, whereas E (18.9%) was the worst. For VAS-D, C (84.7%) was the most effective, whereas P (18.1%) was the worst. ConclusionsThe combination of acoustics and cognitive behavioral therapy may be an effectively treat patients with chronic tinnitus. Level of EvidenceHow common is the problem? Level 2.Is this diagnostic or monitoring test accurate? (Diagnosis) Level 1.What will happen if we do not add a therapy? (Prognosis) Level 1.Does this intervention help? (Treatment Benefits) Level 1.What are the COMMON harms? (Treatment Harms) Level 1.What are the RARE harms? (Treatment Harms) Level 1.Is this (early detection) test worthwhile? (Screening) Level 1I.

TEAM participation in the irradiation of IROC phantoms for cooperative group clinical trials

The participation of radiation oncology team members in the irradiation of Imaging and Radiation Oncology Core (IROC) phantom for cooperative group clinical trials is essential to comply with the latest quality management philosophy. Medical dosimetrists are expected to develop treatment plans for the irradiation of IROC phantoms. For advanced treatment techniques, such as three-dimensional conformal radiation therapy (3DCRT), intensity-modulated radiation therapy (IMRT), and volumetric-modulated arc therapy (VMAT), the irradiation of the IROC phantoms serves as quality audit. If successful, the irradiation processes demonstrate that the institution has the knowledge of the protocol, and has the appropriate equipment to comply with the protocol requirements. This article describes three IROC phantoms used for credentialing external beam photon beam therapy, delivered using conventional medical linear accelerators, to the medical dosimetry community. Guidance and strategies for the development of treatment plans are discussed. Our institutional irradiation of the three IROC phantoms, delivered using the Truebeam medical linear accelerator, resulted in consistent dose accuracy to within ±1%. The participation of the team members may reduce the overall published failing rate stated to be about one-third of all participating institutions.

Microstructure, mechanical and corrosion study of friction stir processed Inconel 625 additive layers deposited via wire arc direct energy deposition

This study explores the application of friction stir processing (FSP) as an effective post-deposition surface treatment technique for improving the mechanical and corrosion properties of wire arc direct energy deposited (WA-DED) Inconel 625 additive layers. The coarse and cube-oriented microstructure observed in as-built Inconel 625 components results in anisotropic mechanical properties. The non-equilibrium solidification in WA-DED Inconel 625 leads to severe micro-segregation of alloying elements, forming large Nb and Mo-rich Laves and carbide phases in the inter-dendritic areas. This causes a heterogeneous distribution of vital alloying elements within the γ-Ni matrix of the material, adversely affecting its mechanical properties and corrosion resistance, thereby restricting the utility of this manufacturing technique in critical applications. The incorporation of FSP has been observed to successfully eradicate the presence of typical coarse and highly oriented microstructure through grain refinement, achieving a more uniform microstructure. Through severe plastic deformation (SPD), coarse eutectic phases are broken down and redistributed within the γ-Ni matrix, enhancing the uniformity of material properties. The research thoroughly investigates the changes in microstructure, mechanical performance, and corrosion resistance of both WA-DED and FSP-enhanced WA-DED Inconel 625 samples. A Thermo-Calc simulation using the classical Scheil model was conducted to understand the solidification pathway and the formation mechanism of the Laves phase in the WA-DED sample. The grain size was significantly reduced by 98.23%, from 138 µm in the WA-DED sample to 2.44 µm in the stir zone (SZ) of the FSP-treated area, due to dynamic recrystallization (DRX), particle-stimulated nucleation (PSN), and the Zener pinning effect. This grain refinement led to remarkable enhancements in the yield strength (YS) by approximately 113%, ultimate tensile strength (UTS) by about 37% and micro-hardness by around 60% compared to the WA-DED sample. In a 3.5 wt% NaCl solution, the FSP-treated sample demonstrated superior corrosion resistance by forming a stable, thicker passive film than the as-built sample. The results of this study will offer valuable insights into utilizing the FSP technique as post-weld surface treatment of WA-DED deposited IN625 superalloy.

Review on integrated advanced oxidation processes for water and wastewater treatment

There is currently a steadily growing concern on a global scale for the creation of alternative water reuse technologies, primarily geared toward industry and agriculture. Due to their high chemical stability and/or poor biodegradability, advanced oxidation processes (AOPs) are viewed in this context as a highly competitive water treatment method for the removal of these organic pollutants. AOPs have an immense amount of potential for treating a variety of these contaminants and enhancing wastewater biodegradability. They still have some significant drawbacks, such as high costs of operation, energy intensive and use of additional chemicals. Combining AOPs with other technique enhances the separation efficiency as compared to individual AOP. AOP is an emerging technology trying to find its place in competition with other large scale industrial processes for wastewater treatment and to counter a major drawback of AOP i.e. cost considerations Integration of AOP with conventional treatment techniques have been studied qualitatively and quantitatively along with their advantages and disadvantages. Quantitative parameters like EEO and performance of each process is discussed in detail with critical comments on each process along with future prospective is discussed in conclusion. This paper reviews recent research advancement in the field of conventional AOP and integrated AOPs such as integrated AOP-biological treatment, integrated AOP-membrane processes, AOP in microreactors, microwave enhanced AOP, and Catalytic wet air oxidation.

Advanced Lightweight Structural Materials for Automobiles: Properties, Manipulation, and Perspective

The key drivers for automotive manufacturers to develop vehicles with decreased weight are the growing requirements for improved fuel efficiency. This endeavor not only tackles the issues related to fuel efficiency but also aligns with the objectives of enhanced recyclability and overall performance of the vehicle, encompassing factors like driving efficiency, braking characteristics, and collision safety. Herein, a successful strategy entails investigating and utilizing lightweight materials with superior performance as substitutes for conventional automotive materials such as cast iron and steel. This article provides a thorough analysis of the lightweight materials that are currently being researched and available for use in the production of next-generation cars. These materials include composites, light alloys, high-strength steel, and other innovative materials. The review covers all aspects of the life cycle of automotive materials, examining their mechanical and physical characteristics, production processes, characterization strategies, and their uses. Both the merits and limitations of these materials are analyzed, leading to a nuanced understanding of suitable scenarios for their application. In anticipation of future challenges, the study suggests that advancements in versatile materials or enhancements in manufacturing and treatment techniques hold promise for overcoming potential obstacles, ultimately facilitating the creation of more capable, safer, durable, and environmentally friendly vehicles.

Efficacy of Cognitive Behavioral Intervention in Improving Executive Function of Children with High Functioning Autism Spectrum Disorder: A Meta-analysis

This meta-analysis examines the efficacy of the cognitive behavioral approach to interventions toward the improvement of executive function for children/adolescents with high-functioning autism spectrum disorder (HF-ASD). This meta-analysis paper has identified ten studies involving 437 participants with high-functioning autism spectrum disorder aged between 5 and 18. All the participants reported IQs were at or above 70. A random effect meta-analysis yielded a moderately significant effect (Hedge g = 0.72) with significant heterogeneity [Q(10) = 228.36, p &lt; .001]. There were considerable variations in the executive function domain, i.e., working memory (hedge g = 1.23) and inhibition (g = 0.47), showing significant treatment effects. On the other hand, cognitive flexibility (g = -0.51) and planning (g = -0.07) show non-significant effects toward cognitive behavioral interventions. The finding suggests that the cognitive behavioral approach to intervention demonstrates efficacy in improving executive function in children or adolescents with high-functioning autism spectrum disorder. All the cognitive behavioral intervention studies were conducted in developed countries, so differences between the approaches between developed and developing countries were inconclusive. Future studies are needed to investigate the effectiveness of cognitive behavioral techniques in intervention for low-functioning autism spectrum disorder children.

서예를 활용한 마음 치료 방안 연구

Calligraphy has been emphasized as an art that goes beyond mere functional acquisition, but expressing one’s temperament, character, personality, and emotions. It has evolved from the human nature theory that calligraphy represents one’s heart, establishes a close relationship between calligraphy and emotions, leads to the theory that calligraphy reflects one’s personality. Through the calligraphy theory and narrative activities, clinical experiments have shown that the calligraphy therapy plays a complementary role in treatment of adult diseases, depression, mental disorders, dementia, and autism, and effectively alleviates those symptoms. Therefore, this paper aims to explore therapeutic approaches by examining the relationship between calligraphy and mind, comparing from the stage before holding the brush to the stage at the end of the calligraphy writing with the mind-study methodology of pausing, breathing, observing, recognizing, putting down, and discovering grace. Therefore, this paper examined the process of preparing calligraphy, the process of writing by Phil-bub, the psychological effect according to the calligraphy, and the psychological purification effect through letters, sentences, and famous phrases, which are the contents of calligraphy. It confirmed that calligraphy can serve as an intervention technique in mind therapy beyond its aspects of discipline theory of body and mind. Engaging in calligraphy involves experiences of pause in the process of organizing one’s surroundings and gathering one’s mind before writing It enhances attention through breath control while using Mo-phil, finds peace of mind through concentration during overlapping strokes, and increases sense of accomplishment. Calligraphy is not only good for self-esteem recovery and strengthening immune system but also maximizing physiological activities, and promoting brain function. practicing calligraphy significantly contributes to health promotion.