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Introduction Inadequate treatment of enlarged lateral lymph nodes (LLNs) in rectal cancer patients is associated with an increased lateral local recurrence (LLR) risk, despite neoadjuvant treatment and total mesorectal excision (TME) surgery. There is a promising role for LLN dissection (LLND) to lower this risk, but this challenging procedure requires appropriate training. This study protocol describes a prospective evaluation of oncological outcomes after standardised treatment based on multidisciplinary training, thereby aiming for a 50% reduction in LLR rate.Methods and analysis A prospective registration study will be opened in hospitals in which the involved multidisciplinary team members (radiologists, radiation oncologists, surgeons and pathologists) have received dedicated training to enhance knowledge and awareness of LLNs and in which standardised treatment including LLND has been implemented. Patients with rectal cancer and at least one enlarged LLN (short-axis ≥7.0 mm), or intermediate LLN (short-axis 5.0–6.9 mm) with at least one malignant feature on primary MRI, evaluated by a trained radiologist, are eligible. Patients will undergo neoadjuvant treatment by trained radiation oncologists, followed by TME surgery in combination with a minimally invasive, nerve-sparing LLND performed by trained surgeons. LLND specimens are evaluated by trained pathologists or grossing assistants. The primary outcome is LLR rate 3 years postoperatively. Secondary outcomes are morbidity, disease-free survival, overall survival and quality of life. To demonstrate a significant reduction in LLR rate from 13% (based on historical control data) to 6% after optimised treatment, 200 patients with enlarged LLNs are required.Ethics and dissemination The medical ethics board of the Vrije Universiteit Medical Centre (VUMC), the Netherlands, approved the study on 23 November 2022 (reference: 2021.0524). Participating centres must obtain local approval and participants are required to provide written informed consent. Results obtained from this study will be communicated via peer-reviewed medical journals and presentations at conferences.Trail registration number NCT04486131, 24 July 2020, https://clinicaltrials.gov/ct2/show/NCT04486131.

During the casting of ferromanganese alloys from electric arc furnaces into sand beds at temperatures of up to 1800°C a considerable amount of very brown fumes are generated when the alloy fume is oxidized in the atmosphere. The fume is difficult to capture because of the large flux of gas that is generated. Possible reasons for this flux include the high evaporation rate of Mn at elevated temperatures, the large surface area of the casting beds and the large thermal plumes over the furnace tapholes and casting beds. It has been found that the use of fine water sprays along the edge of the roof that covers the casting bed resulted in a significant reduction in visible emissions. This paper describes research into the kinetics of the fume to improve the design of the capture hoods, as well as the mechanism of suppression by the water sprays by using CFD analysis. It is shown that the oxidation reaction produces less than 20% of the energy content of the plume over the arc furnace taphole, and also that radiation heat transfer may play an important role in increasing the energy content of the taphole plume. The capture of fume particles by fine spray droplets is shown to have limited efficiency, while the heat sink that is caused by evaporation does not materially contribute to the circulation of fume through the spray. It is postulated that the increased moisture content of the air over the casting beds may be instrumental in reducing the oxygen partial pressure or in the formation of an oxide layer, both of which would reduce metal evaporation and, therefore fume formation. The exact mechanism requires further investigation

Measurement of the outlet particulate concentration on pressure-type bag filters, whether intermittent or continuous, has been avoided in South Africa as cumbersome and possibly inaccurate. A system based on the requirements of the US EPA’s method 5D was however recently designed and installed on three pressure-type reverse air filters serving ferro-chrome electric arc furnaces in order to allow comparison with the legal emission concentration limits for this type of furnace. This paper reports on the design considerations and design process of this system.

Numerical simulations of test particle transport in the presence of synthetic turbulence with known properties still provide the most reliable estimations of the diffusion coefficients of charged particles in turbulent space plasmas available. The development and implementation of such simulations, however, are far from straightforward. The present study provides a comprehensive treatment of the development and testing of such a simulation code, detailing the simulation of synthetic turbulence and diffusion coefficients, as well as various numerical tests to validate code output. Furthermore, a novel test for such codes is proposed, namely, the transport of charged particles in pure slab turbulence, which proves sensitive to numerical factors prior tests remain insensitive to.

African mourning of loss of lives in South Africa has been shaped by discursive practices of both traditional African cultures and the sociopolitical developments under apartheid and in post-apartheid South Africa. This article reports on changes in mourning practices on the basis of a literature review and uses a collection of examples to highlight the navigation of some cultural and gendered issues relating to mourning, against the backdrop of the everyday experiences of loss of life in South Africa due to violence and HIV/AIDS. The article draws on African womanist and feminist scholarship and focuses on the intersections between cultural and gender practices of bereavement in the lives of professional urban African women. The authors argue for the use of positioning theory and witnessing practices to honor and story the ongoing struggle of African women as these women take different agentic positions by accepting, questioning, resisting, and/or changing cultural mourning practices while they compassionately witness the self and others in the narratives they live.

As part of a study on etiology of sexually transmitted infections (STI) among 520 women presenting at the STI clinic in Nairobi, data on partner violence and its correlates were analyzed. Prevalence of lifetime physical violence was 26%, mainly by an intimate partner (74%). HIV seropositive women had an almost twofold increase in lifetime partner violence. Women with more risky sexual behavior such as early sexual debut, number of sex partners, history of condom use and of STI, experienced more partner violence. Parity and miscarriage were associated with a history of lifetime violence. We found an inverse association between schooling and level of violence. Six percent of the women had been raped. Gender-based violence screening and services should be integrated into voluntary counseling and testing programs as well as in reproductive health programs. Multi-sector approaches are needed to change prevailing attitudes towards violence against women.