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Aim: Since the advent of radiotherapy, the success rate of head and neck cancer treatment has increased significantly. However, when the tissue tolerance level is exceeded, unnecessary and uncontrolled exposure to radiation is considered detrimental. Such problems remain difficult to prevent and manage. The aim of the study to evaluate and compare the degree of attenuation of therapeutic radiation using four different radiation shielding materials of varying thickness. Study Setting and Design: In vitro experimental study. Materials and Methods: The samples were divided into four groups based on the different radiation shielding materials of thickness 3mm and 5mm. The materials are Lead (Pb), Silver-tin alloy (Ag-Sn) with Polyvinylsiloxane (PVS), Polymethylmethacrylate (PMMA) with Barium sulphate (BaSO4), and a combination of Ag-Sn with PVS and PMMA with BaSO4 which was exposed to radiation. The radiation dose measurements were recorded and the radiation attenuation properties of the shielding materials were evaluated. Among all of the shielding materials the most efficient material under consideration is determined. Statistical Analysis Used: One-way ANOVA followed by post hoc test was used to compare the means of all four groups. Results: A statistically significant difference between groups was found by a one-way ANOVA with a P = 0.001. In the post hoc test, statistically significant findings were obtained with a P = 0.05 when comparing the variation values of 3mm and 5mm thickness between each group and other groups. Conclusion: The shielding materials results in significant reductions in radiation dosage. It was concluded that the combinations of Ag-Sn alloy with PVS, and PMMA with BaSO4 of thickness 5 mm had a good shielding effect.

BackgroundDifficult facemask ventilation is perilous in children whose tracheas are difficult to intubate. We hypothesised that certain physical characteristics and anaesthetic factors are associated with difficult mask ventilation in paediatric patients who also had difficult tracheal intubation.MethodsWe queried a multicentre registry for children who experienced "difficult" or "impossible" facemask ventilation. Patient and case factors known before mask ventilation attempt were included for consideration in this regularised multivariable regression analysis. Incidence of complications, and frequency and efficacy of rescue placement of a supraglottic airway device were also tabulated. Changes in quality of mask ventilation after injection of a neuromuscular blocking agent were assessed.ResultsThe incidence of difficult mask ventilation was 9% (483 of 5453 patients). Infants and patients having increased weight, being less than 5th percentile in weight for age, or having Treacher-Collins syndrome, glossoptosis, or limited mouth opening were more likely to have difficult mask ventilation. Anaesthetic induction using facemask and opioids was associated with decreased risk of difficult mask ventilation. The incidence of complications was significantly higher in patients with "difficult" mask ventilation than in patients without. Rescue placement of a supraglottic airway improved ventilation in 71% (96 of 135) of cases. Administration of neuromuscular blocking agents was more frequently associated with improvement or no change in quality of ventilation than with worsening.ConclusionsCertain abnormalities on physical examination should increase suspicion of possible difficult facemask ventilation. Rescue use of a supraglottic airway device in children with difficult or impossible mask ventilation should be strongly considered.

Monolithic alumina (Al2O3) demonstrates potential for several high-performance structural applications, including engine turbine components and high-temperature aerospace materials. However, its mechanical constraints, including brittleness and diminished fracture resistance, have hindered its wider utilization. This study addresses these difficulties by fabricating and characterizing graphene-reinforced alumina ceramic matrix composites to improve their mechanical and wear properties. A uniform distribution of sub-micron and nano-phase particles inside the alumina matrix was attained via ball milling, thereafter subjected to hydraulic pressing and sintering in a tube furnace at 1600 °C for 4 hours under an inert Argon environment. Graphene was integrated as a reinforcing agent at different weight percentages (0, 0.25, 0.5, 0.75, and 1.0 wt%). The results indicated that increased graphene content led to a reduction in Vickers hardness, but flexural strength and fracture resistance initially enhanced, reaching a maximum for 0.5 wt%, before decreasing at elevated concentrations. At 0.5 wt% graphene, the flexural strength increased by 49.26 % to 612 MPa, and fracture resistance improved by 40.42 % to 6.6 MPa·m1/2. The results demonstrate that a graphene content of 0.5 wt% is best for enhancing the mechanical performance of alumina composites. Graphene markedly enhanced the tribological performance of alumina composites, in addition to mechanical property improvements. The addition of 0.25 wt% graphene decreased the wear rate under both ambient and elevated temperature conditions. Furthermore, the coefficient of friction (COF) diminished by 64.12 % at ambient temperatures and 51.01 % at increased temperatures. These enhancements underscore graphene's dual function in augmenting both strength and wear resistance, rendering it an exceptionally useful reinforcement material. Altering the graphene concentration from 0 to 1 wt% revealed that optimal attributes were attained at particular weight percentages. The research verifies that graphene-reinforced alumina composites not only overcome the mechanical constraints of monolithic alumina but also offer improved performance for sophisticated structural applications. These findings emphasize the necessity of customizing reinforcement amounts to attain a balance among mechanical strength, fracture resistance, and tribological characteristics.

Diatoms have long been used as bio-indicators for the assessment of surface water quality. This study investigates the biological diatom index (BDI) and water quality index (WQI) for evaluating the water quality impact in the Thamirabarani River, Southern India. Diatom and water samples were taken for the present investigation from ten different locations along the river. The samples were enumerated and the morphometrics valve was documented by light microscopy. In the study area, a total of 70 diatom taxa belonging to 28 genera were recorded. The diatom indices implemented in OMNIDIA software version 6.1 was used to infer the river water quality status. The results showed that based on the BDI and WQI analysis values varied from 6.7 to 17.4 and 48 to 71 were observed. According to the BDI and WQI analysis result during the study period in the river revealed the water quality varied between good (Oligo-mesotrophic) to bad (Eutrophic) ecological conditions. The biological diatom index and water quality index results indicate the respective locations (Site 2, Site 3, Site 7, Site 8, Site 9 and Site 10) represent bad water quality. The result indicated moderate water quality at Sites 4 and Site 6. The diatom indices and water quality index results show the locations Site 1, and Site 5 indicate good water quality. The biological diatom index results from diatom assemblages show more information about the water quality and environmental impact on the river. For the national assessment of water quality better to use diatoms along with physico-chemical parameters variables. Based on the analysis result reveal that the major component of water quality degradation was due to anthropogenic activities, domestic waste and industrial effluents in the study area. [ABSTRACT FROM AUTHOR]

Previous assessments suggest that surgical results of paraesophageal hernia (PEH) repair were negatively impacted by increasing levels of obesity. A better understanding of the association of obesity on outcomes of PEH repair will support surgeons making evidence-based decisions on the surgical candidacy of individual patients. This single institution retrospective cohort study included 884 consecutive patients with giant PEH undergoing surgical repair between 1 January 2000 and 30 June 2020. Preoperative body mass index (BMI) was documented at the time of surgery. Main outcomes included perioperative blood loss, length of hospital stay, major complications, early hernia recurrence, and mortality. The mean (standard deviation [SD]) age at surgery was 68.4 (11.1), and 645 (73.0%) were women. Among the 884 patients, 875 had a documented immediate preoperative BMI and were included in the analysis. Mean (SD) BMI was 29.24 (4.91) kg/m2. Increasing BMI was not associated with increased perioperative blood loss (coefficient, 0.01; 95% confidence interval [CI], −0.01 to 0.02), prolonged length of stay (coefficient, −0.01; 95% CI, −0.02 to 0.01), increased incidence of recurrent hernia (odds ratio [OR], 1.03; 95% CI, 0.95–1.10), or increased major complications (OR, 0.93; 95% CI, 0.82–1.05). The 90-day mortality rate was 0.3%. Furthermore, when compared with the normal weight group, overweight and all levels of obesity were not related to unfavorable outcomes. No association was found between BMI and perioperative outcomes or short-term recurrence in patients undergoing PEH repair. Although preoperative weight loss is advisable, a higher BMI should not preclude or delay surgical management of giant PEH. [ABSTRACT FROM AUTHOR]

Background and Aim of Study: Swachh Bharat Abhiyan (SBA) was launched by the Prime Minister of India to accelerate the efforts for achieving universal sanitation. To ensure adequate participation, community must be sensitized about the mission objectives and its role in bringing the desired change. The aim of the study: to assess the knowledge, perception and practices regarding SBA among rural people, and to study the association between their socio epidemiological factors and awareness regarding SBA. Material and Methods: Community based cross-sectional study was conducted for duration of 6 months (April to September 2021) at a rural area of south Tamilnadu. A sample of 250 subjects was included and was administered a predesigned, pretested, semi structured questionnaire. The responses were recorded and appropriate statistical tests were applied. Results: Mean age group of our study participants was 47.6 ± 9.8 years. Television 126 (50.4%) and newspaper 41 (16.4%) were found to be the main source of information about SBA. This study showed out of 250 participants, 142 (56.8%) of them had good knowledge and 174 (69.6%) had good perception score. Our study found a statistical significant association between educational status and level of knowledge and perception score. Conclusions: The present study found that majority of the subjects were aware of SBA and were having positive attitude and perception but very less practicing in our day today life. Increasing awareness regarding health hazards of open-air defecation and improper disposal of solid waste will create a change in their behavior in adopting healthy lifestyle.