Malignancy with unknown primary presenting as acute cardiac tamponade: a case report

A case report of a patient presenting in cardiac tamponade that was subsequently diagnosed as being secondary to malignancy of unknown primary. The patient was treated by urgent pericardiocentesis, followed by subsequent formation of a subxiphoid pericardial window. He was discharged home and given palliative chemotherapy. Malignant pericardial effusions are common, but it is rare for a patient to present in cardiac tamponade as the presenting feature of an unidentified malignancy. The causes, diagnosis and treatment of cardiac tamponade are discussed

An analysis of the impact of soft skills on Malaysian technical institutions

Many people recognize the importance of technical skills as knowledge and proficiencies required in the accomplishment of professional jobs. However, the importance and applicability of soft skills are mostly ignored despite the fact that, it is a process how individual carry himself in an organization or professional environment for the progress of that individual and the organization he found himself. The paper explored into some journals from the previous the literatures, some soft skills were identified such as communication, lifelong learning, entrepreneurship, leadership, and teamwork, problem solving and critical among TVET institutions in Malaysia. Document analysis was conducted as a methodology for this study. The impacts of these soft skills on TVET related institutions like polytechnics, training centers and universities in Malaysia. It was indicated that, the result of the impact of soft skills on these institutions was generally moderate. The paper concluded that, technical skills alone could not bring about the organizational development there must be a compliment of soft skills for any organizational sustainability. Supplementary of soft and technical skills conceptual model was formulated. The paper was concluded by saying that, the competitive nature of the present situation, soft skills are essential because they have affected all aspect of human development. Some recommendations were suggested, teachers, lecturers and instructor must teach students soft skills for complete individual proficiencies and organizational sustainability

Modeling residential electricity consumption from public demographic data for sustainable cities

Demographic factors, statistical information, and technological innovation are prominent factors shaping energy transitions in the residential sector. Explaining these energy transitions re-quires combining insights from the disciplines investigating these factors. The existing literature is not consistent in identifying these factors, nor in proposing how they can be combined. In this paper, three contributions are made by combining the key demographic factors of households to estimate household energy consumption. Firstly, a mathematical formula is developed by considering the demographic determinants that influence energy consumption, such as the number of persons per household, median age, occupancy rate, households with children, and number of bedrooms per household. Secondly, a geographical position algorithm is proposed to identify the geographical locations of households. Thirdly, the derived formula is validated by collecting demographic factors of five statistical regions from local government databases, and then compared with the electricity consumption benchmarks provided by the energy regulators. The practical feasibility of the method is demonstrated by comparing the estimated energy consumption values with the electricity consumption benchmarks provided by energy regulators. The comparison results indicate that the error between the benchmark and estimated values for the five different regions is less than 8% (7.37%), proving the efficacy of this method in energy consumption estimation processes

Performance evaluation of phosphonium based deep eutectic solvents coated cerium oxide nanoparticles for CO2 capture

The critical challenge being faced by our current modern society on a global scale is to reduce the surging effects of climate change and global warming, being caused by anthropogenic emissions of CO2 in the environment. Present study reports the surface driven adsorption potential of deep eutectic solvents (DESs) surface functionalized cerium oxide nanoparticles (CeNPs) for low pressure CO2 separation. The phosphonium based DESs were prepared using tetra butyl phosphoniumbromide as hydrogen bond acceptor (HBA) and 6 acids as hydrogen bond donors (HBDs). The as-developed DESs were characterized and employed for the surface functionalization of CeNPs with their subsequent utilization in adsorption-based CO2 adsorption. The synthesis of as-prepared DESs was confirmed through FTIR measurements and absence of precipitates, revealed through visual observations. It was found that DES6 surface functionalized CeNPs demonstrated 27% higher adsorption performance for CO2 capturing. On the contrary, DES3 coated CeNPs exhibited the least adsorption progress for CO2 separation. The higher adsorption performance associated with DES6 coated CeNPs was due to enhanced surface affinity with CO2 molecules that must have facilitated the mass transport characteristics and resulted an enhancement in CO2 adsorption performance. Carboxylic groups could have generated an electric field inside the pores to attract more polarizable adsorbates including CO2, are responsible for the relatively high values of CO2 adsorption. The quadruple movement of the CO2 molecules with the electron-deficient and pluralizable nature led to the enhancement of the interactive forces between the CO2 molecules and the CeNPs decorated with the carboxylic group hydrogen bond donor rich DES. The current findings may disclose the new research horizons and theoretical guidance for reduction in the environmental effects associated with uncontrolled CO2 emission via employing DES surface coated potential CeNPs

Design and Energy Analysis of a Solar Desiccant Evaporative Cooling System with Built-In Daily Energy Storage

Heat storage with thermochemical (TC) materials is a promising technology for solar energy storage. In this paper, a solar-driven desiccant evaporative cooling (DEC) system for air-conditioning is proposed, which converts solar heat energy into cooling with built-in daily storage. The system utilises thermochemical heat storage along with the DEC technology in a unique way. Magnesium Chloride (MgCl2·6H2O) has been used, which serves as both a desiccant and a thermochemical heat storage medium. The system has been designed for the subtropical climate of Lahore, Pakistan, for a bedroom with 8 h of cooling requirements during the night. MATLAB has been employed for modelling the system. The simulation results show that 57 kg of magnesium chloride is sufficient to meet 98.8% of cooling demand for the entire month of July at an elevated cooling requirement. It was found that the cooling output of the system increased with increasing heat exchanger effectiveness. The heat exchangers’ effectiveness was increased from 0.7 to 0.8, with the solar fraction increased from 70.4% to 82.44%. The cooled air supplied to the building meets the fresh air requirements for proper ventilation

Production of high-value added exopolysaccharide by biotherapeutic potential Lactobacillus reuteri strain

Exopolysaccharides (EPS) are produced by various microbial groups including bacteria. EPS produced from Lactobacilli is gaining popularity as a new generation functional food to replace various chemically synthesized food additives. EPS production by strains of L. reuteri were reported previously in sourdough fermentation. The submerged cultivation of L. reuteri strain DSM 20016 T was optimised for crude EPS production. Initially, the factors controlling crude EPS generation were explored using one-at-a-time (OFAT). Among the investigated carbon sources, sucrose supplemented medium increased maximal crude EPS generation. Yeast extract was determined to be the greatest nitrogen source for increasing crude EPS and cell mass. Plackett-Burman experimental design (PBD) was employed to screen the important parameters impacting crude EPS production in the growing medium. Three important factors were identified: sucrose, yeast extract and sodium acetate. The RSM quadratic model for crude EPS generation was significant (R2:0.9373) and correlated with the observed response at roughly 94%. About 3.4 g L-1 crude EPS was produced under optimal fermentation conditions of sucrose (106.0 g L-1), yeast extract (30.0 g L-1) and sodium acetate (7.0 g L-1). This study shows the crude EPS synthesis of L. reuteri from sourdough can be used in submerged fermentation and biotechnological applications

OPTIMIZATION STUDIES ON POST BLENDING OF CRUDE PALM AND RUBBER SEED OIL FATTY ACID METHYL ESTERS

In avoiding the major issues of fossil fuel depletion and the environmental concerns, biodiesel is one of the most feasible sources of alternative energy. Rubber seeds, due to its non-edible characteristics have a potential to be converted to biodiesel. Its utilization will help to resolve food versus fuel controversy. Malaysia has a vast number of palm and rubber plantations that can supply sufficient seeds for biodiesel production. In present work, parametric studies and optimized conditions were determined via response surface methodology (RSM), using the central composite design (CCD) of the Design Expert 8.0 software. The parameters studied for solvent extraction of rubber seeds were solvent to seed ratio, temperature, extraction time and drying time of the seeds. A parametric study was also conducted to determine the effect of alcohol to oil (A:0) ratio, catalyst loading, reaction time and temperature on acid esterification and base transesterification process

OPTIMISATION STUDIES ON RUBBER SEED OIL BASED METHYL ESTER SYNTHESIS VIA HYDRODYNAMIC CAVITATION TECHNOLOGY

Hydrodynamic cavitation (HC) technology is a viable way to produce sustainable biodiesel from high free fatty acid non-edible feedstock. This technology has affirmative environmental impacts with lower energy consumption and shorter reaction time, which offers a cleaner possibility. The limitation of conventional mechanical stirring (MS) process involved longer reaction time to obtain methyl ester content. Four newly designed orifice plates were studied as a cavitating device in HC reactor. HC reactor was connected to the diaphragm pump in a close loop reactor. The compressed air was supplied to operate the double diaphragm pump, which is the main device to dissipate the energy in a HC reacto

Managing periprosthetic fractures – a review of the hub and spoke model

Introduction: Periprosthetic fractures are associated with significant morbidity and mortality. The “hub and spoke model” consists of a central organisation (the hub) and a series of secondary units (the spokes). This study reviews the presentation, management, and outcomes of periprosthetic fractures at a large general district hospital, the Royal Blackburn Hospital. Methods: A retrospective data analysis for patients presenting with periprosthetic fractures from a single general district hospital between January 2011 and December 2020. Details recorded were patient demographics, primary arthroplasty procedure, fracture management, ASA grade, morbidity and mortality, and Unified Classification System for Periprosthetic Fractures (UCSPF). Results: With 229 periprosthetic fractures, the number tripled in 2020 that admitted in 2011. The mean age was 78.6 years (range 33–100), 151 were females. Seventy-five percent of the fractures were managed locally, while 25% a referral to the higher specialist centre was sort. Of the 57 referrals, 50 were transferred to the hub, 5 were operated on locally, and 2 were managed non-operatively. Higher-level care transfer resulted in a delayed definitive treatment (4.8 versus 12 days, p = 0.001). About 94.4% of patients treated locally had a favourable outcome versus 92% of patients treated at the hub hospital. Cumulative mortality rates for the two sites were comparable. Discussion: Most of the patients presenting to the local spoke hospital with periprosthetic fractures were managed in house. For this practice to be preserved, there is a need for future planning, such as maintaining an appropriate skill mix at spoke units. Discussion between specialists at the hub and spoke hospitals reduced patient transfer by 14%