DISTRIBUTION OF SILOXANES IN COASTAL SEDIMENTS COLLECTED FROM INDUSTRIAL BAYS IN SOUTH KOREA

Department of Urban and Environmental Engineering (Environmental Science and Engineering )Siloxanes have been used as chemical additives in various consumer and industrial products since the 1940s. Based on their extensive usage, cyclic siloxanes are categorized as high production volume chemicals. However, siloxanes are known to cause potential toxic effects and result in environmental persistence and bioaccumulation. Furthermore, previous studies have detected the high levels of siloxanes in various environmental matrices, which can lead to negative effects on the ecosystem. Therefore, siloxanes are an emerging concern as contaminants in the environment. In this study, 6 cyclic siloxanes (D4???D9) and 13 linear siloxanes (L3???L15) were analyzed in coastal sediment collected from southeastern industrial bays in Ulsan, Busan, Jinhae, and Gwangyang, South Korea (March???April 2016). The four bays are heavily industrialized and designated as special management sea areas by the Korean government, because of severe coastal pollution originating from industrial complexes and commercial ports. A total of 69 surface sediment samples were collected using grab samplers and were extracted by shaking with organic solvents and then analyzed using gas chromatography mass spectrometry (GC/MS). From the results, contamination levels, spatial distribution, and correlationship of siloxanes in coastal sediment was investigated. Additionally, the hazard quotients (HQs) for siloxanes were evaluated using Monte Carlo simulation. The total concentrations of siloxanes were in the range of 10.1 to 3,877.2 (mean: 304.2) ng/g dry weight (dw) for all studied samples. The relative composition of D5 (28%) and D6 (33%) were the highest, followed by L11 (5.9%) and L10 (5.2%). The highest concentration of total siloxanes was found in Busan (579.4 ng/g dw), followed by Ulsan (315.8 ng/g dw), Jinhae (266.2 ng/g dw), and Gwangyang (31.1 ng/g dw). The total concentration levels of siloxanes in South Korea are similar to other countries. Significant correlations exist among the concentrations of siloxanes, the concentrations of persistent organic pollutants (POPs), and TOC content in sediment. The hazard quotients (HQs) for siloxanes in coastal sediment were less than 1, indicating that there is no risk to organisms of the exposure of siloxanes in coastal sediment.clos

Experiential Learning: Critical Analysis of Standardized Patient and Disability Simulation

Current revisions to the accreditation standards for occupational therapy (OT) education include proposed changes to experiential learning. The AOTA Fieldwork/Experiential Learning Ad Hoc Committee recommends that fieldwork Level I experiences be replaced with a new model of experiential education that includes the use of standardized patients and simulation (AOTA, 2017). The purpose of this article is to present critical perspectives about standardized patient simulation and disability simulation to support informed decision-making about the integration of experiential learning in OT professional education. In standardized patient simulation, actors play the roles of clients and important others in therapeutic scenarios; in disability simulation, students act out impairments in a variety of settings. While these forms of simulation are commonly used within OT education, they are critiqued for failing to present participants with authentic lived experiences of disability. This paper presents alternative approaches that would more fully align the OT curriculum with perspectives and priorities of intersectional disability communities. Recommendations to be considered by educators and educational programs include becoming familiar with relevant literature across fields and communities; developing long-term partnerships with disability organizations and community members; involving people with disabilities in the development, implementation, and evaluation of experiential learning opportunities; and providing experiential learning opportunities that take place outside educational and clinical settings and that attend to multiple intersecting dimensions of people with disabilities’ lived experiences. Together, these recommendations can help ensure that students have access to evidence-based educational approaches and best practices that accurately reflect the self-identified needs, concerns, and priorities of intersectional disability communities

Case Report: Single-port laparoscopic total gastrectomy for gastric cancer in patient with situs inversus totalis

Situs inversus totalis (SIT) is a rare anatomical condition, where all the viscera appear in its reverse position. Although minimally invasive surgery has evolved to achieve totally laparoscopic gastrectomy for gastric cancer patients with SIT, it is difficult to perform lymphadenectomy in such a transposed anatomical condition. Recently, we performed a single-port laparoscopic total gastrectomy (SPTG) for gastric cancer in a patient with SIT. No postoperative complications or dietary problems were observed. Based on this experience, we are to design a safe strategy to perform D2 lymphadenectomy during SPTG in patients with SIT

Low-Dose Prasugrel in Patients with Resistance to Clopidogrel for the Treatment of Cerebral Aneurysms

Thromboembolism is one of the major complications of stent assisted coiling in treatment of cerebral aneurysm. Clopidogrel resistance is so common and prasugrel is more effective in its rapid and potent effect. We investigated changes in the value of P2Y12 resistance unit (PRU) when prasugrel was administered to patients with clopidogrel resistance. One hundred mg of aspirin and 75 mg of clopidogrel were administered for 5 days before the procedure, and PRU were examined. The resistance to clopidogrel was defined as the inhibition of PRU was less than 20%. PRU was re-examined after loading 20 mg of prasugrel. We treated 98 consecutive patients between January 2018 and July 2018, and 24 patients (24.5%) had resistance to clopidogrel. Nineteen patients were female. The mean PRU value at admission was 238.5±36.9 and the percentage inhibition value was 4.8±6.3%. After the use of prasugrel, the mean PRU and percentage inhibition values were measured as 124.9±49.9 and 48.0±19.24, respectively. All patients except one patient had a PRU inhibition value as a responder. There was no hemorrhage or thromboembolic complication during mean 1.5 months follow-up after embolization procedure. In conclusion, in patients resistant to clopidogrel, the low dose prasugrel seems to be effective in keeping the percentage inhibition value of PRU within the normal range in treatment of cerebral aneurysm. Further study will be needed to determine the optimal dose of prasugrel to enhance prevention effect of thromboembolism and to reduce hemorrhagic complications during stent assisted coiling

Macrolide-refractory Mycoplasma pneumoniae pneumonia and hemophagocytic lymphohistiocytosis: case report and literature review

Mycoplasma pneumoniae causes various extra-pulmonary complications. As a rare but fatal hematological complication, hemophagocytic lymphohistiocytosis (HLH) can be observed in children with M. pneumoniae infection. We report a case of a 6-year-old girl with HLH who was initially presumed to have macrolide-refractory M. pneumoniae pneumonia. Despite the combination treatment of antimicrobial and anti-inflammatory agents, she showed persistent fever, hepatosplenomegaly, and thrombocytopenia. Secondary HLH associated with M. pneumoniae should be considered if unexplained clinical deterioration is noted in children with macrolide-refractory M. pneumoniae pneumonia

Infusing disability equity within rehabilitation education and practice: A qualitative study of lived experiences of ableism, allyship, and healthcare partnership

BackgroundAddressing issues of diversity, equity, and inclusion (DEI) has become central in implementing inclusive and socially responsible rehabilitation education and clinical practice. Yet, the constructs of disability and d/Deaf identity and culture, as well as ableism and allyship are often overlooked. Or, these concepts are approached using outdated philosophical perspectives that pathologize disability and fail to prioritize the lived experiences, expertise, intersectionality, and self-identified needs of people with disabilities. A Critical Disability Studies (CDS) framework may provide a background for better understanding and responding to these issues through allyship.PurposeThis study employed a CDS framework to understand the lived experiences of ableism and allyship from faculty, staff, and students on University of Washington (UW) campuses who identify as d/Deaf, disabled/with a disability, or as having a chronic health condition.MethodsDuring 2020–2021, we conducted in-depth, semi-structured interviews and focus groups with 22 diverse undergraduate and graduate students, faculty, and staff with disabilities, one third who also identified as people of color. Encounters were audio-recorded, transcribed verbatim, and coded using constant comparison until themes emerged.ResultsFour major themes that emerged from the data are: (1) Ever-present ableism in healthcare, (2) Ableism at the intersections, (3) COVID: Surfacing ableism and expanding access, and (4) Disability allyship and healthcare partnership building. Experiences of ableism and allyship were identified at individual, group/unit, and institutional/systemic levels, though participants reported significantly fewer instances of allyship compared to experiences of ableism. Participants identified intersections between disability and other marginalized identities and juxtaposed the benefits of widespread adoption of many access-increasing practices and technologies due to the COVID-19 pandemic, while also highlighting ways in which the pandemic created new obstacles to inclusion.ConclusionsThis analysis provides insights into ways of implementing inclusive practices in rehabilitation education, practice, and beyond. Rehabilitation students, faculty, and staff may not be aware of how ableism affects their disabled peers or underpins their professional education. It is important to cultivate opportunities within professional education and clinical training to explicitly address our collective role in creating inclusive and accessible academic and healthcare experiences for our diverse community post COVID-19. Drawing on a CDS framework, the research team devised the mnemonic TRAC, which includes Training, Recognition and Representation, Attendance and Action, and Calling to account as strategic guidelines for operationalizing such opportunities

Comparison of surgical resection versus transarterial chemoembolization with additional radiation therapy in patients with hepatocellular carcinoma with portal vein invasion

Background/Aims Portal vein invasion (PVI) is a poor prognostic factor in patients with hepatocellular carcinoma (HCC). We intended to compare the effects of surgical resection and transarterial chemoembolization (TACE) with additional radiation therapy (RT) in HCC patients with PVI. Methods The subjects comprised 43 patients who underwent surgical resection for HCC with PVI without previous treatment and another 43 patients who received TACE followed by RT (TACE+RT) as initial treatment who were matched for Child-Pugh class, tumor size, and extent of PVI. Disease progression and death after the treatment were examined, and progression-free survival (PFS) and overall survival (OS) were compared between groups. Predisposing factors affecting OS were analyzed using univariate and multivariate analyses in HCC patients with PVI. Results The subjects (Age [51, 24-74; median, range], Sex [81/13; male/female], Etiology [78/1/15; hepatitis B virus {HBV}/ hepatitis C virus {HCV}/non-HBV and non-HCV]) were followed for a median of 17 (2-68) months. There were no differences in clinical or tumor characteristics between the resection and TACE+RT groups. The cumulative PFS was not significantly different between groups. The median PFS was 5.6 and 4.0 months in the resection and TACE+RT groups, respectively. However, the cumulative OS was significantly longer in patients treated with resection than in those treated with TACE+RT (P=0.04). The median OS was 26.9 and 14.2 months in the resection and TACE+RT groups, respectively. Univariate and multivariate analyses revealed that surgical resection was an independent predictive factor for better survival outcome. Conclusions Surgical resection might be an effective treatment in HCC patients with PVI