Articles de revues sur le sujet « Glass escalator »

Gender scholars use the metaphor of the “glass escalator” to describe a tendency for men in women-dominated workplaces to be promoted into supervisory positions. More recently, scholars, including the metaphor’s original author, critique the glass escalator metaphor for not addressing the intersections of gender with other relevant identities or the ways that work has changed in the twenty-first century. I apply an intersectional lens to understand how gender and race shape women’s career paths in tech work, where twenty-first century changes to the organization of workplaces are common. I build on theories of raced and gendered labor and the glass escalator to make sense of women’s careers in a contemporary field dominated by men. I find some evidence that white women, but not women of color, experience something similar to a “glass escalator” where they are promoted into management, but those promotions are a smaller step up—more step stool than escalator. These promotions move women out of technical positions and towards business and management, releasing engineering teams from the pressure to fully incorporate women.

This article explores the manner in which race, ethnicity, and gender intersect to produce inequality in wages and employer benefits among “workers” (employees with no job authority), “supervisors” (employees with broad supervisory responsibilities), and “managers” (employees who can hire/fire and set the pay of others). Using data uniquely suited to examine these relationships, the author finds that, contrary to the glass ceiling hypothesis, the white male advantage over women and minorities in wages and retirement benefits generally does not increase with movement up the authority hierarchy net of controls. Instead, relative inequality remains constant at higher and lower levels of authority. However, in nontraditional work settings where white men report to minority and female supervisors, there is evidence that a glass ceiling stifles women and minorities while a glass escalator helps white men. Instead of representing mutually exclusive processes and outcomes, glass ceilings and glass escalators may actually overlap in certain employment contexts. The implications of these results for future analyses of workplace inequality are discussed.

This qualitative study of 10 Black men who teach special education found that they experience their socialization into the profession by school leaders and other system-level influencers as both challenging and conflicting. Although past research demonstrates that Black men who teach special education face pressure to engage in noninstructional roles, especially as disciplinarians and sports coaches, the impact on their school work experiences has not been examined. Study findings show that participants experience a conflict in role that creates a “glass classroom” distinct from the glass ceiling and the glass escalator. The barriers of the glass classroom make school experiences difficult because others do not see Black male teachers’ potential for other meaningful school-based assignments. Thus, their opportunities are constrained. The study uses Wingfield and Chavez’s racial inequity and occupational outcomes and role socialization theory as conceptual frameworks. Implications for practice and research are provided.

In this article we explore the experiences and perceptions of men in social care occupations in Spain in order to understand their reasons for going into care work, their continuation in the sector, how they are perceived, and to what extent gender matters in their work experiences. We use data from the ongoing qualitative research we are undertaking in Catalonia (Spain) on men as carers; this text is based on 31 semi-structured interviews with male workers in the social care sector. Our results show that the economic crisis has drawn Spanish local men into lower-skilled jobs in the social care sector, thus modifying the stratification process based on gender, class and migration. We find that the ‘glass escalator’ has a very limited effect in social care work, and in consequence, the advantages men enjoy only relate to the ease with which they access such jobs. Finally, we find that men working in the social care sector negotiate their masculinity through the tension between the cultural and class norms that oblige them to have a job and the undervalued or feminized characteristics of their work.

Introduction: It's a fact that nursing is a profession where most of their components are women, nevertheless, responsibility and decision-making positions aremainly occupied bymale nurses, and this is like this in spite of that they only represent 16 % of the professional contingent. The tokenism explains well this reality. Objectives: To value if the female nurse suffers discrimination inside the own profession, in the nurses' union and in the professional association. To verify if in the responsibility positions inside the Regional Health Services, the nurse is still relegated to other health professionals or not. Methodology: Bibliography researches weremadein various databases using the keywords and selecting with the ten years filter articles in Spanish and English, and official databases were revised (INE, EPA, CGE, SATSE and websites of the Regional Health Services). Results: The 84 % of the professionals nurses are females, although in the 15 Regional Nurses Councils consulted, there are only 5 chairwomen. In the SATSE, 58 %of secretariats are occupied bywomen, percentage that is not appropriate with the gender distribution in this collective. It is also alleged that nurses are not present as managers of Health Services. Discussion: It has been shown that nursing, despite being a feminized profession, has to deal with the phenomenon of the token in their ownworld somen dominate positions of power as evidenced by the data. Conclusions:The female nurse is still in an inferior position both inside and outside the profession. Keywords: nurse, tokenism, glass escalator, feminization.

In this research, the results of different weight percentage of glass fiber (30, 40 & 50), cement (0, 3 & 6) and polyester resin (70, 60 & 50), on the properties of glass fiber-cement-polyester composites are investigated. The specimens are prepared by hand lay-up technique. All the specimens are tested for tensile and flexural strength as per ASTM standards. Results showed that escalation in glass fiber wt.% improved the tensile strength (by 9% at 40 wt.% and 17% at 50 wt.%) and flexural strength (by 10% at 40 wt.% and 16.5% at 50 wt.%). Whereas an increase in cement weight percentage decreases tensile strength and increases flexural strength. The failure of the sample is due to glass fiber pull out and rupture of the matrix, under tensile load.

The photoconductivity of a nanocomposite MEH-PPV:TiO2 thin film is investigated. The nanocomposite MEH-PPV:TiO2 thin film was deposited on a glass substrate by spin coating technique. The composition of the TiO2 powder was varied from 5 wt% to 20 wt% (with 5 wt% interval). The concentration of the MEH-PPV is given by 1 mg/1 ml. The current voltage characteristics were measured in dark and under illumination. The photoconductivity showed increment in value as the composition of the TiO2 is raised in the polymer based solution. The absorption showed augmentation as the amount of TiO2 is increased. The escalation of the current voltage is then supported by the results of surface morphology.

Management in the context of higher education has been characterized by the predominance of male participation, mainly in senior management positions. As a result, women’s low participation is mainly concentrated in lower management positions, and their chances of escalating hierarchical positions are mediated by various factors ranging from subjective to socially naturalized. The objective of this research is to analyze the barriers women face to enter and escalate positions in university management in Colombia. Under a qualitative design, 26 semi-structured interviews were applied to university managers from different institutions of higher education in Colombia. The transcripts were analyzed using discourse analysis through three categories: individual, internal, and external barriers of the university. It was found that women face entry and promotion barriers marked by experiences, and conditions of inequality and discrimination in a male-dominated context. These barriers are conditioned by personal elements, organizational culture, and the social role of women. In addition, women’s trajectories involve mediation between professional development and family life. The study reveals experiences that contribute to understanding the research phenomenon from the webbing of senses and meanings. It is posited that the “glass ceiling” is mediated by variables in the internal order, and by the relationship between universities and their context.

Methicillin-resistant staph aureus (MRSA) has been known to cause severe hospital-acquired infections with its multi-drug resistant nature. MRSA Infections could quickly escalate into severe sepsis resulting in death, if not recognized and treated abruptly. This pathogen uncommonly causes Community-Acquired Pneumonia (CAP), which can lead to under treatment due to delayed coverage with anti-MRSA antibiotics resulting in poor clinical outcome. We herein describe an unusual case of MRSA CAP during COVID-19 pandemic in an 80-year-old male who was unresponsive and found to be in septic shock, intubated outside the hospital setting, and then brought to intensive care unit for further management. Laboratory and radiographic studies revealed MRSA in sputum culture and extensive bilateral consolidation with bilateral ground glass opacities and pleural effusions on imaging. Our patient was successfully treated with linezolid and extubated within 48 hours with a favorable outcome. High index of suspicion and a timely coverage with anti-MRSA antibiotics would reduce mortality and lead to a better outcome in otherwise fatal infection. Keywords: MRSA; Community-acquired pneumonia; Respiratory failure; Critical care; Case report

Abstract Nurses working in the hospital setting increasingly have become overburdened by managing alarms that, in many cases, provide low information value regarding patient health. The current trend, aided by disposable, wearable technologies, is to promote patient monitoring that does not require entering a patient's room. The development of telemetry alarms and middleware escalation devices adds to the continued growth of auditory, visual, and haptic alarms to the hospital environment but can fail to provide a more complete understanding of patient health. As we begin to innovate to both address alarm overload and improve patient management, perhaps using fundamentally different integration architectures, lessons from the aviation flight deck are worth considering. Commercial jet transport systems and their alarms have evolved slowly over many decades and have developed integration methods that account for operational context, provide multiple response protocol levels, and present a more integrated view of the airplane system state. We articulate three alarm system objectives: (1) supporting hazard management, (2) establishing context, and (3) supporting alarm prioritization. More generally, we present the case that alarm design in aviation can spur directions for innovation for telemetry monitoring systems in hospitals.

Oral semaglutide is the first-in-class glucagon-like peptide-1 receptor agonist available in the form of pills administered per os. PIONEER — the clinical trial program assessing the efficacy and safety of oral semaglutide — demonstrated the dose-­dependent efficacy of the drug: the reduction of up to -1,4% in terms of glucose-lowering effects and the decrease of up to 5 kg in terms of weight loss. Moreover, oral semaglutide is superior in this regard compared to empagliflozin 25 mg, liraglutide 1,8 mg and sitagliptin 100 mg according to the dedicated trials of clinical program. From the cardiovascular perspective oral semaglutide has been proven to be safe. Therapeutic concentration of semaglutide in oral form is reached under ­several conditions: taking tablets on a daily basis in a fasting state with up to half a glass of water and waiting 30 minutes before drinking, eating, or taking other drugs. Most frequent adverse events were GLP-1 associated gastrointestinal reactions (­nausea, vomiting and diarrhea), most of the events were transient and occurred generally during dose escalation.

AbstractRespiratory complications, in particular infections, are common in the setting of hematological malignancy and after hematopoetic stem cell transplant. The symptoms can be nonspecific; therefore, it can be difficult to identify and treat the cause. However, an understanding of the specific immune defect, clinical parameters such as speed of onset, and radiological findings, allows the logical diagnostic and treatment plan to be made. Radiological findings can include consolidation, nodules, and diffuse changes such as ground glass and tree-in-bud changes. Common infections that induce these symptoms include bacterial pneumonia, invasive fungal disease, Pneumocystis jirovecii and respiratory viruses. These infections must be differentiated from inflammatory complications that often require immune suppressive treatment. The diagnosis can be refined with the aid of investigations such as bronchoscopy, computed tomography (CT) guided lung biopsy, culture, and serological tests. This article gives a schema to approach patients with respiratory symptoms in this patient group; however, in the common scenario of a rapidly deteriorating patient, treatment often has to begin empirically, with the aim to de-escalate treatment subsequently after targeted investigations.

Nowadays, the escalation of technology automotive produced a lot of transports. In connection with that, the rates of accident increased also. The application of composites from fiber is many used as a part of transport. The fiber composite used to absorb the impact directly from that accident. Filament winding is one of method to make a composite fiber. In this investigation, mandrel are made from wood with consists of cone with vertex angle 5ºand 10º. Glass fiber filament is use to winding the mandrel with different orientation angle. The orientations angle is 45°/-45°, 90°/45°, 90°/45°/90°, 45°/90°/-45°, 45°/-45°/45°/-45° and 90°/45°/90°/-45°. Resin epoxy used when process of winding start. Then, the specimen will test with impact testing in 4 velocities which 2.7 m/s, 3.1 m/s, 3.4m/s and last 3.8 m/s. Data from that testing will analyst and discuss. In conclusion, the result shown that both vertex angle and fiber orientation controlled the performance of energy absorption capability. The energy absorption increased when impact loading velocities increase. It is observed that different collapse mechanism have characterized the performances of specific energy absorption. The collapse mechanism happened are ring types splitting.

Abstract: Photovoltaic or PV for brief, may be a strategy that's interesting and particular in saddling the sun's energy. One of the comes about that ought to be taken into consideration within the utilize of solar panel is the effectiveness of the sun-based board itself, since productivity alludes to the sum of light of the full module that turns it into power. The proficiency of the solar panel will be lower on the off chance that there's a remove between the cells conjointly since the glass cover and reflect the light from the sun is retained into the cells. Thus, it ought to be given specific consideration since of the effectiveness appear precisely how much power will be produced from the sun-oriented board. Gained control from the photovoltaic sun powered board may be a primary calculate reflects the board execution. This factor is influenced by numerous parameters. Dust thickness, light escalated as well as surrounding temperature have coordinated impact on the board execution. The framework offers ceaseless checking and measuring to the specified parameters in expansion to the yield control of the sun-based board. The collected records are reflecting and affirming the coordinating of the changing within the natural parameters with regard to the collected control.

In the twenty-first century, managing organizational change has become one of the critical issues for the success of any organization. Dynamic changes in the business environment post liberalization, privatization and globalization in India have escalated organizational competition holistically. Moreover, changing government policies, recent technological advancements and increased management pressure to reduce costs have reshaped the entire organizational dynamics. Researchers suggest that creativity and innovation have an important role to play in the transition process of organizations to survive, it is in fact the ‘survival of fittest’ (Chatterjee, 2014). While technological innovation plays the key role in business growth, the success of management depends upon the effective utilization and allocation of resources which are necessary to bring out technological change (Dasgupta, Gupta, & Sahay, 2011). Hence, in order to survive in this competitive market, strategic implementation and management of organizational change have become pivotal for the organization’s survival. This case study explicitly explores and identifies the impact of environmental changes on the small-scale cotton yarn industry in India. Particularly, this study focuses on the changing demand of the cotton yarn ‘manja’ (a specific kind of processed, traditional cotton strings coated with glass to fly kites) in the Indian market against the high competition of the less expensive Chinese ‘manja’ (flying strings for kites made up of nylon and coated with iron, glass and metallic powder) and also as a result of recent favourable government policies to save the indigenous cotton yarn industry of India. Primary data has been collected from the strategic apex as well as from the middle management of the organization through interviews using open-ended and semi-structured questions. Secondary data such as government reports and news articles have also been used to understand the changing business trend in the cotton yarn industry in India. In a sense, the case focuses on two important factors stimulating organizational changes: (a) global competition affecting local business and (b) changes in government policies. Various organizational change models and theories have been used to understand the context of the case and critical strategies have been identified to effectively implement and manage the organizational change in light of the dynamic environmental upheaval.

Transportation of solids with water as a carrier in the form of slurry through long length pipelines is widely used by many industries and power plants. The transportation of slurry through vertical pipeline is a challenging task and require modification to overcome the pressure loss and power consumption requirements. In this perspective, numerical simulation of three-dimensional horizontal slurry pipeline (HSPL) and vertical slurry pipeline (VSPL) carrying glass beads solid particulates of spherical diameter 440 µm and density 2,470 kg/m3 is carried out. The 3D computational model for horizontal and vertical slurry pipeline is developed for a pipe of 0.0549 m diameter and analyzed in available commercial software ANSYS Fluent 16. The simulation is conducted by using Eulerian multiphase model with RNG k-ɛ turbulence closure at solid concentration range 10 – 20% (by volume) for mean flow velocities ranging from 1-4 ms-1. It is found that the pressure drop rises for both HSPL and VSPL with escalation in mean flow velocity and solid concentration. The predicted pressure drop in VSPL is found to follow the same pattern as with HSPL but higher in magnitude for all chosen velocity and solid concentration range. The obtained results of predicted pressure drop in HSPL are validated with the available experimental data in the literature. A parametric study is conducted with the aim of visualizing and understanding the slurry flow behavior in HSPL and VSPL. Finally, the results of solid concentration contour, velocity contour, solid concentration profiles, velocity profiles and pressure drop are predicted for both the slurry pipelines.

The change of chemical composition because of hydrothermal alteration process is related to the modification on mineralogy and elements mobility. Different alteration conditions could lead to dissimilar geochemical character. This study aims to discuss the alteration effect on trace and rare earth elements composition of an andesite outcrop with hydrothermal alteration in Kaligesing, Purworejo, Central Java Province. Microscopic analysis at Central for Geological Survey was applied to determine the modal mineral composition of the selected samples whilst trace and rare earth elements abundances was measured using Inductively Coupled Plasma – Mass Spectrometry. Plagioclase is the major phenocryst embedded in the fine-grained feldspar and glass groundmass of relatively fresh andesite. On the other hand, sericite, chlorite, epidote, and iron oxide are detected in the altered rock. The more Sr and Rb compositions on unaltered sample exhibit their common existence in plagioclase. The bigger Rb/Sr and the lower Ba/Sr ratios inward to the center of alteration might indicate the more degree of K-bearing mineral formation than Ca-rich mineral alteration. The Ba/Zr escalation and Zr/Y reduction from relatively fresh rock through to the vein of the studied samples are parallel to the previous investigation about andesite alteration. Chondrite-normalized rare-earth elements (REE) pattern of unaltered, altered, and vein samples depicts similar patterns: strong enrichment of Low REE, positive Eu anomaly, and relatively flat high REE. The decrease of Eu anomaly may reflect the reduction of plagioclase modal composition because of alteration and might indicate a reductive alteration state.Keywords: Alteration, andesite, geochemistry, trace and rare earth elements.

With the escalation of war destruction in the area of Osijek, foreign journalists showed interest in the events in eastern Croatia. Due to the growing need to share information in foreign languages, Glas Slavonije hired several employees and announced competitions for associates at the International Press Centre. At first, it was called the Press Club and was located in the Hotel Osijek. After the shelling, the team moved to Osijek's Pothodnik with the task of holding and recording all daily press conferences and giving statements used to inform the domestic and foreign public. The specificity of the Underpass itself is that it is an atomic shelter that housed civilians who remained in Osijek but also refugees who did not have adequate accommodation. They witnessed the events in the Underpass and were the first with the information at the field. The historical method will be used to show the context in which the city of Osijek operated at that time. Equally, an analysis of the content from available sources will be used. Also, six key actors who participated in the work of the International Press Centre in Osijek will be interviewed using the indepth interview method.

We are living in the Multiverse realized in artistic phenomena, ontological states, revolutionary scientific discoveries and assumptions, and other areas of being. For instance, contemporary popular and nongenre literature base on the plural structure of the fictional Universe. Interpersonal conflicts escalated into interworld battles, interplanetary collisions have become the base of the fantasy genre, and hidden parallel dimensions are more and more often collapsing in various forms and interpretations. Despite the fact that multiple Universe structure has a form and appearance of modern artifact, the vision of the Universe as a plurality is a deep and ancient tradition that stretches us back to the Middle Ages and beyond. The Medieval period marks the time of development of typography which made it possible to fix the contemporary worldview in a clearer way. The investigations of Nicholas of Cusa, Giordano Bruno, and other thinkers opened the closed structure of the Universe, assuming an existence of infinity of the worlds. The literature of the Middle Ages represented the worlds’ plurality in a similar way but due to the theological foundations of the epoch. The ideology was based on the duality and contrasting of antonymous principles such as Heaven and Hell, Light and Dark, Spiritual and Physical, Sacred and Sinful. One of the basic values of the Middle Ages lies in the establishing of the divine and spiritual as an “objective” form of reality. The current article reveals the paradigm of the development of the phenomenon of plural worlds in theology, philosophy, modal logic, and literature studies. Also, it highlights the main principles of multiple fictional Universe constructing. Lewis Carroll’s “Alice’s Adventures in Wonderland” and “Through the Looking-Glass” brightly reflect the multiple worlds’ structure. Considering all features of the principles of this plurality, we obtained the conclusions which demonstrate the function of multiple worlds, which not only discovers it in a decorative way but also has an identifying role at the personal level and at the level of the individual world.

COVID-19 pneumonia presents distinctive questions and challenges traditional conventions of management of respiratory failure. The trajectory of recommendations on customary intubation practices has undertaken significant paradigm shifts. This review will discuss the role of high flow nasal cannula oxygenation in mitigating respiratory distress in SARS-COV2 pneumonia and will explore the indices that can aid in the timely recognition of failure of non-invasive respiratory support modalities and escalation to mechanical ventilation. The work of breathing is a valuable yardstick for understanding increasing lung elastance. Quantifying work of breathing, though, has its own unique challenges. This article also discusses the emerging controversial proposals of employing high tidal volumes and low PEEP in mechanical ventilation of COVID-19 pneumonia and will review the key concepts of lung stress and strain and the implications of “static” versus “dynamic” strain in ventilator induced lung injury. It considers the established facts of inducing lung strain with larger dynamic deformations caused by high tidal volumes and the benefit of high PEEP in homogenizing the strain distribution. The review suggests that the isolated ground glass opacities could pose as “stress raisers.” The effects of these regional lung homogeneities in amplifying local and global lung stress are also discussed as well as the benefits of PEEP beyond its effect as a pressure barrier against alveolar filling and its utility in lungs with near normal compliance. A physiologic approach is presented to counter the non-uniform and heterogeneous presentations of this unique disease rather than conforming to rigid protocols. One size probably does not fit all. Keywords: Covid-19, early intubation, patient self-induced lung injury (P-SILI), pendelluft, lung stress/strain, H and L phenotypes, high tidal volume, low PEEP

Abstract Background: Primary treatment results of aggressive B-NHL improved substantially after introduction of chemoimmunotherapy. However, current salvage treatment of primary progressive and relapsed disease is often disappointing with remission rates of < 50%. Lenalidomide (L) has been shown to exert single drug activity in this situation. We therefore investigated the combination of L and a standard salvage regimen (R-DHAP: rituximab, dexamethasone, cytarabine, cisplatinum/carboplatinum) in a phase I/II dose escalation study. Patients and Methods : Younger patients (18 to 70 yrs) with primary progressive or relapsed aggressive B-NHL were included into the study. R-DHAP at standard doses was combined with L. Three 21-day-cycles of L at four dose levels (DL) were planned (DL1: 5 mg, day 1 - 7, cycles 2 and 3; DL2: 5 mg, day 1 - 7, cycles 1 to 3; DL3: 15 mg, day 1 - 7, cycles 1 to 3; DL4: 15 mg days - 6 to 7.. All patients were to receive IV heparin for prophylaxis of thromboembolic events. Mobilization of hematopoietic stem cells was attempted after cycle 2 in patients scheduled for autologous stem cell transplantation. Primary endpoint point was the maximum tolerated dose (MTD) of L in combination with R-DHAP. Death due to any cause, prolonged leuko- and thrombopenia (> 28 days) as well as any organ toxicity grade 4 with exception of infection were considered dose-limiting. Escalation to the next DL occurred after complete analysis of > 18 treatment cycles failed to show prohibitive toxicities. Results: From 11/2010 to 10/ 2011 33 patients were included (28 pts DLBCL, 2 DLBCL / Burkitt-like, 1 DLBCL / FL grade III, 2 FL grade III). Median age was 52.9 years (range: 24 - 70). Seventy-seven cycles combining L with R-DHAP were given. Ten patients did not receive all 3 cycles of therapy due to progressive disease (6 pts), hematological toxicity (3 pts) and withdrawal of informed consent (1 pt). Ten patients experienced a severe adverse event (SAE): two cases of renal failure, two cases of arterial embolism of the lung, two cases of prolonged thrombocytopenia, and four infections .. At dose levels 1 to 3 no dose limiting toxicity occurred. With 17 treatment cycles at DL 4 two patients experienced prolonged cytopenia and two other patients failed to mobilize stem cells. Therefore, treatment at DL 4 was stopped and 7 additional patients were treated at DL 3: no further dose-limiting toxicities were observed. Seventeen of 31 evaluable pts (55%) achieved a remission (12 CR/CRu, 5 PR). At time of this analysis, 19 pts (58%) are alive at a median observation time of one year. Conclusion: The combination of L with R-DHAP was feasible and safe up to DL 3 (15 mg of L, days 1 – 7 of max. 3 treatment courses). In contrast, administration of L during the time of recovering hematopoiesis (DL 4) resulted in prolonged thrombocytopenia and failures to mobilize stem cells. The combination of L at DL 3 and R-DHAP at the MTD gave promising results and will be evaluated in the phase II part of this study (DSHNHL-R6). Disclosures Glass: Celgene: Consultancy, Honoraria, Research Funding; Roche: Consultancy, Honoraria, Research Funding; Amgen: Consultancy, Honoraria, Research Funding. Off Label Use: Lenalidomide for treatment of aggressive B-NHL. Truemper:Celgene: Consultancy, Honoraria; Roche: Consultancy, Honoraria. Dreyling:Celgene: Consultancy, Honoraria; Roche: Consultancy, Honoraria. Schmitz:Celgene: Consultancy, Honoraria; Roche: Consultancy, Honoraria.

Background: The purpose of this study was to evaluate the effectiveness of limited-resource hospitals in managing mild and moderate hospitalized cases of COVID-19 with comorbidities and in preventing their progression to severe illness. Methods: Data were obtained from 88 moderate COVID-19 patients with comorbidities who were admitted to limited-resource hospitals. The data were classified into several parts: comorbidities, chronic medication before hospital admission, symptoms of COVID-19 before and during hospitalization, clinical features, laboratory findings on hospital admission, complications during hospitalization, as well as worst laboratory values during hospitalization, hospital stay, and outcomes. The clinical features, laboratory results, type of oxygen therapy used, and the final treatment outcome were all evaluated to assess for any potential relationship. Results: All patients were alive upon discharge. Before admission, the majority of patients (60.2%) received COVID-19 treatment, and the average hospital stay was 12 days. The most common symptoms were fever (88.7%), cough (95.5%), shortness of breath (90.9%), myalgia (84.1%), confusion (63.6%), headache (62.5%), sore throat (88.7%), rhinorrhea (17%), chest pain (58%), diarrhea (19.3%), nausea and vomiting (38.6%), anosmia (62.5%), as well as dysgeusia (64.8%). Based on chest radiograph or computed tomography (CT) scan, 9.1% of the patients had unilateral pneumonia, 90.9% had bilateral pneumonia, and 96.6% had multiple mottling and ground-glass opacity. Age was found associated with a significant increase in headache (p = 0.005), rhinorrhea (p = 0.013), chest pain (p = 0.007), and the need for positive airway pressure (p = 0.008). Between pre- and post-hospital admissions, there was a significant increase in lactate dehydrogenase and ferritin but a decrease in platelet, D-dimer, hemoglobin, lymphocytes, neutrophils, and total leucocyte count (p < 0.001). There was a significant association between hospital stay and D-dimer level (p = 0.05). Conclusion: Limited-resource hospitals in Egypt were efficient in managing mild and moderate hospitalized cases of COVID-19 with comorbidities. Many of these cases did not escalate to severe illness and were all alive upon discharge. Early management of COVID-19 tends to delay the disease progression to severe illness and improves patients’ chances of survival. Treating COVID-19 or using oxygen therapy at home can also delay the need for hospitalization in mild or moderate cases.

e16183 Background: Significant advances have been made in the management of hepatocellular carcinoma (HCC) with the introduction of locoregional therapies including Theraspere, a treatment utilizing glass microspheres coated in radioactive yttrium-90 (Y-90). Hepatocyte exposure to Y-90 results in immunogenic cell death and tumor-specific immunity, suggesting this treatment may synergize with checkpoint inhibitor therapies to improve response rates and disease control. This abstract presents the results of combination therapy with Y-90 and NIVO in patients with advanced HCC. Methods: This study is a prospective, open-label, phase I clinical trial of NIVO plus Y-90. Eligible patients were diagnosed with advanced HCC (CP A6-B7) and were not transplant or resection candidates. Patients were treated with Y-90 following institutional procedures. The NIVO dose was escalated in a standard 3+3 format. Patients at DL1 began therapy 4 weeks after Y90 administration and received 80 mg of NIVO every two weeks. Patients at DL2 began therapy 2 weeks after Y90 administration and received 240 mg of NIVO every two weeks. The primary objective was to determine a maximum tolerated dose (MTD) of NIVO in combination with Y-90 therapy. Secondary objectives included objective response rate (RECIST v1.1), toxicity evaluation, disease control rate and progression free survival. Results: Fifteen patients were registered to DL1, 8 received Y90 and 6 were eligible and received NIVO. Twelve patients were registered to DL2, 9 were eligible for Y90, 7 were eligible for NIVO and 6 completed therapy. Patients that did not complete therapy either withdrew consent, had a decline in performance status or a worsening in hepatic function. Fifty-nine percent of patients were male (N = 10), 82% were Caucasian (N = 14), 12% were Hispanic or Latino (N = 2) and 6% were African American (N = 1). Of the patients who received both Y90 and NIVO, 82% patients were CP B7. The MTD of NIVO is 240mg given 2 weeks after Y90. The disease control rate was 82% (N = 9/11 with stable disease). Forty-six percent of patients (N = 6) had a decrease in circulating levels of AFP, the most significant change was a decrease from 11,080 ng/mL to 260 ng/mL following cycle 2 of NIVO and normalization by cycle 4 of NIVO. The most common toxicities in both treatment groups were Grade 1-2 elevations in ALT/AST, frequency of these side effects was not higher than expected given this patient population. Conclusions: Therapy with Y-90 and NIVO in advanced HCC was tolerable and a maximum tolerated dose of NIVO was established. Combination therapy resulted in a clinical benefit rate of 82%, with 9 patients achieving stable disease. In a notably sick patient population with advanced CP scores this combination offered good disease control without increasing the adverse event rate. Study was stopped early due to lack of funding. Clinical trial information: NCT02837029.

1088 Background: There is limited data about the role of isolated central nervous system (CNS) metastasis (mets) in patients with breast cancer (BC), since prior studies evaluated BC patients with CNS plus visceral mets. Furthermore, though Black race is associated with worse BC outcomes, there are few studies on CNS mets that predominantly included racial and ethnic minorities in their cohorts. Our study compares overall survival (OS) in BC patients with CNS involvement with and without visceral mets in an underrepresented patient population. Methods: This is a retrospective case series study. We used Montefiore’s Clinical Looking Glass software to identify patients. Inclusion criteria were females age ≥18 years at our institution with the diagnosis of BC and CNS mets between 3/31/1997 to 3/31/2019. Chart review was conducted to obtain clinical-pathological features, including date of diagnosis, treatment, clinical course, and survival status. Patients with BC and CNS mets were divided into two cohorts, those with additional mets limited to bone and lymph nodes but without further visceral spread (CNS-NV), and those with CNS mets plus visceral mets (CNS-V). Kaplan-Meier methods were used to analyze the median OS. Results: Our study included a high proportion of underrepresented minorities (n=177); 46.3% were Black, 10.7% were White, and 34.5% were Other Race; besides, 28% were Hispanic. Mean age at diagnosis of CNS mets was 58 years (SD = 12.9). 62.1% were estrogen receptor (ER) and/or progesterone receptor (PR) positive, 27.1% were HER2 positive; and 19.8% were ER, PR and HER2 negative. Mean number of chemotherapy and endocrine therapy lines before CNS mets were 2 (IQR = 1-2) and 1 (IQR = 1-2), respectively. CNS-NV and CNS-V cohorts included 35 and 142 patients, respectively. Patients with CNS-NV had longer OS than CNS-V (2118 vs. 1120 days, p=0.02). Further subgroup analysis for group CNS-NV was performed based on treatment modality. In this cohort, OS was not significantly different between patients who did and did not receive chemotherapy (n =35, mean OS 1509 vs. 960 days, p = 0.49). In addition, OS was not significantly different between patients who received and did not receive endocrine therapy (n = 24, mean OS 857 vs. 1394 days, p = 0.4). Finally, OS did not significantly differ between patients who did and did not receive anti HER2 treatment (n = 11, 1753 vs. 849 days, p = 0.15). Conclusions: Minimal research has been conducted on breast cancer patients with CNS mets and distal involvement limited to the bones or lymph nodes. In a heterogenous racial and ethnic population, patients with BC and CNS mets have prolonged OS if the extent of distal involvement is limited to the bones or lymph nodes, compared to those with visceral mets. More research with larger sample sizes is needed to confirm our findings, which may help to de-escalate and tailor treatment for patients with CNS mets.

BackgroundFor patients with microsatellite stable or mismatch repair proficient (MSS/pMMR) metastatic colorectal cancer, immune checkpoint blockade does not work. Strategies are being devised where immunotherapy is being combined with other novel agents or radiotherapy to enhance PD-L1 expression, alter the tumor microenvironment (turning ‘cold’ tumors ‘hot’) and/or release neoantigens to enhance efficacy of immune checkpoint blockade. We chose Yttrium-90 radioembolization (Y90-RE) in combination with a fixed dose of of immunotherapy given pre- and post-Y90-RE as a treatment strategy to be examined as part of a clinical trial for those patients with metastatic colorectal cancer who have liver-predominant or liver-only metastases.MethodsThis clinical trial will be conducted as a single-center, open-label, Phase I/2 trial to evaluate the feasibility and safety of Yttrium-90 radioembolization (Y90-RE) in combination with a fixed dose of of immunotherapy (durvalumab - 750 mg) in subjects with liver-predominant, metastatic colorectal cancer (mCRC), which is mismatch repair proficient/microsatellite stable (pMMR/MSS). As noted on clinicaltrials.gov, the purpose of this clinical trial is to find out more about the side effects of immunotherapy with a form of radiation treatment for the cancer in the liver called Yttrium-90 RadioEmbolization (Y90-RE). An immunotherapy drug, durvalumab, will be given intravenously every 2 weeks. We are studying what doses of durvalumab are safe for people in combination with this form of radiation treatment. Patients in this study will receive durvalumab, which is experimental and not approved by the U.S. Food and Drug Administration (FDA) for metastatic colorectal cancer. Microscopic radioactive particles (TheraSphere®) will be used for radioembolization to deliver the Y90 drug to the liver.The number of doses of the immunotherapy drug (range: 2 to 5) will depend on the cohort patients are assigned to. There is no placebo. Everyone on the study is treated with immunotherapy alongside the Y90-RadioEmbolization (figure 1). Primary objective is to look at safety and feasibility of this approach. Once the recommended phase-2 dose is determined through an acceleration titration design, a total of 18 patients are being planned to be treated on this study at the University of Iowa Holden Comprehensive Cancer Center. The study has strong correlational components from a tumor microenvironment (pre- and post-biopsies) as well as ‘liquid biopsies’ - circulating tumor DNA (ctDNA) testing already integrated into the protocol. This would provide an opportunity to understand better the changes to the tumor microenvironment from such an approach in addition to understanding mechanisms of immune evasion/resistance.Abstract 331 Table 1Dose escalation cohort of durvalumab.ResultsN/AConclusionsN/ATrial RegistrationNCT04108481ReferencesLe DT, Uram JN, Wang H, et al. PD-1 Blockade in Tumors with Mismatch-Repair Deficiency. The New England Journal of Medicine 2015; 372:2509–20.Chew V, Lee YH, Pan L, et al. Immune activation underlies a sustained clinical response to yttrium-90 radioembolisation in hepatocellular carcinoma. Gut, 2018 Feb 13; doi: 10.1136/gutjnl-2017-315485Demaria S, Golden EB, Formenti SC. Role of local radiation therapy in cancer immunotherapy. JAMA Oncology 2015; 1(9):1325.den Brok MH, Stutmuller RP, van der Voort R, et al. In situ tumor ablation creates an antigen source for the generation of antitumor immunity. Cancer Res 2004; 64:4024-9.Dewan MZ, Galloway AE, Kawashima N, et al. Fractionated but not single-dose radiotherapy induces an immune-mediated abscopal effect when combined with anti-CTLA-4 antibody. Clin Cancr Res 2009; 15(17):5379–88.Hazel Gav, Heinemann V, Sharma NK, et al. SIRFLOX: Randomized Phase II Trial Comparing First-Line mFOLFOX6 (Plus or Minus Bevacizumab) Versus mFOLFOX6 (Plus or Minus Bevacizumab) Plus Selective Internal Radiation Therapy in Patients with Metastatic Colorectal Cancer. Journal of Clinical Oncology, 2016; 34:1723–31.Hickey R, Lewandowski RJ, Prudhomme T, et al. Y90 radioembolization of colorectal hepatic metastases using glass microspheres: safety and survival outcomes from a 531- patient multicenter study. J Nucl Med 2016; 57(5): 665–71.

The quantity of municipal solid waste (MSW) generation is escalating at an alarming rate with every passing year alongside the modernization of our economy. Unfortunately, the majority of this waste remains uncollected or ends up in open dumping and followed by uncontrolled burning. Citing the deep-rooted consequences, open dumping should be absolutely abandoned and scientific interventions should be aggressively exercised to reclaim the municipal brownfields. The present research work undertook the judicial task of assessing the comparative feasibility of biomining and scientific capping as a technology selection for reclamation of about a decade old 120 million tons of waste chunk laying at Jawahar Nagar dump yard. Primary dump samples were collected from various locations, considering depth as a variable. While leachate and groundwater samples were collected from Malkaram lake and preinstalled borewells receptively. Additionally, the ambient air quality and noise level also been ascertained within the buffer zone. The blended representative solid sample was segregated using a 70 mm mesh size trommel into organic and inorganic fractions. The organic fraction was composted using a lab-scale aerobic static pile composting (ASPC) while the trommel reject was processed as refuse derived fuel (RDF). Evidently, the compost lagged quality and depicted nutrient deficiency. While the burning of RDF produced siloxane gas, significantly due to elevated silicon level in the primary waste. Furthermore, due to the prolonged leaching tenure and seasonal dilution, the concentration of legacy leachate was relatively weaker. Borewell samples collected from a depth of 20 feet also portrayed minor contamination up to 500 meters horizontal radius. The issue of leachability can solely be resolved with the capping of the existing dump and the end product quality derived from the biomining process is highly questionable. Thus, handling such large quantity capping is a befitting option over biomining for Jawahar Nagar dumpsite. INTRODUCTION Presently, in India due to rapid urbanization and industrialization, the generation of MSW has been increasing tremendously and also expected to continue a similar trend in the future (Scott, 1995; Bhat et al., 2017; Sethurajan et al., 2018; Sharma et al., 2018). Annually, the comprehensive urban MSW generation in India is more than 62 million tons. Metro cities are the mammoth contributor of the entire chunk and waste production had already reached an alarming figure of 50,000 tonnes/day. While the waste generation from the tier 2 cities is also rigorously escalating and presently contribute up to 20,000 tones/day (Sharma et al., 2018). A study conducted by the central pollution control board (CPCB) revealed MSW generation in India is increasing at a distressing rate of 5 % per annum with a sharp escalation in the quantities of domestic hazardous waste (Sharma et al., 2018). With major financial constraints, inefficacy of collection, treatment, and disposal incurs further reasons to worry. So far India has miserably failed to set up wholesome source segregation and collection method. Presently, the country spends more than 60% of its annual waste management budget only in collection. Besides, only 20% or less of the collected materials are scientifically handled and treated. Citing the statistics, it is evident that the majority of the MSW is simply gets dumped on the low laying grounds located somewhere on the outskirts of the cities. The precipitation, infiltration, surface water runoff, bird menace, rodent interference etc. triggers the vulnerability of waste and leads to mal odor, ground and surface water contamination, human and environmental health deterioration (Jayawardhana et al., 2016). Further, the perseverance of the inorganic and inert fractions leads to soil contamination, poses a fire threat, and also may incur carcinogenicity and acute toxicity among the animals (Mir et al., 2021). There are numerous techniques for the reclamation and remediation of the dumpsites, includes processes such as capping and closure, in-situ vitrification, sub-surface cut-off walls, and waste biomining (Chakrabarti and Dubey, 2015; Thakare and Nandi, 2016). Waste biomining is a stable way to get rid of the entire range of problems associated with open dumping and reclaim valuable land (Kaksonen et al., 2017). There are several instances including reclamation of Mumbai Gorai dump yard by IL & FS Environment, 70 – 80 years old 12,00,000 tons of dump clearance by Nagar Nigam Indore within a minute span of 3 years and many more. But the process of biomining is highly sensitive and case-specific. The success of the process solely depends on factors such as characteristics of the waste, efficacy of the effective microorganism culture, acceptability of the processed end product at the local market etc. (Jerez, 2017; Banerjee et al., 2017; Venkiteela, 2020). Contrarily, though the scientific capping is not an end-to-end solution but still advisable in the cases where the quantity of waste is gigantic, land scarcity is prevalent, no nearby industries to consume the end products etc. Mehta et al. (2018) have also supported the above claim based on the assessment of locations specific MSW dump reclamation case studies. While in another Nagpur-based case study conducted by Ashootosh et al. (2020) reported the superiority of the biominingprocess over simple land capping due to the favorability of the local conditions. Capping eliminates the environmental interference and thereby reduces biosphere contamination and leachate generation. Further, it captivates rodent and vector breeding and thereby curtails the spreading of communicable diseases and improves aesthetics. But right consolidation through compaction and execution is utmost necessary in the above case. As non-compaction and faulty sloping will easily lead to heavy settlement and slope failure (Berkun et al., 2005; Al-Ghouti et al., 2021). The present study has been pursued with the primary objective to run a techno-commercial assessment between scientific capping and biomining. While the secondary objective was to ascertain the level of contamination and propose mitigative measures. MATERIALS AND METHODStudy Area Spanning over 350 acres of a precious piece of land at the outskirts of Hyderabad city, Jawahar Nagar dumping yard was brutally utilized by the Greater Hyderabad Municipal Corporation (GHMC) for open dumping for a prolonged tenure of 10 years. It housed nearly 12 lakh metric tons of heterogeneous solid and domestic hazardous waste and continues polluting until 2015, until the Ramky group was offered to cap the legacy dumping and scientifically handle the site. The present study has been facilitated at Hyderabad Municipal Solid Waste Limited, formerly known as Jawahar Nagar dump yard to analyze and assess the feasibility of bio-mining as handling and management alternate to the existing practice of scientific capping. The epicenter of processing and disposal facility is lying approximately on the cross-section of 17°31'24.45"N and 78°35'23.37"E. As per the contract, the comprehensive legacy dumping to be capped in three phases over about 150 acres of area and Ramky has significantly entered the phase two of the operation only within a span of five years by successfully capping more than half of the legacy footprint. Sampling Methodology The waste pile was divided into three layers namely, base, middle, and top. A uniform amount of sample was collected from the successive layers of all five different corners which cover north, south, east, west, and central of the garbage pile. Sampling inspections were performed using a manual auger besides large samples were collected using a JCB excavator. The top six-inch layer of the pile was removed to avoid any contamination while collecting the samples and 5-10 kg of sample was collected from each of the locations. Further, intermediate and bottom layer samples were collected by digging a 500 mm diameter hole through the heap. A composite was prepared by a homogenized blending of all the fifteen grub samples. The blend was distributed into four equal quadrants and the top and bottom quadrants were eliminated diagonally while the left-over quadrants were mixed thoroughly. This process was repeated until a sample of the required bulk of 20 kg is obtained. Surface and subsurface water samples from borewell were collected in and around the facility. Piezometric monitoring borewells located near the landfills were utilized for the subsurface sample collection. While a rainwater pond turned leachate lake named Malkaram was determined as the primary source for leachate collection. Buffer samples were collected from Ambedkar Nagar, the nearby colony exiting at a distance of only 300 meters. Lab-scale Experimentation The representative sample was characterized for composition and further screened through a 70 mm mesh size trommel. The trommel permeate was considered as the organic fraction while the reject was mostly inorganics and inert. The organics were subjected to ASPC. The quantity of the air required is arrived using the method delineated below (Figure 1). MSW Pile size: 2m x 0.5m x 0.5m Volume of pile: 0.5 m3 Average Density of MSW: 620 Kg/m3 Weight of pile: 310 Kg Nitrogen required for matured compost: 9300 mg/kg dry : 9300 X 310 mg : 2.88 x 106 mg : 2.88 Kg Total air required: 2.88 x 100/76 [as Nitrogen in air is 76% by weight] : 3.79 Kg of dry air : 3.79/1.225 m3 [@ 15 deg C density of air 1.225 kg/m3] : 3.1 m3 This air is to be supplied for 100 min / day for 0.5 m pile Air flow rate required: 3.1 x 60/100 = 1.86 m3/h (for practical purpose a flowrate of 2 m3/h was maintained). The maturation period was considered as 28 days and post-maturation, the stabilized material was further cured for 24 hours and screened using 12 mm and 4 mm trommel respectively to obtain the desired product quality and particle size. Whereas, the trommel reject was evenly spreader on the copper trays and dried in an oven at 1050C for 2 hours. The dried material was micronized to the size of 50 mm or below using a scissor and inert such as glass, sand, stone etc. were segregated manually (Mohan and Joseph, 2020). Concurrently, a bench-scale capped landfill prototype was built using the below-mentioned procedure to evaluate the factors such as settlement and slope stability. A 30 mm thick low permeable soil was laid on the top of the waste, followed by a 60 mm layer of compacted clay liner (CCL). Each join between successive liner material was closely monitored. A 1.5 mm thick HDPE liner was placed on the top of the CCL. A 285 GSM geotextile membrane was placed as the successive above layer followed by a 15 mm thick drainage media layer. A further layer of geotextile membrane was placed on top of the drainage media for better stabilization, grip, and strength. The top vegetative soil layer of 45 mm thickness was laid off on top of the geotextile media and St. Augustine grass was rooted (Cortellazzo et al., 2020; Ashford et al., 2000). 2.4 Sample Analysis pH, Electrical Conductivity (EC) and Turbidity of the samples were analyzed using pH, EC-TDS, and Nephelometer of Mettler Toledo. The pH meter was calibrated with the buffer solution of 4.0, 7.0 & 9.12 at a controlled temperature. EC-TDS meter was calibrated with 0.1 M KCL having 12.8 mS/cm of conductivity. Nephelometer was calibrated with Formazine solution of 10 & 100 NTU. Total Dissolved Solids (TDS), (mg/L) was performed using the gravimetric method at 1800C in the oven. Titrimetric parameters such as Total Alkalinity as CaCO3 (mg/L), Total Hardness as CaCO3 (mg/L), Chloride as Cl- (mg/L), Calcium as Ca2+ (mg/L), Residual Free Chlorine (RFC), (mg/L) were analyzed using APHA (American Public Health Associations) method, 23rd Edition, 2017. Total Kjeldahl Nitrogen (mg/L) and Ammonical Nitrogen (mg/L) were performed through distillation followed by titration with H2SO4 as a titrant. Sulphide as S2- was done with the Iodometric method after distillation. Each titrimetric parameter was analyzed in triplicate after standardizing the titrant with required reagents and crossed checked by keeping a check standard. Sodium as Na (mg/L) and Potassium as K (mg/L) were performed using Flame Photometer. The photometer was calibrated with different standards from 10 to 100 (mg/L) standard solutions. The leachate sample was diluted enough to get the value within the standard range and cross-checked with check standards at the same time. Chemical Oxygen Demand (COD), (mg/L) was performed using the open reflux method for 2 hours at 1500C in COD Digestor. Biochemical Oxygen Demand (BOD), (mg/L) was performed using the alkali iodide azide method for 3 days. The samples were kept in a BOD incubator at 270C for 3 days. It was kept in duplicate to have a check on quality control. Sulphate was analyzed by the gravimetric method instead of turbidimetric or through UV-Visible spectrophotometer as its concentration was found more than 40 mg/L. Nitrate as NO3- was analyzed after filtration at 220-275 nm, while Hexavalent Chromium as Cr6+ was analyzed at 540 nm in the UV-Vis. Parameters like Cyanide as CN-, Fluoride as F-, and Phenolic Compounds were gone through a distillation process followed by UV-Vis. The distillation process ensures the removal of interferences presents either positive or negative. For the parameters like Total Iron or Ferric Iron, the samples were digested properly with the required reagents on the hot plate before analyzing in UV-Vis. For the metal analysis the water samples were digested at a temperature of 1000C using aqua regia as a media. The samples were digested to one-fourth of the volume on a hot plate. The recommended wavelengths as per APHA 3120 B were selected for each of the metals. The standard graph was plotted for each of the metals before analysis and crossed checked with the check standard at the same time. Parameters such as bulk density and particle size were performed through the certified beaker and sieve. The percentage of moisture content was estimated using the oven by keeping the compost sample for 2 hours at 1050C. C/N ratio was estimated through CHNS analyzer keeping sulfanilamide as a check standard. The analysis was performed by extracting the desired component in the desired solution prescribed in the method followed by converting the same from mg/L to mg/Kg. RESULTS AND DISCUSSION An exhaustive bench-study has been pursued and real-time samples were collected and analyzed for all possible parameters to determine the pros and cons attributed to both processes. The investigation begins by collecting the samples and concluded by impact assessment studies inclusive of the buffer zone. Both solid, liquid, and gaseous samples were precisely investigated to opt for the best solution. A detailed finding of the investigation is summarized below. Primarily, the representative solid sample was characterized through a manual separation process and the results are portrayed in Figure 1. Compost Characterization ASPC of the organic fraction has resulted in a recovery of 46.7% of the initial load. While 53.3% of the influent mass were inert and barely degradable fraction contributes to reject, the rest 4.1% is miscellaneous process loss. The processed compost was extensively analyzed including for metal contamination and the same is tabulated in Table 1. The value of C/N ratio, OC, TN, K2O, P2O5, and NPK evidently portrays the shortcoming in terms of nutrient availability. Though it is highly enriched in organic carbon and thus the same can be effectively utilized as a soil preconditioner. Ayilara et al. (2020) also reported a similar finding, where the city compost sourced from MSW lagged major plant nutrients. RDF Characterization Processed trommel rejects constitute cloth, rexine, leather, jute, paper, plastics, coir and other inert contributed to RDF. The fraction of inert was as high as 37.2% of the overall RDF mass and it mostly constituted glass and sand. The combined weight of sand and glass fragments contributed 73.5% of the total inert, while the rest was stone and small brickbats. The higher level of silicon associated with the presence of glass and sand yielded siloxane and triggered the possibility of kiln corrosion. A detailed RDF analysis report is enclosed in Table 2. The values explicitly portray the quality of RDF is moderately lower and higher salts concentration is extremely prevalent. With relatively lower NCV and such high salt concentration, the above specimen will certainly pose a corrosion threat to the kiln and shall be either neglected as kiln feed or can be utilized after dilution with Grade III RDF quality. Further, such high ash generation will also induct high transportation and landfill charges. Leachate Characterization The Malkaram leachate lake is the end result of prolonged, slow, and steady mixing of the legacy leachate through the existing fissure cracks in the sheath rock bottom profile. Apparently, the concentration of leachate is significantly lower due to the dilution. Samples were analyzed in triplicates and the mean value is tabulated here in Table 3. The metal concertation and rest of the parameter values are well within the secondary treatment influent range, except for TDS. Thus, a modular aerobic biological treatment unit such as moving bed biofilm bioreactor (MBBR) or membrane bioreactor (MBR) would be a well-suited pick. However, a reverse osmosis (RO) system needs to be installed to get rid of the high TDS content. The permeate of RO can be reused back into the system. Whereas, the reject can be converted into dried powder through forced evaporation mechanisms. The higher concentration of salts in RDF collaterally justifies the elevated TDS level in leachate. In a leachate impact assessment study performed by El-Salam and Abu-Zuid (2015) the reported BOD/COD ratio of 0.69 is greater than double the value of 0.301 reported in Table 3. Though the difference in both the values are quite high, it is relatable and justifiable by the huge age difference of the source waste. The primarily characterized data is of a fresh leachate generated from regular MSW, while the later one is from a decade old waste that barely has any unstabilized organic content. Groundwater Contamination The obvious reason for downward leachate infiltration and osmotic movement facilitates groundwater contamination. Both surface and subsurface water samples were collected within the dump yard and the buffer zone and analyzed using the standard methods. The results are portrayed in Table 4. The slightly alkaline pH of the borewell sample is an indication of the ongoing anaerobic process. The dissolved oxygen value of 3.5 mg/L further validates the correlation. Higher TDS and hardness values are self-indicative of elevated salt concentration in source waste. Eventually, the same interfered with the RDF quality. Positively in the case of all the parameters, a successive decrement in pollution concentration has been spotted from dump ground towards the buffer zone. In a similar study conducted by Singh et al. (2016) at Varanasi, Uttar Pradesh the reported concentration of the parameters is significantly higher than reported in Table 4. The basic reason behind variation is the dissimilarities of the local soil profile. The sandy and clay loam soil profile of Varanasi allows a greater rate of percolation and infiltration. While the bottom sheath rock profile at Jawahar Nagar permits the only a minute to little percolation rate. The difference in percolation rate is directly correlated to the concentration levels in this case. Contrarily, Kurakalva et al. (2016) have reported much-elevated pollutant concertation both in ground and surface water for a study conducted at the same site in 2016. The higher concentration is relatable to the fact of the non-closure of the open dump back then. Capping activity had at Jawahar Nagar gained its pace 2018 onwards and capping for the primary section of 70 acres got concluded only during mid of 2019. Due to the decrement in runoff and percolation, the quality of both surface and subsurface water has improved drastically. Impact Assessment The odor and groundwater contamination are two of the primary issues that triggered a massive public agitation initially. The root causes of both the issues are identified as rainwater percolation and anaerobic digestion respectively. Eventually, the completion of the capping process would resolve both the problems effectively. Other non-tangential impacts include nausea; headache; irritation of the eye, nasal cavity, and throat; diarrhoeal diseases; vector-borne disease, cattle toxicity etc. Scientific capping can easily cater as the wholesome solution for all (Cortellazzo et al., 2020). Yu et al. (2018) had performed an extensive study to comprehend the relativity of respiratory sickness and MSW borne air pollution. The study made a couple of dreadful revelations such as gases released due to the anaerobic digestion of MSW such as methane, hydrogen sulphide, and ammonia incur detrimental impact on Lysozyme and secretory immunoglobulin A (SIgA). While SO2 was reported as the lung capacity and functionality reducer. Further, a gender-specific study executed by the same research group revealed, air pollution impacts more severely on male children than the female and retards immune functions. Presently, the area of 351 acres has been developed as Asia’s one of the largest state of the art municipal solid waste processing and disposal facility by Ramky Enviro Engineers Limited. This ensured zero dumping and no further environmental interventions. As legal compliance, the facility monitors the quality of groundwater and ambient air quality in and around the facility on monthly basis to assure the biosafety. The variation in concentration of various monitoring parameters between 2012 to 2020 is summarized in Figure 2. The concentration of each of the parameters are showcased in ppm and a standard equipment error was settled at 3% for respirable dust sampler and multi-gas analyzer (Taheri et al., 2014). Despite all parameter values have gradually increased except for methane, the facility still managed to maintain them well under the regulatory limits. The decrement in methane concentration is directly correlated to the practice of aerobic composting and aeration-based secondary treatment that prevented the formation of the anaerobic atmosphere and henceforth methane generation. While for the rest of the parameters the increment in values is quite substantial and predictable due to the sudden escalation in MSW generation in the past decade in correlation with Gross domestic product (GDP) enhancement. The observed and interpreted impacts due to the elevated pollutant level are in-line with the georeferenced findings reported by Deshmukh and Aher (2016) based on a study conducted at Sangamner, Maharashtra. CONCLUSION The study critically analyzed and investigated every techno-environmental and socio-economic aspect correlated to open dumping. The bench-scale experimentation revealed the efficiency of the single liner scientific capping is fair enough to eliminate any further rainwater infiltration, however, it has no control over the generation of leachate due to the inherent moisture. Internal moisture related issue was anyhow compensated with pertinent compaction prior to dispose of the waste. Contrarily, both the products derived through the biomining process namely, compost and RDF lagged quality due to scantier nutrient content and higher salt and silicon content respectively. Besides, impact assessment studies concede the pollutant concentration in groundwater in and around the plant has drastically diminished post-July 2019 due to the partial completion of waste capping. It also abetted lowering the dust and odor issues relatively in the surrounding. ACKNOWLEDGMENT The authors would like to sincerely acknowledge GHMC, Hyderabad Integrated Municipal Solid Waste Limited, and Ramky Enviro Engineers Limited for enabling us to pursue the sample collection and other necessary onsite activities. Further, the authors would like to register profound acknowledgment to EPTRI for supporting us with the essential experimental facilities. REFERENCES Sharma, A., Gupta, A.K., Ganguly, R. (2018), Impact of open dumping of municipal solid waste on soil properties in mountainous region. 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A dearth of women exists in the upper echelons of ballet choreography. Both academia and the popular press have noted and documented this phenomenon. For instance, in “Breaking the Glass Slipper,” New York Times journalist Michael Cooper recently noted, “When it comes to choreography, at least at most major companies, ballet remains overwhelmingly a man’s world” [1]. Similarly, critic Luke Jennings has noted, “In professional ballet companies, faced with heavier workloads and greater competitive stress than their male colleagues (not to mention the exigencies of pointe work), few women have the time, energy or inclination to consider choreography” [2]. And yet many arguments (such as Jennings’) as to why women do not become choreographers reflect back on women in ballet – claiming a lack of interest, ambition, or even ability – and fail to acknowledge the structural and systemic inequities that promote men in ballet at the expense of their female peers. Even women choreographers themselves tend to claim that women do not become choreographers because of their own choices, constraints, etc., instead of citing systemic structures of unequal opportunity [3]. Failing to acknowledge institutional inequality places the fault of discrimination upon its victims, and ignores the gendered hierarchy within ballet institutions. As an alternative, situating ballet choreography in the context of sociological theory can shed light on how institutions promote token men in ballet to artistic leadership positions, and may help disprove the notion that women do not become choreographers simply because of cultural reasons that relate back to the women themselves.

Purpose and objectives: The 'glass escalator' phenomenon holds that men in female dominated professions like nursing can rise quickly to the top. However, they can also suffer discrimination. This phenomenon is widely recognised in advanced countries. Trained, mostly female nurses have been leaving Ghana in droves for greener pastures abroad, particularly the US and UK, with serious consequences on the health delivery service in Ghana. Conversely, increasing numbers of males are joining the nursing profession. It examines whether male nurses in Ghana enjoy any hidden advantages, and if so, what makes the men successful (even with their limited numbers) in a women-dominated field and what the implications are for both male and female nurses. Problem investigated: The article explores gender-based discrimination and the phenomenon of the glass escalator in a developing country context. It examines the position of male nurses in Ghana; the type, nature and extent of advantages they enjoy and any discrimination they face in a female-dominated field. Methodology: An in-depth cross-sectional questionnaire was employed. A thematic and cluster analysis of findings was executed, with data captured using Statistical Package for Social Sciences (SPSS). A combination of descriptive accounts as well as summary statistics using chi-square and correlations was used to examine the findings. Findings and implications: This paper reports the findings of an empirical study that show that male nurses neither suffer gender-based discrimination nor occupy the top positions in the nursing field. It also found that a majority of males do not want to leave the profession even though they feel they are assigned more responsibilities and are sometimes passed over for promotion.Originality: Whilst representing a modest contribution to research in gender-based discrimination in nursing, this paper is a first attempt to investigate the phenomenon in a Ghanaian context, with the dearth of relevant research in an area of increasing importance in Ghana serving as a huge fillip.

Abstract Past research has shown that minority men are more likely than others to enter female-dominated occupations, but less is known about the quality of their jobs in these fields in contrast to other employment options. We use the 2004 and 2008 panels of the Survey of Income and Program Participation (SIPP) to examine whether the female-dominated industries of education and health care produce better job quality in terms of wages, benefits, hours, and job security for working-class men relative to other industries, with emphasis on differences by race-ethnicity. We find that although workers in the education and health care industries fared better during the Great Recession compared to those in other industries, effects for wages, health insurance, hours, and layoff for working-class Men of Color were substantially lower compared to those of White men. We find strong evidence of a racialized glass escalator, but also a racialized safety net in the care sector post-recession: the health care and education industries provide better job quality for White men than for Men of Color, though they are less likely to be in these jobs, and these sectors were more protective of White men as compared to minorities during the recession.

RESUMO Este artigo analisa diferenças entre mulheres e homens na ocupação da carreira docente, área considerada feminina, mas cuja carreira demonstra diferenças de gênero. Noções como a divisão sexual do trabalho de Helena Hirata e Danièle Kergoat (2007) e a existência do glass escalator de Christine Williams (1992, 2013, 2015) em carreiras feminizadas levam ao questionamento sobre quais diferenciações estão presentes na área da educação. A partir de dados quantitativos e entrevistas realizadas com diretoras e diretores, analisamos as diferenças de gênero na ascensão na carreira docente. Os resultados da pesquisa revelam a presença de vantagens para homens na carreira, sejam no que se refere à primeira experiência vivenciada na gestão escolar - idade mais jovem e menor tempo de manejo de sala de aula -, sejam relacionadas aos tipos de incentivo recebidos e à forma de provimento do primeiro cargo na gestão escolar. O provimento por concurso público possibilita uma aparente igualdade entre mulheres e homens no que se refere à idade de ingresso nos cargos de especialistas, embora não garanta uma igualdade na distribuição de mulheres e homens entre os diversos cargos. Os homens estão percentualmente mais presentes em cargos relacionados mais especificamente à face administrativa da gestão - vice-direção, direção e supervisão - do que naqueles dedicados mais diretamente à face pedagógica - orientação e coordenação pedagógica -, o que evidencia uma relação entre gênero e escolha na ascensão na carreira docente.