Heuristic Estimation of the Vacuum Energy Density of the Universe: Part II-Analysis Based on Frequency Domain Electromagnetic Radiation

In Part I of this paper, an inequality satisfied by the vacuum energy density of the universe was derived using an indirect and heuristic procedure. The derivation is based on a proposed thought experiment, according to which an electron is accelerated to a constant and relativistic speed at a distance L from a perfectly conducting plane. The charge of the electron was represented by a spherical charge distribution located within the Compton wavelength of the electron. Subsequently, the electron is incident on the perfect conductor giving rise to transition radiation. The energy associated with the transition radiation depends on the parameter L. It was shown that an inequality satisfied by the vacuum energy density will emerge when the length L is pushed to cosmological dimensions and the product of the radiated energy, and the time duration of emission is constrained by Heisenberg’s uncertainty principle. In this paper, a similar analysis is conducted with a chain of electrons oscillating sinusoidally and located above a conducting plane. In the thought experiment presented in this paper, the behavior of the energy radiated by the chain of oscillating electrons is studied in the frequency domain as a function of the length L of the chain. It is shown that when the length L is pushed to cosmological dimensions and the energy radiated within a single burst of duration of half a period of oscillation is constrained by the fact that electromagnetic energy consists of photons, an inequality satisfied by the vacuum energy density emerges as a result. The derived inequality is given by where is the vacuum energy density. This result is consistent with the measured value of the vacuum energy density, which is 5.38 × 10-10 J/m. The result obtained here is in better agreement with experimental data than the one obtained in Part I of this paper with time domain radiation.

Promoting sustainable consumption and circular economy:the intention of Vietnamese youth consumers to purchase products made from recycled plastics

Recycling is viewed as a key component in a circular economy and serves as an ideal solution for promoting sustainability.During the global plastic crisis,plastic recycling practices have been adopted worldwide,leading to the production of various products made from recycled plastics(PRP).Nevertheless,a gap persists between consumption and demand for such products,which is primarily attributed to a lack of comprehension from the consumer perspective.Given the pivotal role consumers play in the adoption of these products,this study explores consumers’intentions to purchase PRP.This is particularly significant in Vietnam,which is an emerging economy aspiring to achieve the objectives of a circular economy and sustainable development.Utilizing an integrated cognitive-emotional framework comprising the Valence Theory and the Norm Activation Model,data from 564 Vietnamese students were gathered and analyzed using structural equation modeling.The results show that awareness of consequences is a major driver of consumer purchase intentions,followed by perceived ease of application and monetary incentives.The results also indicate that health concerns have the strongest effect on purchase intention and in the negative side,meaning that the health-related risk is the primary concern for consumers during the decision-making process.This research holds substantial value for academics and managers,as it aids in the theoretical exploration and the formulation of strategies to improve consumer acceptance of PRP.

Integrating Levels of Hierarchical Organization in Porous Organic Molecular Materials

Porous organic molecular materials(POMMs)are an emergent class of molecular-based materials characterized by the formation of extended porous frameworks,mainly held by non-covalent interactions.POMMs represent a variety of chemical families,such as hydrogen-bonded organic frameworks,porous organic salts,porous organic cages,C-H···πmicroporous crystals,supramolecular organic frameworks,π-organic frameworks,halogen-bonded organic framework,and intrinsically porous molecular materials.In some porous materials such as zeolites and metal organic frameworks,the integration of multiscale has been adopted to build materials with multifunctionality and optimized properties.Therefore,considering the significant role of hierarchy in porous materials and the growing importance of POMMs in the realm of synthetic porous materials,we consider it appropriate to dedicate for the first time a critical review covering both topics.Herein,we will provide a summary of literature examples showcasing hierarchical POMMs,with a focus on their main synthetic approaches,applications,and the advantages brought forth by introducing hierarchy.

Metabolic-associated fatty liver disease and sarcopenia:A double whammy

The prevalence of metabolic-associated fatty liver disease(MAFLD)has increased substantially in recent years because of the global obesity pandemic.MAFLD,now recognized as the number one cause of chronic liver disease in the world,not only increases liver-related morbidity and mortality among sufferers but also worsens the complications associated with other comorbid conditions such as cardiovascular disease,type 2 diabetes mellitus,obstructive sleep apnoea,lipid disorders and sarcopenia.Understanding the interplay between MAFLD and these comorbidities is important to design optimal therapeutic strategies.Sarcopenia can be either part of the disease process that results in MAFLD(e.g.,obesity or adiposity)or a consequence of MAFLD,especially in the advanced stages such as fibrosis and cirrhosis.Sarcopenia can also worsen MAFLD by reducing exercise capacity and by the production of various muscle-related chemical factors.Therefore,it is crucial to thoroughly understand how we deal with these diseases,especially when they coexist.We explore the pathobiological interlinks between MAFLD and sarcopenia in this comprehensive clinical update review article and propose evidence-based therapeutic strategies to enhance patient care.

The Accelerated Expansion of the Universe in the Light of the Maximum Ordinality Principle

The main aim of the paper is to present (and at the same time offer) a differ-ent perspective for the analysis of the accelerated expansion of the Universe. A perspective that can surely be considered as being “in parallel” to the tradition-al ones, such as those based, for example, on the hypotheses of “Dark Matter” and “Dark Energy”, or better as a “com-possible” perspective, because it is not understood as being “exclusive”. In fact, it is an approach that, when con-firmed by experimental results, always keeps its validity from an “operative” point of view. This is because, in analogy to the traditional perspectives, on the basis of Popper’s Falsification Principle the corresponding “Generative” Logic on which it is based has not the property of the perfect induction. The basic difference then only consists in the fact that the Evolution of the Universe is now modeled by considering the Universe as a Self-Organizing System, which is thus analyzed in the light of the Maximum Ordinality Principle.

Calculation of Two-Tailed Exact Probability in the Wald-Wolfowitz One-Sample Runs Test

The objectives of this paper are to demonstrate the algorithms employed by three statistical software programs (R, Real Statistics using Excel, and SPSS) for calculating the exact two-tailed probability of the Wald-Wolfowitz one-sample runs test for randomness, to present a novel approach for computing this probability, and to compare the four procedures by generating samples of 10 and 11 data points, varying the parameters n0 (number of zeros) and n1 (number of ones), as well as the number of runs. Fifty-nine samples are created to replicate the behavior of the distribution of the number of runs with 10 and 11 data points. The exact two-tailed probabilities for the four procedures were compared using Friedman’s test. Given the significant difference in central tendency, post-hoc comparisons were conducted using Conover’s test with Benjamini-Yekutielli correction. It is concluded that the procedures of Real Statistics using Excel and R exhibit some inadequacies in the calculation of the exact two-tailed probability, whereas the new proposal and the SPSS procedure are deemed more suitable. The proposed robust algorithm has a more transparent rationale than the SPSS one, albeit being somewhat more conservative. We recommend its implementation for this test and its application to others, such as the binomial and sign test.

Coffee Leaf Rust(Hemileia vastatrix)Disease in Coffee Plants and Perspectives by the Disease Control

Coffee Leaf Rust(CLR)is caused by Hemileia vastatrix in Coffea spp.It is one of the most dangerous phytopathogens for coffee plantations in terms of coffee productivity and coffee cup quality.In this review,we resume the problem of CLR in Mexico and the pathogenesis of H.vastatrix.The review abord plant-pathogen interactions which lead a compatible or incompatible interactions and result in CLR disease or resistance,respectively.The review abord Coffea spp.defense response pathways involved in H.vastatrix pathogenicity.Additionally,current measures to control H.vastatrix proliferation and germination were aborded focused on phytosanitary actions,and biological and chemical control.Finally,new trendlines to reduce the impact of CLR as nanoparticles and nanotechnology were analyzed.

Nonaqueous potassium-ion full-cells:Mapping the progress and identifying missing puzzle pieces

This review addresses the growing interest for potassium-ion full-cells(KIFCs)in view of the transition from potassium-ion half-cells(KIHCs)toward commercial K-ion batteries(KIBs).It focuses on the key parameters of KIFCs such as the electrode/electrolyte interfaces challenge,major barriers,and recent advancements in KIFCs.The strategies for enhancing KIFC performance,including interfaces co ntrol,electrolyte optimization,electrodes capacity ratio,electrode material screening and electrode design,are discussed.The review highlights the need to evaluate KIBs in full-cell configurations as half-cell results are strongly impacted by the K metal reactivity.It also emphasizes the importance of understanding solid electrolyte interphase(SEI)formation in KIFCs and explores promising nonaqueous as well as quasiand all-solid-state electrolytes options.This review thus paves the way for practical,cost-effective,and scalable KIBs as energy storage systems by offering insights and guidance for future research.

ThyroidNet:A Deep Learning Network for Localization and Classification of Thyroid Nodules

Aim:This study aims to establish an artificial intelligence model,ThyroidNet,to diagnose thyroid nodules using deep learning techniques accurately.Methods:A novel method,ThyroidNet,is introduced and evaluated based on deep learning for the localization and classification of thyroid nodules.First,we propose the multitask TransUnet,which combines the TransUnet encoder and decoder with multitask learning.Second,we propose the DualLoss function,tailored to the thyroid nodule localization and classification tasks.It balances the learning of the localization and classification tasks to help improve the model’s generalization ability.Third,we introduce strategies for augmenting the data.Finally,we submit a novel deep learning model,ThyroidNet,to accurately detect thyroid nodules.Results:ThyroidNet was evaluated on private datasets and was comparable to other existing methods,including U-Net and TransUnet.Experimental results show that ThyroidNet outperformed these methods in localizing and classifying thyroid nodules.It achieved improved accuracy of 3.9%and 1.5%,respectively.Conclusion:ThyroidNet significantly improves the clinical diagnosis of thyroid nodules and supports medical image analysis tasks.Future research directions include optimization of the model structure,expansion of the dataset size,reduction of computational complexity and memory requirements,and exploration of additional applications of ThyroidNet in medical image analysis.

Low-Cost and Biodegradable Thermoelectric Devices Based on van der Waals Semiconductors on Paper Substrates

We present a method to fabricate handcrafted thermoelectric devices on standard office paper substrates.The devices are based on thin films of WS_(2),Te,and BP(P-type semiconductors)and TiS_(3)and TiS_(2)(N-type semiconductors),deposited by simply rubbing powder of these materials against paper.The thermoelectric properties of these semiconducting films revealed maximum Seebeck coefficients of(+1.32±0.27)mV K^(-1)and(-0.82±0.15)mV K^(-1)for WS_(2)and TiS_(3),respectively.Additionally,Peltier elements were fabricated by interconnecting the P-and N-type films with graphite electrodes.A thermopower value up to 6.11 mV K^(-1)was obtained when the Peltier element were constructed with three junctions.The findings of this work show proof-of-concept devices to illustrate the potential application of semiconducting van der Waals materials in future thermoelectric power generation as well as temperature sensing for low-cost disposable electronic devices.

On the apparent line-of-sight alignment of the peak X-ray intensity of the magnetosheath and the tangent to the magnetopause,as viewed by SMILE-SXI

The Soft X-ray Imager(SXI)on board the Solar wind Magnetosphere Ionosphere Link Explorer(SMILE)spacecraft will be able to view the Earth’s magnetosheath in soft X-rays.Simulated images of the X-ray emission visible from the position of SMILE are created for a range of solar wind densities by using 3 years of the SMILE mission orbit,together with models of the expected X-ray emissivity from the Earth’s magnetosheath.Results from global magnetohydrodynamic simulations and a simple model for exospheric neutral densities are used to compare the locations of the lines of sight along which integrated soft X-ray intensities peak with the lines of sight lying tangent to surfaces(defined here to be the magnetopause)along which local soft X-ray intensities peak or exhibit their strongest gradients,or both,for strongly southward interplanetary magnetic field conditions when no depletion or low-latitude boundary layers are expected.Where,in the parameter space of the various times and seasons,orbital phases,solar wind conditions,and magnetopause models,the alignment of the X-ray emission peak with the magnetopause tangent is good,or is not,is presented.The main results are as follows.The spacecraft needs to be positioned well outside the magnetopause;low-altitude times near perigee are not good.In addition,there are seasonal aspects:dayside-apogee orbits are generally very good because the spacecraft travels out sunward at high altitude,but nightside-apogee orbits,behind the Earth,are bad because the spacecraft only rarely leaves the magnetopause.Dusk-apogee and dawnapogee orbits are intermediate.Dayside-apogee orbits worsen slightly over the first three mission years,whereas nightside-apogee orbits improve slightly.Additionally,many more times of good agreement with the peak-to-tangent hypothesis occur when the solar wind is in a high-density state,as opposed to a low-density state.In a high-density state,the magnetopause is compressed,and the spacecraft is more often a good distance outside the magnetopause.

基于能量信息协同调控的LED智能调光技术

针对当前LED照明系统对智能化的迫切需求和对成本的高度敏感,而现有智能化调控方案在成本和可靠性等方面存在不足等问题,提出一种基于电力电子变换器能量信息协同调控的LED智能调光技术。该技术基于电力电子变换器驱动的LED线性调光照明系统,采用四进制差分相移键控(Quaternary differential phase shift keying,QDPSK)对公共直流母线上的开关纹波进行信息调制,从而在不额外增加硬件成本的条件下,实现四进制数字信号的调制、耦合与传输。从通信视角解构了DC/DC变换器的基本工作原理,揭示了LED调光系统中能量信息协同调控的实现方法,并以隧道LED照明系统的智能调光为例,围绕系统结构、通信协议、噪声干扰、通信速率等方面展开了具体分析。最后,搭建试验平台验证了所提方法的可行性。

Efficacy and tolerability of chitin-glucan combined with simethicone(GASTRAP^(■)DIRECT)in irritable bowel syndrome:A prospective,open-label,multicenter study

BACKGROUND Irritable bowel syndrome(IBS),defined according to the Rome IV diagnostic criteria,is a chronic functional gastrointestinal disorder characterized by recurrent abdominal pain related to altered bowel habits.First-line recommended treatments are limited to combining drugs targeting predominant symptoms,particularly pain(antispasmodics),constipation(laxatives),and diarrhea(loperamide),yielding only a limited therapeutic gain.GASTRAP^(■)DIRECT is a class IIa medical formulation composed of a combination of chitin-glucan and simethicone indicated for the symptomatic treatment of gas-related gastrointestinal disorders by combining different mechanisms of action.AIM To evaluate the efficacy,tolerability,and safety of 4-week GASTRAP^(■)DIRECT treatment in patients with IBS.METHODS In this prospective,multicenter,open-label trial,120 patients with IBS received three sticks of GASTRAP^(■)DIRECT(1.5 g/d of chitin-glucan and 0.75 mg/d of simethicone)per day for 4 weeks.The primary endpoint was the responder rate,defined as the number of patients whose abdominal pain score decreased by≥30%from baseline to week(W)4.The analysis was performed using the per-protocol set.Cardinal symptoms,impact of global symptoms on daily life,change in stool consistency,and improvement in defecatory disorders were evaluated.RESULTS Overall,100 patients were evaluated.At W4,67%(95%CI:57-75)showed improvement in abdominal pain(score:5.8±2.4 vs 2.9±2.0,P<0.0001).Similar improvements were observed for bloating[8.0±1.7 vs 4.7±2.9,P<0.0001;60%(95%CI:50-70)responders],abdominal distension[7.2±2.1 vs 4.4±3.1,P<0.0001;53%(95%CI:43-63)responders],and impact of global symptoms on daily life[7.1±2.0 vs 4.6±2.9,P<0.0001;54%(95%CI:44-64)responders].Stool consistency improved in most patients(90%and 57%for patients with liquid and hard stools,respectively).Overall,42%of patients with defecatory disorders reported very much/considerable improvements by W2.No severe adverse event occurred,and tolerability was rated“good”or“very good”by 93%of patients.CONCLUSION GASTRAP^(■)DIRECT is safe and well tolerated,alleviating IBS symptoms rapidly in 2 weeks.This open-label study suggests that the combination of chitin-glucan and simethicone could be beneficial in patients with IBS.

Simulation of the SMILE Soft X-ray Imager response to a southward interplanetary magnetic field turning

The Solar wind Magnetosphere Ionosphere Link Explorer(SMILE)Soft X-ray Imager(SXI)will shine a spotlight on magnetopause dynamics during magnetic reconnection.We simulate an event with a southward interplanetary magnetic field turning and produce SXI count maps with a 5-minute integration time.By making assumptions about the magnetopause shape,we find the magnetopause standoff distance from the count maps and compare it with the one obtained directly from the magnetohydrodynamic(MHD)simulation.The root mean square deviations between the reconstructed and MHD standoff distances do not exceed 0.2 RE(Earth radius)and the maximal difference equals 0.24 RE during the 25-minute interval around the southward turning.

Genomic Profile of SARS-COV-2 Associated with COVID-19 Outbreaks in N’Djamena, Chad

Background: SARS-CoV-2 has circulated worldwide with dramatic consequences. In Chad, we have no data reported of variants. The aim of this study was to identify the SARS-CoV-2 variants that circulated during the epidemic from 2020 to 2021. Methods: This is a cross-sectional, descriptive study carried out between 2020 and 2021. Samples from patients with suspected COVID-19 were tested in five laboratories in N’Djamena. One hundred quality samples of the positives were sequenced in Kinshasa using Oxford nanopore technologies minion and the Protocol Midnight SARS-CoV2. Data were processed using Excel version 16 software. Results: Of the 100 samples sequenced, 77 (77%) produced sequences, 23 (23%) did not. The genomic profiles were wild-type Wuhan and minor mutations (19A, 19B (A), 20A (B.1, B.2), 20B (AV.1), 20D (B.1.1.1 /C.36), 20C), variant of concern Alpha (20I), variant of concern Delta (21A/J), variant of interest Eta (21D), variant of concern Omicron (21K) and unclassified variant under surveillance (B.1.640). Of these variants, the maximums were detected in patients aged 26 - 35 with 30.26% and 25.26% in 36 - 45. However, 24.67% were in travelers and 75.32% in residents, 35.06% in those vaccinated against COVID-19 and 62.33% in non-vaccinates. The estimated case-fatality rate was 2.44% (107/4374). Conclusion: This work has provided preliminary data on COVID-19 and SARS-CoV-2 variants circulating during the 2020-2021 epidemics in Chad.

Random vibration analysis of FGM plates subjected to moving load using a refined stochastic finite element method

The article introduces a finite element procedure using the bilinear quadrilateral element or four-node rectangular element(namely Q4 element) based on a refined first-order shear deformation theory(rFSDT) and Monte Carlo simulation(MCS), so-called refined stochastic finite element method to investigate the random vibration of functionally graded material(FGM) plates subjected to the moving load.The advantage of the proposed method is to use r-FSDT to improve the accuracy of classical FSDT, satisfy the stress-free condition at the plate boundaries, and combine with MCS to analyze the vibration of the FGM plate when the parameter inputs are random quantities following a normal distribution. The obtained results show that the distribution characteristics of the vibration response of the FGM plate depend on the standard deviation of the input parameters and the velocity of the moving load.Furthermore, the numerical results in this study are expected to contribute to improving the understanding of FGM plates subjected to moving loads with uncertain input parameters.

Data-Driven Decision-Making for Bank Target Marketing Using Supervised Learning Classifiers on Imbalanced Big Data

Integrating machine learning and data mining is crucial for processing big data and extracting valuable insights to enhance decision-making.However,imbalanced target variables within big data present technical challenges that hinder the performance of supervised learning classifiers on key evaluation metrics,limiting their overall effectiveness.This study presents a comprehensive review of both common and recently developed Supervised Learning Classifiers(SLCs)and evaluates their performance in data-driven decision-making.The evaluation uses various metrics,with a particular focus on the Harmonic Mean Score(F-1 score)on an imbalanced real-world bank target marketing dataset.The findings indicate that grid-search random forest and random-search random forest excel in Precision and area under the curve,while Extreme Gradient Boosting(XGBoost)outperforms other traditional classifiers in terms of F-1 score.Employing oversampling methods to address the imbalanced data shows significant performance improvement in XGBoost,delivering superior results across all metrics,particularly when using the SMOTE variant known as the BorderlineSMOTE2 technique.The study concludes several key factors for effectively addressing the challenges of supervised learning with imbalanced datasets.These factors include the importance of selecting appropriate datasets for training and testing,choosing the right classifiers,employing effective techniques for processing and handling imbalanced datasets,and identifying suitable metrics for performance evaluation.Additionally,factors also entail the utilisation of effective exploratory data analysis in conjunction with visualisation techniques to yield insights conducive to data-driven decision-making.

Estimation of Landfill Gas and Its Renewable Energy Potential from the Polesgo Controlled Landfill Using First-Order Decay (FOD) Models

Methane generation in landfills and its inadequate management represent the major avoidable source of anthropogenic methane today. This paper models methane production and the potential resources expected (electrical energy production and potential carbon credits from avoided CH4 emissions) from its proper management in a municipal solid waste landfill located in Ouagadougou, Burkina Faso. The modeling was carried out using two first-order decay (FOD) models (LandGEM V3.02 and SWANA) using parameters evaluated on the basis of the characteristics of the waste admitted to the landfill and weather data for the site. At the same time, production data have been collected since 2016 in order to compare them with the model results. The results obtained from these models were compared to experimental one. For the simulation of methane production, the SWANA model showed better consistency with experimental data, with a coefficient of determination (R²) of 0.59 compared with the LandGEM model, which obtained a coefficient of 0.006. Thus, despite the low correlation values linked to the poor consistency of experimental data, the SWANA model models methane production much better than the LandGEM model. Thus, despite the low correlation values linked to the poor consistency of the experimental data, the SWANA model models methane production much better than the LandGEM V3.02 model. It was noted that the poor consistency of the experimental data justifies these low coefficients, and that they can be improved in the future thanks to ongoing in situ measurements. According to the SWANA model prediction, in 27 years of operation a biogas plant with 33% electrical efficiency using biogas from the Polesgo landfill would avoid 1,340 GgCO2e. Also, the evaluation of revenues due to electricity and carbon credit gave a total revenue derived from methane production of US$27.38 million at a cost of US$10.5/tonne CO2e.

Infection in Multiple Myeloma: Microbiological Profile and Prognosis in Senegalese Patients

Introduction: Infections are additional factors of morbidity and mortality in multiple myeloma (MM), and the current recommendation is antibiotic prophylaxis. In sub-Saharan Africa, few data on infectious complications of MM are available. We aim to describe the microbiological features of infections in MM, and their impact on survival in Senegalese patients. Methods: A retrospective (January 2005-January 2022), analytic, multicenter study on infections in patients followed for MM (IMWG criteria) in Senegalese clinical hematology services. The socio-epidemiological, diagnostic, microbiological, evolutionary and survival aspects were analyzed. Results: The study included 106 patients with multiple myeloma who had an infection at admission or during the treatment. Ten patients have the comorbidity (hypertension, lupus, type 2 diabetes). These patients had 136 infectious events identified at diagnosis (79.2%) or during chemotherapy (20.8%). The sites of infection are lung (42.6%), urinary (29.4%), dermatological (6.6%), digestive (5.2%), osteoarticular (4.4%), ear, nose and throat (3.7%), central nervous system (1.5%), or without site. We recorded 26.4% of patients with multi-site infections. The causal pathogens are bacteria (Gram-negative bacilli: 22.1%;Gram positive bacilli: 9.5%, Mycobacterium tuberculosis: 13.3%), parasitique (plasmodium falciparum 6.6%), viruses (SARS-COV2: 2.9%, VZV: 2.2%) and fungal (2.9%). Survival was reduced in patients who had an infection at the time of multiple myeloma diagnosis (p: 0.189) and those who had multiple infectious foci (p: 0.011). Conclusion: Infections in multiple myeloma are more frequent at diagnosis. The germs are varied and mostly bacteria, particularly gram-negative bacteria, and Kochs bacillus. Our study reveals that multiple infectious foci are a poor prognosis factor. It is necessary to evaluate the infectious risk early, and to adopt an antibiotic prophylaxis based on our tropical environment.

Management of Square Carcinoma of the Lower Lip Using Camille-Bernard Flap under Local Anesthesia: When Constraints Dictate Our Attitude

Introduction: Squamous cell carcinomas of the lip essentially pose a therapeutic management problem. In the West, their treatment is done under general anesthesia and follows the classic rules of oncology. In our context of exercise, we sometimes have a different attitude dictated by various constraints. Observation: 55-year-old patient with no notable history, seen in consultation for a very large ulcerative-budding lesion on the right 2/3 of the lower lip with mucocutaneous involvement without lymph node findings found on examination. Faced with this suspicious lesion and the patient’s financial difficulties, we decided to operate under local anesthesia to remove this tumor. The oncological excision was followed by immediate plasty using a Camille-Bernard flap with a good immediate aesthetic and functional result and postoperative day 7. The patient was unable to take his surgical specimen to anatomy-pathology and was lost to follow-up due to lack of financial resources. On anatomo-pathological analysis of the surgical specimen, the margins were healthy with confirmation of squamous cell carcinoma (anapathological reading made for scientific interest). Discussion: The particular mentality of certain patients and their difficult financial conditions push us to have an unconventional therapeutic attitude in oncology, but which nevertheless makes it possible to resolve certain problems that we often face. Local anesthesia is possible and realistic in cases like ours and the results can be acceptable and life-saving.