Acute worsening of microvascular complications of diabetes mellitus during rapid glycemic control:The pathobiology and therapeutic implications

While chronic hyperglycaemia resulting from poorly controlled diabetes mellitus(DM)is a well-known precursor to complications such as diabetic retinopathy,neuropathy(including autonomic neuropathy),and nephropathy,a paradoxical intensification of these complications can rarely occur with aggressive glycemic management resulting in a rapid reduction of glycated haemoglobin.Although,acute onset or worsening of retinopathy and treatment induced neuropathy of diabetes are more common among these complications,rarely other problems such as albuminuria,diabetic kidney disease,Charcot’s neuroarthropathy,gastroparesis,and urinary bladder dysfunction are also encountered.The World Journal of Diabetes recently published a rare case of all these complications,occurring in a young type 1 diabetic female intensely managed during pregnancy,as a case report by Huret et al.It is essential to have a comprehensive understanding of the pathobiology,prevalence,predisposing factors,and management strategies for acute onset,or worsening of microvascular complications when rapid glycemic control is achieved,which serves to alleviate patient morbidity,enhance disease management compliance,and possibly to avoid medico-legal issues around this rare clinical problem.This editorial delves into the dynamics surrounding the acute exacerbation of microvascular complications in poorly controlled DM during rapid glycaemic control.

Comparative efficacy of sodium glucose cotransporter-2 inhibitors in the management of type 2 diabetes mellitus:A real-world experience

BACKGROUND Sodium glucose cotransporter-2 inhibitors(SGLT-2i)are a class of drugs with modest antidiabetic efficacy,weight loss effect,and cardiovascular benefits as proven by multiple randomised controlled trials(RCTs).However,real-world data on the comparative efficacy and safety of individual SGLT-2i medications is sparse.AIM To study the comparative efficacy and safety of SGLT-2i using real-world clinical data.METHODS We evaluated the comparative efficacy data of 3 SGLT-2i drugs(dapagliflozin,canagliflozin,and empagliflozin)used for treating patients with type 2 diabetes mellitus.Data on the reduction of glycated hemoglobin(HbA1c),body weight,blood pressure(BP),urine albumin creatinine ratio(ACR),and adverse effects were recorded retrospectively.RESULTS Data from 467 patients with a median age of 64(14.8)years,294(62.96%)males and 375(80.5%)Caucasians were analysed.Median diabetes duration was 16.0(9.0)years,and the duration of SGLT-2i use was 3.6(2.1)years.SGLT-2i molecules used were dapagliflozin 10 mg(n=227;48.6%),canagliflozin 300 mg(n=160;34.3%),and empagliflozin 25 mg(n=80;17.1).Baseline median(interquartile range)HbA1c in mmol/mol were:dapagliflozin-78.0(25.3),canagliflozin-80.0(25.5),and empagliflozin-75.0(23.5)respectively.The respective median HbA1c reduction at 12 months and the latest review(just prior to the study)were:66.5(22.8)&69.0(24.0),67.0(16.3)&66.0(28.0),and 67.0(22.5)&66.5(25.8)respectively(P<0.001 for all comparisons from baseline).Significant improvements in body weight(in kilograms)from baseline to study end were noticed with dapagliflozin-101(29.5)to 92.2(25.6),and canagliflozin 100(28.3)to 95.3(27.5)only.Significant reductions in median systolic and diastolic BP,from 144(21)mmHg to 139(23)mmHg;(P=0.015),and from 82(16)mmHg to 78(19)mmHg;(P<0.001)respectively were also observed.A significant reduction of microalbuminuria was observed with canagliflozin only[ACR 14.6(42.6)at baseline to 8.9(23.7)at the study end;P=0.043].Adverse effects of SGLT-2i were as follows:genital thrush and urinary infection-20(8.8%)&17(7.5%)with dapagliflozin;9(5.6%)&5(3.13%)with canagliflozin;and 4(5%)&4(5%)with empagliflozin.Diabetic ketoacidosis was observed in 4(1.8%)with dapagliflozin and 1(0.63%)with canagliflozin.CONCLUSION Treatment of patients with SGLT-2i is associated with statistically significant reductions in HbA1c,body weight,and better than those reported in RCTs,with low side effect profiles.A review of large-scale real-world data is needed to inform better clinical practice decision making.

Rising tide: The global surge of type 2 diabetes in children and adolescents demands action now

Childhood-onset obesity has emerged as a major public healthcare challenge across the globe,fueled by an obesogenic environment and influenced by both genetic and epigenetic predispositions.This has led to an exponential rise in the incidence of type 2 diabetes mellitus in children and adolescents.The looming wave of diabetes-related complications in early adulthood is anticipated to strain the healthcare budgets in most countries.Unless there is a collective global effort to curb the devastation caused by the situation,the impact is poised to be pro-found.A multifaceted research effort,governmental legislation,and effective social action are crucial in attaining this goal.This article delves into the current epidemiological landscape,explores evidence concerning potential risks and consequences,delves into the pathobiology of childhood obesity,and discusses the latest evidence-based management strategies for diabesity.

The Impact of Black Sea Sand Treatment Effectively Reducing Different Type of Pain

Purpose: Low back pain (LBP), Gonarthrosis, knee, and Carpal Tunnel Syndrome have been regarded as affecting more than three-quarters’ of individuals in their lifetime. The aim of this study was conducted to determine and compare the effects of topical patients with sand compared with control related to Gonarthrosis, LBP, knee, and Carpal Tunnel Syndrome pain. Methods: This is a prospective case and control designed study based on 101 pain case with Sand and 101 control subjects. The interventional groups in addition either topical sand or without sand 2 months after the intervention were assessed. We assessed tolerability of an established pain perception scale by the Numeric Rating Scale (NRS). Categorical variables were compared using the chi-square (χ2) test. The paired t-test was used to compare the two groups before and after the intervention. One-way analysis of variance (ANOVA) was employed for comparison of several group means. Results: The study was based on 202 patients, 41 males (20.3%) and 161 females (79.7%). There were statistically significant differences between subjects with and without Sand in term of Gonarthrosis, Rheumatoid Arthritis LBP, knee, and Carpal Tunnel Syndrome pain (p = 0.033). Majority of patients were over age 55 years old (55%) and females 78 (77.2%). The mean score of total pain experience before and after the intervention was 7.41 ± 1.1 for black sand, and 4.24 ± 2.38 for without sand as control group. The mean scores of these 5 groups were highly significant before and after the intervention (p There was statistically highly significant in regarding subjects with Sand as compared with those before Sand after treatment mean score specifically with gonarthrosis before pain 7.23 ± 1.86 vs after treatment 4.54 ± 2.18 p < 0.001;rheumatoid arthritis before 8.28 ± 1.48 vs after treatment 4.80 ± 3.71 p < 0.001;Low Back Pain before 8.42 ± 1.83 vs after treatment 4.37 ± 1.52 p < 0.001;knee pain before 8.93 ± 0.89 vs after treatment 4.24 ± 0.24 p < 0.001;Carpal Tunnel Syndrome before 7.664 ± 1.04 vs after treatment 4.26 ± 1.03 p Conclusion: The current study has revealed that the topical treatments with sand could have a significant effect on the perception of pain compared to those in the control group with respect of gonarthrosis, rheumatoid arthritis, LBP, knee, and Carpal Tunnel Syndrome pain .

PEO coating on Mg-Ag alloy:The incorporation and release of Ag species

In the present study,the distribution of Ag in the coating formed on Mg-Ag alloy by plasma electrolytic oxidation(PEO)and its ionic release kinetics when exposed to a 0.9 wt.%Na Cl solution at 37℃have been investigated.Both metallic Ag and Ag oxide particles with~5 to~40 nm in diameters were observed in the PEO coating.Further,an Ag-enriched layer of~20 nm in thickness at the substrate/coating interface was also observed.The PEO coating on the Mg-Ag alloy not only increases its corrosion resistance with the corrosion current density decreasing by up to 3 orders of magnitude from 8.04×10^(-3)to 4.03×10^(-6)A/cm^(2),but also controls the release of Ag+to the level that is sufficient for anti-infective efficacy without causing cytotoxicity to mammal cells.

Molecular mechanism of fly ash affecting the performance of cemented backfill material

The great challenge of cemented tailings backfill(CTB)is difficult simultaneously maintaining its excellent mechanical properties and low cost.Fly ash(FA)can potentially address this problem and further replace cement in favor of low carbon development.However,its mechanism on CTB with low cement dosage and low Ca system remains unclear.Consequently,this study conducted uniaxial compression,Xray diffraction(XRD),and scanning electron microscopy(SEM)-energy dispersive spectrometer(EDS)tests to investigate the effect of FA dosage on the mechanical property and microstructure of CTB.A molecular model of FA-CSH was constructed to reproduce the molecular structure evolution of CTB with FA based on the test results.The influences of FA dosage and calcium/silica molar ratio(Ca/Si ratio)on the matrix strength and failure model were analyzed to reveal the mechanism of FA on calcium silicate hydrated(C-S-H).The results show that the strength of CTB increases initially and then decreases with FA dosage,and the FA supplement leads to a decrease in Ca(OH)_(2) diffraction intensity and Ca/Si ratio around the FA particles.XRD and SEM-EDS findings show that the Ca/Si ratio of C-S-H decreases with the progression of hydration.The FA-CSH model indicates that FA can reinforce the silica chain of C-S-H to increase the matrix strength.However,this enhancement is weakened by supplementing excessive FA dosage.In addition,the hydrogen bonds among water molecules deteriorate,reducing the matrix strength.A low Ca/Si ratio results in an increase in water molecules and a decrease in the ionic bonds combined with Ca^(2+).The hydrogen bonds among water molecules cannot withstand high stresses,resulting in a reduction in strength.The water absorption of the FA-CSH model is negatively correlated with the FA dosage and Ca/Si ratio.The use of optimal FA dosage and Ca/Si ratio leads to suitable water absorption,which further affects the failure mode of FA-CSH.

Classifying Globular Clusters and Applying them to Estimate the mass of the Milky Way

We combine the kinematics of 159 globular clusters(GCs) provided by the Gaia Early Data Release 3(EDR3) with other observational data to classify the GCs,and to estimate the mass of the Milky Way(MW).We use the agemetallicity relation,integrals of motion,action space and the GC orbits to identify the GCs as either formed in situ(Bulge and Disk) or ex situ(via accretion).We find that 45.3% have formed in situ,while 38.4% may be related to known merger events:Gaia-Sausage-Enceladus,the Sagittarius dwarf galaxy,the Helmi streams,the Sequoia galaxy and the Kraken galaxy.We also further identify three new sub-structures associated with the Gaia-Sausage-Enceladus.The remaining 16.3% of GCs are unrelated to the known mergers and thought to be from small accretion events.We select 46 GCs which have radii 8.0 <r<37.3 kpc and obtain the anisotropy parameter β=0.315_(-0.049)^(+0.055),which is lower than the recent result using the sample of GCs in Gaia Data Release 2,but still in agreement with it by considering the error bar.By using the same sample,we obtain the MW mass inside the outermost GC as M(<37.3 kpc)=0.423_(-0.02)^(+0.02)×10^(12)M_(⊙),and the corresponding M_(200)=1.11_(-0.18)^(+0.25)×10^(12)M_(⊙).The estimated mass is consistent with the results in many recent studies.We also find that the estimated β and mass depend on the selected sample of GCs.However,it is difficult to determine whether a GC fully traces the potential of the MW.

A review of mechanism of action of outdoor exposure in preventing myopia incidence and progression

Various studies have suggested several environmental,pharmacological,medical,and optical interventions and some are in use but their efficacy in myopia control may be transient,and the cellular,molecular,and biochemical mechanisms involved unclear.Daylight exposure is currently regarded as an effective and enduring strategy in the control of myopia development and progression.However,the mechanism behind the effect of outdoor exposure and its association with genetic predisposition and other relatively more significant environmental factors on myopia is still a conundrum.This review focuses on survey-based and intervention-based studies carried out to propose a mechanism that accounts for myopia development and important for its control.

Astrocytes dynamically regulate the blood-brain barrier in the healthy brain

The blood-brain barrier(BBB)(discovered and defined by Max Lewandowsky and Lina Stern,and not,as it is universally,and yet erroneously believed,by Paul Ehrlich(Verkhratsky and Pivoriunas,2023))that separates the nervous system from the circulation is evolutionarily conserved from arthropods to man.The primeval BBB of the invertebrates and some early vertebrates was made solely by glial cells and secured(in invertebrates)by septate junctions.

Artificial intelligence in the diagnosis of thyroid cancer:Recent advances and future directions

The diagnosis and management of thyroid cancer is fraught with challenges despite the advent of innovative diagnostic,surgical,and chemotherapeutic modalities.Challenges like inaccuracy in prognostication,uncertainty in cytopathological diagnosis,trouble in differentiating follicular neoplasms,intra-observer and inter-observer variability on ultrasound imaging preclude personalised treatment in thyroid cancer.Artificial intelligence(AI)is bringing a paradigm shift to the healthcare,powered by quick advancement of the analytic techniques.Several recent studies have shown remarkable progress in thyroid cancer diagnostics based on AI-assisted algorithms.Application of AI techniques in thyroid ultrasonography and cytopathology have shown remarkable improvement in sensitivity and specificity over the traditional diagnostic modalities.AI has also been explored in the development of treatment algorithms for indeterminate nodules and for prognostication in the patients with thyroid cancer.The benefits of high repeatability and straightforward implementation of AI in the management of thyroid cancer suggest that it holds promise for clinical application.Limited clinical experience and lack of prospective validation studies remain the biggest drawbacks.Developing verified and trustworthy algorithms after extensive testing and validation using prospective,multi-centre trials is crucial for the future use of AI in the pipeline of precision medicine in the management of thyroid cancer.

Non-pharmacological interventions for diabetic peripheral neuropathy:Are we winning the battle?

Despite the advent of relatively reliable modalities of diagnosing diabetic peripheral neuropathy(DPN),such as nerve conduction studies,there is still a knowledge gap about the pathophysiology,and thus limited available in-terventions for symptom control and curtailing disease progression.The pharma-cologic aspect of management is mainly centred on pain control,however,there are several important aspects of DPN such as loss of vibration sense,pressure sense,and proprioception which are associated with risks to lower limb health,which pharmacotherapy does not address.Furthermore,published evidence suggests non-pharmacologic interventions such as glycaemic control through dietary modification and exercise need to be combined with other measures such as psychotherapy,to reach a desired,however modest effect.Acupuncture is emerging as an important treatment modality for several chronic medical conditions including neuropathic and other pain syndromes.In their study published in the World Journal of Diabetes on the potential of acupuncture to reduce DPN symptoms and enhance nerve conduction parameters,Hoerder et al have been able to demonstrate that acupuncture improves sensory function and that this effect is likely sustained two months after treatment cessation.Although previous studies also support these findings,larger multi-center randomized control trials including a sham-controlled arm accounting for a placebo effect are required.Overall,given the satisfactory safety profile and the positive results found in these studies,it is likely that acupuncture may become an important aspect of the repertoire of effective DPN management.

Periodontitis:An often-neglected complication of diabetes

The bidirectional association between type 2 diabetes mellitus(T2DM)and periodontitis is now well established,resulting in periodontal disease being considered as the 6th major complication of diabetes mellitus(DM)after cardiovascular disease,eye disease,neuropathy,nephropathy,and peripheral vascular disease.DM can worsen the virulence and invasiveness of pathogenic oral microbial flora aggravating the local inflammation and infection in those with periodontal disease.On the other hand,the chemical and immunological mediators released into the circulation as part of periodontal inflammation worsen the systemic insulin resistance with worsening of T2DM.Periodontitis if undiagnosed or left untreated can also result in eventual tooth loss.A study by Xu et al in the World Journal of Diabetes examined the predictive factors associated with periodontitis in Chinese patients with T2DM.The prevalence of periodontitis was found to be 75.7%in this study.Based on logistic regression analysis,the predictive factors for higher risk were low tooth brushing frequency[odds ratio(OR)=4.3],high triglycerides(TG;OR=3.31),high total cholesterol(TC;OR=2.87),higher glycated hemoglobin(HbA1c;OR=2.55),and higher age(OR=1.05)while higher education level was protective(OR=0.53).However,the most influential variables were HbA1c followed by age,TC,TG,low education level,brushing frequency,and sex on the random forest model(this model showed higher sensitivity for predicting the risk).A good understanding of the predictors for periodontitis in T2DM patients is important in prevention,early detection of susceptible patients,and intervention to improve periodontal health and enable long-term glycaemic control as observed by Xu et al.

Alterations of protein homeostasis in Alzheimer's disease:beyond Procrustean bed of endoplasmic reticulum stress and unfolded protein response

Alzheimer’s disease(AD)is a major age-related form of dementia with a number of cases exponentially growing,causing enormous social and economic impact on individuals and society.Neuropathological hallmarks of AD,evident in postmortem AD brains,include a massive loss of the grey matter in the neocortex,extracellular deposition of amyloid-β(Aβ)in the form of senile plaques and cerebrovascular amyloid angiopathy,and intra-neuronal accumulation of neurofibrillary tangles,formed by hyper-phosphorylated tau protein.

Management of male obesity-related secondary hypogonadism:A clinical update

The global obesity pandemic has resulted in a rise in the prevalence of male obesity-related secondary hypogonadism(MOSH)with emerging evidence on the role of testosterone therapy.We aim to provide an updated and practical approach towards its management.We did a comprehensive literature search across MEDLINE(via PubMed),Scopus,and Google Scholar databases using the keywords“MOSH”OR“Obesity-related hypogonadism”OR“Testosterone replacement therapy”OR“Selective estrogen receptor modulator”OR“SERM”OR“Guidelines on male hypogonadism”as well as a manual search of references within the articles.A narrative review based on available evidence,recommendations and their practical implications was done.Although weight loss is the ideal therapeutic strategy for patients with MOSH,achievement of significant weight reduction is usually difficult with lifestyle changes alone in real-world practice.Therefore,androgen administration is often necessary in the management of hypogonadism in patients with MOSH which also improves many other comorbidities related to obesity.However,there is conflicting evidence for the appropriate use of testosterone replacement therapy(TRT),and it can also be associated with complications.This evidence-based review updates the available evidence including the very recently published results of the TRAVERSE trial and provides comprehensive clinical practice pearls for the management of patients with MOSH.Before starting testosterone replacement in functional hypogonadism of obesity,it would be desirable to initiate lifestyle modification to ensure weight reduction.TRT should be coupled with the management of other comorbidities related to obesity in MOSH patients.Balancing the risks and benefits of TRT should be considered in every patient before and during longterm management.

Understanding the influence of microwave on the relative volatility used in the pyrolysis of Indonesia oil sands

In this paper, pyrolysis of Indonesian oil sands(IOS) was investigated by two different heating methods to develop a better understanding of the microwave-assisted pyrolysis. Thermogravimetric analysis was conducted to study the thermal decomposition behaviors of IOS, showing that 550 °C might be the pyrolysis final temperature. A explanation of the heat–mass transfer process was presented to demonstrate the influence of microwave-assisted pyrolysis on the liquid product distribution. The heat–mass transfer model was also useful to explain the increase of liquid product yield and heavy component content at the same heating rate by two different heating methods. Experiments were carried out using a fixed bed reactor with and without the microwave irradiation. The results showed that liquid product yield was increased during microwave induced pyrolysis,while the formation of gas and solid residue was reduced in comparison with the conventional pyrolysis. Moreover, the liquid product characterization by elemental analysis and GC–MS indicated the significant effect on the liquid chemical composition by microwave irradiation. High polarity substances(ε N 10 at 25 °C), such as oxyorganics were increased, while relatively low polarity substances(ε b 2 at 25 °C), such as aliphatic hydrocarbons were decreased, suggesting that microwave enhanced the relative volatility of high polarity substances. The yield improvement and compositional variations in the liquid product promoted by the microwave-assisted pyrolysis deserve the further exploitation in the future.

Improving the corrosion resistance of AZ91D magnesium alloy through reinforcement with titanium carbides and borides

A composite consisting of magnesium matrix reinforced with a network of TiC-Ti_(2)AlC-TiB_(2)particulates has been fabricated using a practical in-situ reactive infiltration technique.The microstructural and phase composition of the magnesium matrix composite(R-Mg)was investigated using SEM/EDS and XRD.The analyses revealed the complete formation of TiC,Ti_(2)AlC and TiB_(2)particles in the magnesium matrix.Comparative compression tests of R-Mg and AZ91D alloy showed that the reinforcing particles improve the mechanical properties of Mg alloy.EIS and potentiodynamic polarization results indicated that the reinforcing particles significantly improve the corrosion resistance of the reinforced alloy in 3.5%NaCl solution.

Characteristics of the propagation of partial discharge ultrasonic signals on a transformer wall based on Sagnac interference

The acoustic emission(AE)method has been widely recognized for the detection of incipient insulation fault phenomenon(partial discharge,PD)in power transfomiers,nevertheless,the installation and placement of AE sensors should be taken into full consideration.In this manuscript,a three-dimensional multiphysics model was established and simulated to research the characteristics of the propagation in the transformer wall.Furthermore,a piezoelectric transducer was used to detect PD ultrasonic signals and verify the simulation results in the laboratory.To ensure the accuracy of the detection,an optical fiber sensor based on the Sagnac interference principle was designed and adopted.The variation of the amplitude of the ultrasonic signal with distance reveals the characteristics of the ultrasonic signal propagating in the transformer wall.The distribution of sound pressure on the upper and lower surfaces of the simulation model proved that ultrasonic waves propagate in the form of symmetrical Lamb waves in the transformer wall.Moreover,the amplitude of the AE attenuates due to absorption and refraction loss,and local fluctuations on account of acoustic interference.Thus,a stable signal detected by an AE sensor does not represent the absence of PD in a transfomier.To improve the reliability of AE detection,it is proposed in this manuscript that repeated movement of the AE sensor is necessary to obtain a suitable measurement position.Similarly,it is necessary to adjust the position of the AE sensor in order to locate the PD source well.In addition,this study is expected to provide a theoretical analysis and a fiber sensor to address the problem of sensor placement in AE detection.

Understanding the effects of excimer laser treatment on corrosion behavior of biodegradable Mg-1Ca alloy in simulated body fluid

In this study,a KrF excimer laser was used to modify the biodegradable Mg-1Ca alloy and the time-evolution degradation behavior of the alloy before and after laser treatment was investigated in simulated body fluid(SBF)solution using immersion tests and electrochemical impedance spectroscopy(EIS).A 5μm melted layer with a homogeneous microstructure and an MgO film on the surface were achieved by laser radiation.Corrosion observations(hydrogen evolution,morphology and corrosion products)and EIS results revealed an improvement of corrosion resistance after laser treatment for 48 h.It was found a two-layer structure developed after 2 h immersion on both the untreated and laser-treated alloys,but the sequence of forming the two layers was opposite and greatly influenced by the laser-treated layer.The time-evolution corrosion processes on the untreated and laser-treated alloys were discussed,providing a better understanding of corrosion behavior of biodegradable Mg alloys modified by excimer laser.

Linearized Controller Design for the Output Probability Density Functions of Non-Gaussian Stochastic Systems

This paper presents a linearized approach for the controller design of the shape of output probability density functions for general stochastic systems. A square root approximation to an output probability density function is realized by a set of B-spline functions. This generally produces a nonlinear state space model for the weights of the B-spline approximation. A linearized model is therefore obtained and embedded into a performance function that measures the tracking error of the output probability density function with respect to a given distribution. By using this performance function as a Lyapunov function for the closed loop system, a feedback control input has been obtained which guarantees closed loop stability and realizes perfect tracking. The algorithm described in this paper has been tested on a simulated example and desired results have been achieved.

Thermal Analysis and Immobilisation of Spent Ion Exchange Resin in Borosilicate Glass

The underground disposal of waste arising from the nuclear industry needs constant evaluation in order to improve upon it through minimizing the volume and cost by reducing the amount of glass used without compromising the safety of any leakage from the radioactive waste form. The immobilization of the spent resin (NRW-40) in borosilicate glass was investigated to meet the acceptance criteria for disposal of nuclear waste. The organic mixed bed resin in granular form was used as a waste target. The analysis of surrogate resin doped with radioactive and non-radioactive cesium (Cs) and cobalt (Co) was carried out to investigate their thermal and chemical properties and their compatibility with an alkaline borosilicate glass. The thermal analysis indicates that the structural damage caused by 1 mSv gamma radiation to the radioactive resin has altered its properties in comparison with the non-radioactive resin, same amount of cesium (8.88 wt%) and cobalt (1.88 wt%) were used in both resins. The immobilization of residue shows that the excess sulfur in the residue caused phase crystallization in the final glass matrix. It was found that the volatilization of Cs-137 and Co-60 from the successful radioactive resin-glass matrix (HG-3-IER-500) were more than that in the non-radioactive resin-glass matrix (HG-3-IEX-500). The study demonstrates comprehensive experimental and analytical works and shows that it is possible to minimise the volume of the waste while keeping the required safety levels, however further research needs to be carried out in this area.