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1.
Artigo em Inglês | MEDLINE | ID: mdl-38532601

RESUMO

AIM: This article describes the use of graphite(Gr) and boron carbide (B4C) as multiple nanoparticle reinforcements in LM25 aluminum alloy. Because boron carbide naturally absorbs neutron radiation, aluminium alloy reinforced with boron carbide metal matrix composite has gained interest in nuclear shielding applications. The primary goal of the endeavor is to create composite materials with high wear resistance, high microhardness, and high ultimate tensile strength for use in nuclear applications. BACKGROUND: Science and Technology have brought a vast change to human life. The human burden has been minimized by the use of innovation in developing new and innovative technologies. To improve the quality of human life, fresh, lightweight, and creative materials are being used, which play a vital role in science and technology and reduce the human workload. Composite materials made of metal are being used because they are lightweight. Neutron absorption, high ultimate strength, high wear resistance, high microhardness, high thermal and electrical conductivity, high vacuum environmental resistance, and low coefficient of thermal expansion under static and dynamic conditions are all demands for the hybrid metal matrix composites utilized in nuclear applications. OBJECTIVE: • Stir casting is used to create the novel LM 25 aluminum alloy/graphite and boron carbide hybrid nanocomposites. • The mechanical properties such as ultimate tensile strength, yield strength, percentage of elongation, microhardness, and wear behavior are calculated. • Three analyses are performed: microstructure, worn surface analysis, and fracture analysis of the tensile specimen. METHOD: • Stir casting process< • Tensile, Hardness, Wear Test • Materials Characterization - FESEM, Optical Microscopy, EDS< Results: The mechanical properties values are 308.76 MPa, 293.51 MPa, 7.8, 169.2 VHN, and 0.01854mm3/m intended for ultimate tensile strength, yield strength, percentage of elongation, microhardness, and wear behavior, respectively. This implies that the synthesized composite may be used in nuclear applications successfully. CONCLUSION: The subsequent explanation was drawn from this investigative work: • The LM 25/B4C/Gr hybrid nanocomposite was successfully manufactured by employing the stir casting technique. For nuclear shielding applications, these composites were prepared with three different weight percentages of nanoparticle reinforcements in 2,4,6% Boron carbide and constant 4 wt.% graphite. • The microhardness values of the three-hybrid nanocomposite fabricated castings were determined to be 143.4VHN, 156.7VHN, and 169.2VHN, respectively. • The hybrid nano composite's microstructure revealed that the underlying LM 25 aluminum alloy matrix's finegrained, evenly dispersed nanoparticles of graphite and boron carbide were present.

• The microtensile test was carried out and it was found that the ultimate tensile strength, yield strength and percentage of elongation values are 281.35MPa, 296.52MPa, 308.76MPa, 269.43, 274.69, 293.51 and 3.4, 5.7, 7.8 respectively.

• Deformation caused the hybrid LM 25/B4C/Gr nanocomposite to fracture in ductile mode. Dimples and cavities are seen in the fracture because of the nanoparticle reinforcements and the matrix's tight connection.

• The wear loss of nanocomposite based on the input parameter applied load, sliding velocity and sliding distance values are 0.02456, 0.02189, 0.01854, 0.02892, 0.02586, 0.02315 and 0.02682, 0.02254, 0.02015 mm3/m, respectively.

• The LM 25 alloy's elemental analysis displays the aluminum alloy phase as the largest peak and the remaining elements as smaller peaks; also, the spectral analysis reveals the presence of boron (B), graphite (C), silicon, and ferrous in the aluminum alloy LM 25.

• Through worn surface FESEM investigation, it was shown that under sliding and high load situations, debris, delamination, and groove develop. Further rupture, fine, and continuous grooves were seen when low stress and sliding circumstances were applied to the LM 25/B4C/Gr and stir cast specimen. This result implies the presence of mild adhesive and delamination wear processes.

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2.
ACS Nano ; 18(14): 9942-9957, 2024 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-38552006

RESUMO

Highly efficient, cost-effective, and durable electrocatalysts, capable of accelerating sluggish reaction kinetics and attaining high performance, are essential for developing sustainable energy technologies but remain a great challenge. Here, we leverage a facile heterostructure design strategy to construct atomically thin Os@Pd metallenes, with atomic-scale Os nanoclusters of varying geometries confined on the surface layer of the Pd lattice, which exhibit excellent bifunctional properties for catalyzing both hydrogen evolution (HER) and oxygen reduction reactions (ORR). Importantly, Os5%@Pd metallenes manifest a low η10 overpotential of only 11 mV in 1.0 M KOH electrolyte (HER) as well as a highly positive E1/2 potential of 0.92 V in 0.1 M KOH (ORR), along with superior mass activities and electrochemical durability. Theoretical investigations reveal that the strong electron redistribution between Os and Pd elements renders a precise fine-tuning of respective d-band centers, thereby guiding adsorption of hydrogen and oxygen intermediates with an appropriate binding energy for the optimal HER and ORR.

3.
Environ Monit Assess ; 196(4): 352, 2024 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-38466376

RESUMO

With characterized for complex and maximum substance (suspended solids, broke up oil, a mixture of inorganic and chromium sulfides), tannery wastewater was subjected to a treatment process on removal of chemical oxygen demand (COD) via upstream anaerobic sludge blanket reactor where we found reduced departure efficiencies and that process limits were affected by the assortments in regular stacking rates, closeness of chromium, and sulfides. Hence, a combination of the aerobic-anaerobic hybrid reactor was set up for sequential treatment to determine possible COD reduction. This study investigated the biological degradation of tannery wastewater in a laboratory-scale sequential up-flow aerobic-anaerobic reactor. The aerobic zone at the top was packed with spherical ball-shaped polyhedral polypropylene, and the anaerobic zone at the bottom was packed medium with granular media. The aeration flow rate varied by 2 L/min, 4 L/min, and 6 L/min in the aerobic zone, and the reactor maintained an organic loading rate (OLR) of 5 kg COD/m3/d. Parameters like COD and gas yield assess the performance of the reactor. The maximum COD of 86% is removed in the anaerobic zone with an aeration rate of 6 L/min, and the 1800-mL methane gas yield is measured by the 29th day.


Assuntos
Reatores Biológicos , Águas Residuárias , Anaerobiose , Análise da Demanda Biológica de Oxigênio , Monitoramento Ambiental , Cromo , Sulfetos , Eliminação de Resíduos Líquidos , Oxigênio
4.
Nat Commun ; 15(1): 1550, 2024 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-38378733

RESUMO

Super-resolution techniques expand the abilities of researchers who have the knowledge and resources to either build or purchase a system. This excludes the part of the research community without these capabilities. Here we introduce the openSIM add-on to upgrade existing optical microscopes to Structured Illumination super-resolution Microscopes (SIM). The openSIM is an open-hardware system, designed and documented to be easily duplicated by other laboratories, making super-resolution modality accessible to facilitate innovative research. The add-on approach gives a performance improvement for pre-existing lab equipment without the need to build a completely new system.

5.
Int Angiol ; 42(5): 396-401, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-38010012

RESUMO

Buerger's disease (BD) remains a debilitating condition and early diagnosis is paramount for its effective management. Despite many published diagnostic criteria for BD, selective criteria have been utilized in different vascular centers to manage patients with BD worldwide. A recent international Delphi Consensus Study on the diagnostic criteria of BD showed that none of these published diagnostic criteria have been universally accepted as a gold standard. Apart from the presence of smoking, these published diagnostic criteria have distinct differences between them, rendering the direct comparison of patient outcomes difficult. Hence, the expert committees from the Working Group of the VAS-European Independent Foundation in Angiology/Vascular Medicine critically reviewed the findings from the Delphi study and provided practical recommendations on the diagnostic criteria for BD, facilitating its universal use. We recommend that the 'definitive' diagnosis of BD must require the presence of three features (history of smoking, typical angiographic features and typical histopathological features) and the use of a combination of major and minor criteria for the 'suspected' diagnosis of BD. The major criterion is the history of active tobacco smoking. The five minor criteria are disease onset at age less than 45 years, ischemic involvement of the lower limbs, ischemic involvement of one or both of the upper limbs, thrombophlebitis migrans and red-blue shade of purple discoloration on edematous toes or fingers. We recommend that a 'suspected' diagnosis of BD is confirmed in the presence of a major criterion plus four or more minor criteria. In the absence of the major criterion or in cases of fewer than four minor criteria, imaging and laboratory data could facilitate the diagnosis. Validation studies on the use of these major and minor criteria are underway.


Assuntos
Tromboangiite Obliterante , Humanos , Pessoa de Meia-Idade , Tromboangiite Obliterante/diagnóstico , Fumar , Angiografia
6.
ACS Nano ; 17(11): 10733-10747, 2023 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-37196172

RESUMO

Highly efficient and durable electrocatalysts are of the utmost importance for the sustainable generation of clean hydrogen by water electrolysis. Here, we present a report of an atomically thin rhodium metallene incorporated with oxygen-bridged single atomic tungsten (Rh-O-W) as a high-performance electrocatalyst for pH-universal hydrogen evolution reaction. The Rh-O-W metallene delivers ascendant electrocatalytic HER performance, characterized by exceptionally low overpotentials, ultrahigh mass activities, excellent turnover frequencies, and robust stability with negligible deactivation, in pH-universal electrolytes, outperforming that of benchmark Pt/C, Rh/C and numerous other reported precious-metal HER catalysts. Interestingly, the promoting feature of -O-W single atomic sites is understood via operando X-ray absorption spectroscopy characterization and theoretical calculations. On account of electron transfer and equilibration processes take place between the binary components of Rh-O-W metallenes, fine-tuning of the density of states and electron localization at Rh active sites is attained, hence promoting HER via a near-optimal hydrogen adsorption.

7.
Adv Mater ; 35(12): e2208860, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36598813

RESUMO

Developing highly efficient multifunctional electrocatalysts is crucial for future sustainable energy  pursuits, but remains a great challenge. Herein, a facile synthetic strategy is used to confine atomically thin Pd-PdO nanodomains to amorphous Ru metallene oxide (RuO2 ). The as-synthesized electrocatalyst (Pd2 RuOx-0.5 h) exhibits excellent catalytic activity toward the pH-universal hydrogen evolution reaction (η10  = 14 mV in 1 m KOH, η10  = 12 mV in 0.5 m H2 SO4 , and η10  = 22 mV in 1 m PBS), alkaline oxygen evolution reaction (η10  = 225 mV), and overall water splitting (E10  = 1.49 V) with high mass activity and operational stability. Further reduction endows the material (Pd2 RuOx-2 h) with a promising alkaline oxygen reduction activity, evidenced by high halfway potential, four-electron selectivity, and excellent poison tolerance. The enhanced catalytic activity is attributed to the rational integration of favorable nanostructures, including 1) the atomically thin nanosheet morphology, 2) the coexisting amorphous and defective crystalline phases, and 3) the multi-component heterostructural features. These structural factors effectively regulate the material's electronic configuration and the adsorption of intermediates at the active sites for favorable reaction energetics.

8.
Eur Arch Otorhinolaryngol ; 280(3): 985-1004, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36350369

RESUMO

PURPOSE: Hyperacusis is the hypersensitivity to auditory stimuli that would typically not affect those with hearing sensitivity within normal limits. The prevalence of hyperacusis in the general population has been estimated to range from 9% to 15%. There is no universally accepted definition for what defines hyperacusis among kindred illnesses of poor sound tolerance. As a result, hyperacusis prevalence varies more, which has an impact on both assessment and treatment. This study aims to determine the efficacy of the different clinical assessment measures of hyperacusis in assessing hyperacusis through a systematic review. METHODS: A review and reference of literature were done on hyperacusis, and assessment measures were used. A review of 23 articles was conducted to highlight these measures used. Most selected studies included retrospective, prospective, survey, and experimental designs. Study quality reported an overall low risk of bias. RESULTS: This review reports the summary and the current evidence of clinical assessment measures used for diagnosing hyperacusis. CONCLUSIONS: This review highlights a protocol that may be used in the clinical diagnosis of hyperacusis. It also shows the necessity to standardize and validate assessment measures for the younger population.


Assuntos
Audição , Hiperacusia , Humanos , Hiperacusia/diagnóstico , Hiperacusia/epidemiologia , Estudos Retrospectivos , Estudos Prospectivos , Testes Auditivos
9.
Sci Rep ; 12(1): 14128, 2022 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-35986025

RESUMO

This paper discusses the equivalent circuit model and functional verification of an integrated antenna system as its main focus. The integrated antenna system consists of two independent antenna systems, namely the Cognitive Radio antenna and the Ultra Wide Band Multiple Iinput Multiple Output antenna. This article is split into two parts: The first part discusses the equivalent circuit of an integrated antenna system by optimizing the RLC values. The developed lumped equivalent circuit model produces the NB resonant frequencies, which is the same as the S-parameter obtained through EM simulation. The second part of this paper aims to discuss the experimental verification of an integrated CR antenna system with Bayesian learning-based spectrum sensing algorithms using Universal Software Radio Peripheral devices. Real-time sensing and communication functionalities are visualized in the LABVIEW monitor. The integrated antenna system is fabricated and measured after the simulation.

10.
Percept Mot Skills ; 129(1): 33-46, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34749545

RESUMO

In the context of language descriptions, the terms oral and verbal praxis refer to volitional movements for performing oral gestures and movements for speech. These movements involve programming articulators and rapid sequences of muscle firings that are required for speech sound productions. A growing body of research has highlighted the links between oral motor kinematics and language production skills in both typically developing (TD) children and children with developmental language disorders, including Specific Language Impairment (SLI). Yet, there have been limited attempts to assess the link between non-linguistic and linguistic development. In the present study, we investigated oral and verbal praxis behaviors in children with SLI. Fifteen children with SLI formed a clinical group and 15 children with typical development who were matched to the clinical group for chronological age, gender, and socio-economic status formed the TD group. We assessed participants in both groups for their language abilities with age-appropriate standardized language tests. To investigate oral and verbal praxis behaviors, we administered the Assessment Protocol for Oral Motor, Oral Praxis and Verbal Praxis Skills to the two groups. We used the non-parametric Mann-Whitney U test to compare the two groups with respect to oral and verbal praxis measures; and we found a significant difference between isolated and sequential movements in the oral praxis section in two age subgroups of these groups (p ≤ .05). Spearman's correlations revealed a strong correlation between core language scores and sequential movements in the younger children with SLI and in TD children. These results showed co-morbidity between SLI and poor oral motor skills, suggesting that SLI is not just a language disorder, but a group of co-morbid conditions that include oral motor and verbal praxis difficulties.


Assuntos
Transtornos do Desenvolvimento da Linguagem , Aptidão , Criança , Gestos , Humanos , Testes de Linguagem , Fala , Comportamento Verbal
12.
Int Angiol ; 40(5): 395-408, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34236154

RESUMO

Even today thromboangiitis obliterans has disease features that remain misunderstood or underappreciated. The epidemiology, etiology and pathophysiology of the disease are still unclear. Biomarkers and disease activity markers are lacking, thus clinical assessment is difficult. We are still struggling to establish unique diagnostic, staging and treatment criteria. This is an academic-collaborative effort to describe the pathophysiology, the clinical manifestations, the diagnostic approach, and the challenges of management of patients with TAO. A systematic search for relevant studies dating from 1900 to the end of 2020 was performed on the PubMed, SCOPUS, and Science Direct databases. Given the intriguing nature of presentation of TAO, its management, to some extent is not only different in different regions of the world but also varies within the same region. Following this project, we discovered ambiguity, overlap and lack of clear-cut criteria for management of TAO. An international group of experts however came to one conclusion. They all agree that management of TAO needs a call for action for a renewed global look with multi-center studies, to update the geographical distribution of the disease and to establish a unique set of diagnostic criteria and a consensus-based guideline for best treatment based on current evidence.


Assuntos
Cardiologia , Tromboangiite Obliterante , Humanos , Tromboangiite Obliterante/diagnóstico , Tromboangiite Obliterante/epidemiologia , Tromboangiite Obliterante/terapia
13.
Chem Soc Rev ; 50(12): 6700-6719, 2021 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-33959737

RESUMO

Metallenes, atomically thin layers composed primarily of under-coordinated metal atoms, have emerged as the newest members in the family of 2D nanomaterials. Furthermore, the remarkable physicochemical properties associated with metallenes coupled with the ease of applying chemical modifications result in exciting opportunities towards catalyst engineering for electrochemical conversions. Especially in recent years, interest around metallenes has grown, evidenced by the surge in available literature. As such, it is imperative to review the findings and present directions for the future. In this review, we highlight the techniques available for deriving metallenes and further discuss the modification strategies commonly employed in devising metallenes to better suit applications in electrocatalysis. We provide a rational understanding of how each strategy drives performance enhancements and present gaps in the knowledge, necessary for further advancements in the field.

14.
Clin Infect Dis ; 73(Suppl 1): S77-S80, 2021 07 15.
Artigo em Inglês | MEDLINE | ID: mdl-33956136

RESUMO

A suspected outbreak of influenza A and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at a long-term care facility in Los Angeles County was, months later, determined to not involve influenza. To prevent inadvertent transmission of infections, facilities should use highly specific influenza diagnostics and follow Centers for Disease Control and Prevention (CDC) guidelines that specifically address infection control challenges.


Assuntos
COVID-19 , Influenza Humana , Surtos de Doenças , Humanos , Influenza Humana/diagnóstico , Influenza Humana/epidemiologia , Assistência de Longa Duração , SARS-CoV-2
15.
Clin Infect Dis ; 72(12): 2212-2214, 2021 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-32968772

RESUMO

Following increases in reported cases of hepatitis A, we assessed the impact of hepatitis A vaccine in Alaska Native persons. During 1996-2018, only 6 cases of hepatitis A were identified, all in unvaccinated adults. Populations can be protected against hepatitis A by achieving sufficient vaccination coverage over time.


Assuntos
Nativos do Alasca , Vírus da Hepatite A , Hepatite A , Adulto , Alaska/epidemiologia , Hepatite A/epidemiologia , Hepatite A/prevenção & controle , Humanos , Vacinação , Cobertura Vacinal
16.
Int J Obstet Anesth ; 43: 27-29, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32570047

RESUMO

We describe the anaesthetic management of a parturient who, due to a severe needle phobia, requested an inhalational induction of general anaesthesia for an elective caesarean section. If general anaesthesia is indicated, conventional practice in the UK is to perform a rapid sequence induction via an intravenous route of drug administration to allow rapid intubation of the trachea. This is because obstetric patients are considered to have a 'full stomach' due to the effects of pregnancy and labour on gastric emptying, and a higher risk of aspiration with consequent maternal and fetal adverse outcomes. Despite a thorough consent process highlighting these significant risks, the patient insisted on an inhalational induction of anaesthesia. We present the case and discuss the ethical dilemma (relating to patient care) in situations in which decisions made by patients deviate from medical recommendations.


Assuntos
Anestesia Geral/métodos , Anestesia por Inalação/métodos , Anestesia Obstétrica/ética , Anestesia Obstétrica/métodos , Cesárea , Transtornos Fóbicos/psicologia , Anestesia por Inalação/ética , Anestesia por Inalação/psicologia , Anestesia Obstétrica/psicologia , Procedimentos Cirúrgicos Eletivos , Feminino , Humanos , Gravidez
17.
Vaccine ; 38(27): 4273-4280, 2020 06 02.
Artigo em Inglês | MEDLINE | ID: mdl-32409137

RESUMO

BACKGROUND: In Alaska, while introduction of 13-valent pneumococcal conjugate vaccine led to declines in invasive pneumococcal disease, carriage prevalence remained stable because of replacement with non-vaccine serotypes. We assessed antibiotic non-susceptibility of carried pneumococci during serotype redistribution, determined the contributions of within-serotype shifts, and assessed factors that could explain changes in non-susceptibility. METHODS: Each year from 2008 to 2015, at multiple sites in Alaska, we collected nasopharyngeal swabs and completed surveys for a convenience sample of participants. Pneumococcal serotyping and antimicrobial susceptibility testing for penicillin and erythromycin were performed. We described changes in non-susceptibility of isolates from 2008-2011 to 2012-2015, and assessed the contributions of serotype redistribution and within-serotype changes in non-susceptibility by comparing observed data to modeled data removing either factor. We used weighted logistic regression to assess whether reported risk factors could explain changes over time in non-susceptibility within serotypes. RESULTS: From 2008-2011 to 2012-2015, the overall proportion of isolates non-susceptible to penicillin or erythromycin increased by 3%, from 23% (n = 1,183) to 26% (n = 1,589; P < 0.05). However, a decrease of 3% would be expected if serotype redistribution occurred without within-serotype changes in non-susceptibility. Standardization by either factor produced hypothetical data significantly different to observed data. Within serotypes, the average annual increase in odds of non-susceptibility to penicillin or erythromycin was 1.08 (95% CI 1.05-1.11). Recent antibiotic exposure, urban residence and increased household size of participants predicted isolate non-susceptibility but did not explain the increase over time. DISCUSSION: An overall increase in non-susceptibility of carried pneumococcal isolates to penicillin or erythromycin resulted from increases in non-susceptibility within serotypes, which outweighed a protective effect of serotype redistribution. Characterization of emerging resistant clones within carried non-vaccine serotypes, including risk factors for colonization and disease, would support disease prevention efforts and inform vaccine strategies.


Assuntos
Antibacterianos , Infecções Pneumocócicas , Alaska/epidemiologia , Antibacterianos/farmacologia , Humanos , Lactente , Testes de Sensibilidade Microbiana , Infecções Pneumocócicas/epidemiologia , Infecções Pneumocócicas/prevenção & controle , Vacinas Pneumocócicas , Sorogrupo , Sorotipagem
18.
J Trace Elem Med Biol ; 57: 126418, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31704176

RESUMO

BACKGROUND: The determination of dietary mineral solubility is one of the main steps in the evaluation of their availability for a given species. METHODS: This study proposed an in vitro digestion method (acidic and alkaline hydrolysis). The method was applied to evaluate the solubility of inorganic and organic forms of zinc (Zn), selenium (Se) and manganese (Mn) in salmonid diets. An inorganic mineral (IM) diet was supplemented with zinc sulphate, sodium selenite and manganous sulphate and an organic mineral (OM) diet was supplemented with zinc chelate of glycine, l-selenomethionine and manganese chelate of glycine. RESULTS: The solubility of Zn was similar in both diets tested. The amount of soluble Zn was low in the acidic hydrolysis (3-8%) and lower in the alkaline hydrolysis (0.4-2%). The solubility of Se was higher in the OM diet (7-34%) compared with the IM diet (3-12%). Regarding Mn, after the acidic hydrolysis the solubility was higher in the IM diet (6-25%) than the OM diet (4-17%). The in vitro solubility were compared with in vivo availability of Zn, Se and Mn. Data obtained for solubility (%) of Zn, Se and Mn was lower when compared with apparent availability (%) of Zn, Se and Mn. CONCLUSION: Data obtained demonstrated that solubility of Zn, Se and Mn was influenced by the mineral chemical form supplemented to the diet and by the gastrointestinal environment. The solubility of Zn, Se and Mn was not comparable with the apparent availability of Zn, Se and Mn. Nevertheless, the effect of the chemical form of the minerals was similar for the solubility of Zn, Se and Mn and the apparent availability of Zn, Se and Mn. Considering the overall results of this study, the in vitro method could replace some of the in vivo studies for a qualitative evaluation but not for a quantitative evaluation.


Assuntos
Manganês/metabolismo , Salmo salar/metabolismo , Selênio/metabolismo , Oligoelementos/metabolismo , Zinco/metabolismo , Animais , Suplementos Nutricionais
19.
Anesthesiol Res Pract ; 2019: 3408940, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31871449

RESUMO

INTRODUCTION: Optimum perioperative fluid therapy is important to improve the outcome of the surgical patient. This study prospectively compared goal-directed intraoperative fluid therapy with traditional fluid therapy in general surgical patients undergoing open major bowel surgery. METHODOLOGY: Patients between 20 and 70 years of age, either gender, ASA I and II, and scheduled for elective open major bowel surgery were included in the study. Patients who underwent laparoscopic and other surgeries were excluded. After routine induction of general anaesthesia, the patients were randomised to either the control group (traditional fluid therapy), the FloTrac group (based on stroke volume variation), or the PVI group (based on pleth variability index). Fluid input and output, recovery characteristics, and complications were noted. RESULTS: 306 patients, with 102 in each group, were enrolled. Five patients (control (1), FloTrac (2), and PVI (2)) were inoperable and were excluded. Demographic data, ASA PS, anaesthetic technique, duration of surgery, and surgical procedures were comparable. The control group received significantly more crystalloids (3200 ml) than the FloTrac (2000 ml) and PVI groups (1875 ml), whereas infusion of colloids was higher in the FloTrac (400-700 ml) and PVI (200-500 ml) groups than in the control group (0-500 ml). The control group had significantly positive net fluid balance intraoperatively (2500 ml, 9 ml/kg/h) compared to the FloTrac (1515 ml, 5.4 ml/kg/h) and PVI (1420 ml, 6 ml/kg/h) groups. Days to ICU stay, HDU stay, return of bowel movement, oral intake, morbidity, duration of hospital stay, and survival rate were comparable. The total number of complications was not different between the three groups. Anastomotic leaks occurred more often in the Control group than in the others, but the numbers were small. CONCLUSIONS: Use of goal-directed fluid management, either with FloTrac or pleth variability index results in a lower volume infusion and lower net fluid balance. However, the complication rate is similar to that of traditional fluid therapy. This trial is registered with CTRI/2018/04/013016.

20.
PeerJ ; 7: e6996, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31183254

RESUMO

Atlantic salmon (Salmo salar) feeds have changed drastically in their composition from being predominantly marine-based to plant-based. This has altered the dietary supply and availability of micro-nutrients to Atlantic salmon. The impact of graded inclusion levels of a nutrient package (NP) comprising of 25 different micro-nutrients were studied in Atlantic salmon parr in freshwater (Trial 1) and post-smolts in seawater (Trial 2). In brief, the NP was included from 0 to 400%, where 100% corresponded to the recommendation by the National Research Council, 2011. Micro-nutrients, namely Zn, Mn, Se, Cu, Fe, Co, I and vitamin D3 were included in the NP with the objective of (re)evaluating the dietary need to meet the requirement of Atlantic salmon parr and post-smolt, when fed low fish meal, plant ingredient-based diets. Responses in apparent availability coefficient (AAC), whole body and vertebrae mineral concentrations, and retention were analysed. AAC of Cu, Mn, Se and Zn responded in a quadratic fashion with an increase in NP from 0 to 400% in freshwater parr; AAC could not be measured in post-smolt salmon. The whole-body concentration of Zn, Se, Co and I in Atlantic salmon parr were significantly affected by increasing NP inclusion; the same was observed for Zn, Se and Co in post-smolt Atlantic salmon. Vertebrae mineral concentration as the response criterion was non-responsive in parr; whereas, in post-smolt, Co had a linear increase, while Zn and Se showed a non-linear increase upon 0 to 400 NP inclusion. Zinc concentration and activities of alkaline phosphatase (ALP) and tartrate-resistant acid phosphatase (TRAP) in vertebrae indicated increased bone resorption in post-smolt Atlantic salmon; TRAP activity increased linearly with NP inclusion in post-smolt, but not in parr. Significant correlations between Zn and Se were observed in AAC and vertebral concentrations, indicating an interaction in intestinal uptake and vertebral deposition. Overall, Atlantic salmon parr held in freshwater were able to satisfy the requirement for the trace minerals Zn, Mn, Se, Cu, and Fe through supply from 100-150 NP, corresponding to 101-132, 47-63, 0.6-0.8, 12-16 and 150-166 mg kg -1, respectively; for iodine, dietary supply from 150-200 NP, corresponding to 0.7-1.6 mg kg-1, was required. In the seawater, Atlantic salmon post-smolt, in general, required micro-minerals and vitamin D3 levels as supplied through 150-200 NP, corresponding to 140-177, Zn; 61-67, Mn; 0.9-1, Se; 14-16, Cu; and vitamin D3, 0.06-0.09 mg kg -1 to fulfil the requirement, except for Cu which was satisfied at 100-150 NP, equivalent to 13-14 mg kg -1 diet.

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