Effectiveness of a Surgery Admission Unit for patients undergoing major elective surgery in a tertiary university hospital

<p>Abstract</p> <p>Background</p> <p>The increasing demand on hospitalisation, either due to elective activity from the waiting lists or due to emergency admissions coming from the Emergency Department (ED), requires looking for strategies that lead to effective bed management. The aim of this study was to evaluate the effectiveness of a surgery admission unit for major elective surgery patients who were admitted for same-day surgery.</p> <p>Methods</p> <p>We included all patients admitted for elective surgery in a university tertiary hospital between the 1st of September and the 31st of December 2006, as well as those admitted during the same period of 2008, after the introduction of the Surgery Admission Unit. The main outcome parameters were global length of stay, pre-surgery length of stay, proportion of patients admitted the same day of the surgery and number of cancellations. Differences between the two periods were evaluated by the T-test and Chi-square test. Significance at P < 0.05 was assumed throughout.</p> <p>Results</p> <p>We included 6,053 patients, 3,003 during 2006 and 3,050 patients during 2008. Global length of stay was 6.2 days (IC 95%:6.4-6) in 2006 and 5.5 days (IC 95%:5.8-5.2) in 2008 (p < 0.005). Pre-surgery length of stay was reduced from 0.46 days (IC 95%:0.44-0.48) in 2006 to 0.29 days (IC 95%:0.27-0.31) in 2008 (p < 0.005). The proportion of patients admitted for same-day surgery was 67% (IC 95%:69%-65%) in 2006 and 76% (IC 95%:78%-74%) in 2008 (p < 0.005). The number of cancelled interventions due to insufficient preparation was 31 patients in 2006 and 7 patients in 2008.</p> <p>Conclusions</p> <p>The implementation of a Surgery Admission Unit for patients undergoing major elective surgery has proved to be an effective strategy for improving bed management. It has enabled an improvement in the proportion of patients admitted on the same day as surgery and a shorter length of stay.</p

The juvenile hormone analogue, pyriproxifen, alters protein and fat composition of Tenebrio molitor larvae

Maximising the yield of product from livestock is common practice in the agriculture industry and there is potential to extend this practice to the emerging insect industry, to produce high-quality, sustainable protein. Tenebrio molitor larvae, commonly called yellow mealworms, were fed for 28 days on wheat bran containing the juvenile hormone analogue, pyriproxifen at either 2 mg pyriproxifen/kg wheat bran (JH-PL) or 15 mg pyriproxifen/kg wheat bran (JH-PH). As expected, pupation was inhibited in both pyriproxifen treated groups and significant changes in nutritional composition were observed. Pyriproxifen treated mealworms had a higher protein content per 100 grams of dried material, while fat content was reduced 68% in JH-PH compared to control. These changes were associated with an increase in moisture content and reduction in energy content. The fatty acid profile of extracted fat also displayed significant alterations, with pyriproxifen treated mealworms showing an increase in proportions of saturated fatty acids, reduction in oleic acid but no effect on linoleic acid. The amino acid composition also exhibited a change in composition as a result of pyriproxifen treatment, including an increase in the essential amino acid, lysine, in JH-PH treated mealworms. This change in amino acid profile was associated with a change in the protein composition as observed on SDS-PAGE, with the appearance of a new band identified as the egg-yolk protein, vitellogenin, which has lipid-transporter activity. Hence, pyriproxifen treatment of mealworms has a repartitioning effect, resulting in an increase in the proportion of protein and a decrease in fat on a dry matter basis, demonstrating that mealworm nutrient composition can be manipulated to provide a higher value feed ingredient

Changes in nutrient composition and gene expression in growing mealworms (Tenebrio molitor)

Insects are of high interest as a sustainable source of nutrients to be included in the food production system. The larvae of Tenebrio molitor, commonly known as yellow mealworms (MW), have a high protein content, which means potential applications in the animal feed and human food sectors. However, previous reports have shown considerable variability in the nutrient composition of mealworms, which may in part, be due to harvesting at different developmental stages. A better understanding of the regulation of composition during development would potentially facilitate future attempts to manipulate nutrient content, perhaps through gene editing, to maximize commercial value. In the present study, mealworms were harvested at various time points within a 24 day period leading up to the start of pupation. At the earliest time points (between days −24 and −17), a 44% increase in fat content was seen, which was maintained throughout the rest of development. By day −12, protein content fell by 12%, a change that was also maintained. Throughout development there was a change in fatty acid composition, with a shift from oleic acid being the major fatty acid at day −24, to linoleic acid being predominant at later time points. In an attempt to better understand the genetic basis of these changes, an analysis of the transcriptome was undertaken. In the absence of a specific annotated genome for the mealworm, an Affymetrix GeneChip microarray for Drosophila was utilized. The hybridisation of RNA extracted from five developmental stages (larvae and pupae) showed differential gene expression; and some potential orthologs were identified which may be involved in regulating nutrient composition during development. However, we were unable to identify a significant proportion of the most highly regulated genes, highlighting the need for a fully annotated mealworm genome

CT-Scan study of crack patterns of fiber-reinforced concrete loaded monotonically and under low-cycle fatigue

Most fatigue models for concrete under compression assume, as an axiom, that compressive tests are a limit case for a cyclic test where failure is achieved in the first cycle. This is supported by the fact that the crack patterns obtained in both cases are similar to the naked eye. This paper focuses on verifying whether this observation is correct or not. For that, we used a Computed Tomography Scan together with digital image processing to obtain 3D damage maps of tested 40 mm edge-length cubes made of steel fiber-reinforced concrete. The cubes were classified in series according to the type of loading: intact, monotonic and cyclic. They were scanned to acquire their 3D damage maps. Additionally, a specific post-processing algorithm was developed by the authors to compare the different crack patterns. The results show that average damage maps for monotonically and cyclically-tested cubes are statistically similar, thereby confirming the initial hypothesis for steel fiber-reinforced concrete. Furthermore, damage distribution near the platens apparently depends on whether it is a fixed platen or it is adjustable to the specimen surface due to a spherical seat.Ministerio de Economía y Competitividad, Spain, under grants BIA2015-68678-C2-1-R and BIA2015-68678-C2-2-

The trophic importance of epiphytic algae in a freshwater macrophyte system (Potamogeton perfoliatus L.): stable isotope and fatty acid analyses

Stable isotope and fatty acid analyses were used to study carbon sources for animals in a submerged plant bed. Epiphytes growing on Potamogeton perfoliatus, sand microflora, and alder leaves were the most important carbon sources. The most abundant macrophyte, P. perfoliatus was unimportant as a food source. Modelling (IsoSource) showed that epiphytes were the most important food source for the most abundant benthic invertebrates, the isopod Asellus aquaticus (annual mean contribution 64%), the amphipod Gammarus pulex (66%), and the gastropod Potamopyrgus antipodarum (83%). The mean annual contributions of sand microflora were, respectively, 21, 19, and 9%; and of alder leaves, 15, 15, and 8% for these three species. The relative importance of carbon sources varied seasonally. The relative contribution of epiphytes was lowest for all three grazer species in July: A. aquaticus 38%, G. pulex 43%, and P. antipodarum 42%. A decline in epiphyte biomass in summer may have caused this switch to less attractive food sources. P. perfoliatus provided habitat and shelter for consumers, but food was mainly supplied indirectly by providing space for attached epiphytes, which are fast-growing and provide a highly nutritious food source

Extensive cross-disciplinary analysis of biological and chemical control of Calanus finmarchicus reproduction during an aldehyde forming diatom bloom in mesocosms

Egg and faecal pellet production and egg hatching success of the calanoid copepod Calanus finmarchicus were monitored over a period of 14 days (14-28 April, 2008) while fed water from 4 differently treated mesocosms and ambient water. Two of the mesocosms used were inoculated with the polyunsaturated aldehyde (PUA)-producing diatom Skeletonema marinoi, while 2 received only nutrient additions with or without silica. The mesocosms developed blooms of S. marinoi, mixed diatoms or the haptophyte Phaeocystis pouchetii, respectively. Faecal pellet production of C. finmarchicus increased with increasing food availability. Egg production increased with time in all mesocosms to a maximum single female production of 232 eggs female(-1) day(-1) (average of 90 eggs female(-1) day(-1)) and followed the development of ciliates and P. pouchetii, but was not affected by the observed high (up to 15 nmol L(-1)) PUA production potential of the phytoplankton. The hatching success of the eggs produced on the mesocosm diets was high (78-96%) and was not affected by either aldehydes in the maternal diet or exposure to the dissolved aldehydes in the water

Long-Term Conditioning to Elevated pCO2 and Warming Influences the Fatty and Amino Acid Composition of the Diatom Cylindrotheca fusiformis

The unabated rise in anthropogenic CO2 emissions is predicted to strongly influence the ocean's environment, increasing the mean sea-surface temperature by 4°C and causing a pH decline of 0.3 units by the year 2100. These changes are likely to affect the nutritional value of marine food sources since temperature and CO2 can influence the fatty (FA) and amino acid (AA) composition of marine primary producers. Here, essential amino (EA) and polyunsaturated fatty (PUFA) acids are of particular importance due to their nutritional value to higher trophic levels. In order to determine the interactive effects of CO2 and temperature on the nutritional quality of a primary producer, we analyzed the relative PUFA and EA composition of the diatom Cylindrotheca fusiformis cultured under a factorial matrix of 2 temperatures (14 and 19°C) and 3 partial pressures of CO2 (180, 380, 750 μatm) for >250 generations. Our results show a decay of ∼3% and ∼6% in PUFA and EA content in algae kept at a pCO2 of 750 μatm (high) compared to the 380 μatm (intermediate) CO2 treatments at 14°C. Cultures kept at 19°C displayed a ∼3% lower PUFA content under high compared to intermediate pCO2, while EA did not show differences between treatments. Algae grown at a pCO2 of 180 μatm (low) had a lower PUFA and AA content in relation to those at intermediate and high CO2 levels at 14°C, but there were no differences in EA at 19°C for any CO2 treatment. This study is the first to report adverse effects of warming and acidification on the EA of a primary producer, and corroborates previous observations of negative effects of these stressors on PUFA. Considering that only ∼20% of essential biomolecules such as PUFA (and possibly EA) are incorporated into new biomass at the next trophic level, thepotential impacts of adverse effects of ocean warming and acidification at the base of the food web may be amplified towards higher trophic levels, which rely on them as source of essential biomolecules

Updated Iberian archeomagnetic catalogue: new full vector paleosecular variation curve for the last three millennia

In this work, we present 16 directional and 27 intensity high‐quality values from Iberia. Moreover, we have updated the Iberian archeomagnetic catalogue published more than 10 years ago with a considerable increase in the database. This has led to a notable improvement of both temporal and spatial data distribution. A full vector paleosecular variation curve from 1000 BC to 1900 AD has been developed using high‐quality data within a radius of 900 km from Madrid. A hierarchical bootstrap method has been followed for the computation of the curves. The most remarkable feature of the new curves is a notable intensity maximum of about 80 μT around 600 BC, which has not been previously reported for the Iberian Peninsula. We have also analyzed the evolution of the paleofield in Europe for the last three thousand years and conclude that the high maximum intensity values observed around 600 BC in the Iberian Peninsula could respond to the same feature as the Levantine Iron Age Anomaly, after travelling westward through Europe