Challenges and advancement in water absorption of natural fiber-reinforced polymer composites

Natural fibres (NFRs) composite materials are acquiring popularity in the modern world due to their eco-friendliness and superior mechanical properties. Although it has been shown that determining this is a herculean endeavour in the literature, the water absorption (WA) qualities of the natural fibre (NFR) are crucial in the progressive degradation of the features of the resulting composites. This article seeks to report exhaustively on studies pertaining to the WA attributes of polymer composites reinforced with NFRs. This article provides an overview of NFR, its characterization, and the issues related to its addition to the matrix. The primary purpose of this research study is to investigate existing studies on the problems associated with the creation of cellulosic fibre hybrid composites, water absorption, and its impact on the tensile (TS), flexural (FS), and impact strength (IS) of NFR reinforced composites. We reviewed various surface treatments (ST) applied to NFR, including alkali treatment, silane treatment, acetylation, as well as recent advancements aimed at mitigating WA, enhancing hydrophobicity, and improving the interfacial bonding (IB) between NFR and the polymer matrix (PM). Additionally, we assessed the effectiveness of utilizing nanoparticles (NAPs) in specific ST of NFR to minimize water absorption

Comprehensive insights on mechanical attributes of natural-synthetic fibres in polymer composites

In order to increase the robustness of natural fiber (NFR), hybridization with synthetic fibers is crucial. The widespread usage of hybrid composites (HCs) in modern structural applications reflects their increasing popularity. When compared to non-hybrid composites, hybridization offers additional advantages due to its combination of inexpensive, high-quality fibers that enhance the properties of a composite without a significant increase in cost. Although the mechanical properties (MP) of various HCs have not yet been explored in depth, it is one of the benefits brought by hybridization. This article reviews and analyzes the latest information on the MP of HCs composed of synthetic and natural fibers. It also conducts a critical analysis of the important information that can be gleaned from published research on the factors that influence the morphological characteristics, physical-mechanical attributes, benefits, and challenges associated with NFR-reinforced composites. As a result, this compilation provides an in-depth critical analysis of innovative treatment techniques that are suitable for enhancing interfacial bonding (IB) between NF and polymer matrix (PM) and their MP. Additionally, each category of HCs, including thermoset and thermoplastic polymers as well as bionanocomposites, is discussed. Overall, this comprehensive study demonstrates that lignocellulosic fibers are widely employed in composite reinforcement and confirms that the hybridization of various reinforcing fibers has synergistic impacts on the mechanical properties of HCs

Epidemiology of surgery associated acute kidney injury (EPIS-AKI): a prospective international observational multi-center clinical study

Purpose: The incidence, patient features, risk factors and outcomes of surgery-associated postoperative acute kidney injury (PO-AKI) across different countries and health care systems is unclear. Methods: We conducted an international prospective, observational, multi-center study in 30 countries in patients undergoing major surgery (> 2-h duration and postoperative intensive care unit (ICU) or high dependency unit admission). The primary endpoint was the occurrence of PO-AKI within 72 h of surgery defined by the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Secondary endpoints included PO-AKI severity and duration, use of renal replacement therapy (RRT), mortality, and ICU and hospital length of stay. Results: We studied 10,568 patients and 1945 (18.4%) developed PO-AKI (1236 (63.5%) KDIGO stage 1500 (25.7%) KDIGO stage 2209 (10.7%) KDIGO stage 3). In 33.8% PO-AKI was persistent, and 170/1945 (8.7%) of patients with PO-AKI received RRT in the ICU. Patients with PO-AKI had greater ICU (6.3% vs. 0.7%) and hospital (8.6% vs. 1.4%) mortality, and longer ICU (median 2 (Q1-Q3, 1-3) days vs. 3 (Q1-Q3, 1-6) days) and hospital length of stay (median 14 (Q1-Q3, 9-24) days vs. 10 (Q1-Q3, 7-17) days). Risk factors for PO-AKI included older age, comorbidities (hypertension, diabetes, chronic kidney disease), type, duration and urgency of surgery as well as intraoperative vasopressors, and aminoglycosides administration. Conclusion: In a comprehensive multinational study, approximately one in five patients develop PO-AKI after major surgery. Increasing severity of PO-AKI is associated with a progressive increase in adverse outcomes. Our findings indicate that PO-AKI represents a significant burden for health care worldwide

Acute kidney disease beyond day 7 after major surgery: a secondary analysis of the EPIS-AKI trial

Purpose: Acute kidney disease (AKD) is a significant health care burden worldwide. However, little is known about this complication after major surgery. Methods: We conducted an international prospective, observational, multi-center study among patients undergoing major surgery. The primary study endpoint was the incidence of AKD (defined as new onset of estimated glomerular filtration rate (eCFR) < 60 ml/min/1.73 m2 present on day 7 or later) among survivors. Secondary endpoints included the relationship between early postoperative acute kidney injury (AKI) (within 72 h after major surgery) and subsequent AKD, the identification of risk factors for AKD, and the rate of chronic kidney disease (CKD) progression in patients with pre-existing CKD. Results: We studied 9510 patients without pre-existing CKD. Of these, 940 (9.9%) developed AKD after 7 days of whom 34.1% experiencing an episode of early postoperative-AKI. Rates of AKD after 7 days significantly increased with the severity (19.1% Kidney Disease Improving Global Outcomes [KDIGO] 1, 24.5% KDIGO2, 34.3% KDIGO3; P < 0.001) and duration (15.5% transient vs 38.3% persistent AKI; P < 0.001) of early postoperative-AKI. Independent risk factors for AKD included early postoperative-AKI, exposure to perioperative nephrotoxic agents, and postoperative pneumonia. Early postoperative-AKI carried an independent odds ratio for AKD of 2.64 (95% confidence interval [CI] 2.21-3.15). Of 663 patients with pre-existing CKD, 42 (6.3%) had worsening CKD at day 90. In patients with CKD and an episode of early AKI, CKD progression occurred in 11.6%. Conclusion: One in ten major surgery patients developed AKD beyond 7 days after surgery, in most cases without an episode of early postoperative-AKI. However, early postoperative-AKI severity and duration were associated with an increased rate of AKD and early postoperative-AKI was strongly associated with AKD independent of all other potential risk factors