Mechanical properties of La-based bulk amorphous alloy and composites

Influence of different microstructure of La-based fully amorphous samples and its composites on the impact fracture energy were investigated and discussed. Results showed improvement in fracture energy of glassy metals with the presence intermetallic phases, but deteriorated in the presence of dendrite phases and high volume % of crystalline phases.Singapore-MIT Alliance (SMA

Assessment of nutritional status and nutrition impact symptoms in patients undergoing resection for upper gastrointestinal cancer: Results from the multi-centre nourish point prevalence study

Background: Identification and treatment of malnutrition are essential in upper gastrointestinal (UGI) cancer. However, there is limited understanding of the nutritional status of UGI cancer patients at the time of curative surgery. This prospective point prevalence study involving 27 Australian tertiary hospitals investigated nutritional status at the time of curative UGI cancer resection, as well as presence of preoperative nutrition impact symptoms, and associations with length of stay (LOS) and surgical complications. Methods: Subjective global assessment, hand grip strength (HGS) and weight were performed within 7 days of admission. Data on preoperative weight changes, nutrition impact symptoms, and dietary intake were collected using a purpose-built data collection tool. Surgical LOS and complications were also recorded. Multivariate regression models were developed for nutritional status, unintentional weight loss, LOS and complications. Results: This study included 200 patients undergoing oesophageal, gastric and pancreatic surgery. Malnutrition prevalence was 42% (95% confidence interval (CI) 35%, 49%), 49% lost ≥5% weight in 6 months, and 47% of those who completed HGS assessment had low muscle strength with no differences between surgical procedures (p = 0.864, p = 0.943, p = 0.075, respectively). The overall prevalence of reporting at least one preoperative nutrition impact symptom was 55%, with poor appetite (37%) and early satiety (23%) the most frequently reported. Age (odds ratio (OR) 4.1, 95% CI 1.5, 11.5, p = 0.008), unintentional weight loss of ≥5% in 6 months (OR 28.7, 95% CI 10.5, 78.6, p < 0.001), vomiting (OR 17.1, 95% CI 1.4, 207.8, 0.025), reduced food intake lasting 2–4 weeks (OR 7.4, 95% CI 1.3, 43.5, p = 0.026) and ≥1 month (OR 7.7, 95% CI 2.7, 22.0, p < 0.001) were independently associated with preoperative malnutrition. Factors independently associated with unintentional weight loss were poor appetite (OR 3.7, 95% CI 1.6, 8.4, p = 0.002) and degree of solid food reduction of <75% (OR 3.3, 95% CI 1.2, 9.2, p = 0.02) and <50% (OR 4.9, 95% CI 1.5, 15.6, p = 0.008) of usual intake. Malnutrition (regression coefficient 3.6, 95% CI 0.1, 7.2, p = 0.048) and unintentional weight loss (regression coefficient 4.1, 95% CI 0.5, 7.6, p = 0.026) were independently associated with LOS, but no associations were found for complications. Conclusions: Despite increasing recognition of the importance of preoperative nutritional intervention, a high proportion of patients present with malnutrition or clinically significant weight loss, which are associated with increased LOS. Factors associated with malnutrition and weight loss should be incorporated into routine preoperative screening. Further investigation is required of current practice for dietetics interventions received prior to UGI surgery and if this mitigates the impact on clinical outcomes

Preoperative nutrition intervention in patients undergoing resection for upper gastrointestinal cancer: Results from the multi-centre nourish point prevalence study:Results from the Multi-Centre NOURISH Point Prevalence Study

Background: Preoperative nutrition intervention is recommended prior to upper gastrointestinal (UGI) cancer resection; however, there is limited understanding of interventions received in current clinical practice. This study investigated type and frequency of preoperative dietetics intervention and nutrition support received and clinical and demographic factors associated with receipt of intervention. Associations between intervention and preoperative weight loss, surgical length of stay (LOS), and complications were also investigated. Methods: The NOURISH Point Prevalence Study was conducted between September 2019 and May 2020 across 27 Australian tertiary centres. Subjective global assessment and weight were performed within 7 days of admission. Patients reported on preoperative dietetics and nutrition intervention, and surgical LOS and complications were recorded. Results: Two-hundred patients participated (59% male, mean (standard deviation) age 67 (10)). Sixty percent had seen a dietitian preoperatively, whilst 50% were receiving nutrition support (92% oral nutrition support (ONS)). Patients undergoing pancreatic surgery were less likely to receive dietetics intervention and nutrition support than oesophageal or gastric surgeries (p 2 weeks had lower mean (SD) percentage weight loss than those who did not (1.2 (1.8) vs. 2.9 (3.4), p = 0.001). In malnourished patients, total dietetics appointments ≥3 was independently associated with reduced surgical complications (odds ratio 0.2, 95% confidence interval (CI) 0.1, 0.9, p = 0.04), and ONS >2 weeks was associated with reduced LOS (regression coefficient −7.3, 95% CI −14.3, −0.3, p = 0.04). Conclusions: Despite recommendations, there are low rates of preoperative dietetics consultation and nutrition support in this population, which are associated with increased preoperative weight loss and risk of increased LOS and complications in malnourished patients. The results of this study provide insights into evidence–practice gaps for improvement and data to support further research regarding optimal methods of preoperative nutrition support

Cohort feasibility study of an intermittent pneumatic compression device within a below-knee cast for the prevention of venous thromboembolism

OBJECTIVES: To determine the likely enrolment rate of eligible participants into a randomised controlled trial (RCT) in which a within-cast intermittent pneumatic compression device using Jet Impulse Technology (IPC/JIT) is 1 of 3 possible interventions in a RCT for the prevention of venous thromboembolism (VTE) in the clinical setting of isolated lower limb cast immobilisation. DESIGN: A prospective, open-label feasibility study of the IPC/JIT device placed within a lower limb cast. SETTING: Wellington Regional Hospital Fracture Clinic.PARTICIPANTS: Individuals aged 18-70 who presented with a lower limb injury requiring a minimum of 4 weeks below-knee cast immobilisation. INTERVENTION: Placement of an IPC/JIT device within lower limb cast. OUTCOME MEASURES: The main outcome measure was the proportion of eligible participants who participated in the feasibility study. Secondary outcome measures included adherence to device usage throughout the study, ease of application of the device and adverse events potentially associated with its use. RESULTS: The proportion of potentially eligible participants for the IPC/JIT device was only 7/142 (5%), 95% CI 2 to 9.9. Devices were used for a mean (range) of 4.1 (1.9 to 10.2) hours per day and none of 7 participants had adequate adherence to the device. 3 of the 7 participants suffered an adverse event, including 1 deep vein thrombosis, 2 dorsal foot ulcer and 1 skin maceration. CONCLUSIONS: A within-cast IPC/JIT device is unlikely to be a feasible randomisation arm for a RCT assessing possible interventions for the reduction of VTE risk in the clinical setting of lower limb injury requiring below knee cast immobilisation for a minimum of 4 weeks

Cohort feasibility study of an intermittent pneumatic compression device within a below-knee cast for the prevention of venous thromboembolism

OBJECTIVES: To determine the likely enrolment rate of eligible participants into a randomised controlled trial (RCT) in which a within-cast intermittent pneumatic compression device using Jet Impulse Technology (IPC/JIT) is 1 of 3 possible interventions in a RCT for the prevention of venous thromboembolism (VTE) in the clinical setting of isolated lower limb cast immobilisation. DESIGN: A prospective, open-label feasibility study of the IPC/JIT device placed within a lower limb cast. SETTING: Wellington Regional Hospital Fracture Clinic.PARTICIPANTS: Individuals aged 18-70 who presented with a lower limb injury requiring a minimum of 4 weeks below-knee cast immobilisation. INTERVENTION: Placement of an IPC/JIT device within lower limb cast. OUTCOME MEASURES: The main outcome measure was the proportion of eligible participants who participated in the feasibility study. Secondary outcome measures included adherence to device usage throughout the study, ease of application of the device and adverse events potentially associated with its use. RESULTS: The proportion of potentially eligible participants for the IPC/JIT device was only 7/142 (5%), 95% CI 2 to 9.9. Devices were used for a mean (range) of 4.1 (1.9 to 10.2) hours per day and none of 7 participants had adequate adherence to the device. 3 of the 7 participants suffered an adverse event, including 1 deep vein thrombosis, 2 dorsal foot ulcer and 1 skin maceration. CONCLUSIONS: A within-cast IPC/JIT device is unlikely to be a feasible randomisation arm for a RCT assessing possible interventions for the reduction of VTE risk in the clinical setting of lower limb injury requiring below knee cast immobilisation for a minimum of 4 weeks

Subsurface properties of Lucus Planum, Mars, as seen by MARSIS

Lucus Planum, extending for a radius of approximately 500 km around 181°E, 5°S, is part of the Medusae Fossae Formation (MFF), a set of several discontinuous deposits of fine-grained, friable material straddling across the Martian highland-lowland boundary. Parts of the MFF have been probed through radar sounding by MARSIS and SHARAD, synthetic-aperture, low-frequency radars carried respectively by ESA's Mars Express and NASA's Mars Reconnaissance Orbiter. They transmit low-frequency radar pulses that are capable of penetrating below the surface, and are reflected by any dielectric discontinuity present in the subsurface. The dielectric permittivity of the MFF material, estimated from data of both radars, is consistent with either a substantial component of water ice or a low-density, ice-poor material. There is no evidence for internal layering in SHARAD data, despite the fact that layering at scales of tens of meters has been reported in many parts of the MFF. This lack of detection can be the result of one or more factors, such as high interface roughness, low dielectric contrast between materials, or discontinuity of the layers. After more than 10 years of observations, MARSIS has acquired about 240 orbits across Lucus Planum, making it possible to map the presence and depth of subsurface interfaces to a much greater detail than in previous works. The positions and strengths of subsurface echoes were extracted manually from radargrams and mapped across Lucus Planum, converting echo time delay to apparent depth. The strongest subsurface echoes, resulting from weak internal attenuation, strong subsurface reflectivity, or both, are found within the deposits located NW of Apollinaris Patera, while no subsurface echoes could be detected in the central section of Lucus Planum, in spite of several high-SNR observations. Subsurface reflections are common in the Eastern and Northwestern sectors, in some cases to depths of more than 2000 m assuming a dielectric permittivity of about 3. The lack of subsurface reflections in the central part of Lucus Planum can be the result of several factors, some of which depend on surface properties. A high topographic roughness at scales comparable to the radar wavelength causes scattering of the impinging pulse, resulting in weaker surface and subsurface echoes. However, surface roughness estimated from MOLA data is higher in the Eastern part of Lucus Planum. Another possibility is that roughness at the base of the deposit is higher in its central part, although there is no indication of such kind of trend in the older surrounding terrains. Because subsurface echoes appear to be closely associated with areas of distinct surface morphology, it is possible that Lucus Planum is in fact laterally inhomogeneous and that the central part consists of denser, more radar-attenuating material. This work was supported by the Italian Space Agency (ASI) through contract no. I/032/12/1