14 research outputs found
Degradation of methyl red using Cd-Sb/C layered double hydroxide catalyst under visible light
This research work presents the degradation of Methyl red using cadmium-antimony-carbon (Cd-Sb/C) catalyst under visible light. The double layered hydroxide was successfully prepared from cadmium fluoride (CdF2), antimony chloride (SbCl3), and rice husks activated carbon, and then characterized by X-ray Diffaractometry (XRD) Scanning Electron Microscopy (SEM) and Fourier Transform Infrared (FTIR) methods. The peaks at 2Ө 10.0, 23.4 and 35.5 in the XRD result confirmed the presence of double layered hydroxide. The effect of catalyst dosage, pH and initial concentration, on the photo degradation of Methyl red was investigated. The experimental results showed that after 100 min visible light irradiation, the percentage degradation using 200 mg Cd-Sb/C, pH 5 and 3ppm Methyl red concentration reached to 50.36%. For kinetics studies the data obtained were analysed using pseudo first order and pseudo second order kinetic models. From the linear regression coefficient values the data were found to be best fitted to pseudo second order kinetics. The results revealed that the Cd-Sb/C show good catalytic activity
PEMETAAN PERUBAHAN EKOSISTEM WILAYAH PESISIR KECAMATAN DULLAH UTARA KOTA TUAL
The high-use activities, the lack of information and data on the ecosystem as a basic reference for management of coastal areas of the Subdistrict North Dullah. This study aims to determine the potential and distribution of major ecosystems and analyze the rate of change in a certain period of time based on image interpretation. Based on the results of image analysis will be known the extent and distribution of major ecosystems, are then compared with some of the imagery in the past period of time to analyze the rate of change. This research was conducted in the coastal region of North Dullah Subdistrict Tual City. The imagery analysis used the transformation of depth invariant index and supervised classification. Landsat 8 year 2014 image interpretation shows coral reef extents are 1934.82 hectares while for sea grass extents are 614.43 hectares. In 2004 to 2009 there was a increase in coral reef ecosystems extents to 133.56 hectares (4.78%), while for the seagrass ecosystem extents increase to 84.69 ha (14.58%). In 2009 to 2014 coral reefs extent decrease to 992.16 hectares (33.89%) while for seagrass extents decrease to 51.21 hectares (7.69%).Tingginya aktivitas pemanfaatan serta kurangnya informasi dan data tentang ekosistem sebagai acuan dasar pengelolaan di wilayah pesisir Kecamatan Dullah Utara. Penelitian ini bertujuan mengetahui potensi dan sebaran ekosistem terumbu karang dan lamun serta menganalisis laju perubahannya dalam periode waktu tertentu berdasarkan hasil interpretasi citra. Berdasarkan hasil analisis citra akan diketahui luasan dan sebaran ekosistem, kemudian dibandingkan dengan beberapa citra pada periode waktu lampau untuk menganalisis laju perubahannya. Penelitian ini dilakukan di wilayah pesisir Kecamatan Dullah Laut Kota Tual. Metode analisis citra yang digunakan adalah teknik transformasi depth invariant indeks dan klasifikasi terbimbing. Hasil interpretasi citra Landsat 8 tahun 2014 menunjukkan luasan terumbu karang sebesar 1.934,82 ha sedangkan luasan lamun sebesar 614.43 ha. Pada tahun 2004 ke 2009 terjadi peningkatan luas ekosistem terumbu karang sebesar 133.56 Ha (4.78%), sedangkan ekosistem lamun terjadi peningkatan luas sebesar 84.69 ha (14.58%). Pada tahun 2009 ke 2014 ekosistem terumbu karang mengalami penurunan luas sebesar 992.16 ha (33.89%) sedangkan untuk ekosistem lamun mengalami penurunan luas sebesar 51.21 ha (7.69%)
Surgical outcomes of gallbladder cancer:the OMEGA retrospective, multicentre, international cohort study
Background: Gallbladder cancer (GBC) is rare but aggressive. The extent of surgical intervention for different GBC stages is non-uniform, ranging from cholecystectomy alone to extended resections including major hepatectomy, resection of adjacent organs and routine extrahepatic bile duct resection (EBDR). Robust evidence here is lacking, however, and survival benefit poorly defined. This study assesses factors associated with recurrence-free survival (RFS), overall survival (OS) and morbidity and mortality following GBC surgery in high income countries (HIC) and low and middle income countries (LMIC). Methods: The multicentre, retrospective Operative Management of Gallbladder Cancer (OMEGA) cohort study included all patients who underwent GBC resection across 133 centres between 1st January 2010 and 31st December 2020. Regression analyses assessed factors associated with OS, RFS and morbidity. Findings: On multivariable analysis of all 3676 patients, wedge resection and segment IVb/V resection failed to improve RFS (HR 1.04 [0.84–1.29], p = 0.711 and HR 1.18 [0.95–1.46], p = 0.13 respectively) or OS (HR 0.96 [0.79–1.17], p = 0.67 and HR 1.48 [1.16–1.88], p = 0.49 respectively), while major hepatectomy was associated with worse RFS (HR 1.33 [1.02–1.74], p = 0.037) and OS (HR 1.26 [1.03–1.53], p = 0.022). Furthermore, EBDR (OR 2.86 [2.3–3.52], p < 0.0010), resection of additional organs (OR 2.22 [1.62–3.02], p < 0.0010) and major hepatectomy (OR 3.81 [2.55–5.73], p < 0.0010) were all associated with increased morbidity and mortality. Compared to LMIC, patients in HIC were associated with poorer RFS (HR 1.18 [1.02–1.37], p = 0.031) but not OS (HR 1.05 [0.91–1.22], p = 0.48). Adjuvant and neoadjuvant treatments were infrequently used. Interpretation: In this large, multicentre analysis of GBC surgical outcomes, liver resection was not conclusively associated with improved survival, and extended resections were associated with greater morbidity and mortality without oncological benefit. Aggressive upfront resections do not benefit higher stage GBC, and international collaborations are needed to develop evidence-based neoadjuvant and adjuvant treatment strategies to minimise surgical morbidity and prioritise prognostic benefit. Funding:Cambridge Hepatopancreatobiliary Department Research Fund.</p
Prediction of morbidity and mortality after early cholecystectomy for acute calculous cholecystitis: results of the S.P.Ri.M.A.C.C. study
Artículo escrito por un elevado número de autores, solo se referencian el que aparece en primer lugar, el nombre del grupo de colaboración, si lo hubiere, y los autores pertenecientes a la UAMLess invasive alternatives than early cholecystectomy (EC) for acute calculous cholecystitis (ACC) treat‑
ment have been spreading in recent years. We still lack a reliable tool to select high-risk patients who could beneft from these alternatives. Our study aimed to prospectively validate the Chole-risk score in predicting postoperative complications in patients undergoing EC for ACC compared with other preoperative risk prediction models. Method The S.P.Ri.M.A.C.C. study is a World Society of Emergency Surgery prospective multicenter observational study. From 1st September 2021 to 1st September 2022, 1253 consecutive patients admitted in 79 centers were included. The inclusion criteria were a diagnosis of ACC and to be a candidate for EC. A Cochran-Armitage test of the trend was run to determine whether a linear correlation existed between the Chole-risk score and a complicated postoperative course. To assess the accuracy of the analyzed prediction models—POSSUM Physiological Score (PS), modifed Frailty Index, Charlson Comorbidity Index, American Society of Anesthesiologist score (ASA), APACHE II score, and ACC severity grade—receiver operating characteristic (ROC) curves were generated. The area under the ROC curve (AUC) was used to compare the diagnostic abilities. Results A 30-day major morbidity of 6.6% and 30-day mortality of 1.1% were found. Chole-risk was validated, but POSSUM PS was the best risk prediction model for a complicated course after EC for ACC (in-hospital mortality: AUC
0.94, p<0.001; 30-day mortality: AUC 0.94, p<0.001; in-hospital major morbidity: AUC 0.73, p<0.001; 30-day major morbidity: AUC 0.70, p<0.001). POSSUM PS with a cutof of 25 (defned in our study as a ‘Chole-POSSUM’ score) was then validated in a separate cohort of patients. It showed a 100% sensitivity and a 100% negative predictive value for mortality and a 96–97% negative predictive value for major complications. Conclusions The Chole-risk score was externally validated, but the CHOLE-POSSUM stands as a more accurate pre‑ diction model. CHOLE-POSSUM is a reliable tool to stratify patients with ACC into a low-risk group that may represent a safe EC candidate, and a high-risk group, where new minimally invasive endoscopic techniques may fnd the most useful feld of actio
Surgical outcomes of gallbladder cancer:the OMEGA retrospective, multicentre, international cohort study
Background: Gallbladder cancer (GBC) is rare but aggressive. The extent of surgical intervention for different GBC stages is non-uniform, ranging from cholecystectomy alone to extended resections including major hepatectomy, resection of adjacent organs and routine extrahepatic bile duct resection (EBDR). Robust evidence here is lacking, however, and survival benefit poorly defined. This study assesses factors associated with recurrence-free survival (RFS), overall survival (OS) and morbidity and mortality following GBC surgery in high income countries (HIC) and low and middle income countries (LMIC). Methods: The multicentre, retrospective Operative Management of Gallbladder Cancer (OMEGA) cohort study included all patients who underwent GBC resection across 133 centres between 1st January 2010 and 31st December 2020. Regression analyses assessed factors associated with OS, RFS and morbidity. Findings: On multivariable analysis of all 3676 patients, wedge resection and segment IVb/V resection failed to improve RFS (HR 1.04 [0.84–1.29], p = 0.711 and HR 1.18 [0.95–1.46], p = 0.13 respectively) or OS (HR 0.96 [0.79–1.17], p = 0.67 and HR 1.48 [1.16–1.88], p = 0.49 respectively), while major hepatectomy was associated with worse RFS (HR 1.33 [1.02–1.74], p = 0.037) and OS (HR 1.26 [1.03–1.53], p = 0.022). Furthermore, EBDR (OR 2.86 [2.3–3.52], p < 0.0010), resection of additional organs (OR 2.22 [1.62–3.02], p < 0.0010) and major hepatectomy (OR 3.81 [2.55–5.73], p < 0.0010) were all associated with increased morbidity and mortality. Compared to LMIC, patients in HIC were associated with poorer RFS (HR 1.18 [1.02–1.37], p = 0.031) but not OS (HR 1.05 [0.91–1.22], p = 0.48). Adjuvant and neoadjuvant treatments were infrequently used. Interpretation: In this large, multicentre analysis of GBC surgical outcomes, liver resection was not conclusively associated with improved survival, and extended resections were associated with greater morbidity and mortality without oncological benefit. Aggressive upfront resections do not benefit higher stage GBC, and international collaborations are needed to develop evidence-based neoadjuvant and adjuvant treatment strategies to minimise surgical morbidity and prioritise prognostic benefit. Funding:Cambridge Hepatopancreatobiliary Department Research Fund.</p
Prediction of morbidity and mortality after early cholecystectomy for acute calculous cholecystitis : results of the SPRi.MACC study
Peer reviewe
Choosing To Thrive: Finding Self And Fulfillment Through My Organizational Dynamics Learning Journey
As I sought a better life for myself, making me first in my family in many ways, I struggled to navigate the uncharted territories of college and the workplace far away from home. I was racked with guilt, shame, and fear about the what-ifs, which held me back from living a more authentic life. Various frameworks from the Organizational Dynamics program and other influential experiences have given me the tools to reposition my thinking more purposefully, and to create a vision for living and to uncover my potential as an instrument of change. I describe the powerful moments that propelled me into wanting to thrive and not just survive. I also share my exploration in learning and identifying with the impostor phenomenon experience
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
background: healthcare cannot achieve net-zero carbon without addressing operating theatres. the aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.Methods: This study adopted a four-phase delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was coprioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low-middle-income countries.Results: In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of 'single-use' consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low-middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.Conclusion: This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high- and low-middle-income countries
Reducing the environmental impact of surgery on a global scale:systematic review and co-prioritization with healthcare workers in 132 countries
Reducing the environmental impact of surgery on a global scale : systematic review and co-prioritization with healthcare workers in 132 countries
Background:
Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.
Methods:
This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries.
Results:
In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.
Conclusion:
This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries