Prevention of post-operative nausea and vomiting with honey as a pre-operative oral carbohydrate : a randomised controlled pilot trial

Background: Post-operative nausea and vomiting (PONV) is the second-most common post-operative complication. Prolonged pre-operative fasting is common in Australia despite guidelines recommending reduced fasting to improve patient outcomes, such as PONV. Commercially prepared preoperative oral carbohydrate (OC) drinks may be used to reduce fasting time. In this study commercial products were replaced with honey, an inexpensive and common food item. Design: Partially blinded, four parallel arms randomised controlled non-inferiority trial compared pre-operative OC loading with overnight fasting. Methods: Adult elective laparoscopic cholecystectomy and thyroidectomy patients having two or more risk factors for PONV were allocated into intervention and control groups by simple randomisation. The intervention group ingested 60g of honey in 100 ml of water at least two hours before surgery as pre-operative OC loading to reduce PONV. Participants and assessors to the group assignment were blinded to the study outcomes. Early PONV (0–6 hours) was measured with Rhodes index of nausea, vomiting and retching (R-INVR) and a numeric rating scale (NRS). Results: The four groups (N = 142) were control and intervention groups of thyroidectomy patients (n = 72: C = 37, I = 35), and control and intervention groups of laparoscopic cholecystectomy patients (n = 70: C = 37, I = 33) and had similar distributions of variables. The estimated effect size was 140 with a 95 percent confidence interval. The PONV incidence (Pearson χ2 = 4.54; df = 1; p = 0.03) and severity were significantly lower in the laparoscopic cholecystectomy intervention group (R-INVR: Mann–Whitney U = 446.5; p = 0.01; NRS: Mann–Whitney U = 444.5; p = 0.01) and results were not conclusive in the thyroidectomy group (NRS: Mann–Whitney U = 629.5; p = 0.95; R-INVR: Mann–Whitney U = 629.5; p = 0.76). Conclusion: Honey could be recommended as an inexpensive pre-operative OC to reduce PONV in adult patients receiving general anaesthesia

Urban share of the "burden" : impact of a support organisation on caregiver burden of people affected by dementia

Purpose. This study investigated the experiences and expectations of unpaid caregivers who were members of a nonprofit social support organisation. Design and Methods. Colaizzi's phenomenological exploration was followed. Data were saturated after 15 in-depth individual interviews at a centre for people affected with dementia. Findings. The themes reported with the COREQ checklist were contributory to caregiver burden, the escalation of dementia symptoms, changes in family roles, psychological distress, social challenges, membership in a social network, and developing effective coping skills. Practice Implications. Access, availability, and continuity of psychosocial support programs are vital for the wellbeing of people affected with dementia

Rehabilitation after surgery for hip fracture – the impact of prompt, frequent and mobilisation-focused physiotherapy on discharge outcomes: an observational cohort study

Purpose: To determine the relationship between three postoperative physiotherapy activities (time to first postoperative walk, activity on the day after surgery, and physiotherapy frequency), and the outcomes of hospital length of stay (LOS) and discharge destination after hip fracture. Methods: A cohort study was conducted on 437 hip fracture surgery patients aged ≥ 50 years across 36 participating hospitals from the Australian and New Zealand Hip Fracture Registry Acute Rehabilitation Sprint Audit during June 2022. Study outcomes included hospital LOS and discharge destination. Generalised linear and logistic regressions were used respectively, adjusted for potential confounders. Results: Of 437 patients, 62% were female, 56% were aged ≥ 85 years, 23% were previously living in a residential aged care facility, 48% usually walked with a gait aid, and 38% were cognitively impaired prior to their injury. The median acute and total LOS were 8 (IQR 5–13) and 20 (IQR 8–38) days. Approximately 71% (n = 179/251) of patients originally living in private residence returned home and 29% (n = 72/251) were discharged to a residential aged care facility. Previously mobile patients had a higher total LOS if they walked day 2–3 (10.3 days; 95% CI 3.2, 17.4) or transferred with a mechanical lifter or did not get out of bed day 1 (7.6 days; 95% CI 0.6, 14.6) compared to those who walked day 1 postoperatively. Previously mobile patients from private residence had a reduced odds of return to private residence if they walked day 2–3 (OR 0.38; 95% CI 0.17, 0.87), day 4 + (OR 0.38; 95% CI 0.15, 0.96), or if they only sat, stood or stepped on the spot day 1 (OR 0.29; 95% CI 0.13, 0.62) when compared to those who walked day 1 postoperatively. Among patients from private residence, each additional physiotherapy session per day was associated with a -2.2 (95% CI -3.3, -1.0) day shorter acute LOS, and an increased log odds of return to private residence (OR 1.76; 95% CI 1.02, 3.02). Conclusion: Hip fracture patients who walked earlier, were more active day 1 postoperatively, and/or received a higher number of physiotherapy sessions were more likely to return home after a shorter LOS

Scaling up self-constructing biological architectures through a novel application of synthetic morphogenesis

Thesis: S.M., Massachusetts Institute of Technology, Department of Architecture, 2018.Thesis: S.M., Massachusetts Institute of Technology, Department of Electrical Engineering and Computer Science, 2018.Cataloged from PDF version of thesis.Includes bibliographical references (pages 127-131).In this thesis, I introduce a novel biofabrication method Architectures from Staged Self-assembly of Morphogenetic Building Elements (ASSEMBLE), that brings about self-constructing biological structures at the architectural scale by merging scientists' newly developing ability to control the morphogenetic power of living matter with architects' and builders' discrete assembly method, which they have used for centuries to scale up their structures. ASSEMBLE arose from a recognition that in nature, simple building blocks, such as biological cells, self-organize into higher-order, complex structures with no descriptive blueprints at hand and no intelligent designer telling them what to do; instead, they execute a set of generative rules encoded in their DNA. By editing these rules, synthetic biologists can now program living cells to undergo synthetic morphogenesis, and thereby construct higher-order structures by design. However, so far, the biggest programmable structures we have developed in this way are merely on the order of millimeters, which is too small to be relevant in architectural practice. ASSEMBLE bridges this gap by employing these millimeter-scale structures as morphogenetic building elements that can self-assemble with one another through a set of physical assembly cues they are programmed grow on their surfaces. To identify which assembly cues needed on a group of morphogenetic building elements for them to self-assemble into a target structure, I also introduce a 3D global-to-local structural compiler. In this way, ASSEMBLE enables us to create self-constructing architectures by exploiting biological cells as an infinite supply of building material, into which desired structuralby Gizem Gumuskaya.S.M

Remedial actions for disassembly lines with stochastic task times

We suggest the incorporation of remedial actions for profit-oriented disassembly lines with stochastic task times. When task times are stochastic, there is a probability that some of the tasks are not completed within the predefined cycle time. For task incompletions in disassembly lines, pure remedial actions of stopping the line and offline disassembly are proposed along with the hybrid line which is a combination of the two pure remedial actions. The remedial actions have a significant effect on the expected cycle time as well as the expected profit due to line stoppages and offline disassembly, which together make up the incompletion costs. Stopping the line allows the line to be stopped until all incomplete tasks are completed, while in offline disassembly, incomplete tasks are completed in an offline disassembly area after the core leaves the line. The approaches used in assembly lines for quantifying the associated costs with stopping the line and offline repair for a given line balance are modified and used. Hybrid lines can implement both pure remedial actions for two different task classes: The line is stopped for Finish (F-) tasks and offline disassembly is executed for Pass (P-) tasks. For hybrid lines, we formulate the problem for given line balance so as to maximize the expected profit as a Mixed Integer Programming model. A full enumeration scheme is proposed to derive the hybrid line solution. As partial disassembly is allowed, for offline disassembly and hybrid line, we also formulate and solve the task selection problem so as to determine which incomplete P-tasks to execute during offline disassembly. Our computational study aims to show the significance of incompletion costs, analyze the effect of the base cycle time and demonstrate that hybrid lines are capable of improving the expected profit as well as expected cycle time compared to the pure remedial actions. Stopping the line and hybrid line on average yield 26% higher expected profits compared to offline disassembly

Carbohydrate components and crystalline structure of organosolv hemp (Cannabis sativa L.) bast fibers pulp

Changes in carbohydrate components and crystalline structure of hemp bast fibers during organosolv pulping were investigated by X-ray diffractometry, FT-IR spectroscopy and high performance liquid chromatography (HPLC). The reasons for defibrillation and beating problems with organosolv hemp bast fiber pulp were investigated with reference to these properties of pulp samples. Hemp bast fibers and organosolv pulp samples had low hemicellulose contents and high cellulose contents. It was found that the disorder parameter of cellulose in hemp bast fibers was very low, when crystalline cellulose ratio was high and the crystalline structure of cellulose in hemp bast fibers was very stable. These properties affected defibrillation and beating of organosolv hemp bast fibers pulp negatively. (c) 2006 Elsevier Ltd. All rights reserved

EVALUATING THE PERFORMANCE OF HEMP BAST FIBRES IN THE PRODUCTION OF PACKAGING PAPER USING DIFFERENT WASTEPAPER BLENDS

The predicted scarcity of wood-based fibre supplies has necessitated the search for alternative sources including non-woods by paper manufacturers. As a raw material for pulping, hemp bast fibre has some potential. To provide a guide for the pulp and paper industries, the suitability of hemp bast fibres for the pulp and paper industries was evaluated in this study, and blending trials with wastepaper pulp were conducted. In the hemp bast fibre preparation, the length of the fibres was first reduced to 4 mm. Subsequently, kraft pulping was applied to them. Along with the preparation of wastepaper pulps, hemp bast fibres and wastepaper handsheets were prepared according to a blending plan. Finally, the handsheets were subjected to paper strength tests. The properties of raw, cooked and beaten hemp bast fibres were investigated by characterisation methods such as optical microscopy, X-ray diffraction and Fourier-transform infrared spectroscopy. Additionally, carbohydrate components, solubility and ash content tests were run on raw hemp bast fibres. As a result of the experiments and analyses, the targeted results were achieved. Following the resolution of the fibrillation problem, it was determined that hemp bast fibre pulp can be used in adequate blends of wastepaper pulp when the strength values of the end product are desired to be increased (including CMT, CCT, RCT, SCT, stiffness and tear resistance) or decreased (air resistance).Ege University Scientific Research Fund [FYL-2019-21080]; Ege University Planning and Monitoring Coordination of Organizational Development and Directorate of Library and DocumentationThe authors acknowledge the technical support from Selkasan Kagit ve Pak. Malz. San. ve Tic. A.S. and the financial support from Ege University Scientific Research Fund under project no. FYL-2019-21080. We are grateful to Ege University Planning and Monitoring Coordination of Organizational Development and Directorate of Library and Documentation for their support in editing and proofreading service of this study