Physicochemical Properties, Cytotoxicity, and Antioxidative Activity of Natural Deep Eutectic Solvents Containing Organic Acid

Natural deep eutectic solvents (NADES) may be considered ‘designer solvents’ due to their numerous structural variations and the possibility of tailoring their physicochemical properties. Prior to their industrial application, characterization of NADES is essential, including determination of their physicochemical properties, cytotoxicity, and antioxidative activity. The most important physicochemical properties of eight prepared NADES (choline chloride:malic acid, proline:malic acid, choline chloride:proline:malic acid, betaine:malic acid, malic acid:glucose, malic acid:glucose:glycerol, choline chloride:citric acid, and betaine:citric acid) were measured as functions of temperature and water content. In general, the structure of prepared NADES greatly influences their physical properties, which could be successfully modified and adjusted by addition of water. All tested NADES were absolutely benign and noncorrosive for investigated steel X6CrNiTi18-10. Furthermore, cytotoxicity of prepared solvents was assessed toward three human cell lines (HEK-293T, HeLa, and MCF-7 cells), and antioxidative activity was measured by the Oxygen Radical Absorbance Capacity (ORAC) method. With regard to cell viability, all tested NADES containing carboxylic acid could be classified as practically harmless and considered environmentally safe. The ORAC values indicated that the tested NADES displayed antioxidative activity

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research