Experimental investigation on performance of short pineapple leaf fiber reinforced tapioca biopolymer composites

The performance of short pineapple leaf fiber (PALF) reinforced tapioca biopolymer (TBP) composites were investigated, specifically the effect of fiber length and fiber composition on mechanical properties (tensile properties, flexural strength, and impact strength). Composite samples with different fiber lengths (< 0.50 mm, 0.51 mm to 1.00 mm, and 1.01 mm to 2.00 mm) and different fiber compositions (10%, 20%, 30%, and 40%) were prepared through crushing, sieving, internal mixing, compression molding, and machining processes. The combination of PALF and TBP enhanced the mechanical properties of composites with 30% as the optimum fiber content. However, the influence of different fiber lengths up to 2.00 mm provided no significant effect on producing maximum tensile properties. Good interfacial adhesion between PALF and TBP was evident from scanning electron microscopy analysis. Therefore, the combination of PALF and TBP has great potential as a renewable and biodegradable polymer. Moreover, PALF-TBP composites are expected to become alternatives to petroleum-based polymers

Overview of the important factors influencing the performance of eco-friendly brake pads

The braking system is a crucial element in automotive safety. In order for the braking mechanism to function effectively, the brake pads’ durability as well as quality are crucial aspects to take into account. A brake pad is a part of a vehicle that holds the wheel rotation so that braking can occur. Asbestos, which is harmful to human health, is a raw material that is recently being widely used as a material mixture for the manufacturing of brake pads. Many efforts have been made by researchers to find other natural alternative materials to replace the use of asbestos. Natural materials that have received much attention and research include coconut fiber, wood powder or flour, bamboo fiber, shell powder, etc. This review paper focuses on analyzing the main parameters that affect brake pad performance. The composition of filler and fiber types of reinforcement for polymer composites is discussed. Previous studies’ information on the fabrication and testing of brake pads are also highlighted. Furthermore, the findings of this review can provide researchers and academicians with useful information and points to consider for further research

Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

: The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135-15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359-5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138-5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184-5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598-9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090-6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286-5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p &lt; 0.001; 95% CI 1.912-7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138-0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143-0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990)

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract 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

Mechanical properties of mengkuang leave fiber reinforced low density polyethylene composites

Mengkuang (Pandanus tectorius) grows abundantly in the coastal region of Southeast Asia. To date, the application of mengkuang leaves fiber (MLF) as reinforcement in polymer matrix is still limited in literature making its potential as reinforced material remain unknown. Therefore, this chapter focuses on the tensile properties, flexural, and impact properties of (MLF)/LDPE composite fabricated through the hot compression machine. In this study, the effect of volume fraction, fiber length of MLF was investigated. Two main groups of MLF/LDPE composite samples were established. The first group consists of different fiber mesh size range (<0.5 mm, 0.5–8 mm, and 1–2 mm) with constant volume fraction (10 wt%) while in another group volume fraction is varying (10, 20, and 30 wt%) but constant fiber length (<0.5 mm). Further investigation was conducted by treating the MLF/LDPE composite of volume fraction 30 wt% and fiber length 0.5 mm with maleic anhydride polyethylene (MAPE) with loading content of 2, 4, and 6 wt% The surface fracture of each samples was analyzed via scanning electron microscope. The result from both groups is compared to the pure LDPE. From the result, it can be concluded that both volume fraction and fiber length do not improve tensile properties and impact properties of MLF/LDPE composite. However, the flexural strength of MLF/LDPE increased significantly. A similar result was obtained when MLF/LDPE composite was treated with the MAPE

Experimental Investigation on Performance of Short Pineapple Leaf Fiber Reinforced Tapioca Biopolymer Composites

The performance of short pineapple leaf fiber (PALF) reinforced tapioca biopolymer (TBP) composites were investigated, specifically the effect of fiber length and fiber composition on mechanical properties (tensile properties, flexural strength, and impact strength). Composite samples with different fiber lengths (< 0.50 mm, 0.51 mm to 1.00 mm, and 1.01 mm to 2.00 mm) and different fiber compositions (10%, 20%, 30%, and 40%) were prepared through crushing, sieving, internal mixing, compression molding, and machining processes. The combination of PALF and TBP enhanced the mechanical properties of composites with 30% as the optimum fiber content. However, the influence of different fiber lengths up to 2.00 mm provided no significant effect on producing maximum tensile properties. Good interfacial adhesion between PALF and TBP was evident from scanning electron microscopy analysis. Therefore, the combination of PALF and TBP has great potential as a renewable and biodegradable polymer. Moreover, PALF-TBP composites are expected to become alternatives to petroleum-based polymers

Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic

Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P &lt; 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)