THE EFFECT OF POLYMER TYPE AND FIBER ORIENTATION ON THE COMPLIANCE PROPERTIES OF ELECTROSPUN VASCULAR GRAFTS

Vascular diseases are a major source of fatalities globally. However, the lack of accessibility of autologous vessels and the poor efficacy of commercial small-diameter vascular grafts limit surgical alternatives. Researchers therefore aimed to develop vascular prostheses that meet all requirements. Apart from the benefits of tissue-engineered grafts, significant obstacles that still hinder successful grafting include compliance mismatch, dilatation, thrombus development, and the absence of elastin. Among these issues, compliance mismatch between native vessel and artificial vascular scaffold has been mentioned in the literature as a possible cause of intimal hyperplasia, suture site rupture and endothelial and platelet cell damage. As a result, the usage of suitable materials and optimized fabrication techniques are required to achieve better control over the characteristics and functionality of the grafts. In particular, in the case of electrospun vascular grafts, the compliance can be adjusted throughout a broad range of values by adjusting the electrospinning parameters such as material selection, fiber orientation, porosity, and wall thickness. In this study, the electrospun vascular grafts consisting of pure PCL, PLA, and their blends were produced by using two different rotation speeds to achieve the oriented and non-oriented scaffolds. The impact of polymer type and fiber orientation on the compliance properties was evaluated. The results revealed that both material selection and fiber alignment have a significant effect on the compliance levels. PCL100_R grafts had the highest compliance value whereas the PCLPLA50_O scaffold had the lowest

Maternal Thyroid Dysfunction and Neonatal Thyroid Problems

Aim. To investigate obstetric features of pregnant women with thyroid disorders and thyroid function tests of their newborn infants. Methods. Women with hypothyroidism and having anti-thyroglobulin (ATG) and anti-thyroid peroxidase (anti-TPO) antibodies were assigned as group I, women with hypothyroidism who did not have autoantibodies were assigned as group II, and women without thyroid problems were assigned as group III. Results. Pregnant women with autoimmune hypothyroidism (group I) had more preterm delivery and their babies needed more frequent neonatal intensive care unit (NICU) admission. In group I, one infant was diagnosed with compensated hypothyroidism and one infant had transient hyperthyrotropinemia. Five infants (23.8%) in group II had thyroid-stimulating hormone (TSH) levels >20 mIU/mL. Only two of them had TSH level >7 mIU/L at the 3rd postnatal week, and all had normal free T4 (FT4). Median maternal TSH level of these five infants with TSH >20 mIU/mL was 6.6 mIU/mL. In group III, six infants (6.5%) had TSH levels above >20 mIU/mL at the 1st postnatal week. Conclusion. Infants of mothers with thyroid problems are more likely to have elevated TSH and higher recall rate on neonatal thyroid screening. Women with thyroid disorders and their newborn infants should be followed closely for both obstetrical problems and for thyroid dysfunction

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

An Investigation of the Constructional Design Components Affecting the Mechanical Response and Cellular Activity of Electrospun Vascular Grafts

Cardiovascular disease is anticipated to remain the leading cause of death globally. Due to the current problems connected with using autologous arteries for bypass surgery, researchers are developing tissue-engineered vascular grafts (TEVGs). The major goal of vascular tissue engineering is to construct prostheses that closely resemble native blood vessels in terms of morphological, mechanical, and biological features so that these scaffolds can satisfy the functional requirements of the native tissue. In this setting, morphology and cellular investigation are usually prioritized, while mechanical qualities are generally addressed superficially. However, producing grafts with good mechanical properties similar to native vessels is crucial for enhancing the clinical performance of vascular grafts, exposing physiological forces, and preventing graft failure caused by intimal hyperplasia, thrombosis, aneurysm, blood leakage, and occlusion. The scaffold’s design and composition play a significant role in determining its mechanical characteristics, including suturability, compliance, tensile strength, burst pressure, and blood permeability. Electrospun prostheses offer various models that can be customized to resemble the extracellular matrix. This review aims to provide a comprehensive and comparative review of recent studies on the mechanical properties of fibrous vascular grafts, emphasizing the influence of structural parameters on mechanical behavior. Additionally, this review provides an overview of permeability and cell growth in electrospun membranes for vascular grafts. This work intends to shed light on the design parameters required to maintain the mechanical stability of vascular grafts placed in the body to produce a temporary backbone and to be biodegraded when necessary, allowing an autologous vessel to take its place

Who Makes Acquisitions? An Empirical Investigation of Restaurant Firm

The purpose of this study is to examine the financial and operational factors that explain acquisition decisions in restaurant firms. We analyze the effects of franchising, dividends, leverage, Tobin\u27s Q, total assets, sales growth, and cash flows on restaurant firms\u27 acquisition decisions. The findings show that firms with high growth prospects and excess cash flows (i.e. small firms and franchising restaurant firms) are more likely to make acquisitions than their counterparts. Furthermore, firms with higher dividend payouts are less likely to engage in acquisition deals due to lack of cash. Shareholders perceive acquisitions to be value-decreasing only if large restaurant firms (not necessarily franchising) make acquisitions, while shareholders perceive acquisitions to be value-increasing when franchising firms make acquisitions. The findings provide partial support for the postulations of overinvestment and underinvestment theories. Theoretical and practical implications are discussed

Membranous Glomerulonephritis Evolving After Diffuz Proliferative Glomerulonephritis. A Rare Assocation. A Case Report

WOS: 00034137770029