Enhanced Recovery After Surgery (ERAS) protocol in bariatric and metabolic surgery (BMS)-analysis of practices in nutritional aspects from five continents

This study aims to understand the prevalent practices on the nutritional aspects of the enhanced recovery after surgery (ERAS) protocol based on the knowledge and practice of surgeons, nutritionists, and anesthesiologists who work in the bariatric and metabolic surgery (BMS) units worldwide. This cross-sectional study enrolled BMS unit professionals from five continents-Africa, America, Asia, Europe, and Oceania. An electronic questionnaire developed by the researchers was provided to evaluate practices about the three nutritional aspects of ERAS protocol in BMS (Thorel et al. 2016): preoperative fasting, carbohydrate loading, and early postoperative nutrition. Only surgeons, nutritionists, and anesthesiologists were invited to participate. One hundred twenty-five professionals answered the questionnaires: 50.4% from America and 39.2% from Europe. The profile of participating professionals was bariatric surgeons 70.2%, nutritionists 26.4%, and anesthesiologists 3.3%. Approximately 47.9% of professionals work in private services, for about 11 to 20 years (48.7%). In all continents, a large majority were aware of the protocol. Professionals from the African continent reported having implemented the ERAS bariatric protocol 4.0 ± 0 years ago. It is worth mentioning that professionals from the five continents implemented the ERAS protocol based on the published literature (p = 0.012). About preoperative fasting abbreviation protocol, a significant difference was found between continents and consequently between services (p = 0.000). There is no uniformity in the conduct of shortening of fasting in the preoperative period and the immediate postoperative period. Early postoperative (PO) period protein supplementation is not performed in a standard fashion in all units globally. ERAS principles and practices are partial and insufficiently implemented on the five continents despite the prevalent knowledge of professionals based on evidence. Moreover, there is no uniformity in fasting, immediate postoperative diet, and early protein supplementation practices globally.info:eu-repo/semantics/publishedVersio

Cysteamine functionalised reduced graphene oxide modification of maleated poly(propylene)

Graphene oxide (GO) was reduced (rGO) and then functionalised with an amino terminated thiol molecule (cysteamine) via a thiol-ene click chemistry reaction to produce reduced graphene oxide-cysteamine (rGO-cyst). The presence of the C–S bond in the X-ray photoelectron spectrum (XPS) confirmed the reaction between the thiol in cysteamine and both the double bonds present on the rGO surface and the pyrazolic structures formed due to reduction. The rGO-cysyteamine was reacted with polypropylene-graft-maleic anhydride (PP-g-MA) to produce PP-g-MA-rGO-cysteamine, where the free amino group present on the rGO-cysteamine reacts with the maleic anhydride group of PP-g-MA. This was confirmed from solid state 13C Magic-Angle-Spinning, Nuclear Magnetic Resonance (MAS NMR), Fourier transform infrared (FTIR) and XPS studies which demonstrated that a mixture of open and closed ring structures based on amides, imides and imines were formed. Growth of the PP chain on the rGO surface was observed from electron microscopy imaging. Cysteamine acts like a ‘cross-linker’ between the rGO and PP-g-MA, increasing interfacial interaction between the two phases resulting in increased thermal stability and altering the crystallization behaviour of the maleated PP. The approach described could be used to compatabilise graphene oxide and a range of polymers to produce functional composite materials

The SAVEMEDCOASTS-2 webGIS: The Online Platform for Relative Sea Level Rise and Storm Surge Scenarios up to 2100 for the Mediterranean Coasts

Here we show the SAVEMEDCOASTS-2 web-based geographic information system (webGIS) that supports land planners and decision makers in considering the ongoing impacts of Relative Sea Level Rise (RSLR) when formulating and prioritizing climate-resilient adaptive pathways for the Mediterranean coasts. The webGIS was developed within the framework of the SAVEMEDCOASTS and SAVEMEDCOASTS-2 projects, funded by the European Union, which respond to the need to protect people and assets from natural disasters along the Mediterranean coasts that are vulnerable to the combined effects of Sea Level Rise (SLR) and Vertical Land Movements (VLM). The geospatial data include available or new high-resolution Digital Terrain Models (DTM), bathymetric data, rates of VLM, and multi-temporal coastal flooding scenarios for 2030, 2050, and 2100 with respect to 2021, as a consequence of RSLR. The scenarios are derived from the 5th Assessment Report (AR5) provided by the Intergovernmental Panel on Climate Change (IPCC) and encompass different Representative Concentration Pathways (RCP2.6 and RCP8.5) for climate projections. The webGIS reports RSLR scenarios that incorporate the temporary contribution of both the highest astronomical tides (HAT) and storm surges (SS), which intensify risks to the coastal infrastructure, local community, and environment