Risk factors for unfavourable postoperative outcome in patients with Crohn's disease undergoing right hemicolectomy or ileocaecal resection An international audit by ESCP and S-ECCO

Background Patient and disease-related factors, as well as operation technique all have the potential to impact on postoperative outcome in Crohn's disease. The available evidence is based on small series and often displays conflicting results. Aim To investigate the effect of pre- and intra-operative risk factors on 30-day postoperative outcome in patients undergoing surgery for Crohn's disease. Method International prospective snapshot audit including consecutive patients undergoing right hemicolectomy or ileocaecal resection. This study analysed a subset of patients who underwent surgery for Crohn's disease. The primary outcome measure was the overall Clavien-Dindo postoperative complication rate. The key secondary outcomes were anastomotic leak, re-operation, surgical site infection and length of stay at hospital. Multivariable binary logistic regression analyses were used to produce odds ratios (OR) and 95% confidence intervals (CI). Results Three hundred and seventy five resections in 375 patients were included. The median age was 37 and 57.1% were female. In multivariate analyses, postoperative complications were associated with preoperative parenteral nutrition (OR 2.36 95% CI 1.10-4.97)], urgent/expedited surgical intervention (OR 2.00, 95% CI 1.13-3.55) and unplanned intraoperative adverse events (OR 2.30, 95% CI 1.20-4.45). The postoperative length of stay in hospital was prolonged in patients who received preoperative parenteral nutrition (OR 31, CI [1.08-1.61]) and those who had urgent/expedited operations (OR 1.21, CI [1.07-1.37]). Conclusion Preoperative parenteral nutritional support, urgent/expedited operation and unplanned intraoperative adverse events were associated with unfavourable postoperative outcome. Enhanced preoperative optimization and improved planning of operation pathways and timings may improve outcomes for patients

The aerobic treatment of reverse osmosis permeate for reuse : a thesis submitted in partial fulfilment of the requirements for the degree of Master of Technology in Environmental Engineering

The reduction of effluent streams and the demand for freshwater intake in the dairy industry, may be accomplished by the segregation and reuse of streams that can be readily treated. This study assessed the biodegradability and suitability for reuse of reverse osmosis (R/O) permeate from Kiwi Dairies Ltd processing factory (Hawera), using aerobic treatment. Analysis of the permeate showed that there was a direct relationship between chemical oxygen and lactose concentration. The chemical oxygen demand of R/O permeate from two reverse osmosis membrane plants operating in parallel varied widely during the period of study. This wide variation in permeate chemical oxygen was directly related to the membrane efficiency. Elemental analysis of the R/O permeate showed that iron and phosphorous would need to be supplemented to ensure balanced microbial growth. The biodegradability was characterised by a series of batch tests to determine the biokinetic constants µm, Ks, qsm and Yt. These tests showed that the biodegradability of reverse osmosis permeate is comparable to general dairy wastes. Batch tests were also performed on permeate from R/O membranes of varying performance efficiency, with different lactose and mineral concentrations. There were no conclusive variations in biokinetic constants between permeates from R/O membranes of varying performance efficiency. Operation of a model activated sludge pilot plant showed that soluble COD removal efficiencies of over 90% could be achieved at hydraulic retention times of 10 and 20 hours. The sludge settling characteristics were more favourable at a 10 hour hydraulic retention time. Sudden fluctuations in membrane efficiency caused shock loads resulting in a deterioration in treatment efficiency and sludge settling characteristics. Although the pilot plant achieved satisfactory reductions, soluble COD levels were not decreased to the level of 10 to 15 mg l -1 required to enable the reuse of the permeate. In order to determine if low substrate levels could be achieved when aerobically treating R/O permeate from an efficient membrane plant, a laboratory scale reactor was used to treat permeate with a COD of 200 mg l-1. It was established that R/O permeate could be aerobically treated to levels suitable for reuse, provided the previous membrane processes performed efficiently

Oxonium (R)-O-acetylmandelate

The three H atoms of the oxonium H30+ cation are disordered equally over four orientations and are involved in an extensive three-dimensional hydrogen-bonding network with the carbonyl and carboxylate O atoms of four neighbouring (Ph)CH(OAc)COO- anions [H...O 1.62- 1.85, O...O 2.722(3)-2.902(3) A]; the O-acetyl oxygen is not involved in any hydrogen bonding, Principal bond lengths include Cs:--Ocarbonyl 1.211(4), Csp 2- Oearboxylate 1.234(4) and 1.246(3) ,4,. The main torsion angles defining the conformation in the mandelate anion are: Ocarboxylate--Csf--Csp a-Car 84.6(2) and -92.3(2)°; Csp 2-O -- Csp 3- Car -- 171.6(2) and Csp 2 --O --Csp 3 -- Csp 2 67.7(2) °

r-modes in Relativistic Superfluid Stars

We discuss the modal properties of the $r$-modes of relativistic superfluid neutron stars, taking account of the entrainment effects between superfluids. In this paper, the neutron stars are assumed to be filled with neutron and proton superfluids and the strength of the entrainment effects between the superfluids are represented by a single parameter $\eta$. We find that the basic properties of the $r$-modes in a relativistic superfluid star are very similar to those found for a Newtonian superfluid star. The $r$-modes of a relativistic superfluid star are split into two families, ordinary fluid-like $r$-modes ($r^o$-mode) and superfluid-like $r$-modes ($r^s$-mode). The two superfluids counter-move for the $r^s$-modes, while they co-move for the $r^o$-modes. For the $r^o$-modes, the quantity $\kappa\equiv\sigma/\Omega+m$ is almost independent of the entrainment parameter $\eta$, where $m$ and $\sigma$ are the azimuthal wave number and the oscillation frequency observed by an inertial observer at spatial infinity, respectively. For the $r^s$-modes, on the other hand, $\kappa$ almost linearly increases with increasing $\eta$. It is also found that the radiation driven instability due to the $r^s$-modes is much weaker than that of the $r^o$-modes because the matter current associated with the axial parity perturbations almost completely vanishes.Comment: 14 pages, 4 figures. To appear in Physical Review