Properties of hemp fibre reinforced concrete composites

This research is concerned with the mechanical and physical properties of hemp fibre reinforced concrete (HFRC). An experimental program was developed based on the statistical method of fractional factors design. The variables for the experimental study were: (1) mixing method; (2) fibre content by weight; (3) aggregate size; and (4) fibre length. Their effects on the compressive and flexural performance of HFRC composites were investigated. The specific gravity and water absorption ratio of HFRC were also studied. The results indicate that the compressive and flexural properties can be modelled using a simple empirical linear expression based on statistical analysis and regression, and that hemp fibre content (by weight) is the critical factor affecting the compressive and flexural properties of HFRC

Considerations regarding alternative uses of lignocellulose composites in Central America

One of the most serious problems of Central America is that of housing; more than 18 million people are in need of shelter. At one time, timber from extensive forests covering the region could have been used to provide the building materials needed to solve the housing problem. Unwise clearing of the forests to provide land for agricultural purposes, however, has largely depleted timber reserves. Since extensive forest land that could provide abundant solid wood to build housing is no longer available, alternative means to solve the problem are needed. Thinnings from reforestation projects and commercial plantations along with agricultural residues such as rice straw, sugar cane bagasse, banana, coconut, and African palm are producing substantial amounts of unused residues. The production of ligno-cellulose composites from those residues can provide construction materials to aid in the solution of the housing problem, provide additional sources of income, promote incentives to a sustainable use of natural resources, and stimulate the forest and agriculture sectors to engage in activities that benefit the region as a whole. The objective of this research was to provide the background information, based on the Central American experience, needed to help guide future research and development of ligno-cellulose composites intended for housing in this region of the world. This research considered the social, economic, technical and managerial environments of the construction sector of Central America as means of determining the possibilities and defining the constraints which would hinder the introduction and use of these composites. The research is based on literature reviews, consultation with experts, field visits, case study analysis, evaluation of statistics and projections, testing and analysis of material properties, and design of a proposed house solution. The results of the study indicate that ligno-cellulose composites can provide a viable alternative to traditional materials and construction systems used for housing in Central America. Furthermore, ligno-cellulose composites can provide Central America with alternative uses of natural resources within the framework of sustainable development

coMpliAnce with evideNce-based cliniCal guidelines in the managemenT of acute biliaRy pancreAtitis): The MANCTRA-1 international audit

Background/objectives: Reports about the implementation of recommendations from acute pancreatitis guidelines are scant. This study aimed to evaluate, on a patient-data basis, the contemporary practice patterns of management of biliary acute pancreatitis and to compare these practices with the recommendations by the most updated guidelines. Methods: All consecutive patients admitted to any of the 150 participating general surgery (GS), hepatopancreatobiliary surgery (HPB), internal medicine (IM) and gastroenterology (GA) departments with a diagnosis of biliary acute pancreatitis between 01/01/2019 and 31/12/2020 were included in the study. Categorical data were reported as percentages representing the proportion of all study patients or different and well-defined cohorts for each variable. Continuous data were expressed as mean and standard deviation. Differences between the compliance obtained in the four different subgroups were compared using the Mann-Whitney U, Student's t, ANOVA or Kruskal-Wallis tests for continuous data, and the Chi-square test or the Fisher's exact test for categorical data. Results: Complete data were available for 5275 patients. The most commonly discordant gaps between daily clinical practice and recommendations included the optimal timing for the index CT scan (6.1%, χ2 6.71, P = 0.081), use of prophylactic antibiotics (44.2%, χ2 221.05, P < 0.00001), early enteral feeding (33.2%, χ2 11.51, P = 0.009), and the implementation of early cholecystectomy strategies (29%, χ2 354.64, P < 0.00001), with wide variability based on the admitting speciality. Conclusions: The results of this study showed an overall poor compliance with evidence-based guidelines in the management of ABP, with wide variability based on the admitting speciality. Study protocol registered in ClinicalTrials.Gov (ID Number NCT04747990)

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 < 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). Graphical abstract: [Figure not available: see fulltext.]