Thermoformed Containers Based on Starch and Starch/Coffee Waste Biochar Composites

Biodegradable containers support zero-waste initiatives when alternative end-of-life scenarios are available (e.g., composting, bio digestion). Thermoplastic starch (TPS) has emerged as a readily biodegradable and inexpensive biomaterial that can replace traditional plastics in applications such as food service ware and packaging. This study has two aims. First, demonstrate the thermoformability of starch/polycaprolactone (PCL) as a thermoplastic material with varying starch loadings. Second, incorporate biochar as a sustainable filler that can potentially lower the cost and enhance compostability. Biochar is a stable form of carbon produced by thermochemical conversion of organic biomass, such as food waste, and its incorporation into consumer products could promote a circular economy. Thermoformed samples were successfully made with starch contents from 40 to 60 wt.% without biochar. Increasing the amount of starch increased the viscosity of the material, which in turn affected the compression molding (sheet manufacturing) and thermoforming conditions. PCL content reduced the extent of biodegradation in soil burial experiments and increased the strength and elongation at break of the material. A blend of 50:50 starch:PCL was selected for incorporating biochar. Thermoformed containers were manufactured with 10, 20, and 30 wt.% biochar derived from waste coffee grounds. The addition of biochar decreased the elongation at break but did not significantly affect the modulus of elasticity or tensile strength. The results demonstrate the feasibility of using starch and biochar for the manufacturing of thermoformed containers

Prevalence and factors associated with sarcopenia among urban and rural Indian adults in middle age: A cross-sectional study from Western India

Sarcopenia is the age-related loss of muscle mass and function. India has 8.6% of the global elderly (>60 years) population, and this is expected to increase to 20% by 2050. Around 70% of Indians live in rural areas where lifestyle factors like diet and physical activity differ from urban areas. Understanding age, sex and location-specific sarcopenia prevalence in India is crucial. Thus, our aim was to assess the prevalence and determinants of sarcopenia in urban and rural community-dwelling men and women aged 40 years and older, representing the next generation of older Indian adults. This cross-sectional study included 745 adults (400 women) from urban and rural areas near Pune, Western India. Assessments included socio-demography, diet by-24-hr recall, physical activity, anthropometry (height, weight), muscle mass measurement by dual-energy X-ray absorptiometry, muscle strength (hand grip) & muscle function by Short Physical Performance Battery (SPPB). Sarcopenia was defined by Asian Working Group on Sarcopenia-2019 guidelines Mean age of participants was 53±7.6yrs. Overall prevalence of sarcopenia was 10% and of severe sarcopenia was 4.2%. Sarcopenia prevalence was higher in rural (14.8%) than urban (6.8%) participants and in men (12.5%) than women (8%, all p<0.05). Muscle mass, grip strength and SPPB score were all higher in urban than rural participants (p<0.05). Older age, rural residence, inadequate protein intake, and lower socio-economic status were independently associated with sarcopenia. In this middle-aged group, sarcopenia prevalence was similar to that observed in older Western populations, over 100% higher among rural than urban participants, and higher amongst men than women. Age, location, protein intake and socioeconomic status were factors associated with sarcopenia. Given this rapidly increasing population of older adults in India there is an urgent need to plan strategies for early sarcopenia diagnosis and management, especially in rural populations

Mechanical Venous Thrombectomy for Deep Venous Thrombosis in Cancer Patients: A Single-Center Retrospective Study

PURPOSE: Venous thromboembolism (VTE) is a major contributor to the mortality of cancer patients. Mechanical thrombectomy (MT) is an endovascular technique that physically removes a thrombus without thrombolytics. The purpose of this study was to evaluate safety, efficacy, and clinical outcomes following MT for lower extremity DVT in cancer patients. METHODS: This single-center, retrospective study evaluated outcomes following MT of lower extremity DVT in cancer patients from November 2019 to May 2023. The primary outcome measure was clinical success, defined as a decrease in Villalta score by at least 2 points following the intervention. Secondary outcomes included repeat intervention-free survival and overall survival. Technical success was defined as restoring venous flow with mild (\u3c 10%) or no residual filling defect. RESULTS: In total, 90 patients and 113 procedures were included. Technical and clinical success was achieved in 81% and 87% of procedures performed. Repeat intervention-free survival at 1 month, 3 months, and 6 months post-procedure was 92%, 82%, and 77%, respectively. The complication rate was 2.7%. Pathologic analysis of the extracted thrombus revealed tumor thrombus in 18.4% (18/98) samples. Overall survival for the study cohort was 87% at 1 month, 74% at 3 months, and 62% at 6 months. Patients who were found to have tumor thrombi were noted to have a decreased overall survival compared to patients with non-tumor thrombi (P = 0.012). CONCLUSION: MT is safe and efficacious in reducing cancer patients\u27 VTE-related symptoms. The high rate of tumor thrombus in thrombectomy specimens suggests this phenomenon is more common than suspected

Acknowledgement

Submitted in partial ful llment of the requirement

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population.The aim of this study was to inform vaccination prioritization by modelling the impact of vaccination on elective inpatient surgery. The study found that patients aged at least 70 years needing elective surgery should be prioritized alongside other high-risk groups during early vaccination programmes. Once vaccines are rolled out to younger populations, prioritizing surgical patients is advantageous

Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care. We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care