Recent advances and perspectives on starch nanocomposites for packaging applications

Starch nanocomposites are popular and abundant materials in packaging sectors. The aim of this work is to review some of the most popular starch nanocomposite systems that have been used nowadays. Due to a wide range of applicable reinforcements, nanocomposite systems are investigated based on nanofiller type such as nanoclays, polysaccharides and carbonaceous nanofillers. Furthermore, the structures of starch and material preparation methods for their nanocomposites are also mentioned in this review. It is clearly presented that mechanical, thermal and barrier properties of plasticised starch can be improved with well-dispersed nanofillers in starch nanocomposites

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

Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and developm nt investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens

Polyvinyl Alcohol / Starch/ Glycerol/ Halloysite Nanotube Bionanocomposites for Biodegradable Packaging Applications

Polyvinyl alcohol/ starch/ glycerol/ halloysite nanotube bionanocomposite films were manufactured using the solution casting method. The effect of material composition and nanofiller contents on mechanical, thermal, optical, water resistance and biodegradable properties as well as the migration rates of material constituents were investigated along with the morphological structures. Modelling approaches for permeabilities have developed based on Nielsen model and Cussler model in good agreement with experimental results. Finally, prepared bionanocomposite films were confirmed to be effective food-packaging materials for lipidic and acidic fruits

Polyvinyl alcohol/halloysite nanotube bionanocomposites as biodegradable packaging materials

This book focuses on the preparation and characterisation of polyvinyl alcohol (PVA)/ halloysite nanotube (HNT) bionanocomposite films with different HNT contents for potential use in food packaging. It examines the effect of material composition and nanofiller content on mechanical, thermal and optical properties in relation to their morphological structures, and also comprehensively describes the water resistance, biodegradation and migration rates of such bionanocomposites, as well as their barrier properties in terms of water vapour transmission, and water vapour, air and oxygen permeabilities. Further, this book discusses the use of Nielsen model and Cussler model to predict the relative permeability of bionanocomposites, demonstrating that Nielsen model is more effective and in better agreement with experimental data obtained. Lastly, it discusses the application of bionanocomposite films in food packaging to prolong the shelf life of freshly cut avocados and peaches

Studying the some biochemical parameters for thalassemia patients in AL-Najaf province

The current study aims to study some biochemical indicators for thalassemia patients in the Najaf governorate, and the study included 25 patients with major beta thalassemia during the period from November 2019 to February 2020 and their ages ranged between (2 - 65) years and 15 healthy people who arenot He had genetic blood diseases and their ages ranged between (2-65) years. The results of the study showed that there are in some biochemical indicators, as there was a significant increase in the level of the enzyme of liver function  ALT that was the focus in patients 23.74 ± 29.53 U\L and in healthy people it was 4.61 ± 11.67U\L Also, the creatinine concentration patients 9.92 ± 26.08 mmol\L and in healthy was, 68.06 ± 51.54 mmol\L, Except for urea, we notice that there was a decrease in its concentration in patients 0.89 ± 3.96 mmol\L and in healthy was 1.03 ± 2.36 mmol\L, There was an increase in the concentration of iron in the blood in patients 382.05 ±64.37 Umol\L And in healthy was 9.48 ± 61.36 Umol\L, as well as a decrease in the concentration of glucose in patients and an increase in healthy peopl

Assessments of Roof-Harvested Rainwater in Disctrict Dir Lower, Khyber Pakhtunkhwa Pakistan

The main objective of this study was to assess the quality and quantity of roof-harvested rainwater to overcome the water shortage problem in the study area. We also aimed to find health hazards associated with rainwater in the study area. For this purpose, rainwater samples were collected from five sites in the study area. The samples were analyzed using standard methods of the World Health Organization and the American Public Health Association in a laboratory. The analysis showed that all the physicochemical parameters were within the permissible limits of the WHO’s guidelines except pH, turbidity, and some trace metals such as iron (Fe) and lead (Pb). The mean values of pH range from 5.18 to 6.26, indicating slight acidity, while the highest mean turbidity was found at 5.77 NTU. Similarly, the highest mean concentrations of Fe and Pb were 0.95 mg/L and 0.056 mg/L, respectively, which was above the permissible limit of the WHO’s guidelines for drinking water. The annual rainwater-harvesting potential was assessed using the formula annual rainfall × roof area× runoff coefficient. The annual rainwater-harvesting potential of the study area was 56.803 L per household. At the same time, the average monthly rainwater-harvesting potential was 4733 L in the study area. This shows the potential for roof-harvested rainwater in the study area. A risk assessment of heavy metals showed that the rainwater of the study area is safe and does not pose any risk. This study concludes that rainwater is suitable for drinking and other domestic consumption if proper care is taken to clean the roof area and storage system and divert the first flush from the storage system

Preparation and characterisation of poly(vinyl) alcohol (PVA)/starch (ST)/halloysite nanotube (HNT) nanocomposite films as renewable materials

Poly(vinyl) alcohol (PVA)/starch (ST) films (weight ratio: 80/20) were prepared using a solution casting method, in the presence of 30 wt% glycerol (GL) as a plasticiser. Halloysite nanotubes (HNTs) were used as relatively new clay nanofillers to PVA/ST/GL blends for more economical material packaging. HNTs at filler loadings of 0.25, 0.5, 1, 3 and 5 wt% were incorporated to enhance mechanical and thermal properties of resulting PVA/ST/HNT nanocomposites. The tensile strength of such nanocomposites was found to be improved by 20 and 3.4%, respectively, with the inclusion of 0.25 and 0.5 wt% HNTs as opposed to those of PVA/ST/GL blends. However, a decreasing strength trend was observed beyond the HNT loading of 0.5 wt% due to HNT agglomeration, as evidenced by relevant micrographs via scanning electron microscopy (SEM). However, Young’s modulus was enhanced by 148% with the addition of 1 wt% HNTs when compared with PVA/ST/GL blends. X-ray diffraction (XRD) analysis is indicative of slightly intercalated nanocomposite structures formed at low HNT loadings of 0.25–1 wt%. In general, the incorporation of HNTs improved the thermal stability of PVA/ST/GL blends by increasing melting and decomposition temperatures along with the reduction in weight loss

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