Identificación de propiedades presentes en jugo de Opuntia megacantha Salm-Dyck importantes para la producción de biopolímeros

In order to identify chemical and antioxidant properties of interest in the biopolymer industry, the chemical characterization of the juice of four variants of Opuntia megacantha cladodes was carried out; the variants present two degrees of maturity (tender and mature) and two different managements during their development (wild and cultivated). The degree of maturity of the cladodes was statistically significant (p ≤ 0.05), the juice of mature cladodes presented a greater amount of crude fiber and nitrogen-free material, while the juice of tender cladodes contains a greater amount of protein, ethereal extract and ashes. There was no significant statistical difference (p = 0.6917), in the content of phenols in the four studied variants, with concentrations between 165.6 and 176.6 mg GAE/mL; (2.18 and 3.61 mg GAE/g in dry weight). Ripe cladodes juices contain more of the different quantified sugars (p ≤ 0.05). Biopolymer films were prepared using clarified juice of tender wild cladodes, determining their tensile strength of 1.42 MPa, Young’s modulus of 1.77 MPa and elongation at breakage of 124.16%, it is considered that the juices characterized in this work can offer viable alternative to petroleum-derived polymers.Con el objetivo de identificar las propiedades químicas y los antioxidantes de interés en la industria de los biopolímeros se realizó la caracterización química del jugo de cuatro variantes de cladodios de Opuntia megacantha; las variantes presentan dos grados de madurez (tiernos y maduros) y dos manejos diferentes durante su desarrollo (silvestres y cultivados). El grado de madurez de los cladodios fue estadísticamente significativo (p ≤ 0.05), el jugo de los cladodios maduros presentó mayor cantidad de fibra cruda y material libre de nitrógeno, el jugo de cladodios tiernos contiene mayor cantidad de proteína, extracto etéreo y cenizas. No existió diferencia estadística significativa (p = 0.6917), en el contenido de los fenoles en las cuatro variantes se obtuvieron concentraciones entre 165.6 y 176.6 mg GAE/mL; (2.18 y 3.61 mg GAE/g en peso seco). Los jugos de los cladodios maduros contienen mayor cantidad de los diferentes azúcares cuantificados (p ≤ 0.05). Se prepararon películas de biopolímero utilizando jugo clarificado de cladodios silvestres tiernos para determinar su resistencia a la tensión con un resultado de 1.42 MPa, módulo de Young de 1.77 MPa y elongación a la rotura de 124.16%; se concluye que los jugos caracterizados en este trabajo pueden ofrecer una alternativa viable a los polímeros derivados del petróleo

Comportamiento al intemperismo natural de compositos polipropileno-madera

Se estudió el comportamiento al intemperismo de compositos polipropileno-madera formulados con partículas de pino malla 60, 100 y finos, con proporciones de polipropileno-madera 67-30, 57-40 y 47-50, con 2 % de agente acoplante (Maleic Anhydride Polypropylene) y 1 % de estearato de calcio. Estos fueron sometidos a 2 856 h (septiembre-enero) de intemperismo natural. Se evaluaron los efectos de la radiación solar y humedad sobre el cambio de claridad (?L) y morfología superficial, mediante microscopía electrónica de barrido (SEM) y resistencia al impacto. Todos los compositos experimentaron un incremento de claridad, no así los de polipropileno 100 %. Independientemente del tamaño de partícula, el aumento de la proporción de madera provocó una mayor modificación de la claridad. También se observó que los elaborados con partículas de madera malla 100 y fina tuvieron un incremento superior de la claridad. El microagrietamiento superficial ocurrió en el polipropileno 100 % y en los compositos polipropileno-madera. Su severidad fue mayor con las partículas más grandes y ligeramente más notorio a 40 % y 50 % de madera. En todas las formulaciones se perdiZapotitlán resistencia al impacto, menor en los compositos con partículas malla 60 a 30 % y 40 % de madera. Con una proporciZapotitlánn alta de partículas de madera, disminuyó notoriamente la resistencia al impacto. Las resistencias de todas las formulaciones de polipropileno-madera después del intemperismo superaron a las del polipropileno puro

Mechanical and Physicochemical Properties of 3D-Printed Agave Fibers/Poly(lactic) Acid Biocomposites

In order to provide a second economic life to agave fibers, an important waste material from the production of tequila, filaments based on polylactic acid (PLA) were filled with agave fibers (0, 3, 5, 10 wt%), and further utilized to produce biocomposites by fused deposition modeling (FDM)-based 3D printing at two raster angles (−45°/45° and 0°/90°). Differential scanning calorimetry, water uptake, density variation, morphology, and composting of the biocomposites were studied. The mechanical properties of the biocomposites (tensile, flexural, and Charpy impact properties) were determined following ASTM international norms. The addition of agave fibers to the filaments increased the crystallinity value from 23.7 to 44.1%. However, the fibers generated porous structures with a higher content of open cells and lower apparent densities than neat PLA pieces. The printing angle had a low significant effect on flexural and tensile properties, but directly affected the morphology of the printed biocomposites, positively influenced the impact strength, and slightly improved the absorption values for biocomposites printed at −45°/45°. Overall, increasing the concentrations of agave fibers had a detrimental effect on the mechanical properties of the biocomposites. The disintegration of the biocomposites under simulated composting conditions was slowed 1.6-fold with the addition of agave fibers, compared to neat PLA

Comportamiento al intemperismo natural de compositos polipropileno-madera

Se estudió el comportamiento al intemperismo de compositos polipropileno-madera formulados con partículas de pino malla 60, 100 y finos, con proporciones de polipropileno-madera 67-30, 57-40 y 47-50, con 2 % de agente acoplante (Maleic Anhydride Polypropylene) y 1 % de estearato de calcio. Estos fueron sometidos a 2 856 h (septiembre-enero) de intemperismo natural. Se evaluaron los efectos de la radiación solar y humedad sobre el cambio de claridad (ΔL) y morfología superficial, mediante microscopía electrónica de barrido (SEM) y resistencia al impacto. Todos los compositos experimentaron un incremento de claridad, no así los de polipropileno 100 %. Independientemente del tamaño de partícula, el aumento de la proporción de madera provocó una mayor modificación de la claridad. También se observó que los elaborados con partículas de madera malla 100 y fina tuvieron un incremento superior de la claridad. El microagrietamiento superficial ocurrió en el polipropileno 100 % y en los compositos polipropileno-madera. Su severidad fue mayor con las partículas más grandes y ligeramente más notorio a 40 % y 50 % de madera. En todas las formulaciones se perdió resistencia al impacto, menor en los compositos con partículas malla 60 a 30 % y 40 % de madera. Con una proporción alta de partículas de madera, disminuyó notoriamente la resistencia al impacto. Las resistencias de todas las formulaciones de polipropileno-madera después del intemperismo superaron a las del polipropileno puro

Surgical site infection after gastrointestinal surgery in children : an international, multicentre, prospective cohort study

Introduction Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings. Methods A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI). Results Of 1159 children across 181 hospitals in 51 countries, 523 (45 center dot 1%) children were from high HDI, 397 (34 center dot 2%) from middle HDI and 239 (20 center dot 6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12 center dot 8% (51/397) in middle HDI and 24 center dot 7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI. Conclusion The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.Peer reviewe

Evolution over Time of Ventilatory Management and Outcome of Patients with Neurologic Disease∗

OBJECTIVES: To describe the changes in ventilator management over time in patients with neurologic disease at ICU admission and to estimate factors associated with 28-day hospital mortality. DESIGN: Secondary analysis of three prospective, observational, multicenter studies. SETTING: Cohort studies conducted in 2004, 2010, and 2016. PATIENTS: Adult patients who received mechanical ventilation for more than 12 hours. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Among the 20,929 patients enrolled, we included 4,152 (20%) mechanically ventilated patients due to different neurologic diseases. Hemorrhagic stroke and brain trauma were the most common pathologies associated with the need for mechanical ventilation. Although volume-cycled ventilation remained the preferred ventilation mode, there was a significant (p < 0.001) increment in the use of pressure support ventilation. The proportion of patients receiving a protective lung ventilation strategy was increased over time: 47% in 2004, 63% in 2010, and 65% in 2016 (p < 0.001), as well as the duration of protective ventilation strategies: 406 days per 1,000 mechanical ventilation days in 2004, 523 days per 1,000 mechanical ventilation days in 2010, and 585 days per 1,000 mechanical ventilation days in 2016 (p < 0.001). There were no differences in the length of stay in the ICU, mortality in the ICU, and mortality in hospital from 2004 to 2016. Independent risk factors for 28-day mortality were age greater than 75 years, Simplified Acute Physiology Score II greater than 50, the occurrence of organ dysfunction within first 48 hours after brain injury, and specific neurologic diseases such as hemorrhagic stroke, ischemic stroke, and brain trauma. CONCLUSIONS: More lung-protective ventilatory strategies have been implemented over years in neurologic patients with no effect on pulmonary complications or on survival. We found several prognostic factors on mortality such as advanced age, the severity of the disease, organ dysfunctions, and the etiology of neurologic disease

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

International audienceBackground: Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods: WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings: Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0–4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2–6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation: In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates. Funding: European Society of Intensive Care Medicine, European Respiratory Society

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

Background Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0–4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2–6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

Background: Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods: WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings: Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0-4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2-6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation: In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates. Funding: European Society of Intensive Care Medicine, European Respiratory Society