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Background: Seven per cent of general waste and 20% of healthcare risk waste produced in acute hospitals in Ireland comes from operating theatres. Surgical wrap comprises 11% of operating theatre waste. Aims: The primary aim of this study was to pilot the implementation of a recycling initiative for surgical instrument set wrap in an operating theatre in Ireland. Secondary aims included quantification of the surgical wrap diverted from general waste to recycling streams over a 5-week period and estimation of the annual carbon emissions associated with gynaecology surgical wrap use in Cork. Methods: The amount of polypropylene surgical wrap generated by a single gynaecology theatre at Cork University Maternity Hospital was prospectively quantified from 24/1/22 to 1/3/22. At the end of the study period, individual sheets of polypropylene wrap were counted and dimensions were measured to calculate the total surface area of surgical wrap saved for recycling. Results: A total of 66 surgeries were performed over the 5-week study period. Two hundred twenty-one individual sheets of surgical wrap were collected, equating to 282.1 m2 of polypropylene wrap. An estimated 11,564 m2 of surgical wrap could be recycled annually from the gynaecology theatre service in Cork with an associated annual carbon emissions equivalent of at least 2.2 tonnes of CO2. Conclusion: Diversion of surgical wrap from general waste and clinical waste streams to the recycling stream is achievable in every operating theatre. Small changes to operating theatre waste disposal practices have the potential to yield significant reductions to theatre waste outputs and to hospital carbon emissions. [ABSTRACT FROM AUTHOR]

In this paper we provide an introduction to a set of tools for syntactic analysis based on graph theory, and apply them to the study of some properties of English accusativus cum infinitivo constructions, more commonly known as raising to object or exceptional case marking structures. We focus on puzzling extraction asymmetries between base-generated objects and 'raised' objects and on the interaction between raising to object and Right Wrap. We argue that a lexicalised derivational grammar with grammatical functions as primitives delivers empirically adequate analyses. [ABSTRACT FROM AUTHOR]

Telur ayam mudah mengalami kerusakan, untuk menghambat keruskan telur dengan cara menutup pori pori kerabang telur. Tujuan penelitain adalah untuk mengetahui lama simpan telur ayam ras yang dikeas dalam plastic warm terhadap kualitas fisik. Penelitian ini menggunakan RAL. Kualiatas fisik diamati pada hari ke 0, 7, 14, 21, 28, dan 35. Parameter kualitas fisik meliputi kualitas fisik eksternal dan kualitas fisik internal. Berat telur, panjamg telur, lebar telur, dan indek telur tidak berbeda nyata terhadap kulitas fisik eksternal telur yang dikemas pada kemasan platik warm. Indek putih telur, indek putih telur menurun dengan bertambahnya lama simpan. pH putih telur dan pH kuning telur meningkat dengan bertambahnya lama simpan. Warna telur meningkat dengan meningkatnya umur simpan. Nilai Haugh Units meningkat dengan bertambahnya umur. Kesimpulan bahwa kualitas ekternal telur ayam ras dalam kemasan platik warp dalam suhu ruang tidak berbeda nyata. Sedangkan kualitas internal dengan lama penyimpanan pada suhu ruang semakin menurun pada hari ke 14.

INTRODUCTION: Our objective was determining the optimal combinations of cerebrospinal fluid (CSF) biomarkers for predicting disease progression in Alzheimer's disease (AD) and other neurodegenerative diseases. METHODS: We included 1,983 participants from three different cohorts with longitudinal cognitive and clinical data, and baseline CSF levels of Aβ42, Aβ40, phosphorylated tau at threonine‐181 (p‐tau), neurofilament light (NfL), neurogranin, α‐synuclein, soluble triggering receptor expressed on myeloid cells 2 (sTREM2), glial fibrillary acidic protein (GFAP), YKL‐40, S100b, and interleukin 6 (IL‐6) (Elecsys NeuroToolKit). RESULTS: Change of modified Preclinical Alzheimer's Cognitive Composite (mPACC) in cognitively unimpaired (CU) was best predicted by p‐tau/Aβ42 alone (R2 ≥ 0.31) or together with NfL (R2 = 0.25), while p‐tau/Aβ42 (R2 ≥ 0.19) was sufficient to accurately predict change of the Mini‐Mental State Examination (MMSE) in mild cognitive impairment (MCI) patients. P‐tau/Aβ42 (AUC ≥ 0.87) and p‐tau/Aβ42 together with NfL (AUC ≥ 0.75) were the best predictors of conversion to AD and all‐cause dementia, respectively. DISCUSSION: P‐tau/Aβ42 is sufficient for predicting progression in AD, with very high accuracy. Adding NfL improves the prediction of all‐cause dementia conversion and cognitive decline. [ABSTRACT FROM AUTHOR]

Although the rate of infection after the reconstruction of a ruptured anterior cruciate ligament (ACL) is low, prophylactic incubation of the graft with vancomycin (Vanco-wrap or vancomycin soaking) is routinely performed. A cytotoxic effect of vancomycin is reported for several cell types, and the prophylactic treatment might prevent infection but harm the tissue and cells. Aim: A comprehensive study was performed to investigate the effect of vancomycin on tendon tissue and isolated tenocytes using cell viability, molecular and mechanical analysis. Material and methods: Rat tendons or isolated tenocytes were incubated in increasing concentrations of vancomycin (0–10 mg/mL) for different times, and cell viability, gene expression, histology and Young's modulus were analyzed. Results: The clinically used concentration of vancomycin (5 mg/mL for 20 min) had no negative effect on cell viability in the tendons or the isolated tenocytes, while incubation with the toxic control significantly reduced cell viability. Increasing the concentration and prolonging the incubation time had no negative effect on the cells. The expression of Col1a1, Col3a1 and the tenocyte markers mohawk, scleraxis and tenomodulin was not affected by the various vancomycin concentrations. The structural integrity as measured through histological and mechanical testing was not compromised. Conclusion: The results proved the safe application of the Vanco-wrap on tendon tissue. Level of evidence: IV. [ABSTRACT FROM AUTHOR]

Antimicrobial coatings have a finite lifetime because of wear, depletion of the active ingredient, or surface contamination that produces a barrier between the pathogen and the active ingredient. The limited lifetime means that facile replacement is important. Here, we describe a generic method for rapidly applying and reapplying antimicrobial coatings to common-touch surfaces. The method is to deposit an antimicrobial coating on a generic adhesive film (wrap), and then to attach that modified wrap to the common-touch surface. In this scenario, the adhesion of the wrap and antimicrobial efficacy are separated and can be optimized independently. We demonstrate the fabrication of two antimicrobial wraps, both using cuprous oxide (Cu2O) as the active ingredient. The first uses polyurethane (PU) as the polymeric binder and the second uses polydopamine (PDA). Our antimicrobial PU/Cu2O and PDA/Cu2O wraps, respectively, kill >99.98% and >99.82% of the human pathogen, P. aeruginosa, in only 10 min, and each of them kill >99.99% of the bacterium in 20 min. These antimicrobial wraps can be removed and replaced on the same object in <1 min with no tools. Wraps are already frequently used by consumers to coat drawers or cars for aesthetic or protective purposes. [ABSTRACT FROM AUTHOR]

Objective: To investigate the clinical application value of integrated wrapping and reinforcing technique of ligamentum teres hepatis and falciform ligament in pancreaticoduodenectomy (PD) of soft pancreas. Methods: Clinical data of patients with soft pancreas undergoing opern PD or pylorus-preserving pancreaticoduodenectomy (PPPD) were retrospectively analyzed in Harbin Medical University Cancer Hospital from January 2016 to December 2021. According to whether the integrated wrapping and reinforcing technique of ligamentum teres hepatis and falciform ligament was applied, the patients were divided into two groups: non-wrapping or rein- forcing group (2016.1-2018.12, 246 cases), wrapping and reinforcing group (2019.1-2021.12, 244 cases). The basic preoperative characteristics, intraoperative data, postoperative data, treatment measures and outcomes of patients with post-pancreatectomy hemorrhage. (PPH) were compared between the two groups. Results: In preoperative basic clinical data, there were no significant differences in age, gender, preoperative hypertension and diabetes history, American society of anesthesiologists (ASA) score, preoperative alanine amino- transferase, serum albumin and total bilirubin, preoperative biliary drainage, tumor location and tumor nature between the two groups (P>0.05). In intraoperative data, there were no significant differences in operative time, intraoperative blood loss, intraoperative blood transfusion, resection type, PV or SMV resection and reconstruction, and main pancreatic duct diameter between the two groups (P>0.05). In postoperative data, there were significant differences in the incidence of overall postoperative complications, clinically related postoperative pancreatic fistula (CR-POPF) and intra-abdominal infection, rate of percutaneous catheter drainage, incidence of late extraluminal post-pancreatectomy hemorrhage (PPH) and grade C late extraluminal PPH, and rates of PPH-related reoperation and total reoperation, and postoperative hospital stay between the two groups (P<0.05); There were no significant differences in postoperative biliary fistula, delayed gastric empty, early PPH, late intraluminal PPH, grade A and grade B late extraluminal PPH, and perioperative mortality between the two groups (P>0.05). In terms of treatment measures and outcomes of PPH patients, there was significant difference in the rate of the invasive treatment between the two groups (P<0.05); There were no significant differences in the different invasive treatment options and rate of PPH case-fatality between the two groups (P>0.05). Conclusion: The technique of integrated wrapping and reinforcing of ligamentum teres hepatis and falciform ligament can reduce the incidence of overall postoperative complications, CR-POPF, late extraluminal PPH and grade C late extraluminal PPH after PD in patients with soft pancreas, and it can also simultaneously reduce the incidence of intra-abdominal infection, the rates of percutaneous catheter drainage and reoperation, and shorten postoperative hospital stay. [ABSTRACT FROM AUTHOR]

In this article, a new technology of surface wrapping and strengthening of expandable polystyrene (EPS) beads is proposed. Three wrapping materials including magnesium phosphate cement (MPC), ultra-high performance concrete (UHPC), and water-borne polyurethane (WPU) were evaluated. Four groups of uniaxial compression tests of EPS concrete specimens were conducted: the failure process and the characteristics of the specimens were analyzed; and the complete stress–strain equation is proposed based on these analyses. The research shows that the EPS beads were strengthened by wrapping, and the axial compressive strength of concrete is increased by 50–75%; the concrete with EPS beads wrapped by MPC and WPU has obvious brittleness; the concrete with EPS beads wrapped by UHPC has axial compressive strength close to that of EPS concrete wrapped with MPC and WPU but has a larger ductility coefficient (150%), a larger toughness coefficient (50–90% larger), a higher energy dissipation coefficient (40% larger), and larger residual stress. The proposed stress–strain model is in good agreement with the experimental results, which can accurately describe the stress and deformation characteristics of EPS concrete under uniaxial compression and has good applicability. The discovery of this study provides background knowledge for the structural analysis and design of this kind of concrete; it provides a basis for selecting EPS concrete as structural materials.

Cryogenic tanks are still considered the most efficient method of storing fluids. This is due to its resistance to much damage caused by corrosion induced by low temperature and internal pressure. In this study, the finite element method is used to analyze the repair performance by a composite wrap in a corroded tank. A parametric analysis was carried out in order to highlight the effects of low temperature and pressure on the thermo-mechanical behavior of the corroded structure and to predict the evolution of stresses in the vicinity of corrosion. An approach to this problem based on the notion of material strength was necessary since it was essential to take both the size of the pre-existing defect and the amount of mechanical stresses. The results obtained show the effect of thermal and mechanical loading to examine their impact on the strength of the structure on the one hand, and on the other hand, the influence of the composite wrap repair in the different corrosion lengths (Path 1, 2, 3) on the reinforcement of the tank. Finally, repairing damage (corrosion) using FRP composites increases the durability of cryogenic tanks, which increases their efficiency their performance and increases their life, although the rate of improvement depends largely on operating conditions, such as pressure and temperature. [ABSTRACT FROM AUTHOR]

Resolvin D1 (RvD1) belongs to a family of endogenously derived proresolving lipid mediators that have been shown to attenuate inflammation, activate proresolution signaling, and promote homeostasis and recovery from tissue injury. In this study we present a poly(lactic-co-glycolic acid) (PLGA) based thin-film device composed of layers of varying ratios of lactic and glycolic acid that elutes RvD1 unidirectionally to target tissues. The device demonstrated sustained release in vitro for 56 days with an initial burst of release over 14 days. The asymmetric design of the device released 98% of RvD1 through the layer with the lowest molar ratio of lactic acid to glycolic acid, and the remainder through the opposite side. We validated structural integrity of RvD1 released from the device by mass spectrometry and investigated its bioactivity on human vascular endothelial (EC) and smooth muscle cells (VSMC). RvD1 released from the device attenuated VSMC migration, proliferation, and TNF-α induced NF-κB activation, without evidence of cytotoxicity. Delivery of RvD1 to blood vessels was demonstrated ex vivo in a flow chamber system using perfused rabbit aortas and in vivo in a rat carotid artery model, with the devices applied as an adventitial wrap. Our results demonstrate a novel approach for sustained, local delivery of Resolvin D1 to vascular tissue at therapeutically relevant levels. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 31-41, 2017.

Copyright of Transactions the Japan Society of Refrigerating & Air Conditioning Engineers is the property of Japan Society of Refrigerating & Air Conditioning Engineers and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Antimicrobial coatings have a finite lifetime because of wear, depletion of the active ingredient, or surface contamination that produces a barrier between the pathogen and the active ingredient. The limited lifetime means that facile replacement is important. Here, we describe a generic method for rapidly applying and reapplying antimicrobial coatings to common-touch surfaces. The method is to deposit an antimicrobial coating on a generic adhesive film (wrap), and then to attach that modified wrap to the common-touch surface. In this scenario, the adhesion of the wrap and antimicrobial efficacy are separated and can be optimized independently. We demonstrate the fabrication of two antimicrobial wraps, both using cuprous oxide (Cu2O) as the active ingredient. The first uses polyurethane (PU) as the polymeric binder and the second uses polydopamine (PDA). Our antimicrobial PU/Cu2O and PDA/Cu2O wraps, respectively, kill >99.98% and >99.82% of the human pathogen, P. aeruginosa, in only 10 min, and each of them kill >99.99% of the bacterium in 20 min. These antimicrobial wraps can be removed and replaced on the same object in

Copyright of Art-E is the property of Suleyman Demirel University, Faculty of Fine Arts and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Synchrony plays a major role in the interconnection process between local electric power generation systems and the electrical grid. Grid phase disturbances prevent the generation system from maintaining synchrony. Therefore, an efficient phase tracking method is necessary in order to detect phase jumps and abrupt changes in amplitude. In this paper, we propose a software-designed method to strengthen phase tracking based on the wrap process of a second-level Phase Locked Loop (PLL). The term ‘wrap’ means establishing the phase values of the reference signal in intervals of π to match it with the values obtained from the PLL output (sync pulse). To quantify phase error, a mathematical transformation of the time domain to the frequency domain is implemented. The validity of the proposed wrap function is verified using electrical disturbances.

In this study the finite element method is used to analyze the performances of bonded composite wrap repair of cracked steel pipelines. Parametric analysis was performed in order to highlight the effects of the geometrical properties on the repair efficiency. The experimental design method is used to explore the effects of wrap dimensions (length, angle and thickness) in order to optimize the repair process. We showed in using the MOODE.5 software the most dominant geometrical parameters on stress intensity factor at the crack front which to determine the most important parameters on the repair efficiency. This optimization can help the composite wrap designers to improve the repair performance and rehabilitation

Copyright of Revista Croma is the property of Revista Croma and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The key approach to manage and prevent potential hazards arising from specific contaminants in water networks is to consider water as the main product delivered. This new concept, addressed as water-reuse risk assessment program (WRAP), has been further developed from hazard analysis of critical control points (HACCP) to illustrate the potential hazards which are the roots of hindering intra-facility water reuse strategies. For industrial sectors applying water reclamation and reuse schemes, it is paramount that the reclaimed water quality stays within the desired quality. The objective of WRAP is to establish a new methodology and knowledge, which will contribute to the sustainable development of industrial water management, and demonstrate its capabilities in identifying and addressing any potential hazards in the selected schemes adoption by the industries. A ‘what-if’ scenario was simulated using a refinery as a case study to show strategies on how to benefit reclaimed or reuse water based on reliable, applied and scientific research within the process integration area. In conclusion, the WRAP model will facilitate operators, consultants and decision makers to reuse water on a fit-for-use basis whilst avoiding contaminant accumulation in the overall system and production of sub-quality products from inadequate processes after several reuses.

NIMH requires intervention research to utilize an experimental therapeutic approach, identifying mediators to examine causal mechanisms of change. The authors propose utilizing self-determination theory (SDT) to guide research design for self-management interventions, using Wellness Recovery Action Plan (WRAP) as an exemplar. To delineate the theory's relevance to self-management interventions and recovery outcomes, the authors describe the main constructs of SDT and demonstrate its applicability to WRAP and recovery. Suggestions for research design and measurement strategies are provided. [ABSTRACT FROM AUTHOR]

Prehensile and gripping organs are recurring structures in different organisms that enhance friction by the reinforcement and redirection of normal forces. The relationship between organ structure and biomechanical performance is poorly understood, despite a broad relevance for microhabitat choice, movement ecology and biomimetics. Here, we present the first study of the biomechanics of prehensile feet in long-legged harvestmen. These arachnids exhibit the strongest sub-division of legs among arthropods, permitting extreme hyperflexion (i.e. curling up the foot tip). We found that despite the lack of adhesive foot pads, these moderately sized arthropods are able to scale vertical smooth surfaces, if the surface is curved. Comparison of three species of harvestmen differing in leg morphology shows that traction reinforcement by foot wrapping depends on the degree of leg sub-division, not leg length. Differences are explained by adaptation to different microhabitats on trees. The exponential increase of foot section length from distal to proximal introduces a gradient of flexibility that permits adaptation to a wide range of surface curvature while maintaining integrity at strong flexion. A pulley system of the claw depressor tendon ensures the controlled flexion of the high number of adesmatic joints in the harvestman foot. These results contribute to the general understanding of foot function in arthropods and showcase an interesting model for the biomimetic engineering of novel transportation systems and surgical probes. [ABSTRACT FROM AUTHOR]

Prehensile and gripping organs are recurring structures in different organisms that enhance friction by the reinforcement and redirection of normal forces. The relationship between organ structure and biomechanical performance is poorly understood, despite a broad relevance for microhabitat choice, movement ecology and biomimetics. Here, we present the first study of the biomechanics of prehensile feet in long-legged harvestmen. These arachnids exhibit the strongest sub-division of legs among arthropods, permitting extreme hyperflexion (i.e. curling up the foot tip). We found that despite the lack of adhesive foot pads, these moderately sized arthropods are able to scale vertical smooth surfaces, if the surface is curved. Comparison of three species of harvestmen differing in leg morphology shows that traction reinforcement by foot wrapping depends on the degree of leg sub-division, not leg length. Differences are explained by adaptation to different microhabitats on trees. The exponential increase of foot section length from distal to proximal introduces a gradient of flexibility that permits adaptation to a wide range of surface curvature while maintaining integrity at strong flexion. A pulley system of the claw depressor tendon ensures the controlled flexion of the high number of adesmatic joints in the harvestman foot. These results contribute to the general understanding of foot function in arthropods and showcase an interesting model for the biomimetic engineering of novel transportation systems and surgical probes. [ABSTRACT FROM AUTHOR]

Abstract—Experiments on extension of polyethylene film have been performed: the results have been analyzed in order to select wrapping material with optimal properties. [ABSTRACT FROM AUTHOR]

Prehensile and gripping organs are recurring structures in different organisms that enhance friction by the reinforcement and redirection of normal forces. The relationship between organ structure and biomechanical performance is poorly understood, despite a broad relevance for microhabitat choice, movement ecology and biomimetics. Here, we present the first study of the biomechanics of prehensile feet in long-legged harvestmen. These arachnids exhibit the strongest sub-division of legs among arthropods, permitting extreme hyper-flexion (i.e. curling up the foot tip). We found that despite the lack of adhesive foot pads, these moderately sized arthropods are able to scale vertical smooth surfaces, if the surface is curved. The comparison of three species of harvestmen differing in leg morphology show that traction reinforcement by foot wrapping depends on the degree of leg sub-division, not leg length. Differences are explained by adaptation to different microhabitats on trees. The exponential increase of foot section length from distal to proximal introduces a gradient of flexibility that permits adaptation to a wide range of surface curvature while maintaining integrity at strong flexion. A pulley system of the claw depressor tendon ensures the controlled flexion of the high number of adesmatic joints in the harvestman foot. These results contribute to the general understanding of foot function in arthropods and showcase an interesting model for the biomimetic engineering of novel transportation systems and surgical probes. [ABSTRACT FROM AUTHOR]

In this study the finite element method is used to analyse the performances of bonded composite wrap repair in cracked pipelines. Parametric analysis was performed in order to highlight the effects of the geometrical properties on the repair efficiency. The obtained results show that the optimization of the geometric properties of the wrap is still required to best improve the quality of repair. [ABSTRACT FROM AUTHOR]

In this study the finite element method is used to analyze the performances of bonded composite wrap repair of cracked steel pipelines. Parametric analysis was performed in order to highlight the effects of the geometrical properties on the repair efficiency. The experimental design method is used to explore the effects of wrap dimensions (length, angle and thickness) in order to optimize the repair process. We showed in using the MOODE.5 software the most dominant geometrical parameters on stress intensity factor at the crack front which to determine the most important parameters on the repair efficiency. This optimization can help the composite wrap designers to improve the repair performance and rehabilitation. [ABSTRACT FROM AUTHOR]

We describe a patient who developed acute chest pain and ST-segment elevation in the inferior leads on electrocardiography. In his control electrocardiography after 15 min, ST-segment elevation was observed in the anterior leads. Cardiac catheterization showed that there was wraparound left anterior descending artery and an occlusion in the proximal region. The occlusion was resolved by typical ballooning. To our knowledge, simultaneous ST elevations in anterior and inferior leads have been reported in the literature; however, in our case, with serial electrocardiographic (ECG) records, we realized that inferior ST-segment elevation altered to anterior ST-segment elevation. This indicates the importance of serial ECG records in emergency departments to explain the mechanism.

The essay explains Central-European traditional forms of manpower transport, in particular the ways to transport children. Carrying children using different transport aids has a long tradition and many common elements within the researched area, but we can also find many specific techniques and ways of carrying children as well as transport aids there. We can encounter regional archaisms and specifics there which make these ways of transport special. We focus on the oldest and most common transport mean -- a wrap that -- as a universal mean -- served for carrying children until the mid-20th century. We record the ways of carrying children on mother's body -- in front, on side or on back. The children used to be fixed in more ways as to their age, weight, and occasion to which they were transported (to the field, doctor's, baptism etc.). We have noticed a special way of carrying children in baskets on mother's back. Many of these described archaic ways are being revitalised, whereby original carrying techniques, and modern transport aids and materials are used. The essay summarizes results of long-term research and it compares them with materials published in the ethnographic atlases of Slovakia (EAS) and Poland, as well as with Czech works. [ABSTRACT FROM AUTHOR]

Perivascular medical devices and perivascular drug delivery systems are conceived for local application around a blood vessel during open vascular surgery. These systems provide mechanical support and/or pharmacological activity for the prevention of intimal hyperplasia following vessel injury. Despite abundant reports in the literature and numerous clinical trials, no efficient perivascular treatment is available. In this review, the existing perivascular medical devices and perivascular drug delivery systems, such as polymeric gels, meshes, sheaths, wraps, matrices, and metal meshes, are jointly evaluated. The key criteria for the design of an ideal perivascular system are identified. Perivascular treatments should have mechanical specifications that ensure system localization, prolonged retention and adequate vascular constriction. From the data gathered, it appears that a drug is necessary to increase the efficacy of these systems. As such, the release kinetics of pharmacological agents should match the development of the pathology. A successful perivascular system must combine these optimized pharmacological and mechanical properties to be efficient. [ABSTRACT FROM AUTHOR]

Gastroesophageal reflux disease (GERD) is a very common condition and affects approximately 7-20% of the pediatric population. Symptoms from pathological GERD include regurgitation, irritability when feeding, respiratory problems, and substernal pain. Treatment typically starts with dietary modifications and postural changes. Antireflux medications may then be added. Indications for operative management in the pediatric population include failure of medical therapy with poor weight gain or failure to thrive, continued respiratory symptoms, and complications such as esophagitis. Laparoscopic Nissen fundoplication has become the standard of care for surgical treatment of children with GERD. The key technical aspects of laparoscopic Nissen fundoplication include creation of an adequate intra-abdominal esophagus, minimal dissection of the hiatus with exposure of the right crus to identify the gastroesophageal junction, crural repair, and creation of floppy, 360° wrap that is oriented at the 11 o׳clock position. [ABSTRACT FROM AUTHOR]

Introduction Gastroesophageal reflux disease is a common condition in pediatric age group. Many surgeons believe that complete fundoplication provides better reflux control, yet it results in more dysphagia and gas-bloat symptoms. On the other hand, a partial wrap is reported to have fewer adverse effects but a higher failure rate in controlling reflux. Until now, there is no agreement and little evidence as to whether complete or partial fundoplication is the optimal procedure in this age group. Patients and methods This is a prospective singleblinded randomized comparative study that included 30 patients who were admitted in the time period from May 2013 to May 2015 and were treated laparoscopically by either Nissen or Thal fundoplication. Results Operative time (minutes) was significantly longer in the Thal group (186 ± 52) when compared with the Nissen group (150 ±48) (P =0.031). Intraoperative complications showed no significant difference when comparing the two groups. Although the incidence of postoperative dysphagia was statistically insignificant, the duration of dysphagia did show significantly shorter duration in the Thal group (median: 6 days), when compared with the Nissen group (median: 17 days). There was no recurrence in the Thal group, whereas there was one recurrence in the Nissen group. Conclusion This study suggests that Thal fundoplication offers an effective alternative to Nissen fundoplication with apparently shorter duration of dysphagia and thus earlier return to the normal eating pattern. Level of evidence: 1b. [ABSTRACT FROM AUTHOR]

[Display omitted] • SWAT+ model and WRAP were coupled to obtain daily streamflow data. • Disaggregation technique based on flow pattern is recommended. • Disaggregation of a monthly calibrated model estimates reliable environmental flows. • SWAT+ model calibrated on a daily scale underestimates environmental flow. • An alternative for environmental flows estimation in anthropized watersheds is shown. The Water Framework Directive requires all water bodies in EU countries to ensure the ecological integrity of freshwater ecosystems in all water bodies. A "good" status in water bodies leads to their biological elements to reproduce reference conditions, so quantity and timing should be considered in describing environmental flows. However, the availability of daily natural flow data is one of the major drawbacks, especially in highly water-regulated countries, such as Spain, and hydrological models, such as the Soil and Water Assessment Tool (SWAT+) model, can be used to generate them. This work evaluated three different approaches for obtaining daily flows used to characterise the natural regime and to estimate environmental flows in the Piloña River (northern Spain) and Tagus River (centre Spain) basins: Scenario 1) daily flows simulated by the SWAT+ model calibrated on a monthly scale; Scenario 2) daily flows estimated by applying monthly-to-daily disaggregation techniques from the monthly series obtained from the SWAT+ model calibrated on a monthly scale using Water Rights Analysis Package (WRAP) software; and Scenario 3) daily flows simulated by the SWAT+ model calibrated on a daily scale. The Kling–Gupta efficiency (KGE), percent bias (PBIAS), Nash–Sutcliffe efficiency (NSE), root mean square error (RMSE) and standard deviation ratio (RSR) were used to evaluate the model's performance. Furthermore, the indicators of hydrologic alteration in rivers (IAHRIS) and the basic flow methods were assessed and compared with those obtained directly using the real data observed at the gauging station. Our results indicated that Scenario 2 outperformed the rest of the approaches for all the statistics used. KGE and NSE varied between 0.78 and 0.92 for both basins in Scenario 2 while these values decreased to 0.50–0.60 for KGE and 0.20–0.40 for NSE in Scenarios 1 and 3. Moreover, PBIAS ranged between 3.24 and 4.47% in validation periods in Scenario 2, while it decreased to −14.64% in Scenario 3. Likewise, Scenario 2 was also observed to show better performance related to both the patterns of the natural regime and the basic flow values, which were generally underestimated by the other scenarios. The methodology proposed provides a valuable tool for evaluating and managing the hydrological and environmental status of river basins. [ABSTRACT FROM AUTHOR]

Introduction: Our objective was determining the optimal combinations of cerebrospinal fluid (CSF) biomarkers for predicting disease progression in Alzheimer's disease (AD) and other neurodegenerative diseases., Methods: We included 1,983 participants from three different cohorts with longitudinal cognitive and clinical data, and baseline CSF levels of Aβ42, Aβ40, phosphorylated tau at threonine-181 (p-tau), neurofilament light (NfL), neurogranin, α-synuclein, soluble triggering receptor expressed on myeloid cells 2 (sTREM2), glial fibrillary acidic protein (GFAP), YKL-40, S100b, and interleukin 6 (IL-6) (Elecsys NeuroToolKit)., Results: Change of modified Preclinical Alzheimer's Cognitive Composite (mPACC) in cognitively unimpaired (CU) was best predicted by p-tau/Aβ42 alone (R 2 ≥ 0.31) or together with NfL (R 2  = 0.25), while p-tau/Aβ42 (R 2 ≥ 0.19) was sufficient to accurately predict change of the Mini-Mental State Examination (MMSE) in mild cognitive impairment (MCI) patients. P-tau/Aβ42 (AUC ≥ 0.87) and p-tau/Aβ42 together with NfL (AUC ≥ 0.75) were the best predictors of conversion to AD and all-cause dementia, respectively., Discussion: P-tau/Aβ42 is sufficient for predicting progression in AD, with very high accuracy. Adding NfL improves the prediction of all-cause dementia conversion and cognitive decline., (© 2023 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)

Polygenic risk scores (PRSs) have been used to combine the effects of variants with small effects identified by genome-wide association studies. We explore the potential for using pathway-specific PRSs as predictors of early changes in Alzheimer's disease (AD)-related biomarkers and cognitive function. Participants were from the Wisconsin Registry for Alzheimer's Prevention, a longitudinal study of adults who were cognitively asymptomatic at enrollment and enriched for a parental history of AD. Using genes associated with AD in the International Genomics of Alzheimer's Project's meta-analysis, we identified clusters of genes that grouped into pathways involved in amyloid-β (Aβ) deposition and neurodegeneration: Aβ clearance, cholesterol metabolism, and immune response. Weighted pathway-specific and overall PRSs were developed and compared to APOE alone. Mixed models were used to assess whether each PRS was associated with cognition in 1,200 individuals, cerebral Aβ deposition measured using amyloid ligand (Pittsburgh compound B) positron emission imaging in 168 individuals, and cerebrospinal fluid Aβ deposition, neurodegeneration, and tau pathology in 111 individuals, with replication performed in an independent sample. We found that PRSs including APOE appeared to be driven by the inclusion of APOE, suggesting that the pathway-specific PRSs used here were not more predictive than an overall PRS or APOE alone. However, pathway-specific PRSs could prove to be useful as more knowledge is gained on the genetic variants involved in specific biological pathways of AD. [ABSTRACT FROM AUTHOR]

Background Intimal hyperplasia (IH) remains a major cause of poor patient outcomes after surgical revascularization to treat atherosclerosis. A multitude of drugs have been shown to prevent the development of IH. Moreover, endovascular drug delivery following angioplasty and stenting has been achieved with a marked diminution in the incidence of restenosis. Despite advances in endovascular drug delivery, there is currently no clinically available method of periadventitial drug delivery suitable for open vascular reconstructions. Herein we provide an overview of the recent literature regarding innovative polymer platforms for periadventitial drug delivery in preclinical models of IH as well as insights about barriers to clinical translation. Methods A comprehensive PubMed search confined to the past 15 years was performed for studies of periadventitial drug delivery. Additional searches were performed for relevant clinical trials, patents, meeting abstracts, and awards of NIH funding. Results Most of the research involving direct periadventitial delivery without a drug carrier was published prior to 2000. Over the past 15 years there have been a surge of reports utilizing periadventitial drug-releasing polymer platforms, most commonly bioresorbable hydrogels and wraps. These methods proved to be effective for the inhibition of IH in various animal models (e.g. balloon angioplasty, wire injury, and vein graft), but very few have advanced to clinical trials. There are a number of barriers that may account for this lack of translation. Promising new approaches including the use of nanoparticles will be described. Conclusions No periadventitial drug delivery system has reached clinical application. For periadventitial delivery, polymer hydrogels, wraps, and nanoparticles exhibit overlapping and complementary properties. The ideal periadventitial delivery platform would allow for sustained drug release yet exert minimal mechanical and inflammatory stresses to the vessel wall. A clinically applicable strategy for periadventitial drug delivery would benefit thousands of patients undergoing open vascular reconstruction each year. [ABSTRACT FROM AUTHOR]

The present study evaluated the effectiveness of the Wellness Recovery Action Planning (WRAP) in a matched controlled design among individuals in recovery of mental illness in Hong Kong. Feedback from the first batch of WRAP facilitators in Hong Kong was sought for future implementation of WRAP. Participants were recruited from the service units of the largest nongovernmental organization (NGO) serving people in recovery in Hong Kong. Fifty-nine service users were recruited to learn WRAP and 59 service users served as matched controls. The WRAP program consisted of eight weekly sessions delivered by NGO staff who were certified WRAP facilitators. Assessments were completed before, immediately after, and 3 months after the program. Findings based on repeated measures ANOVAs showed that compared with their matched controls, WRAP participants reported significant increase in perceived social support. No significant change was noted in empowerment, hope, self-stigma, social network size, symptom severity, and recovery. Facilitators discussed issues on cultural adaptation and resources needed for future implementation of WRAP for Chinese. Discrepancies between the present findings and those from previous studies were discussed. This is the first quantitative study evaluating the effectiveness of WRAP among Chinese. [ABSTRACT FROM AUTHOR]

Executing a life cycle carbon analysis on a building has two components to consider: the Embodied Carbon (EC) and In-use Carbon, the sum of these forms ‘the building carbon budget'. The in-use can be obtained through regulatory tools such as the Standard Assessment Procedure (SAP) in the UK. Embodied carbon has a loose framework with little guidance on a standardised methodology. This paper explores embodied carbon analysis using building components to enhance the understanding of the sensitivity and categorisation of measurements to propose a methodology. The exploration of differing methods on a Passivhaus case study was undertaken with the use of global warming potential identified as the correct unit of measurement. Different methods of estimating quantities and datasets used for an EC calculation are discussed. Results highlight a variation in carbon emissions for certain common building materials between the method used in the Environmental Performance Declarations (EPD) compared to current databases such as Inventory of Carbon and Energy (ICE) using Cradle to Gate data. Designers prefer simple embodied carbon calculation methods. This paper identifies a calculation method giving an acceptable accuracy with the least amount of input data required to implement regulatory standardisation within the industry. [ABSTRACT FROM AUTHOR]

Business is all about profit, but at the same time the organizations are answerable to the society. The associated farmers, workers, stakeholders, retailers, customers and the society as a whole should get benefit through the corporate sector. Textile industries play a major role in global economy and at the same time affect the social and environmental aspects at large extent from cultivation/ production of fibres to apparel manufacturing. It is essential that corporate sector must insure social and environmental compliance as per the standard norms. Therefore in India, the Companies Act 2013 necessitates the corporate sector to spend and work on these societal issues with fulfilling certain criteria. The present paper discusses corporate social responsibility in context to textile and apparel sector along with its various economic, social and environment and ecological aspects. The paper also elaborates various Corporate Social Responsibility (CSR) initiatives in the form of code of conducts such as Social Accountability 8000 (SA 8000), International Organization for Standardization (ISO) 14001, Worldwide Responsible Accredited Production (WRAP), Fair Labor Association (FLA), Occupational Health and Safety Assessment Series (OHSAS), etc. [ABSTRACT FROM AUTHOR]

Cognitive decline is one of the hallmark features of Alzheimer's disease, but many studies struggle to find strong associations between cognitive function and genetic variants. In order to identify which aspects of cognition are more likely to have a strong genetic component, we assessed the heritability of various cognitive functions related to Alzheimer's disease in 303 initially asymptomatic middle-aged adult siblings with a parental history of Alzheimer's disease from the Wisconsin Registry for Alzheimer's Prevention. Participants underwent extensive cognitive testing, and six cognitive factors were identified via factor analysis. Working Memory and Visual Learning & Memory had the highest heritability (52% and 41%, respectively). Inclusion of APOE allele counts did not notably change heritability estimates, indicating that there are likely additional genetic variants contributing to cognition. These findings suggest that future genetic studies should focus on the cognitive domains of Working Memory and Visual Learning & Memory. [ABSTRACT FROM AUTHOR]

A case of severe restrictive strabismus after a consecutive exotropia surgery is presented. We describe the exitous managment through a technique consist of wrapping with amniotic membrane (AM) the affected muscle where we add a second AM graft in the reconstruction of the ocular Surface., (Copyright © 2022 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.)

The development of daily naturalized flow in the water rights analysis package (WRAP) model at ungaged stations has difficulties because of low daily flow measurement at gaged stations, low available monthly naturalized flow, and budget constraints. This study proposes a procedure for developing daily naturalized flow at ungaged stations. The soil and water assessment tool (SWAT) model was validated with little daily flows and used for predicting the daily flow at gage stations that are near ungaged stations. The predicted daily flow is transferred at ungaged stations using the drainage area ratio (DAR) method. The transferred daily flow is aggregated and compared with monthly regulated flow computed by the WRAP model with the mean, standard deviation, mean relative error, Nash-Sutcliffe model efficiencies, and correlation coefficient (R²). The SWAT daily flow, which is referred to as the regulated flows, is converted using regression equations into naturalized flow and used as the daily pattern flow for monthly naturalized flow disaggregation. The system application of the SWAT and WRAP models with DAR and pattern methods provides alternative ways to generate daily naturalized flow at ungaged stations through disaggregating monthly naturalized flow at primary stations. [ABSTRACT FROM AUTHOR]

BACKGROUND: The purpose of this study was to assess the efficacy of absorbable mesh wrapping (MW) versus perihepatic packing (HP) for severe hepatic injury. METHODS: From January 2001 to December 2012, data were collected for MW patients with hepatic injury. Patients who underwent HP were matched with MW patients by injury mechanism, liver injury grade, Injury Severity Score, and age. RESULTS: Twenty-six MW and twenty-six HP patients were matched. Eighteen blunt and 8 penetrating injuries were present in each group. There were 9 (35%) mortalities in the MW group and 16 (62%) in the HP groups (P = .03). Average transfusions were 12.0 and 24.5 (P = .03) packed red blood cells in the MW and HP groups, respectively. Average laparotomies per survivors were 1.3 for the MW and 3.1 for the HP groups (P = .01). Average length of stay for survivors was 19 and 47 (P = .04) days in the MW and HP groups, respectively. CONCLUSION: MW for hepatic injuries can significantly decrease mortality, transfusions, laparotomies, and length of stay. [ABSTRACT FROM AUTHOR]

Das Kraftwerk Meliti in Nordgriechenland ist ein Braunkohlekraftwerk mit einer Bruttoleistung von 330 MW und wird von der Public Power Corporation (PCC) betrieben. Am 25. Juli 2014 brach ein Feuer an einer Förderbandanlage aus, die den Brennstoff zum Bunkerschwerbau fördert. Es entstanden Schäden in der 240 m langen stählernen Förderbandbrücke sowie in dem angrenzenden Betonbunkerschwerbau. Die Förderbandbrücke wurde durch Auswechselung der beschädigten Stäbe und Verbindungsmittel ohne Einsatz von Lehrgerüsten zur temporären Abstützung instandgesetzt. Am Bunkerschwerbau entstanden lokale Schäden, die mit Hilfe von CFK-Lamellen und -Gewebe behoben werden konnten. Nach zwei Monaten Instandsetzung wurde die Kraftwerksanlage wieder in Betrieb genommen. Structural rehabilitation of the power plant Meliti, Greece after fire. The power plant Meliti in Northern Greece is a 300 MW power station that uses lignite as fuel. On the 25th of July 2014 a fire broke out in the conveyor belt that transports the coal to the bunker. The fire resulted in damages in the 240 m long steel conveyor bridge and the concrete bunker structure. The conveyor bridge was repaired without scaffolding temporary supports by exchanging the damaged parts and the connection media with new. The bunker was subjected to local damages that were rehabilitated by application of FRP sheets and FRP wraps. The plant was in operation in two months after it was fully rehabilitated. [ABSTRACT FROM AUTHOR]

This paper aims to provide a rational approach to the concept of circumferential strain efficiency factor κε of circular concrete columns wrapped with fiber-reinforced polymer (FRP) jackets. The variable κε reflects the reduction in the FRP hoop rupture strain observed in experiments, relative to the true rupture strain of the FRP material obtained from standard coupon tests or manufacturer datasheets. Currently, the ACI 440.2R-08 design guide uses a constant empirical κε factor of 0.55 for any column, regardless of geometric or mechanical properties. A rational approach is proposed to calculate κε. It employs a simplified Tsai-Wu interaction failure envelope of FRP laminates and acknowledges the biaxial state of stresses in the jacket. A large database of 454 circular concrete specimens wrapped with unidirectional FRP fabrics has been compiled from literature and subjected to rigorous statistical evaluations. While the proposed model performed quite similarly to the current ACI 440.2R-08 in that it did not lead to significant improvement in prediction, it has the advantage of offering analytical rational bases to the observed phenomenon. It also distinguishes between columns of different geometric and mechanical properties, leading to a variable κε of 0.05 to 0.98 with a 0.65 average, which is consistent with experimental observations and more logical than the constant value of 0.55. [ABSTRACT FROM AUTHOR]

Topic: This article reflects on the importance of fidelity in the delivery of the peer-based Wellness Recovery Action Plan. Purpose: The purpose of this account is to describe efforts being made to preserve the evidenced-based practice of the Wellness Recovery Action Plan in ways that sustain the core value of self-determination, maintain fidelity to its copyrighted curriculum, and support its positive impact for all people. Sources Used: The writing is based on personal knowledge and research literature related to the Wellness Recovery Action Plan. Conclusions and Implications for Practice: The implementation and training of facilitators committed to the value of self-determination is critical to the fidelity of the evidence-based, peer-delivered Wellness Recovery Action Plan. Value-based training and WRAP standards are essential to ensure that WRAP continues to contribute substantially to transformative change. [ABSTRACT FROM AUTHOR]

From 2004 to 2008, 1,834 Environmental Resource Permits were issued for development projects in coastal wetlands within the Charlotte Harbor National Estuary Program. We evaluated 118 sites utilizing three wetland functional assessment methods (WFAMs): Hydrogeomorphic Method (HGM), Wetland Rapid Assessment Procedure (WRAP), and Uniform Mitigation Assessment Method (UMAM). All functioned as designed and produced similar assessments of wetlands but yielded different mitigation results. The study results showed that HGM was most effective in identifying and quantifying wetland functions of coastal wetlands. UMAM and WRAP are useful but delivered mitigation ratios less than one in both function and area, resulting in net wetland losses. The wetland area lost over the study period was small relative to total wetland area, but the permitted wetland elimination is gradually reducing the extent of wetlands. The process relocates wetland functions out of impacted watersheds toward off-site mitigation areas. The WFAM site evaluations indicated an equal or greater balance of ecosystem functions within the total service area when utilizing off-site mitigation. However, there is loss of wetland area and function in the donor watershed and an increase in function, but not area, of wetlands in the receiving watershed. [ABSTRACT FROM AUTHOR]

Summary: Background: Healthcare educators face numerous challenges including technological change, information overload, and the need to maintain clinical expertise and research knowledge across multiple specialities. Students also need to develop their capacity for critical thinking, using and discriminating between diverse sources of knowledge in order to advance their own practice. Objectives: To investigate student perceptions of the affordances of a novel web 2.0-based tool – the Web Resource Appraisal Process (WRAP), designed to support the development of critical thinking skills, and to identify how student''s understanding of critical thinking and their use of web 2.0 resources might inform the cross-disciplinary development of the WRAP. Design: A two phase, action research study of student perceptions of the WRAP and their ability to source and identify valid information sources. Settings: Implemented at the University of South Australia, development of the WRAP is an international project with the University of Westminster, UK. Participants: Students from international locations participated in the project. Methods: A mixed methods approach was adopted involving a two phase action research study. In phase one, student perceptions of the WRAP were obtained using a modified course feedback questionnaire. This informed the development of a subsequent questionnaire used to survey student perceptions of their usage of online resources, the ease of access of such resources and their approaches to determining their validity. Results: Results suggest that students mainly use traditional resources when preparing work for assessment and they either do not understand the concept of, or do not exercise, critical thinking skills in such activities. However, the feedback from students using the WRAP, demonstrated that they found it instructive and useful. Conclusions: To ensure that practice developments are based on authoritative evidence, students need to develop critical thinking skills which may be facilitated by tools such as the WRAP. [Copyright &y& Elsevier]

Circumferential wrapping of fiber-reinforced polymer (FRP) sheets is one of the most common applications for repair and rehabilitation of large-scale columns. Common types of fibers used for wrapping are carbon FRP (CFRP), glass FRP (GFRP), and aramid FRP (AFRP). Recently, steel FRP (SFRP) has been introduced as a new class of composites for strengthening applications. Up to now, there has been no experimental data available on the behavior of large-scale columns wrapped with SFRP sheets. Thus, in this paper, the behavior of nonreinforced and reinforced large-scale columns (300 × 1;200 mm) wrapped with CFRP and SFRP sheets is examined and compared with that of unwrapped columns. The experimental results include stress-strain behavior, ultimate stress, ultimate strain, dilation, and ductility of large-scale columns. This study presents the first ever insight into the strain variation of large-scale circular columns wrapped with CFRP and SFRP sheets using the digital image correlation technique (DICT). This technique is a photogrammetric technique that allows capturing strains from the surface of FRP-confined concrete. Results from DICT were used to analyze the strain efficiency of the SFRP sheets. Results indicate that the overall performance of the SFRP-wrapped concrete columns is superior to that of the CFRP-wrapped concrete columns. [ABSTRACT FROM AUTHOR]

Abstract: This paper reports on an experimental investigation that evaluates the effectiveness of newly developed material, steel fibre reinforced polymer (SFRP) sheets to confine small-scale plain concrete circular and square columns. Different parameters were investigated including: number of SFRP layers (1, 2, and 3), target concrete compressive strength (25, 30, and 35MPa), cross-section of the columns (circular and square), and corner radius for square columns (3, 6, 10, and 25mm). The experimental investigation was conducted in three phases. In Phase I, 36 circular specimens (150mm diameter×300mm height) and in Phase II, 36 square specimens (150mm side length×300mm height) were tested. In each phase, the specimens were divided into three groups according to concrete compressive strength. In each group, three specimens were tested without wrapping for comparison purposes, and three specimens for each number of layers. In Phase III, 12 SFRP wrapped (one layer) square specimens with a target concrete compressive strength of 25MPa were tested to investigate the effect of varying the corner radii on the confined compressive strength. The specimens were tested under monotonic concentric uni-axial compression load. Results showed that SFRP confinement improved the performance of both circular and square specimens in terms of axial strength and ductility; however, the improvement for square specimens was not as prominent as that for circular specimens. Rounding the corners of the square specimens improves the situation for square specimens and performance enhances with increasing corner radius. The confined concrete compressive strength was predicted using equations available in different codes and models and compared with experimental results. [Copyright &y& Elsevier]