High temperature PEMs developed from the blends of Polybenzimidazole and poly(azomethine-ether)

Abstract

Proton exchange membrane (PEM) has been developed from the polymer blend of polybenzimidazole (PBI) and poly(azomethine-ether) (PAME). The effects of the blend compositions on the properties such as thermo-mechanical stability, proton conductivity etc. of PEM were studied. The miscibility of the blend membranes was confirmed by characterizing the blend samples using varieties of spectroscopy and thermo dynamical techniques. FT-IR and SS-NMR studies revealed the presence of specific interactions between the two polymers. All blend membranes showed single glass transition temperature (T_g) attributing that the this blend system is a miscible blend. The thermogravimetric studies confirmed that the blend membranes were more stable than the pristine PBI below 300 °C temperatures and less stable above 300 °C. Morphology probed by transmission electron microscopy studies displayed morphological features which consisted of both thread like structure and particle like structures thus confirming the uniform mixing of polymers in the blends. Mechanical stabilities of the blend membranes were quite high compared to the pristine polymers as obtained from the dynamic mechanical analyzer (DMA) studies. The blend membranes showed higher proton conductivity compared to pristine PBI. The proton conductivity increased upon increasing the percentage of PAME in the blend membranes. All these results indicated that the blend membranes are promising candidates for the application in high temperature proton exchange membrane in fuel cell.

Graphical abstract

Polybenzimidazole Blends as PEM for the use in Fuel Cell

http://bit.ly/2SpFhZy

Outcomes after splenectomy in children: a 48-year population-based study

Abstract

Purpose

In children who have undergone splenectomy, there may be impaired immunologic function and an increased risk of infection. We aimed to define the long-term rate of and risk factors for post-splenectomy infection using a population-based cohort study.

Methods

All children (< 18 years) who underwent splenectomy from 1966 to 2011 in Olmsted County, MN were identified using the Rochester Epidemiology Project (REP). Descriptive statistics, Kaplan–Meier estimates, and Cox Proportional hazard ratios were performed to evaluate for risk factors associated with developing infection.

Results

Ninety patients underwent splenectomy and 46% were female. Indications included trauma (42%), benign hematologic disease (33%), malignancy (13%), and other (11%). Most were performed open. Vaccination was completed in (72%) for pneumococcal, H. influenza, and meningococcal vectors. Nineteen patients developed infection, and associated factors included non-traumatic, non-malignant disease [HR 4.83 (1.18–19.85)], and performance of multiple surgical procedures [HR 2.80 (1.09–7.21)]. Estimated survival free of infection rates at 15 and 20 years following surgery was both 97%.

Conclusions

After splenectomy in children, most patients do not develop infection. Nearly three-quarters of patients were vaccinated with the lowest rates in patients that underwent a splenectomy for trauma. In patients who received multiple procedures during a splenectomy, the infection risk was higher.

http://bit.ly/2G6Rtst

Standardized text messages improve 30-day patient follow-up for ACS pediatric NSQIP cases

Abstract

Purpose

Thirty-day follow-up is a critical and challenging component of the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP). We hypothesized the simplicity and immediacy of text messaging would increase response rates while reducing workload.

Methods

For 6 months, text messages were the primary form of contact for first and second follow-up attempts. If no response, a phone call was made. Results of this protocol were compared to the previous 6 months when phone calls were the primary method.

Results

The text message (TM) group had 298 cases and phone call (PC) group had 354. The first contact was successful in 63.8% of the TM group compared to 47.5% of the PC group. The second contact was successful in 15.4% (TM) and 16.9% (PC). In the third attempt, 3.0% answered the call in the TM group versus 9.3% in the PC group. Some families remained unreachable: 17.8% in TM group and 26.3% in PC group (p = 0.01). When totaled, time spent to obtain caregivers' responses was over five times higher in the PC group (910 min) than the TM group (173 min) (p = 0.005).

Conclusion

Patient follow-up using text messaging has improved our follow-up rate while decreasing workload.

http://bit.ly/2D0E4OW

Enhanced recovery after surgery (ERAS) protocols in neonates should focus on the respiratory tract

Abstract

Background/purpose

Enhanced recovery after surgery (ERAS) protocols have shown significant benefits in terms of patient outcomes and institutional cost savings in colorectal and bariatric surgery. This has not, however, been tried in the neonatal setting. One of the major barriers to developing ERAS protocols in the neonatal intensive care unit (NICU) is the often-prolonged intubation of neonates after surgery. To this end, we evaluated our institutional data to determine if prolonged intubation post-operatively is associated with adverse events.

Methods

This is a retrospective cohort study of neonates who were intubated for a surgical procedure from January 2012 to December 2016. Documented data included pre-operative intubation status, timing of post-operative extubation: immediate (< 24 h) or delayed (> 24 h), and adverse respiratory events. The Fisher exact test and Student's t test were used to study differences amongst categorical and continuous variables, respectively.

Results

58 surgical procedures were identified, where the patient was intubated specifically for the surgical intervention, of which 28 were extubated immediately and 30 were extubated in a delayed fashion. The overall incidence of adverse respiratory events was increased in the delayed extubation group (P = 0.03).

Conclusions

Healthcare providers should encourage early extubation after neonatal surgery. Consideration should be given to implementing ERAS protocols in NICUs.

Level of evidence

Prognosis study—level II.

http://bit.ly/2G81EwU

Letter to the Editor concerning: “the non-visualized appendix and secondary signs on ultrasound for pediatric appendicitis in the community hospital setting”

http://bit.ly/2D0DIYC

Postural sway, falls, and self-reported neuropathy in aging female cancer survivors

Publication date: March 2019

Source: Gait & Posture, Volume 69

Author(s): Peter C. Fino, Fay B. Horak, Mahmoud El-Gohary, Carolyn Guidarelli, Mary E. Medysky, Sarah J. Nagle, Kerri M. Winters-Stone

Abstract

Background

Falls are a major public health concern in older adults, and the proportion of older adults that has been diagnosed with cancer is growing. Yet, while falls, peripheral neuropathy, and postural instability are more common in aging cancer survivors, it is unclear how these factors interact.

Research question

Our objective was to examine how components of sway related to self-reported neuropathy and falls.

Methods

Postural sway during static stance was recorded with an inertial sensor (APDM Opal), placed on the lumbar spine region in 434 older female cancer survivors (mean age 63) and 49 healthy older female control subjects (mean age 63). Measures of sway were resolved into principal components that were compared between women with and women without self-reported falls in the previous 6 months and between those with and without self-reported symptoms of peripheral neuropathy.

Results

Cancer survivors had worse sway than healthy control subjects in components related to sway magnitude and mediolateral frequency of sway, but no difference in the component related to resultant / AP sway jerk and frequency. Cancer survivors who reported neuropathy were more likely to have higher resultant / AP sway frequencies and jerk than asymptomatic survivors, while survivors who reported a fall were more likely to have lower frequencies of mediolateral sway than non-fallers. Falls were more strongly associated with mediolateral sway in survivors with more severe neuropathy; whereas falls were more strongly associated with resultant / AP sway frequency in survivors with less severe neuropathy

Significance

Postural stability, falls, and neuropathy have complex interactions that can vary across components of postural sway. While the frequency of mediolateral sway was associated with falls across our entire cohort, neuropathy influenced the associations between specific characteristics of sway and falls, which may have implications for fall prevention interventions.

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Postural sway, falls, and self-reported neuropathy in aging female cancer survivors

Publication date: March 2019

Source: Gait & Posture, Volume 69

Author(s): Peter C. Fino, Fay B. Horak, Mahmoud El-Gohary, Carolyn Guidarelli, Mary E. Medysky, Sarah J. Nagle, Kerri M. Winters-Stone

Abstract

Background

Falls are a major public health concern in older adults, and the proportion of older adults that has been diagnosed with cancer is growing. Yet, while falls, peripheral neuropathy, and postural instability are more common in aging cancer survivors, it is unclear how these factors interact.

Research question

Our objective was to examine how components of sway related to self-reported neuropathy and falls.

Methods

Postural sway during static stance was recorded with an inertial sensor (APDM Opal), placed on the lumbar spine region in 434 older female cancer survivors (mean age 63) and 49 healthy older female control subjects (mean age 63). Measures of sway were resolved into principal components that were compared between women with and women without self-reported falls in the previous 6 months and between those with and without self-reported symptoms of peripheral neuropathy.

Results

Cancer survivors had worse sway than healthy control subjects in components related to sway magnitude and mediolateral frequency of sway, but no difference in the component related to resultant / AP sway jerk and frequency. Cancer survivors who reported neuropathy were more likely to have higher resultant / AP sway frequencies and jerk than asymptomatic survivors, while survivors who reported a fall were more likely to have lower frequencies of mediolateral sway than non-fallers. Falls were more strongly associated with mediolateral sway in survivors with more severe neuropathy; whereas falls were more strongly associated with resultant / AP sway frequency in survivors with less severe neuropathy

Significance

Postural stability, falls, and neuropathy have complex interactions that can vary across components of postural sway. While the frequency of mediolateral sway was associated with falls across our entire cohort, neuropathy influenced the associations between specific characteristics of sway and falls, which may have implications for fall prevention interventions.

from #Audiology via ola Kala on Inoreader http://bit.ly/2D7tzZV