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Contemporary esophageal physiological testing for primary esophageal motility disorder (PEMD) and gastroesophageal reflux disease (GERD) before bariatric surgery: A systematic literature review
Get PDFObjective
This systematic review was conducted to evaluate the preoperative prevalence of primary esophageal motility disorders and gastroesophageal reflux disease in patients with morbid obesity before bariatric surgery.
Background
The use of esophageal manometry ± 24-hour pH study before bariatric surgery was explored.
Material and Methods
Articles on preoperative conventional or high-resolution manometry ± 24-hours pH-study or both before bariatric surgery between 1999 and 2023 were identified using the Medline, PubMed, EMBASE, Cochrane Register of Systematic Reviews, and Science Citation Index. The search terms were selected for each search engine to optimize the published literature and meet the inclusion criteria. The modified AXIS was used as a critical appraisal tool to assess the quality of studies.
Results
Thirty-three studies performing preoperative esophageal manometry ± pH studies or both were identified. Various manometric abnormalities have been described by the authors depending on the type of technique used. Twenty-two studies undertook a 24-hour ambulatory pH study to identify abnormal acid exposure. Twenty studies performed preoperative gastroscopy. The incidence of hiatal hernia varied from 5.4% to 52.6%, and reflux esophagitis from 4.4% to 42%.
Conclusions
The preoperative prevalence of PEMD and GERD was significant in patients with morbid obesity. This implies that the selection of the most appropriate bariatric procedure needs to be tailored not only for weight reduction but also for the prevention of further deterioration in esophageal motor function and GERD and its future consequences, such as Barrett's esophagus, erosive esophagitis, and esophageal adenocarcinoma, in both the short and long term
Commentary: Heart-brain interaction in cardiogenic dementia: pathophysiology and therapeutic potential
Get PDFInterconnected health: A concept analysis of planetary empathy for healthcare professionals
Get PDFBackground
Planetary Health emphasizes the interconnectedness of human health and the natural environment. Despite this, human-induced destruction of ecosystems threatens planetary stability. Understanding planetary empathy may offer insights into how healthcare professionals can better live and work with nature.
Purpose
This paper presents a concept analysis of planetary empathy, exploring its impact on healthcare and the roles of healthcare professionals.
Methods
The Walker and Avant eight-stage approach for concept analysis informed this paper. Data were obtained from literature searches, dictionaries, encyclopedias, and relevant international organization websites.
Discussion
Planetary empathy is a cyclical process involving reflection, reciprocal relationships with nature, recognition of biases, responsibility for future generations, and behavioral responses to protect planetary health.
Conclusion
Planetary empathy catalyzes prosocial environmental behaviors. Healthcare professionals who embody this empathy are more likely to be engaged in creating a healthier, more equitable world for all people and ecosystems
AIAA SciTech Forum 2025
No full textThe simultaneous optimisation of a platform and its operation, commonly called codesign, is a promising tool for hypersonic platforms given its potential to reduce the number of expensive hardware development cycles. A key advantage of codesign is its ability develop vehicles beyond optimizing a single operating point. For example, it is possible to incorporate integral constraints such as critical heat loading, and to target vehicles for complex and relevant mission objectives. Here, we present a framework for codesign of a hypersonic vehicle's nose-cone, targeting the trade-off between heat transfer and aerodynamic performance. We demonstrate (i) that constraining cumulative leading-edge heat load significantly affects optimal vehicle trajectories, and, (ii) codesign with this constraint significantly affects leading edge shape. This result shows that point estimates for nose-cone heat transfer are insufficient, motivating the use of more sophisticated heat transfer models. Finally, we show how codesign can be used to design vehicles that are performant over a range of missions, rather than optimizing for a nominal mission specification
Converting waste poly(ethylene terephthalate) into hierarchical porous carbon towards a high-performance supercapacitor
No full textThe massive annual production of polyethylene terephthalate (PET) generates a large amount of waste, thus raising widespread environmental concerns. Converting waste PET into porous carbon materials represents a promising sustainable and green method to reduce its burden on the environment. However, there have been some key challenges with existing carbonization methods, such as a complicated carbonization process and extensive use of corrosive activators. To overcome these challenges, herein, we propose a mild and efficient one-step pyrolysis strategy that can convert waste PET into hierarchical porous carbon (HPC) using K2CO3 as an activator/template. The resulting product obtained at a carbonization temperature of 700 °C (HPC-700) showed a unique interconnected hierarchical porous structure and higher oxygen content. The as-prepared HPC-based supercapacitor exhibited an exceptionally high specific capacitance of 332.3 F g−1 at a current density of 0.5 A g−1, which were far higher than those exhibited by previously reported PET-derived carbon counterparts. Furthermore, an excellent rate capability and high cycling stability with 95.98% capacitance retention was achieved after 10 000 cycles. Thus, this work offers a facile and effective approach to converting waste PET into porous carbon materials, showing great potential applications for high-performance capacitors and other energy storage materials. In addition, this study conducted a life cycle assessment (LCA) to understand the ecological impact of the material conversion process
Influence of Biodegradable Poly(lactic acid) in Poly(vinylidene fluoride)-Based Conducting Multifunctional Blend Nanocomposites on the Structure, Morphology, Electrical, Electromagnetic Interference Shielding, and Piezoelectric Properties
No full textThis study explores the influence of biodegradable poly(lactic acid) (PLA) when blended with poly(vinylidene fluoride) (PVDF) and expanded graphite (ExGr) on the electrical, electromagnetic interference shielding effectiveness (EMI SE), and piezoelectric properties of the blend nanocomposites. Temperature-gradient-introduced compression molding of neat PVDF and PVDF–x wt % PLA (x = 10, 20, 40) films results in the generation of the β-phase of PVDF along with γ- and α-phases. The compression-molded neat PVDF film exhibits a higher β-phase content in comparison to the PVDF–PLA blend and blend nanocomposites. The electrical conductivity increases for blend nanocomposites with higher PLA loading due to enhanced dispersion of graphite nanosheets, as evidenced through the FESEM analysis of selected samples. The impedance and the real part of relative permittivity analyses of blend nanocomposites support enhanced dispersion of ExGr particles with an increase in the PLA content in the blend. In finger tapping mode, the maximum output voltage of 2 V (average voltage of 1.5 V) is obtained for PVDF–10 wt % PLA–9 wt % ExGr hybrid nanocomposites due to the higher electroactive phase content. The total EMI SE of 0.2 mm thick PVDF–40 wt % PLA–9 wt % ExGr blend nanocomposite film obtained is 34 dB at 10 GHz, which is dominated by the absorption process. The EMI SE obtained in this work is better than those of many PVDF-based foams and aerogels. Thus, the blend nanocomposites hold promise in microwave absorption and piezoelectric nanogenerator applications
Thermoplastic Elastomer-Reinforced Hydrogels with Excellent Mechanical Properties, Swelling Resistance, and Biocompatibility
Get PDFStrong and tough hydrogels are promising candidates for artificial soft tissues, yet significant challenges remain in developing biocompatible, anti-swelling hydrogels that simultaneously exhibit high strength, fracture strain, toughness, and fatigue resistance. Herein, thermoplastic elastomer-reinforced polyvinyl alcohol (PVA) hydrogels are prepared through a synergistic combination of phase separation, wet-annealing, and quenching. This approach markedly enhances the crystallinity of the hydrogels and the interfacial interaction between PVA and thermoplastic polyurethane (TPU). This strategy results in the simultaneous improvement of the mechanical properties of the hydrogels, achieving a tensile strength of 11.19 ± 0.80 MPa, toughness of 62.67 ± 10.66 MJ m−3, fracture strain of 1030 ± 106%, and fatigue threshold of 1377.83 ± 62.78 J m−2. Furthermore, the composite hydrogels demonstrate excellent swelling resistance, biocompatibility, and cytocompatibility. This study presents a novel approach for fabricating strong, tough, stretchable, biocompatible, and fatigue- and swelling-resistant hydrogels with promising applications in soft tissues, flexible electronics, and load-bearing biomaterials
Degradation mechanisms of low-calcium fly ash-based geopolymer mortar in simulated aggressive sewer conditions
Get PDFAlkali-activated geopolymers are increasingly studied as alternatives to Ordinary Portland Cement (OPC) concrete
for use in challenging service environments. Low-calcium geopolymers have been advocated to mitigate Microbial-Induced Concrete Corrosion (MICC) in sewer pipes; however, their broader acceptance as a repair material for sewer rehabilitation remains to be established. This study evaluated the degradation mechanism of low-calcium fly ash-based geopolymer (FAGP) repair mortar under laboratory-simulated sewer conditions by exposing it to varying concentrations of sulphuric acid (pH 0.5, 1, and 4) for extended durations. The corrosion of the mortar samples was assessed based on visual changes, mass loss, residual mechanical strength, pore evolution, and ion transport over three exposure durations. Comparative analysis with OPC counterparts served as a benchmark. The degradation of FAGP and OPC due to acid exposure appears to escalate with both acid concentration and exposure. However, FAGP displayed superior performance by maintaining their shape and
retaining approximately 30% of mechanical strength even after 3000 h of exposure under highly aggressive sewer conditions at pH 0.5. In contrast, OPC fails to endure acid exposure beyond 2000 h. The loss of matrix integrity primarily stems from ion leaching, supported by Scanning Electron Microscopy and Mercury Intrusion Porosimetry analysis, which revealed the creation of intrinsic pores facilitating the ingress of sulphate ions into the matrix. X-Ray Diffraction (XRD) and Fourier Transform Infrared (FTIR) Spectroscopy patterns indicate no significant phase alterations, confirming this phenomenon. In conclusion, this study demonstrated that FAGP
mortar is more resilient and durable in mild to aggressive sewer conditions than OPC
University of Southern Queensland Innovations in Child and Adolescent Mental Health and Wellbeing 2025
No full textChildren struggle to access timely and effective mental health care, with the greatest barriers faced by those with complex needs and intersecting identities. Those with complex needs and intersecting identities face the greatest barriers. Schools are well-positioned to close these gaps. This presentation shares findings from a Rotary Health Australia-funded pragmatic trial of Trauma-Informed Behaviour Support (TIBS), a school-based mental health program. We will present evidence of TIBS’ impact on child mental health, learning outcomes, and educator capacity building. The program was delivered through digital resources and university student-led, school-based clinics, making child mental health care more accessible within schools. Findings from this trial informed our research partnership with the Queensland Department of Education, which focuses on building an equity-focused system of support in schools. We will discuss how such approaches can support students with complex needs - improving outcomes and expanding access to mental health care for children