Готові списки джерел за темами / Enhanced recovery pathways

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Добірка наукової літератури з теми "Enhanced recovery pathways"

Автор: Grafiati

Опубліковано: 11 березня 2023

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Статті в журналах з теми "Enhanced recovery pathways"

Joshi, Girish P., and Henrik Kehlet. "Enhanced Recovery Pathways." Anesthesia & Analgesia 128, no. 1 (January 2019): 5–7. http://dx.doi.org/10.1213/ane.0000000000003746.

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Durmusoğlu, Fatih, and Erkut Attar. "Enhanced Recovery Pathways in Gynecology." Journal of Gynecologic Surgery 36, no. 4 (August 1, 2020): 165–72. http://dx.doi.org/10.1089/gyn.2020.0014.

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Zainfeld, Daniel, Ankeet Shah, and Siamak Daneshmand. "Enhanced Recovery After Surgery Pathways." Urologic Clinics of North America 45, no. 2 (May 2018): 229–39. http://dx.doi.org/10.1016/j.ucl.2017.12.007.

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Cornett, ElyseM, AlanDavid Kaye, RichardD Urman, BrendonM Hart, Azem Chami, JulieA Gayle, and CharlesJ Fox. "Enhanced recovery pathways in orthopedic surgery." Journal of Anaesthesiology Clinical Pharmacology 35, no. 5 (2019): 35. http://dx.doi.org/10.4103/joacp.joacp_35_18.

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Nelson, Gregg, Eleftheria Kalogera, and Sean C. Dowdy. "Enhanced recovery pathways in gynecologic oncology." Gynecologic Oncology 135, no. 3 (December 2014): 586–94. http://dx.doi.org/10.1016/j.ygyno.2014.10.006.

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Barton, Joshua G. "Enhanced Recovery Pathways in Pancreatic Surgery." Surgical Clinics of North America 96, no. 6 (December 2016): 1301–12. http://dx.doi.org/10.1016/j.suc.2016.07.003.

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Hegarty, Aoife, and Nirav Shah. "Enhanced recovery: pathways to better care." British Journal of Hospital Medicine 78, no. 10 (October 2, 2017): 597. http://dx.doi.org/10.12968/hmed.2017.78.10.597.

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Asgeirsson, Theodor, and Anthony J. Senagore. "The Economics of Enhanced Recovery Pathways." Seminars in Colon and Rectal Surgery 21, no. 3 (September 2010): 176–79. http://dx.doi.org/10.1053/j.scrs.2010.05.010.

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Arasi, L., J. Stauffer, L. Pereira, T. Taylor-Overholts, and H. Asbun. "Enhanced recovery pathways for pancreatic resections." HPB 19 (April 2017): S40—S41. http://dx.doi.org/10.1016/j.hpb.2017.02.019.

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Liu, Henry, Usama Iqbal, JeremyB Green, Srikant Patel, Yiru Tong, Marcus Zebrower, AlanD Kaye, RichardD Urman, MatthewR Eng, and ElyseM Cornett. "Preoperative patient preparation in enhanced recovery pathways." Journal of Anaesthesiology Clinical Pharmacology 35, no. 5 (2019): 14. http://dx.doi.org/10.4103/joacp.joacp_54_18.

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Дисертації з теми "Enhanced recovery pathways"

Coxon, Astrid. "Improving the implementation of enhanced recovery pathways through realist evaluation." Thesis, University of East Anglia, 2018. https://ueaeprints.uea.ac.uk/67759/.

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Aim: This doctoral research aimed to develop a better understanding of the process of implementing Enhanced Recovery Pathways (ERPs) in real-world settings. Through a realist evaluation approach, I aimed to identify which implementation strategies worked, to what extent, for whom, under what circumstances, and why. Background: ERPs are an increasingly popular, evidence-based approach to streamlining a broad range of surgeries. When successfully implemented, ERPs have demonstrated an improvement in patient outcomes, including reduced length of stay, reduced pain and improved recovery. However, implementation and staff adherence to ERPs remains inconsistent, limiting the potential benefits of ERPs in practice. Methodology: I conducted a realist synthesis of existing UK literature related to ERP implementation research. Building on these findings, I designed a qualitative investigation of a new ERP being introduced in three UK hospitals. This empirical study, conducted over the twelve-month implementation period, involved repeat-interviewing of the co-ordinating change agents, and secondary analysis of ethnographic data. I analysed the entire dataset using thematic analysis. Findings: My realist synthesis of ERP implementation literature identified the most commonly used strategies for ERP implementation in UK NHS hospitals, but also highlighted the lack of detailed reporting regarding selection and design of these strategies. My subsequent empirical research tested and refined these programme theories further, identifying a number of critical factors which mediate the successful implementation of ERPs. These included: change agent understanding of role and responsibilities, ward staff readiness to change, and contextual sensitivity of implementation strategy design. Conclusions: Although no single, general implementation strategy can be applied to ensure successful ERP implementation across all contexts, the programme theories developed through this research highlight important areas for attention when designing ERP implementation design strategies. Future ERP implementation efforts should prioritise contextually sensitive, evidence-based implementation strategies, in order to maximise pathway adherence and optimise patient care.

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Phipps, Tracy. "The Effects of an Enhanced Recovery Pathway on Emergency Room Visits Following Bariatric Surgery." Mount St. Joseph University Dept. of Nursing / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=msjdn1619446806348706.

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Chalfouh, Chaima. "Effet de la stimulation magnétique répétitive trans-spinale comme thérapie non invasive dans le cadre des lésions médullaires. The Regenerative Effect of Trans-spinal Magnetic Stimulation After Spinal Cord Injury: Mechanisms and Pathways Underlying the Effect FoxJ1 regulates spinal cord development and is required for the maintenance of spinal cord stem cell potential Inhibition of ADAMTS-4 Expression in Olfactory Ensheathing Cells Enhances Recovery after Transplantation within Spinal Cord Injury Resident neural stem cells guarantee the regeneration promoted by bulbar olfactory ensheathing cell transplantation after spinal cord injury." Thesis, Normandie, 2020. http://www.theses.fr/2020NORMR099.

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Les lésions de la moelle spinale constituent un problème de santé public d’une ampleur grandissante. Bien que l’espérance de vie ait été améliorée, les patients médullo-lésés souffrent de certains handicaps entraînant une perte partielle ou complète des fonctions sensorielles et/ou motrices. La moelle spinale lésée entreprend aussitôt une réponse à cette lésion. Chronologiquement, la lésion se divise en deux grandes phases : la phase primaire qui se caractérise par la destruction tissulaire induite par le traumatisme mécanique, suivie d’une destruction cellulaire. Alors que la phase secondaire est la conséquence moléculaire et cellulaire de la phase primaire. Durant plusieurs années, différentes stratégies thérapeutiques ont été proposé principalement la thérapie cellulaire qui a prouvé ses effets bénéﬁques dans différents modèles expérimentaux de la lésion , mais de nombreux obstacles sont à prendre en considération tel que, principalement, son caractère invasif. aﬁn de pouvoir l’appliquer chez l’homme d’une manière efficace et reproductible . A la vue de ces contraintes cliniques, nous avons décidé d’explorer un traitement non invasif connu pour ses effets neuroprotecteurs et neurotrophiques dans le SNC ; la stimulation magnétique répétitive trans-spinale (rTSMS). Etonnement, peu d’études ont exploré cette thérapie dans le cadre des LMTs, et rare sont celles qui l’ont utilisé d’une manière focale, c’est à dire directement au niveau du site de la lésion. A ce jour, les mécanismes et les voies sous-jacentes de ces effets dans ce cadre restent toujours inconnus. C’est pourquoi nous avons entrepris de caractériser ces effets dans le cadre de mes travaux de Thèse. En effet, en premier lieu, nous avons évalué les effets de la rTSMS sur la réparation tissulaire, via la modulation de la cicatrice médullaire et de ces différentes composantes in vivo, ainsi que sur la récupération fonctionnelle dans différents paradigmes (aigue et chronique) et à différents âges (juvénile, adulte et vieux) chez des souris WT ayant subi une transsection complète de la moelle spinale. En second lieu, l’objectif était de décrire les mécanismes à l’origine des effets de la rTSMS. Pour ce faire, des analyses protéomiques ont été réalisées, puis nous avons évalué l’effet de la rTSMS sur la réactivité des cellules souches endogènes de la moelle, ainsi que, la contribution de ces dernières dans la mise en place de la cicatrice gliale in vitro et in vivo via un modèle de souris transgénique hFoxJ1-CreER T2 ::tdTomato. L’objectif global était d’étudier, pour la première fois, l’effet de la rTSMS sur la réponse des différentes composantes cellulaires résidentes de la moelle spinale, les mécanismes à l’origine de ces effets, ainsi que la capacité à restaurer les fonctions motrices perdues suite à la lésion médullaire
Spinal cord injury (SCI) leads to a loss of sensitive and motor functions. Currently, there is no therapeutic intervention offering a complete recovery. Here, we report that repetitive trans-spinal magnetic stimulation (rTSMS) can be a noninvasive SCI treatment that enhances tissue repair and functional recovery. Several techniques including immunohistochemical, behavioral, cells cultures, and proteomics have been performed. Moreover, different lesion paradigms, such as acute and chronic phase following SCI in wild-type and transgenic animals at different ages (juvenile, adult, and aged), have been used. We demonstrate that rTSMS modulates the lesion scar by decreasing fibrosis and inflammation and increases proliferation of spinal cord stem cells. Our results demonstrate also that rTSMS decreases demyelination, which contributes to axonal regrowth, neuronal survival, and locomotor recovery after SCI. This research provides evidence that rTSMS induces therapeutic effects in a preclinical rodent model and suggests possible translation to clinical application in humans

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DI, FABIO Francesco. "Implementation of Enhanced Recovery Programme for Pancreatic Resections: Lessons Learnt from Colorectal Surgery." Doctoral thesis, 2015. http://hdl.handle.net/11562/901810.

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Lo scopo di questa tesi è stato di valutare la fattibilità, la sicurezza ed i risultati di Enhanced Recovery Protocol (ERP) per la pancreaticoduodenectomia e la pancreatectomia distale laparoscopica in un ospedale universitario di riferimento in Regno Unito. Specificamente per la pancreatectomia distale laparoscopica, l'obiettivo era anche quello di analizzare l'impatto della chirurgia laparoscopica e di ERP sui costi. Nella Parte I, Capitolo 2, abbiamo valutato la fattibilità e la sicurezza di ERP per la pancreaticoduodenectomia, in assenza di simili programmi pubblicati nel Regno Unito. La parte II e' incentrata sulla pancreatectomia distale. Nel capitolo 3 abbiamo valutato l'impatto dell'introduzione dell' approccio laparoscopico per la pancreatectomia distale e il suo impatto sui risultati e costi. Nel capitolo 4 abbiamo valutato se l'attuazione di uno specifico ERP per la pancreatectomia distale laparoscopica avrebbe potuto migliorare ulteriormente i risultati e costi. Nella Parte III, capitolo 5 di questa tesi, si sintetizzano i risultati principali, si illustra qual e' lo stato dell'arte e si discutono prospettive future. Nella parte IV i protocolli di ERP attualmente adottati presso University Hospital di Southampton per la pancreaticoduodenectomia e la pancreatectomia distale laparoscopica sono illustrati.
The aim of this thesis was to assess the feasibility, safety and outcomes of ERP for pancreaticoduodenectomy and laparoscopic distal pancreatectomy in a tertiary referral UK university hospital. Specifically for laparoscopic distal pancreatectomy, the aim was also to analyze the impact of laparoscopic surgery and ERP on the cost economics. In Part I, Chapter 2, we evaluated the feasibility and safety of ERP for pancreaticoduodenectomy, at a time when no other evidence was available from the UK. Part II focuses on distal pancreatectomy. In Chapter 3 we assessed the impact of the introduction of the laparoscopic approach for distal pancreatectomy and its impact on outcomes and costs. In Chapter 4 we evaluated whether the implementation of a specific ERP for laparoscopic distal pancreatectomy could have improved further outcomes and costs. Part III, Chapter 5 of this thesis summarises the main finding, discusses where we stand and addresses future prospective. In Part IV the ERPs currently adopted at University Hospital Southampton for pancreaticoduodenectomy and laparoscopic distal pancreatectomy are illustrated.

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Dias, Carolina Tintim Lopes Lobato. "Enhanced Recovery After Surgery Pathway-how has the implementation of this pathway influenced digestive surgery outcomes?" Master's thesis, 2017. https://repositorio-aberto.up.pt/handle/10216/109073.

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Dias, Carolina Tintim Lopes Lobato. "Enhanced Recovery After Surgery Pathway-how has the implementation of this pathway influenced digestive surgery outcomes?" Dissertação, 2017. https://repositorio-aberto.up.pt/handle/10216/109073.

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WAHID, Haytham Gareer. "Postoperative management after pancreatic resections; controversies and recommendations for a fast-track protocol." Doctoral thesis, 2014. http://hdl.handle.net/11562/685969.

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Nonostante la disponibilità di prove scientifiche per il fast- track concetto di chirurgia pancreatica sua traduzione nella pratica clinica, dalla maggior parte delle istituzioni, rimane lento. Motivi per essere la mancanza di consapevolezza dei dati accelerata basata sull'evidenza; una mancanza di accordo con i dati (difficili da accettare); mancanza di convinzione che la propria istituzione può realmente eseguire un intervento chirurgico fast-track, limiti di tempo e competenze insufficienti o personale di supporto. Tuttavia recenti scoperte all'interno di specifici componenti di assistenza perioperatoria del pancreas gestione postoperatoria potrebbe contribuire a convalidare ulteriormente chirurgia pancreatica fast- track e migliorare il suo adattamento. Metodi: Tra il gennaio 2011 e agosto 2013, i pazienti sottoposti a resezione pancreatica sono stati arruolati nello studio ad una delle due istituzioni. Il braccio Università di Verona sottoposto ad innalzare il protocollo post-operatorio di recupero Verona, mentre il National Cancer Institute, gruppo di Università del Cairo sono stati sottoposti ai tradizionali gestione postoperatoria. Entrambi i gruppi sono stati seguiti per un efficace controllo del dolore, di ricominciare precoce di alimentazione orale, efficace mobilitazione immediata e il ripristino della funzione intestinale dopo intervento chirurgico. Le misure di esito per ciascun gruppo di pazienti sono stati valutati in termini di complicanze postoperatorie, quali fistola pancreatica (PF), ritardato svuotamento gastrico, perdita biliare, ascesso intra-addominale, post-pancreatectomy emorragia, pancreatite acuta, infezione della ferita, mortalità a 30 giorni, postoperatoria tariffe per l'ospedale, e di riammissione. Risultati: morbilità generale per Verona (n = 101) e Il Cairo (n= 98) è stato del 35% e 44,6 %, rispettivamente; e la mortalità a 30 giorni è stata del 5,9 % contro 8,2%. In entrambi i gruppi postoperatoria PF era la complicazione associata più frequente. Abbiamo osservato 10 fistole nel gruppo di Verona ( 9,9 % ), e 32 in gruppo Cairo ( 32,7 % ) . Ritardato svuotamento gastrico si è verificato nel 5% dei pazienti Verona e il 10,2 % del Cairo. Tasso di riammissione è stata del 4 % ( Verona) e il 2,8 % (Il Cairo ) . La lunghezza complessiva del soggiorno, tenendo in considerazione le riammissioni, è rimasto significativamente più breve nel gruppo fast track ( mediana 9 giorni, range: 7-16 giorni contro 14 giorni, range: 8-29 giorni ; p < 0.001 ). La destinazione di scarico primario era a casa in entrambi i gruppi. Conclusioni: Le prove disponibili e dati rispetto ai risultati, fornire una serie di raccomandazioni per suggerire alcuni elementi per un protocollo standardizzato. I dati sulla lunghezza del soggiorno per entrambi i percorsi sono incoraggianti verso l'attuazione di un percorso standardizzato di gestione postoperatoria.
Background: Despite the availability of the scientific evidence for the pancreatic fast-track surgery concept its translation into clinical practice, by most institutions, remains slow. Reasons being lack of awareness of evidence-based fast-track data; a lack of agreement with the data (difficult to accept); lack of belief that their own institution can actually perform fast-track surgery, time-limitation and insufficient expertise or staff support. However recent findings within specific perioperative care components of pancreatic postoperative management could help further validate pancreatic fast-track surgery and enhance its adaptation. Methods: Between January 2011 and August 2013, patients who underwent pancreatic resection were enrolled into the study at either of the two institutions. The Verona University arm subjected to the Verona enhanced recovery postoperative protocol while the National Cancer Institute, Cairo University group were subjected to conventional postoperative management. Both groups were followed up for effective control of pain, early reinstitution of oral feeding, effective immediate mobilization and restoration of bowel function following surgery. Outcome measures for each patient group were assessed in terms of postoperative complications such as pancreatic fistula (PF), delayed gastric emptying, biliary leak, intra-abdominal abscess, post-pancreatectomy hemorrhage, acute pancreatitis, wound infection, 30-day mortality, postoperative hospital stay, and readmission rates. Results: Overall morbidity for Verona (n= 101) and Cairo (n= 98) was 35% and 44.6%, respectively; and 30-day mortality was 5.9% versus 8.2%. In both groups postoperative PF was the most frequent associated complication. We observed 10 fistulae in the Verona group (9.9%), and 32 in Cairo group (32.7%). Delayed gastric emptying occurred in 5% of Verona patients and 10.2% of Cairo. Readmission rate was 4% (Verona) and 2.8% (Cairo). The overall length of stay, taking into consideration readmissions, remained significantly shorter in the fast track group (median 9 days, range: 7-16 days versus 14 days, range: 8-29 days; p<0.001). The primary discharge destination was home in both groups. Conclusions: The available evidence and data when compared to the results, provide a set of recommendations to suggest some items for a standardized protocol. Data on length of stay for both pathways are encouraging towards implementing a standardized postoperative management pathway.

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Книги з теми "Enhanced recovery pathways"

Scott, Michael J., and Monty Mythen. Enhanced surgical recovery programmes in the ICU. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0364.

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Enhanced recovery programmes (ERPs) are evidence-based care pathways starting from the point of patient referral right through the peri-operative period until discharge home. The ERP aims to reduce surgical stress and enhance post-operative physiological function with resulting early return of enteral diet and mobilization to improve outcomes. There are 20 evidence-based elements, many of which are delivered by a multidisciplinary team. Many elements support a treatment intervention, but some aim to avoid an intervention, which can negatively impact on recovery. An ERP with good compliance has been shown to reduce length of stay and medical complications. Minimal access surgery, high quality analgesia, and goal-directed fluid therapy are key factors ensuring optimal outcomes. There has been successful adoption and transfer of enhanced recovery principles into many surgical specialties. There is wide variation in the use of critical care within ERPs depending on local policy and patient risk factors.

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Furnish, Timothy, and Engy Said. New Vistas in Perioperative Pain Management. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190457006.003.0022.

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The chapter “New Vistas in Perioperative Pain Management” provides an overview of analgesics for acute pain that have been recently introduced and that are in development as well as a discussion of enhanced recovery after surgery (ERAS) programs that make use of multimodal analgesic regimens. It reviews the innovation in analgesics that has focused on new formulations and uses of older compounds including oral, intravenous, and transmucosal agents. It describes the potential role of mu-opioid g-protein modulators as novel opioids with an improved adverse effect profile as well as a novel opioid with the potential for lower abuse potential. It also explains the use of analgesic regimens and pathways in ERAS programs to reduce recovery times and length of hospital stays.

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Jester, Rebecca, Julie Santy Tomlinson, and Jean Rogers. Oxford Handbook of Trauma and Orthopaedic Nursing. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780198831839.001.0001.

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The second edition of the Oxford Handbook of Orthopaedic and Trauma Nursing is an easily accessible, practical, and comprehensive guide to orthopaedic and trauma care. Principally aimed at nurses working in the specialty, it is also a useful guide for all healthcare practitioners and students. This edition provides new information about supporting people with a learning disability within orthopaedic and trauma care settings, virtual clinics, updated management and competencies, fast-track and enhanced recovery pathways, and a stronger emphasis on the health promotion role of nurses in the field. It is written in a readable note-based style with clear illustrations and comprehensive text. The Oxford Handbook of Orthopaedic and Trauma Nursing brings together the authors’ many years of collective experience in one easy-to-use format the student and practitioner won’t want to be without.

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Berrill, Andrew, Will Jones, and David Pegg. Regional anaesthesia of the trunk. Edited by Philip M. Hopkins. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0053.

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Analgesia of the thorax and abdomen can be challenging. Surgical incisions are commonly associated with severe postoperative pain. Whilst continuous epidural analgesia remains the ‘gold standard’ in terms of postoperative pain relief after major surgery, there remain concerns regarding rare serious side effects. It has been difficult to demonstrate conclusive evidence of improvement in outcomes when epidural analgesia is used. Superior pain relief and a reduction in postoperative respiratory morbidity are, however, clear advantages of regional anaesthesia. Interest has increased in techniques such as paravertebral and rectus sheath blocks in part due to the ready availability of high-definition portable ultrasound equipment, but also in response to concerns regarding neuraxial blockade and the development of enhanced recovery pathways. In addition, novel approaches to analgesia of the trunk, such as the transversus abdominis plane block, have been developed and are now widely used as part of a multimodal analgesic regimen. In this chapter, techniques of neuraxial and peripheral nerve block are discussed along with their indications and complications.

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Bank, Asian Development. Carbon Dioxide-Enhanced Oil Recovery in Indonesia: An Assessment of Its Role in a Carbon Capture and Storage Pathway. Asian Development Bank Institute, 2019.

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Fawcett, William J. Anaesthesia for abdominal surgery. Edited by Philip M. Hopkins. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0061.

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Care of patients undergoing major gastrointestinal surgery has been revolutionized in the last decade. The widespread adoption of laparoscopic surgery has bought benefits but also new challenges. Anaesthetic techniques, particularly refinements in analgesic regimens and fluid management, have also brought benefits to patients. However, many more elderly and frail patients are undergoing major surgery which is a challenge in both expertise and resources. Anaesthesia for patients undergoing gastrointestinal surgery has evolved into a package of perioperative care, with the anaesthetist increasingly viewed as the perioperative physician. Anaesthetists are now involved not only within the operating theatre, but with assessing risk for patients, optimizing them prior to surgery, and supervising postoperative care and in particular early recognition and treatment of complications. Liver surgery has become routine for patients particularly with secondary colorectal metastases. Previously, 5-year survival was very rare in these groups of patients, but now approximately half of patients are alive at 5 years. Colorectal surgery has also been transformed and the enhanced recovery programme has typified the way in which many years of dogma have been challenged, to be replaced by evidence-based pathways. Overall, for major elective surgery, results have improved and in general, morbidity, mortality, complications, and length of hospital stay for patients have reduced. For emergency patients, although there have been improvements too, there is still widespread concern about high mortality and marked variation in care between centres.

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Vincent, Laura, and Carl Waldmann. Rehabilitation from critical illness after hospital discharge. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0386.

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The majority of patients admitted to intensive care units survive to hospital discharge, but then face a long and challenging functional recovery, due to the physical and psychological sequelae of their critical illness. There is associated physical, emotional, and financial strain on families and care-givers, in addition to the ongoing impact on patients themselves. The optimization of post-ICU morbidity and ‘health-related quality of life’ have thus become key components of the critical care treatment pathway. Structured exercise rehabilitation programmes, tailored to the specific needs of individual patients can enhance the long-term recovery from critical illness, but the practical implementation of such programmes remains inconsistent and non-standardized. Validated screening and assessment tools are being developed to identify those patients who would benefit from post-ICU rehabilitation programmes, target the specific needs of individuals and monitor the response to treatment. Ongoing research aims to determine the features of a successful post-ICU rehabilitation programme, with respect to the location and supervision of the regime, and the actual content of the intervention. Rehabilitation commenced as soon as possible after hospital discharge is likely to be most effective, but further evidence is required to identify the timing of treatment that would achieve the optimal therapeutic impact. The National Institute of Clinical Excellence have issued a post-ICU rehabilitation guideline. As well as providing a framework for implementation of such a programme, this further endorses the understanding that exercise rehabilitation can no longer be considered an afterthought and should be fully incorporated into the critical care treatment pathway.

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Частини книг з теми "Enhanced recovery pathways"

Rollins, Katie E., and Dileep N. Lobo. "Perioperative Intravenous Fluid Therapy in ERAS Pathways." In Enhanced Recovery After Surgery, 167–73. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-33443-7_18.

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Shawki, Sherief, David Liska, and Conor P. Delaney. "Enhanced Recovery Pathways in Colorectal Surgery." In Clinical Decision Making in Colorectal Surgery, 45–54. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-319-65942-8_6.

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Brady, Justin T., Yuxiang Wen, and Conor P. Delaney. "Enhanced Recovery Pathways in Colorectal Surgery." In Operative Techniques in Single Incision Laparoscopic Colorectal Surgery, 1–8. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-63204-9_1.

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Mustain, W. Conan, and Conor P. Delaney. "Quality Improvement: Enhanced Recovery Pathways for Open Surgery." In Difficult Decisions in Colorectal Surgery, 485–502. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-40223-9_43.

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Roulin, Didier, and Nicolas Demartines. "Enhanced Recovery Pathways in Hepato-pancreato-biliary Surgery." In The SAGES / ERAS® Society Manual of Enhanced Recovery Programs for Gastrointestinal Surgery, 301–12. Cham: Springer International Publishing, 2015. http://dx.doi.org/10.1007/978-3-319-20364-5_25.

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Lee, Lawrence, and Liane S. Feldman. "Enhanced Recovery Pathways: Is It Laparoscopy or Is It Everything Else?" In Current Common Dilemmas in Colorectal Surgery, 21–29. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-70117-2_3.

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Cannon, Lisa Marie. "The Use of Enhanced Recovery Pathways in Patients Undergoing Surgery for Inflammatory Bowel Disease." In Mastery of IBD Surgery, 29–38. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-030-16755-4_4.

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Watson, Deborah J., and Claudiane Poisson. "Department-Wide Implementation of an Enhanced Recovery Pathway: Barriers and Facilitators." In Enhanced Recovery After Surgery, 581–89. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-33443-7_59.

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Lee, Lawrence. "Department-Wide Implementation of an Enhanced Recovery Pathway." In The SAGES / ERAS® Society Manual of Enhanced Recovery Programs for Gastrointestinal Surgery, 329–43. Cham: Springer International Publishing, 2015. http://dx.doi.org/10.1007/978-3-319-20364-5_27.

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Goonewardene, Sanchia S., Karen Ventii, Amit Bahl, Raj Persad, Hanif Motiwala, and David Albala. "Robotic Radical Cystectomy and Enhanced Recovery: An Evolving Care Pathway." In Management of Urology, 413–15. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-57915-9_61.

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Тези доповідей конференцій з теми "Enhanced recovery pathways"

Burra, K. G., and A. K. Gupta. "Co-Processing of Municipal Solid Waste With Gypsum Waste for Enhanced Product Recovery." In ASME 2022 Power Conference. American Society of Mechanical Engineers, 2022. http://dx.doi.org/10.1115/power2022-85550.

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Abstract With growing generation of municipal solid wastes, development of sustainable disposal techniques is essential for effective utilization of these resources. While waste-to-energy (WtE) facilities provide energy recovery from these wastes, the low relative value of energy makes it unattractive. Simultaneously, high oxidation environment in these facilities also means losing significantly valuable resources such as metals/mineral in the form of their oxides and forming pollutant flue gases and fly-ash. Alternative pathways in waste-to-energy involve designing variable oxygen staging to effectively limit oxidation to only carbonaceous materials while minimizing high oxidation state products of metals. In such operating conditions, formation of char from the MSW components is thermodynamically favored and effective utilization of this resource in-situ can be valuable to improve the reactor operability. In this study, we investigated the feasibility of utilizing waste gypsum from construction/demolition sector to co-process in WtE process. Thermogravimetric analysis (TGA) with FTIR analysis of evolved gas was utilized to understand the operation conditions for such a co-processing and the formation of evolved gas products such as CO2, CO and SO2. Char formed from pyrolysis of waste tires was investigated to examine its reactions with gypsum. Char was found to be reduced by reacting with the anhydrous gypsum at temperatures beyond 850 °C. These studies also include the effect of oxidation potential of the purge gas on this reaction which was carried out by introducing 4.8% O2 into the TGA purge gas to understand its effect on the reaction of gypsum with the char in comparison to char oxidation.

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Bourazani, M., E. Karopoulou, N. Fyrfiris, S. Poulopoulou, G. Fasoi, M. Kelesi, and D. Papatheodorou. "EP1096 Implementing enhanced recovery after surgery (ERAS) pathways in major gynecologic oncology operations in Greece (The pre-eliminary results of our department)." In ESGO Annual Meeting Abstracts. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/ijgc-2019-esgo.1138.

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Rossen, William R., Rouhi Farajzadeh, George J. Hirasaki, and Mohammadreza Amirmoshiri. "Potential and Challenges of Foam-Assisted CO2 Sequestration." In SPE Improved Oil Recovery Conference. SPE, 2022. http://dx.doi.org/10.2118/209371-ms.

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Abstract Foam is a promising means to assist in the permanent, safe subsurface sequestration of CO2, whether in aquifers or as part of an enhanced-oil-recovery (EOR) process. Here we review the advantages demonstrated for foam that would assist CO2 sequestration, in particular sweep efficiency and residual trapping, and the challenges yet to be overcome. CO2 is trapped in porous geological layers by an impermeable overburden layer and residual trapping, dissolution into resident brine, and conversion to minerals in the pore space. Over-filling of geological traps and gravity segregation of injected CO2 can lead to excessive stress and cracking of the overburden. Maximizing storage while minimizing overburden stress in the near term depends on residual trapping in the swept zone. Therefore, we review the research and field-trial literature on CO2 foam sweep efficiency and capillary gas trapping in foam. We also review issues involved in surfactant selection for CO2 foam applications. Foam increases both sweep efficiency and residual gas saturation in the region swept. Both properties reduce gravity segregation of CO2. Among gases injected in EOR, CO2 has advantages of easier foam generation, better injectivity, and better prospects for long-distance foam propagation at low pressure gradient. In CO2 injection into aquifers, there is not the issue of destabilization of foam by contact with oil, as in EOR. In all reservoirs, surfactant-alternating-gas foam injection maximizes sweep efficiency while reducing injection pressure compared to direct foam injection. In heterogeneous formations, foam helps equalize injection over various layers. In addition, spontaneous foam generation at layer boundaries reduces gravity segregation of CO2. Challenges to foam-assisted CO2 sequestration include the following: 1) verifying the advantages indicated by laboratory research at the field scale 2) optimizing surfactant performance, while further reducing cost and adsorption if possible 3) long-term chemical stability of surfactant, and dilution of surfactant in the foam bank by flow of water. Residual gas must reside in place for decades, even if surfactant degrades or is diluted. 4) verifying whether foam can block upward flow of CO2 through overburden, either through pore pathways or microfractures. 5) optimizing injectivity and sweep efficiency in the field-design strategy. We review foam field trials for EOR and the state of the art from laboratory and modeling research on CO2 foam properties to present the prospects and challenges for foam-assisted CO2 sequestration.

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Ahmed, Shehzad, Alvinda Hanamertani, and Waleed Alameri. "Improved CO2-Foam Properties and Flow Behavior by Hydrophobically Modified Polymers: Implications for Enhanced CO2 Storage and Oil Recovery." In International Petroleum Technology Conference. IPTC, 2022. http://dx.doi.org/10.2523/iptc-22628-ms.

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Abstract CO2-foam enhanced oil recovery (EOR) has been considered a proven technology to mitigate adverse effects from CO2 front instabilities in highly heterogeneous reservoirs, such as viscous fingering, gravity segregation, and superior flow in high permeability streaks, leading to premature CO2 breakthrough. A highly stable CO2-foam is required to provide significant mobility control effect that stimulates flow diversion from high-permeability to low-permeability regions, hence improved sweep efficiency. CO2-foam EOR process can also be advanced for effective CO2 utilization and long-term CO2 sequestration in addition to improved oil production. However, harsh in-situ environments of hydrocarbon reservoirs greatly determine the performance of CO2-foam and the efficiency of the entire operations, leading to a need of foam formulation optimization in addition to technical development. As an innovative solution, hydrophobically modified polymer was employed to improve overall CO2-foam properties and CO2 mobility control performance inside porous media. A comprehensive evaluation on foaming properties (foamability and foam stability) and foam rheological behavior was performed under supercritical conditions to warrant the suitability of developed formulation as high-performance foaming agent. CO2-foam was generated using the primary foaming agent (alpha olefin sulfonate and betaine) in combination with different types of hydrophobically modified polymers, referred as to HMP, and conventional polymers (HPAMs) as foam stabilizers. The steady-state foam resistance established by each foam during dynamic flow tests was assessed under reservoir conditions to indicate the extent of mobility control effect for better sweep efficiency and the capability of the developed CO2-foam formulation of suppressing CO2 migration, hence improved storage efficiency. The formulation containing the selected HMP offered an acceptable foam generation ability compared to the formulations containing classical HPAM polymers. The presence of HMP with a higher degree of hydrophobes and lower molecular weight in surfactant-stabilized foam system was able to produce an improved flow resistance. These are attributed to the formation of organized and bridged polymer network triggered by hydrophobic association in the bulk and lamella interface hence providing steric forces at the interface that leads to substantial elasticity. Results from dynamic flow experiments revealed the superior performance of HMP stabilized CO2-foam in porous media in which its flow resistance was found to be 70% and 95% higher than that of polymer-free CO2-foam, and individual CO2, respectively. This research provides an alternative solution by promoting a relatively new foam formulation which is stabilized by hydrophobically modified water-soluble polymer. Besides offering better mobility control effect during EOR process, the application of developed CO2-foam formulation was also extended to CO2 trapping improvement for better CO2 sequestration by suppressing unfavorable CO2 mobility through high-permeability pathways. Therefore, the designed foam should be able to control CO2 plumes migration, enhance CO2 storage potential, and improve CO2 utilization for complex reservoirs.

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Feitelberg, Alan S., and Sanjay M. Correa. "The Role of Carbon Monoxide in NO2 Plume Formation." In ASME 1999 International Gas Turbine and Aeroengine Congress and Exhibition. American Society of Mechanical Engineers, 1999. http://dx.doi.org/10.1115/99-gt-053.

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Through a series of computational studies, carbon monoxide has been identified as an important promoter of NO oxidation to NO2 in combustion turbine exhaust gas at intermediate temperatures (450 to 750°C). NO2 formation is accompanied by enhanced CO burnout at these temperatures. Perfectly stirred reactor and plug flow reactor calculations indicate that concentrations of CO as low as 50 ppmv in exhaust gas containing 25 ppmv NO can result in the conversion of 50% of the NO to NO2 in less than 1 second. NO2 concentrations as low as 15 ppmv can result in visible, yellow-brown plumes from large diameter exhaust stacks. If NO2 plumes are to be prevented, then designers of gas turbines and heat recovery steam generators need to be aware of the relationships between time, temperature, and composition which cause NO2 to form in exhaust gas. Reaction path analysis indicates that the mutually promoted oxidation of CO and NO occurs through a self-propagating, three-step chain reaction mechanism. CO is oxidized by OH, (R2)CO+OH→CO2+Hwhile NO is oxidized by HO2:(R23)NO+HO2→NO2+OHIn a narrow temperature range, the H-atom produced by R2 can react with O2 in a three body reaction to yield the hydroperoxy radical needed in R23:(R9)H+O2+M→HO2+Mwhere M is any third body. The observed net reaction isCO+O2+NO→CO2+NO2which occurs stoichiometrically at temperatures below about 550°C. As the temperature increases, additional reaction pathways become available for H, HO2, and OH which remove these radicals from the chain and eventually completely decouple the oxidation of CO from NO. An abbreviated set of elementary chemical reactions, including 15 species and 33 reactions, has been developed to model CO-enhanced oxidation of NO to NO2. This reaction set was derived from a larger reaction set with more than 50 species and 230 elementary chemical reactions, and was validated by comparison of PSR and PFR calculations using the two sets.

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Iyengar, Arun K. S., Brian J. Koeppel, Dale L. Keairns, Mark C. Woods, Gregory A. Hackett, and Travis R. Shultz. "Performance of a Natural Gas Solid Oxide Fuel Cell System With and Without Carbon Capture." In ASME 2019 13th International Conference on Energy Sustainability collocated with the ASME 2019 Heat Transfer Summer Conference. American Society of Mechanical Engineers, 2019. http://dx.doi.org/10.1115/es2019-3918.

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Abstract The fuel cell program at the United States Department of Energy (DOE) National Energy Technology Laboratory (NETL) is focused on the development of low-cost, highly efficient, and reliable fossil-fuel-based solid oxide fuel cell (SOFC) power systems that can generate environmentally-friendly electric power with at least 90 percent carbon capture. NETL’s SOFC technology development roadmap is aligned with near-term market opportunities in the distributed generation sector to validate and advance the technology while paving the way for utility-scale natural gas (NG)- and coal-derived synthesis gas-fueled applications via progressively larger system demonstrations. The present study represents a part of a series of system evaluations being carried out at NETL to aid in prioritizing technological advances along research pathways to the realization of utility-scale SOFC systems, a transformational goal of the fuel cell program. In particular, the system performance of utility-scale NG fuel cell (NGFC) systems with and without carbon dioxide (CO2) capture is presented. The NGFC system analyzed features an external auto-thermal reformer (ATR) feeding the fuel to the SOFC system consisting of planar anode-supported SOFC with separated anode and cathode off-gas streams. In systems with CO2 capture, an air separation unit (ASU) is used to provide the oxygen for the ATR and for the combustion of unutilized fuel in the SOFC anode exhaust along with a CO2 purification unit to provide a nearly pure CO2 stream suitable for transport for usage in enhanced oil recovery operations or for storage in underground saline formations. Remaining thermal energy in the exhaust gases is recovered in a bottoming steam Rankine cycle while supplying any process heat requirements. A reduced order model (ROM) developed at the Pacific Northwest National Laboratory (PNNL) is used to predict the SOFC performance. The ROM, while being computationally effective for system studies, provides other detailed information about the state of the stack, such as the internal temperature gradient, generally not available from simple performance models often used to represent the SOFC. Such additional information can be important in system optimization studies to preclude operation under off-design conditions that can adversely impact overall system reliability. The NGFC system performance was analyzed by varying salient system parameters, including the percent of internal (to the SOFC module) NG reformation — ranging from 0 to 100 percent — fuel utilization, and current density. The impact of advances in underlying SOFC technology on electrical performance was also explored.

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Herman, George, Nicole Lichterfeld-Weber, and Christian Bittner. "Unique Synergistic Surfactant Mixture to Match Ultralow Interfacial Tension with Solubility at High Temperature and High Salinity." In ADIPEC. SPE, 2022. http://dx.doi.org/10.2118/211435-ms.

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Abstract Chemical enhanced oil recovery offers the huge benefit to reduce the carbon footprint in oil production. Mature oil fields with existing infrastructure can be turned into fields with higher productivity. Thereby, costly exploration of new fields can be avoided. The rejuvenation of mature oil fields can be achieved by surfactant flooding. Well-designed surfactants can reduce the tension between crude oil and water to ultralow values and thereby mobilize physically trapped oil. With respect to fields of high salinity and elevated temperature, it is particularly challenging to match the reduction of interfacial tension with the surfactant solubility as well as the chemical stability. In this paper, the solubility of surfactants in model reservoir brine (rich in calcium and magnesium ions) at elevated temperature was evaluated. The capability of surfactants to reduce interfacial tension between light crude oil and model reservoir brine was tested by phase behavior tests as well as by spinning-drop experiments. The thermal stability of stored surfactant solutions was analyzed by use of high-performance liquid chromatography (HPLC). The focus of the investigations was a temperature above 100°C and salinities of at least 100,000 ppm TDS for fields with light crude oils. Alkyl ether carboxylates are chemically very stable and offer a good potential to reduce interfacial tension. However, they usually lack sufficient solubility. In contrast, cationic surfactants are well soluble under such harsh conditions. However, they typically lack chemical stability and sufficient potential to reduce the interfacial tension. By taking the typical degradation pathways of cationic surfactants into consideration, it was possible to identify a cationic surfactant that is stable under harsh conditions. A well-designed formulation of the alkyl ether carboxylate with the cationic surfactant allows to match reduction of interfacial tension with solubility. Several other surfactant classes and their combinations were evaluated, but they were not able provide similar performance. This study reveals a unique synergistic surfactant mixture, which provides ultralow interfacial tensions against light crude oil at elevated temperature of 125°C and at high salinity 139,000 ppm TDS. In addition, the surfactant mixture is soluble and chemically stable under such harsh conditions.

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Liotiri, D., E. Sioka, A. Diamantis, V. Grapsidi, G. Stamatiou, and D. Zacharoulis. "B316 Opioid-free anaesthesia and postoperative analgesia clinical pathway for enhanced recovery after pancreatoduodenectomy: a case series." In ESRA Abstracts, 39th Annual ESRA Congress, 22–25 June 2022. BMJ Publishing Group Ltd, 2022. http://dx.doi.org/10.1136/rapm-2022-esra.390.

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Ochoa, Oscar, Meenakshi Rajan, Minas Chrysopoulo, Steven Pisano, Peter Ledoux, Gary Arishita, Ramon Garza, and Chet Nastala. "Abstract PD6-2: Enhanced recovery after surgery (ERAS) pathway reduces hospital stay and narcotic use in microsurgical breast reconstruction." In Abstracts: 2019 San Antonio Breast Cancer Symposium; December 10-14, 2019; San Antonio, Texas. American Association for Cancer Research, 2020. http://dx.doi.org/10.1158/1538-7445.sabcs19-pd6-2.

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Hustad, Carl-W. "Deployment of Low and Zero Emission Fossil Fuel Power Generation in Emerging Niche Markets." In ASME Turbo Expo 2008: Power for Land, Sea, and Air. ASMEDC, 2008. http://dx.doi.org/10.1115/gt2008-50106.

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The opportunities for near-term implementation of low and zero-emission fossil fuel power generation using Carbon Capture and Storage (CCS) is emerging in niche markets. This is primarily motivated by regulations following a growing awareness regarding the potential impact of climate-change, and partly the opportunities for use of carbon-dioxide (CO2) with enhanced oil recovery (EOR). However there remain significant technology, engineering, investment and political barriers that need to be overcome before CCS can be accepted as commercially mature for the power generation industry and the finance community. The risk with early projects is high, while collaboration and trust between government, industry and investors will also be needed to commercialize the technology. With an emerging sense of urgency regarding a global consensus for tackling climate-change, one also observes that technology pathways are integrated with political agendas and it becomes important to roadmap a commercial strategy for the respective technologies taking account of government requirements for compromise and burden sharing. To some extent this can also impact on comparative choices for the most cost-effective technologies that are supported through to future commercial deployment. The situation is complicated by the fact that technology choice—be it pre-combustion, post-combustion or oxy-combustion—remains an open question, where parties are probably influenced by their historical expertise, available hardware and near-term perception of future carbon challenge. The fact that energy, materials and engineering costs have been escalating rapidly while there is also a fundamental paradigm change occurring, somewhat undermines the use of historical data and past experience to predict business opportunities for the future. Within this context the paper considers on-going carbon market evolution in three regions, namely Texas, North Europe and Canada, seen from a technology and project developer perspective. The paper applies updated project engineering costs for capture from natural gas (NG) and coal using post- and oxy-combustion technology. Under all circumstances projects still exhibit poor economic return on invested capital and depend on government participation; they therefore remain unattractive to the investment community. But perhaps more important is the current perception of technology and market risk which also appears to undermine motivation to make significant commitments when evaluating projects within the old paradigm. However such a situation is not politically sustainable and a new paradigm must emerge. This will occur through regulation and significant changes in pricing in the energy and commodity market—including valuation of captured and avoided CO2. And this will also impact on the relative merits of various technology options. For the time being these discussion and results are only indicative of how a new paradigm and evolving technology may become “game-changing”, but the paper does attempt to provide some foresight into future opportunities.

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Звіти організацій з теми "Enhanced recovery pathways"

Nair, Abhijit, and Hamed Humayid Mohammed Al Aamri. Enhanced recovery after surgery pathways for patients undergoing laparoscopic appendectomy- a systematic review and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, August 2022. http://dx.doi.org/10.37766/inplasy2022.8.0005.

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Review question / Objective: Does implementing enhanced recovery after surgery pathways improve outcomes in adult patients undergoing laparoscopic appendectomy when compared to conventional pathways? Condition being studied: Adult patients (more than 18 years) with acute appendicitis undergoing laparoscopic appendicectomy. Information sources: We will search all electronic databases. In published articles were outcome details appear incomplete, the corresponding author will be contacted the details will be sought. If not available, that outcome will be excluded from analysis.

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Barg, Rivka, Kendal D. Hirschi, Avner Silber, Gozal Ben-Hayyim, Yechiam Salts, and Marla Binzel. Combining Elevated Levels of Membrane Fatty Acid Desaturation and Vacuolar H+ -pyrophosphatase Activity for Improved Drought Tolerance. United States Department of Agriculture, December 2012. http://dx.doi.org/10.32747/2012.7613877.bard.

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Background to the topic: In previous works we have shown that Arabidopsis and tomato over-expressing H+-pyrophosphatase show increased tolerance to drought imposed by withholding irrigation of young plants in pots (Park et al. 2005). In addition, young tobacco plants over-expressing fatty acid desaturase 3 (OEX-FAD3) also showed increasing tolerance to drought stress (Zhang et al 2005), and similarly OEX-FAD3 young tomato plants (unpublished data from ARO), hence raising the possibility that pyramiding the two could further improve drought tolerance in tomato. Based on these findings the specific objects originally set were: 1. To analyze the impact of pyramiding transgenes for enhanced fatty acid desaturation and for elevated H+-PPase activity on tomato yielding under water deficit stress conditions. 2. To elucidate the biochemical relationship between elevated desaturation of the membrane lipids and the activities of selected vacuolar transporters in the context of drought responses. 3. To explore the S. pennellii introgression lines as alternative genetic sources for drought tolerance related to enhanced fatty acid desaturation and/or H+-PPase activity. 4. Since OEX-FAD3 increases the levels of linolenic acid which is the precursor of various oxylipins including the stress hormone Jasmonate. (JA), study of the effect of this transgene on tolerance to herbivore pests was added as additional goal. The Major conclusions, solutions, and achievements are: (1) The facts that ectopic over-expression of vacuolarH+-PPases (in line OEX-AVP1) does not change the fatty acid profile compared to the parental MoneyMaker (MM) line and that elevated level of FA desaturation (by OEX-FAD3) does not change the activity of either H+-PPase, H+-ATPaseor Ca2+ /H+ antiport, indicate that the observed increased drought tolerance reported before for increase FA desaturation in tobacco plants and increased H+PPase in tomato plants involves different mechanisms. (2) After generating hybrid lines bringing to a common genetic background (i.e. F1 hybrids between line MP-1 and MM) each of the two transgenes separately and the two transgenes together the effect of various drought stress regimes including recovery from a short and longer duration of complete water withhold as well as performance under chronic stresses imposed by reducing water supply to 75-25% of the control irrigation regime could be studied. Under all the tested conditions in Israel, for well established plants grown in 3L pots or larger, none of the transgenic lines exhibited a reproducible significantly better drought tolerance compare to the parental lines. Still, examining the performance of these hybrids under the growth practices followed in the USA is called for. (3) Young seedlings of none of the identified introgression lines including the S. pennellii homologs of two of the H+-PPase genes and one of the FAD7 genes performed better than line M82 upon irrigation withhold. However, differences in the general canopy structures between the IL lines and M82 might mask such differences if existing. (4). Over-expression of FAD3 in the background of line MP-1 was found to confer significant tolerance to three important pest insects in tomato: Bordered Straw (Heliothis peltigera), Egyptian cotton leafworm (Spodoptera littoralis) and Western Flower Thrips (Frankliniella occidentalis). Implications: Although the original hypothesis that pyramiding these two trasgenes could improve drought tolerance was not supported, the unexpected positive impact on herbivore deterring, as well as the changes in dynamics of JA biosynthesis in response to wounding and the profound changes in expression of wound response genes calls for deciphering the exact linolenic acid derived signaling molecule mediating this response. This will further facilitate breeding for herbivore pest and mechanical stress tolerance based on this pathway.

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Brosh, Arieh, Gordon Carstens, Kristen Johnson, Ariel Shabtay, Joshuah Miron, Yoav Aharoni, Luis Tedeschi, and Ilan Halachmi. Enhancing Sustainability of Cattle Production Systems through Discovery of Biomarkers for Feed Efficiency. United States Department of Agriculture, July 2011. http://dx.doi.org/10.32747/2011.7592644.bard.

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Feed inputs represent the largest variable cost of producing meat and milk from ruminant animals. Thus, strategies that improve the efficiency of feed utilization are needed to improve the global competitiveness of Israeli and U.S. cattle industries, and mitigate their environmental impact through reductions in nutrient excretions and greenhouse gas emissions. Implementation of innovative technologies that will enhance genetic merit for feed efficiency is arguably one of the most cost-effective strategies to meet future demands for animal-protein foods in an environmentally sustainable manner. While considerable genetic variation in feed efficiency exist within cattle populations, the expense of measuring individual-animal feed intake has precluded implementation of selection programs that target this trait. Residual feed intake (RFI) is a trait that quantifies between-animal variation in feed intake beyond that expected to meet energy requirements for maintenance and production, with efficient animals being those that eat less than expected for a given size and level of production. There remains a critical need to understand the biological drivers for genetic variation in RFI to facilitate development of effective selection programs in the future. Therefore, the aim of this project was to determine the biological basis for phenotypic variation in RFI of growing and lactating cattle, and discover metabolic biomarkers of RFI for early and more cost-effective selection of cattle for feed efficiency. Objectives were to: (1) Characterize the phenotypic relationships between RFI and production traits (growth or lactation), (2) Quantify inter-animal variation in residual HP, (3) Determine if divergent RFIphenotypes differ in HP, residual HP, recovered energy and digestibility, and (4) Determine if divergent RFI phenotypes differ in physical activity, feeding behavior traits, serum hormones and metabolites and hepatic mitochondrial traits. The major research findings from this project to date include: In lactating dairy cattle, substantial phenotypic variation in RFI was demonstrated as cows classified as having low RMEI consumed 17% less MEI than high-RMEI cows despite having similar body size and lactation productivity. Further, between-animal variation in RMEI was found to moderately associated with differences in RHP demonstrating that maintenance energy requirements contribute to observed differences in RFI. Quantifying energetic efficiency of dairy cows using RHP revealed that substantial changes occur as week of lactation advances—thus it will be critical to measure RMEI at a standardized stage of lactation. Finally, to determine RMEI in lactating dairy cows, individual DMI and production data should be collected for a minimum of 6 wk. We demonstrated that a favorably association exists between RFI in growing heifers and efficiency of forage utilization in pregnant cows. Therefore, results indicate that female progeny from parents selected for low RFI during postweaning development will also be efficient as mature females, which has positive implications for both dairy and beef cattle industries. Results from the beef cattle studies further extend our knowledge regarding the biological drivers of phenotypic variation in RFI of growing animals, and demonstrate that significant differences in feeding behavioral patterns, digestibility and heart rate exist between animals with divergent RFI. Feeding behavior traits may be an effective biomarker trait for RFI in beef and dairy cattle. There are differences in mitochondrial acceptor control and respiratory control ratios between calves with divergent RFI suggesting that variation in mitochondrial metabolism may be visible at the genome level. Multiple genes associated with mitochondrial energy processes are altered by RFI phenotype and some of these genes are associated with mitochondrial energy expenditure and major cellular pathways involved in regulation of immune responses and energy metabolism.

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