Polylactic acid (PLA) is a promising alternative to petroleum‐based polymers due to its biodegradability. However, its low mechanical properties in the presence of moisture are a challenge for textile applications. In this study, we investigated the effects of two anti‐hydrolysis agents, an epoxy‐based agent (ADR) and an aromatic carbodiimide‐based agent (ZIKA), on the mechanical properties and hydrolysis resistance of PLA fibers. A melt‐spinning process was used to prepare anti‐hydrolysis fibers by adding 0.3 and 0.5 wt% of ADR and ZIKA to PLA. The topology of ADR/PLA and ZIKA/PLA was determined by Fourier transform infrared spectroscopy (FT‐IR). Analysis of the compound chip revealed that ADR formed a branched chain in PLA, while ZIKA produced a linear molecular structure. The hydrolysis resistance of the fibers was evaluated by analyzing their crystallinity, hydrothermal shrinkage behavior, morphology, and tensile strength. ZIKA/PLA fibers showed higher orientation and crystallinity than ADR/PLA fibers. After hydrolysis, the tensile strength of ADR 0.5%/PLA fibers decreased by 31%, while that of ZIKA 0.5%/PLA fibers decreased by only 5% due to the linear molecular structure of ZIKA/PLA. Our findings indicate that ZIKA is more effective than ADR in producing hydrolysis‐resistant PLA fibers with high crystallinity, orientation, and mechanical durability.
Background
Textbook outcome (TO) has been introduced as a novel composite measure for lung cancer surgery. We investigated TO after lobectomy for early‐stage non‐small cell lung cancer (NSCLC) in a Korean tertiary hospital and its prognostic implications for overall survival and recurrence.
Methods
Between January 2012 and December 2017, 418 consecutive patients who underwent lobectomy for clinical stages I and II NSCLC were identified and retrospectively reviewed. TO was defined as complete resection (negative resection margins and sufficient lymph node dissection), no 30‐day or in‐hospital mortality, no reintervention within 30 days, no readmission to the intensive care unit, no prolonged hospital stay (<14 days), no hospital readmission within 30 days, and no major complications. Propensity score matching analysis was performed to investigate the association between TO, medical costs, and long‐term outcomes.
Results
Of 418 patients, 277 (66.3%) achieved TO. The most common events leading to TO failure were prolonged air leakage (n = 54, 12.9%) and prolonged hospital stay (n = 53, 12.7%). Male sex (odds ratio [OR] = 2.148, p = 0.036) and low diffusing capacity for carbon monoxide (OR = 0.986, p = 0.047) were significant risk factors for failed TO in multivariate analysis. In matched cohorts, achieving TO was associated with lower medical costs and better overall survival but not cancer recurrence.
Conclusions
TO is associated with low medical cost and favorable overall survival; thus, surgical teams and hospitals should make efforts to improve the quality of care and achieve TO.
During nursing education, clinical practice education is an important process that can be trained by applying the learned knowledge. Especially, in the next generation, it is difficult to completely perform tasks only with simple theoretical knowledge. Therefore, the learner's practical experience and convergence and complex thinking process are essential. This study was conducted to provide a theoretical basis for future education experts to establish practical education methods and strategies by examining the meaning and content of clinical practice experience by checking the experience of nursing students who are doing psychiatric nursing practice for the first time. The research method is a qualitative study intended to explore through phenomenological methods after in-depth interviews to understand the experiences of nursing students conducting clinical practice in mental health nursing at the Community Mental Health Welfare Center. As a result, the five essential themes are expectations for practice, the uniqueness of psychiatric practice, difficulty in the practice environment, awareness of the role of psychiatric nurses, and change through clinical practice. Through this study, continuous follow-up studies are suggested to understand students' perceptions and develop an appropriate curriculum for clinical practice education so that they can have confidence in psychiatric practice.
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