Securing China's rice harvest: unveiling dominant factors in production using multi-source data and hybrid machine learning models.

Ensuring the security of China's rice harvest is imperative for sustainable food production. The existing study addresses a critical need by employing a comprehensive approach that integrates multi-source data, including climate, remote sensing, soil properties and agricultural statistics from 2000 to 2017. The research evaluates six artificial intelligence (AI) models including machine learning (ML), deep learning (DL) models and their hybridization to predict rice production across China, particularly focusing on the main rice cultivation areas. These models were random forest (RF), extreme gradient boosting (XGB), conventional neural network (CNN) and long short-term memory (LSTM), and the hybridization of RF with XGB and CNN with LSTM based on eleven combinations (scenarios) of input variables. The main results identify that hybrid models have performed better than single models. As well, the best scenario was recorded in scenarios 8 (soil variables and sown area) and 11 (all variables) based on the RF-XGB by decreasing the root mean square error (RMSE) by 38% and 31% respectively. Further, in both scenarios, RF-XGB generated a high correlation coefficient (R2) of 0.97 in comparison with other developed models. Moreover, the soil properties contribute as the predominant factors influencing rice production, exerting an 87% and 53% impact in east and southeast China, respectively. Additionally, it observes a yearly increase of 0.16 °C and 0.19 °C in maximum and minimum temperatures (Tmax and Tmin), coupled with a 20 mm/year decrease in precipitation decline a 2.23% reduction in rice production as average during the study period in southeast China region. This research provides valuable insights into the dynamic interplay of environmental factors affecting China's rice production, informing strategic measures to enhance food security in the face of evolving climatic conditions.

Prediction of water distribution uniformity of sprinkler irrigation system based on machine learning algorithms.

The coefficients of uniformity Christiansen's uniformity coefficient (CU) and distribution uniformity (DU) are an important parameter for designing irrigation systems, and are an accurate measure for water lose. In this study, three machine learning algorithms Random forest (RF), extreme gradient boosting (XGB) and random forest-extreme gradient boosting (XGB-RF) were developed to predict the water distribution uniformity based on operating pressure, heights of sprinkler, discharge, nozzle diameter, wind speed, humidity, highest and lowest temperature for three different impact sprinklers (KA-4, FOX and 2520) for square and triangular system layout based on four scenarios (input combinations). The main findings were; the highest CU value was 86.7% in the square system of 2520 sprinkler under 200 kPa, 0.5 m height and 0.855 m3/h (Nozzle 2.5 mm). Meanwhile, in the triangular system, it was 87.3% under the same pressure and discharge and 1 m height. For applied machine learning, the highest values of R2 were 0.796, 0.825 and 0.929 in RF, XGB and XGB-RF respectively in the first scenario for CU. Moreover, for the DU, the highest values of R2 were 0.701, 0.479 and 0.826 in RF, XGB and XGB-RF respectively in the first scenario. The obtained results revealed that the sprinkler height had the lowest impact on modeling of the water distribution uniformity.

Assessment of environmental and toxicity impacts and potential health hazards of heavy metals pollution of agricultural drainage adjacent to industrial zones in Egypt.

The objectives of this study were to assess the environmental impact of industrial wastewater disposal in the El-Khadrawiya agricultural drain, Menoufia Governorate, Egypt, as well as the effect on water, soil, and plant qualities in the drain's extension area, which was primarily adjacent to the industrial zone. The analyses results of wastewater at El-Khadrawiya drain revealed that heavy metal concentrations in water samples exceeded WHO permitted limits. Heavy metal levels followed the following pattern: (Pb > Zn > Cr > Cd > Ni > As), where Heavy metal levels average were: (1.8492 > 1.7857 > 0.1815 > 0.1578 > 0.059 > 0.0048. Wastewater, soil and plant samples were analyzed using (PerkinElmer AAnalyst 400 Atomic Absorption Spectrometer A Analyst 400), Heavy metal pollution evaluation indicators: Target hazard quotient (THQ), Hazard index (HI), Chronic daily intake (CDI), Carcinogenic risk (CR), and Heavy metals pollution index (HPI)) showed that a majority of samples discovered values referring to carcinogenic health risks for the population. In contrast, the soil contamination indices followed the same trend, with the contamination factor (CF) indicating that the majority of samples exposed low to medium levels of pollution for (Ni, Cd, and Zn), while Pb and Cr were between high and very high, and the contamination degree (Cd) and modified degree of contamination (mCd) indicating that the majority of samples revealed the medium level of pollution, with the exception of one site with a high level of contamination. The bioaccumulation factor (BAF) revealed that heavy metal accumulation in plants exceeds the critical range. This study should be expanded to include additional agricultural regions with comparable conditions in order to provide environmental monitoring of present challenges and work toward solutions.

Correction: Salimiyekta et al. Random Regression Model for Genetic Evaluation and Early Selection in the Iranian Holstein Population. Animals 2021, 11, 3492.

There was an error in the original publication [...].

Comparison of different response variables in genomic prediction using GBLUP and ssGBLUP methods in Iranian Holstein cattle.

We compared the reliability and bias of genomic evaluation of Holstein bulls for milk, fat, and protein yield with two methods of genomic best linear unbiased prediction (GBLUP) and single-step GBLUP (ssGBLUP). Four response variables of estimated breeding value (EBV), daughter yield deviation (DYD), de-regressed proofs based on Garrick (DRPGR) and VanRaden (DRPVR) were used as dependent variables. The effects of three weighting methods for diagonal elements of the incidence matrix associated with residuals were also explored. The reliability and the absolute deviation from 1 of the regression coefficient of the response variable on genomic prediction (Dev) using GBLUP and ssGBLUP methods were estimated in the validation population. In the ssGBLUP method, the genomic prediction reliability and Dev from un-weighted DRPGR method for milk yield were 0.44 and 0.002, respectively. In the GBLUP method, the corresponding measurements from un-weighted EBV for fat were 0.52 and 0.008, respectively. Moreover, the un-weighted DRPGR performed well in ssGBLUP with fat yield values for reliability and Dev of 0.49 and 0.001, respectively, compared to equivalent protein yield values of 0.38 and 0.056, respectively. In general, the results from ssGBLUP of the un-weighted DRPGR for milk and fat yield and weighted DRPGR for protein yield outperformed other models. The average reliability of genomic predictions for three traits from ssGBLUP was 0.39 which was 0.98% higher than the average reliability from GBLUP. Likewise, the Dev of genomic predictions was lower in ssGBLUP than GBLUP. The average Dev of predictions for three traits from ssGBLUP and GBLUP were 0.110 and 0.144, respectively. In conclusion, genomic prediction using ssGBLUP outperformed GBLUP both in terms of reliability and bias.

Using Machine Learning Models to Predict Hydroponically Grown Lettuce Yield.

Prediction of crop yield is an essential task for maximizing the global food supply, particularly in developing countries. This study investigated lettuce yield (fresh weight) prediction using four machine learning (ML) models, namely, support vector regressor (SVR), extreme gradient boosting (XGB), random forest (RF), and deep neural network (DNN). It was cultivated in three hydroponics systems (i.e., suspended nutrient film technique system, pyramidal aeroponic system, and tower aeroponic system), which interacted with three different magnetic unit strengths under a controlled greenhouse environment during the growing season in 2018 and 2019. Three scenarios consisting of the combinations of input variables (i.e., leaf number, water consumption, dry weight, stem length, and stem diameter) were assessed. The XGB model with scenario 3 (all input variables) yielded the lowest root mean square error (RMSE) of 8.88 g followed by SVR with the same scenario that achieved 9.55 g, and the highest result was by RF with scenario 1 (i.e., leaf number and water consumption) that achieved 12.89 g. All model scenarios having Scatter Index (SI) (i.e., RMSE divided by the average values of the observed yield) values less than 0.1 were classified as excellent in predicting fresh lettuce yield. Based on all of the performance statistics, the two best models were SVR with scenario 3 and DNN with scenario 2 (i.e., leaf number, water consumption, and dry weight). However, DNN with scenario 2 requiring less input variables is preferred. The potential of the DNN model to predict fresh lettuce yield is promising, and it can be applied on a large scale as a rapid tool for decision-makers to manage crop yield.

Random Regression Model for Genetic Evaluation and Early Selection in the Iranian Holstein Population.

The objective of this study was to use a model to predict breeding values for sires and cows at an early stage of the first lactation of cows and progeny groups in the Iranian Holstein population to enable the early selection of sires. An additional objective was to estimate genetic and phenotypic parameters associated with this model. The accuracy of predicted breeding values was investigated using cross-validation based on sequential genetic evaluations emulating yearly evaluation runs. The data consisted of 2,166,925 test-day records from 456,712 cows calving between 1990 and 2015. (Co)-variance components and breeding values were estimated using a random regression test-day model and the average information (AI) restricted maximum likelihood method (REML). Legendre polynomial functions of order three were chosen to fit the additive genetic and permanent environmental effects, and a homogeneous residual variance was assumed throughout lactation. The lowest heritability of daily milk yield was estimated to be just under 0.14 in early lactation, and the highest heritability of daily milk yield was estimated to be 0.18 in mid-lactation. Cross-validation showed a highly positive correlation of predicted breeding values between consecutive yearly evaluations for both cows and sires. Correlation between predicted breeding values based only on records of early lactation (5-90 days) and records including late lactation (181-305 days) were 0.77-0.87 for cows and 0.81-0.94 for sires. These results show that we can select sires according to their daughters' early lactation information before they finish the first lactation. This can be used to decrease generation interval and to increase genetic gain in the Iranian Holstein population.

Assessing the WEPP model performance for predicting daily runoff in three terrestrial ecosystems in western Syria.

Soil erosion is one of the main threats facing the agriculture and natural resources sector all over the world, and the same is true for Syria. Several empirical and physically based tools have been proposed to assess erosion induced soil losses and runoff driving the processes, from plot to regional spatial scales. The main goal of this research is to evaluate the performance of the Water Erosion Prediction Project (WEPP) model in predicting runoff in comparison with field experiments in the Al-Sabahia region of Western Syria in three ecosystems: agricultural lands (AG), burned forest (BF) and forest (FO). To achieve this, field experimental plots (2∗1.65∗0.5 m) were prepared to obtain runoff observation data between September 2012 and December 2013. In addition, the input data (atmospheric forcing, soil, slope, land management) were prepared to run the WEPP model to estimate the runoff. The results indicate that the average observed runoffs in the AG, BF and FO were 12.54 ± 1.17, 4.81 ± 0.97 and 1.72 ± 0.16 mm/event, respectively, while the simulated runoffs in the AG, BF and FO were 15.15 ± 0.89, 9.23 ± 1.48 and 2.61 ± 0.47mm/event, respectively. The statistical evaluation of the model's performance showed an unsatisfactory performance of the WEPP model for predicting the run-offs in the study area. This may be caused by the structural flaws in the model, and/or the insufficient site-specific input parameters. So, to achieve good performance and reliable results of the WEPP model, more observation data is required from different ecosystems in Syria. These findings can provide guidance to planners and environmental engineers for proposing environmental protection and water resources management plans in the Coastal Region in Syria.

Phenolic profiling of different Jasminum species cultivated in Egypt and their antioxidant activity.

This study focused on the profiling of phenolic constituents in 80% methanolic extracts of the leaves of some Jasminum species cultivated in Egypt and their antioxidant activities. Phenolic profiling was performed by total phenolic contents, total flavonoid contents and HPLC-DAD for selected species in comparison to authentic standards. DPPH assay was used to estimate the antioxidant activities of Jasminum azoricum L., Jasminum humile L., Jasminum multiflorum (Burm.f.) Andrew, Jasminum officinale L., Jasminum sambac (Ait) L. "Arabian Nights cultivar" and Jasminum sambac (Ait) L. "Grand Duke of Tuscany cultivar". Jasminum multiflorum showed the highest antioxidant activity among selected species with IC50 of 34.8 µg/ml. J. multiflorum showed high concentrations of hydroxytyrosol, protocatechuic acid, hydroxybenzoic acid, kaempferol-3-O- neohesperidoside, and quercetin-3-O-glucoside with concentrations of 977.1 µg/g, 2224.7 µg/g, 714.8 µg/g, 1738.8 µg/g, and 4356.1 µg/g, respectively.

The benefit of adding lidocaine to ketamine during rapid sequence endotracheal intubation in patients with septic shock: A randomised controlled trial.

BACKGROUND: Patients with septic shock commonly require endotracheal intubation under general anaesthesia in the operating theatre, the emergency department, and the intensive care unit. Hypotension is a serious complication after induction of general anaesthesia, especially in patients with circulatory failure. No randomised controlled trials had previously investigated protocols for induction of anaesthesia in septic shock patients. The aim of the current work is to compare two protocols, lidocaine-ketamine combination versus ketamine full-dose for rapid-sequence endotracheal intubation in patients with septic shock. METHODS: Forty-four adult patients, with septic shock, scheduled for emergency surgical intervention were enrolled in this randomised, double-blinded, controlled study. Patients were randomised to receive either 1 mg/kg ketamine (ketamine group, n = 22) or 0.5 mg/kg ketamine plus 1 mg/kg lidocaine (ketamine-lidocaine group, n = 22) for induction of anaesthesia in addition to 0.05 mg/kg midazolam (in both groups). Our primary outcome was the mean arterial pressure (MAP). Other outcomes included frequency of post-induction hypotension, heart rate, and cardiac output. RESULTS: Forty-three patients were available for final analysis. The average MAP reading in the first 5 min post-induction was higher in ketamine-lidocaine group than in the ketamine group {82.8 ± 5.6 mmHg and 73 ± 10.2 mmHg, P < 0.001}. Furthermore, the incidence of post-intubation hypotension was lower in the ketamine-lidocaine group than in the ketamine group {1 patient (5%) versus 17 patients (77%), P < 0.001}. The ketamine-lidocaine group showed higher MAP in almost all the readings after induction compared to ketamine group. Other haemodynamic variables including cardiac output and heart rate were comparable between both study groups. CONCLUSION: Lidocaine-ketamine combination showed less incidence of hypotension compared to ketamine full-dose when used for rapid-sequence endotracheal intubation in patients with septic shock. REGISTRATION URL: https://clinicaltrials.gov/ct2/show/NCT03844984?cond=NCT03844984&rank=1.

Application of neural network and time series modeling to study the suitability of drain water quality for irrigation: a case study from Egypt.

Limited water resources are one of the major challenges facing Egypt during the current stage. The agricultural drainage water is an important water resource which can be reused for agriculture. Thus, the current study aims to assess the quality of drainage water for irrigation purpose through monitoring and predicting its suitability for irrigation. The chemical composition of Bahr El-Baqr water drain, especially salinity, as well as ions are mainly involved in calculating indicators of water suitability for irrigation, i.e., Ca2+, Mg2+, Na+, K+, HCO-3, Cl-, and SO42-. Further analysis was carried out to evaluate the irrigation water quality index (IWQI) through integrated approaches and artificial neural network (ANN) model. Further, ARIMA models were developed to forecast IWQI of Bahr El-Baqr drain in Egypt. The results indicated that the computed IWQI values ranged between 46 and 81. Around 11% of the samples were classified as excellent water, while 89% of the samples were categorized as good water. The results of IWQI showed a standard deviation of 8.59 with a mean of 62.25, indicating that IWQI varied by 13.79% from the average. ANN model showed much higher prediction accuracy in IWQI modeling with R2 value greater than 0.98 during training, testing and validation. A relatively good correlation was obtained, between the actual and forecasted IWQI based on the Akaike information criterion (AIC); the best fit models were ARIMA (1,0) (0,0) without seasonality. The determination coefficient (R2) of ARIMA models was 0.23. Accordingly, 23% of IWQI variability could be explained by different model parameters. These findings will support the water resources managers and decision-makers to manage the irrigation water resources that can be implemented in the future.

Estimation of additive and non-additive genetic variance component for growth traits in Adani goats.

Non-additive genetic effects are important to increase the accuracy of estimating genetic parameters for growth traits. The aim of this study was to estimate genetic parameters and variance components, specially dominance and epistasis genetic effects, for growth traits (birth weight (BW), weaning weight (WW), 3 (W3), 6 (W6), 9 (W9), and 12 (W12) month weight) in Adani goats. Analyses were carried out using Bayesian method via Gibbs sampler animal model by fitting of 18 different models. All fixed effects (sex, type of birth, age of dam, and year) showed significant effects on BW, WW, W3, and W6, whereas the type of birth and age of dam were not significant on W9 and W12. With the best model, direct heritability estimates were 0.347, 0.178, 0.158, 0.359, 0.278, and 0.281 for BW, WW, W3, W6, W9, and W12 traits, respectively. Maternal permanent environmental effect was significant for BW and WW, but maternal genetic effect was significant only for W3. Dominance and epitasis effects were significant almost for all traits and as a proportion of phenotypic variance were ranged from 0.115 to 0.258 and 0.107 to 0.218, respectively. The range of accuracy of breeding values estimated for growth traits with appropriate evaluation models was from 0.521 to 0.652, 0.616 to 0.694, and 0.548 to 0.684 for the all animals, 10% of the best males and 50% of the best females, respectively. When dominance and epistasis effects added to models, the error variance was reduced and the accuracy of estimated breeding values increased. The accuracy of the best model showed a significant difference with the accuracy of other models (p < 0.01). The result of the present study suggests that non-additive genetic effects should be in genetic evaluation models for goat growth traits because of its effect on accuracy of estimated breeding values.

The role of Gabapentin oral solution in decreasing desflurane associated emergence agitation and delirium in children after stabismus surgery, a prospective randomized double-blind study.

BACKGROUND: Short acting inhalational anesthetic (Desflurane) produces emergence agitation (EA) in pediatrics with an incidence up to 80%. The aim of the present study was to examine the role of Gabapentin oral solution in attenuating desflurane associated EA in children after strabismus surgery under general anesthesia. METHODS: Seventy patients, 2-6 years old, scheduled for strabismus surgery were randomly allocated into two groups (35 each); Control group (c): received 5 ml of oral strawberry juice (placebo) and Gabapentin group (G) received 5 mg/Kg gabapentin oral solution in 5 ml strawberry juice, 1 h before anesthesia. Patient separation, cooperation, emergence incidence and emergence severity were assessed. Also time to extubation and time to emergence, duration of PACU stay, PONV and number of patients required meperidine postoperatively were recorded. RESULTS: Duration to extubation and duration to emergence were statistically prolonged in gabapentin group compared to the control group. The incidence of EA and its severity were reduced in gabapentin group with more tendencies to be asleep and less attentive. More patients in the control group required postoperative meperidine to reduce crying and agitation. CONCLUSION: Oral gabapentin 5 mg/kg reduced the incidence and severity scoring of emergence agitation (by 20%) with more tendencies for sleeping with preserved response to stimuli in PACU. TRIAL REGISTRATION: Number: NCT03347916 , date: November 17, 2017, retrospectively.

Low dose propofol vs. lidocaine for relief of resistant post-extubation laryngospasm in the obstetric patient / Dose baixa de propofol versus lidocaína para alívio de laringoespasmo resistente pós-extubação em paciente obstétrica

Abstract Background Post-extubation laryngospasm is a dangerous complication that should be managed promptly. Standard measures were described for its management. We aimed to compare the efficacy of propofol (0.5 mg.kg-1) vs. lidocaine (1.5 mg.kg-1) for treatment of resistant post-extubation laryngospasm in the obstetric patients, after failure of the standard measures. Method This study was conducted over 2 years on all obstetric patients scheduled for cesarean delivery. Post-extubation laryngospasm was initially managed with a standard protocol (removal of offending stimulus, jaw thrust, positive pressure ventilation with 100% oxygen). When this protocol failed, the tested drug was the second line (lidocaine in the first year and propofol in the second year). Lastly, succinylcholine was used when the tested drug failed. Results In lidocaine group, 5% of parturients developed post-extubation laryngospasm, 31.9% of them were successfully treated via standard protocol, and 68.1% required lidocaine treatment. Among these, 65.6% of patients treated with lidocaine responded successfully and 34.4% required succinylcholine to relieve laryngospasm. In propofol group, 4.7% of parturients developed post-extubation laryngospasm, 30.1% of them were successfully treated via standard protocol, and 69.9% required propofol treatment. Among these, 82.8% of patients treated with propofol responded successfully and 17.2% required succinylcholine to relieve laryngospasm. Conclusion Small dose of propofol (0.5 mg.kg-1) is marginally more effective than lidocaine (1.5 mg.kg-1) for the treatment of resistant post-extubation laryngospasm in obstetric patients, after failure of standard measures and before the use of muscle relaxants.

Resumo Justificativa O laringoespasmo pós-extubação é uma complicação perigosa que deve ser prontamente tratada. Medidas padrão para o seu manejo foram descritas. O nosso objetivo foi comparar a eficácia de propofol (0,5 mg.kg-1) versus lidocaína (1,5 mg.kg-1) no tratamento de laringoespasmo resistente pós-extubação em pacientes obstétricas após falha das medidas padrão. Método Este estudo foi conduzido ao longo de dois anos em todas as pacientes obstétricas programadas para cesariana. O laringoespasmo pós-extubação foi inicialmente tratado com um protocolo padrão (remoção do estímulo ofensivo, protrusão mandibular, ventilação com pressão positiva com oxigênio a 100%). Ao constatar a falha desse protocolo, o fármaco testado foi a segunda opção (lidocaína no primeiro ano e propofol no segundo ano). Por fim, succinilcolina foi usada quando houve falha do fármaco testado. Resultados No grupo lidocaína, 5% das parturientes desenvolveram laringoespasmo pós-extubação, 31,9% delas foram tratadas com sucesso via protocolo padrão e 68,1% precisaram de tratamento com lidocaína, das quais, 65,6% responderam com sucesso ao tratamento com lidocaína e 34,4% precisaram de succinilcolina para alívio do laringoespasmo. No grupo propofol, 4,7% das parturientes desenvolveram laringoespasmo pós-extubação, 30,1% delas foram tratadas com sucesso via protocolo padrão e 69,9% precisaram de tratamento com propofol, das quais, 82,8% responderam com sucesso ao tratamento com propofol e 17,2% precisaram de succinilcolina para alívio do laringoespasmo. Conclusão Uma pequena dose de propofol (0,5 mg.kg-1) é marginalmente mais eficaz do que lidocaína (1,5 mg.kg-1) no tratamento de laringoespasmo resistente pós-extubação em pacientes obstétricas, após falha das medidas padrão e antes do uso de relaxantes musculares.

[Low dose propofol vs. lidocaine for relief of resistant post-extubation laryngospasm in the obstetric patient]. / Dose baixa de propofol versus lidocaína para alívio de laringoespasmo resistente pós­extubação em paciente obstétrica.

BACKGROUND: Post-extubation laryngospasm is a dangerous complication that should be managed promptly. Standard measures were described for its management. We aimed to compare the efficacy of propofol (0.5mg.kg-1) vs. lidocaine (1.5mg.kg-1) for treatment of resistant post-extubation laryngospasm in the obstetric patients, after failure of the standard measures. METHOD: This study was conducted over 2 years on all obstetric patients scheduled for cesarean delivery. Post-extubation laryngospasm was initially managed with a standard protocol (removal of offending stimulus, jaw thrust, positive pressure ventilation with 100% oxygen). When this protocol failed, the tested drug was the second line (lidocaine in the first year and propofol in the second year). Lastly, succinylcholine was used when the tested drug failed. RESULTS: In lidocaine group, 5% of parturients developed post-extubation laryngospasm, 31.9% of them were successfully treated via standard protocol, and 68.1% required lidocaine treatment. 65.6% of patients treated with lidocaine responded successfully and 34.4% required succinylcholine to relieve laryngospasm. In propofol group, 4.7% of parturients developed post-extubation laryngospasm, 30.1% of them were successfully treated via standard protocol, and 69.9% required propofol treatment. 82.8% of patients treated with propofol responded successfully and 17.2% required succinylcholine to relieve laryngospasm. CONCLUSION: Small dose of propofol (0.5mg.kg-1) is marginally more effective than lidocaine (1.5mg.kg-1) for the treatment of resistant post-extubation laryngospasm in obstetric patients, after failure of standard measures and before the use of muscle relaxants.

Effect of Single Compared to Repeated Doses of Intravenous S(+) Ketamine on the Release of Pro-inflammatory Cytokines in Patients Undergoing Radical Prostatectomy.

BACKGROUND: Radical prostatectomy is a major surgical procedure that is associated with marked inflammatory response and impairment of the immune system which may affect the postoperative outcome. The aim of this study was to evaluate the effect of preincision single or multiple doses of S(+) ketamine on the pro-inflammatory cytokines, namely tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6). PATIENTS AND METHODS: This is a randomized controlled trial including 60 American Society of Anesthesiologists Physical Status I and II patients scheduled for radical prostatectomy under combined general-epidural anesthesia in Cairo university Teaching Hospital. Patients were randomly divided into three groups each of twenty patients: Group I received no S(+) ketamine (control group), Group II received S(+) ketamine as a single preincision dose, and Group III received preincision and repeated doses of S(+) ketamine. S(+) ketamine was injected as a single intravenous dose of 0.5 mg/kg in Group II and III, repeated as 0.2 mg/kg at 20 min interval until 30 min before the end of surgery. RESULTS: The three groups were comparable in age, weight, and duration of the operation. The study also revealed that a single preincision dose of S(+) ketamine decreased TNF-α to reach 1027.04 ± 50.13 µ/ml and IL-6 to reach 506.89 ± 25.35 pg/ml whereas the repeated doses of S(+) ketamine decreased TNF-α to reach 905.64 ± 35065 µ/ml and IL-6 to reach 412.79 ± 16.5 pg/ml (P < 0.05). CONCLUSION: S(+) ketamine suppresses pro-inflammatory cytokine production, especially when given in repeated doses.

Leg elevation decreases the incidence of post-spinal hypotension in cesarean section: a randomized controlled trial.

BACKGROUND: Maternal hypotension is a common complication after spinal anesthesia for cesarean section (CS). In this study we investigated the role of leg elevation (LE) as a method for prevention of post-spinal hypotension (PSH) for cesarean section. METHODS: One hundred and fifty full term parturients scheduled for CS were included in the study. Patients were randomized into two groups: Group LE (leg elevation group, n = 75) and group C (Control group, n = 75). Spinal block was performed in sitting position after administration of 10 mL/Kg Ringer's lactate as fluid preload. After successful intrathecal injection of local anesthetic, Patients were positioned in the supine position. Leg elevation was performed for LE group directly after spinal anesthesia and maintained till skin incision. Intraoperative hemodynamic parameters (Arterial blood pressure and heart rate), intra-operative ephedrine consumption, incidence of PSH, and incidence of nausea and vomiting were reported. RESULTS: LE group showed lower incidence of PSH (34.7% Vs 58.7%, P = 0.005) compared to the control group. Arterial blood pressure was higher in the LE group compared to the control group in the first two readings after spinal block. Other readings showed comparable arterial blood pressure and heart rate values between both study groups; however, LE showed less ephedrine consumption (4.9 ± 7.8 mg Vs 10 ± 11 mg, P = 0.001). CONCLUSION: LE performed immediately after spinal block reduced the incidence of PSH in parturients undergoing CS. TRIAL REGISTRATION: The study was registered at Pan African Clinical Trials Registry system on 5/10/2015 with trial number PACTR201510001295348 .

Preprocedural ultrasound examination versus manual palpation for thoracic epidural catheter insertion.

BACKGROUND AND AIMS: Ultrasound imaging before neuraxial blocks was reported to improve the ease of insertion and minimize the traumatic trials. However, the data about the use of ultrasound in thoracic epidural block are scanty. In this study, pre-insertion ultrasound scanning was compared to traditional manual palpation technique for insertion of the thoracic epidural catheter in abdominal operations. SUBJECTS AND METHODS: Forty-eight patients scheduled to midline laparotomy under combined general anesthesia with thoracic epidural analgesia were included in the study. Patients were divided into two groups with regard to technique of epidural catheter insertion; ultrasound group (done ultrasound screening to determine the needle insertion point, angle of insertion, and depth of epidural space) and manual palpation group (used the traditional manual palpation technique). Number of puncture attempts, number of puncture levels, and number of needle redirection attempts were reported. Time of catheter insertion and complications were also reported in both groups. RESULTS: Ultrasound group showed lower number of puncture attempts (1 [1, 1.25] vs. 1.5 [1, 2.75], P = 0.008), puncture levels (1 (1, 1) vs. 1 [1, 2], P = 0.002), and needle redirection attempts (0 [0, 2.25] vs. 3.5 [2, 5], P = 0.00). Ultrasound-guided group showed shorter time for catheter insertion compared to manual palpation group (140 ± 24 s vs. 213 ± 71 s P = 0.00). CONCLUSION: Preprocedural ultrasound imaging increased the incidence of first pass success in thoracic epidural catheter insertion and reduced the catheter insertion time compared to manual palpation method.

Effects of Sabbagh Universal Spring 2 fixed functional appliance on class II/1 patients at their postpubertal-peak growth period compared with the extraction method : A randomized clinical trial.

OBJECTIVE: The aim of this study was to evaluate the therapeutic effects of the Sabbagh Universal Spring 2 (SUS 2) fixed functional appliance compared to the premolar extraction method in correcting class II/1 malocclusion in patients who had passed their peak of postpubertal growth (stages 4-6 of Cervical Vertebral Maturation Index). METHODS: In all, 40 class II/1 patients were randomized to receive SUS 2 application (7 males, 13 females, age 15.75 ± 1.02 years) or maxillary premolar extraction (8 males, 12 females, age 15.40 ± 0.99 years). Pre- and posttreatment digital cephalographs were traced at least twice. A paired t test was used to compare the pre- and posttreatment measurements. Treatment changes were compared using an independent samples t test (P ≤ 0.05). RESULTS: The extent of change was significant in the following variables: ANB, nasolabial angle, Mand1-ML, 1L-NB, anterior and posterior facial heights, N-A-Pog, 1U-NF, 6L-MP, Ar-Go, OP-HP, A-B, A-Sn, B-Sm, APDI, NAPog, AB-NPog, POr-DOP, SN-OcP, POr-OcP, Wits, 1 l-APog, 1LMeLm, S-Go:N-Me, N-ANS-Pog, Ap1LAp1u-DOP, ANS-Cond, Pog-Cond, SS-Ls, A-N-Pog, Pog-Pog', MeGoOcP, 1L-Npog, Go-Me, Go-Me:N-S, S-Me, Ls-(Sn-Pog'), Stms-Stmi, N'-Gn', N'NsPog', 6u-PTV, 1u-NA, FMIA, and IMPA. CONCLUSIONS: SUS 2 corrected class II/1 malocclusion of patients in the postpubertal growth period by inhibiting the maxilla's forward growth, advancing the mandible, decreasing the nasolabial and interincisal angles, proclining the incisors, increasing the facial height, and clockwise rotation of the occlusal plane. Extraction reduced the interincisal angle and protruded the lower incisors. However, it did not change the soft tissue thickness and did not cause a clockwise rotation in the occlusal plane.

Effect of Bionator and Farmand Appliance on the Treatment of Mandibular Deficiency in Prepubertal Stage.

OBJECTIVE: The present study aimed to compare dentoskeletal changes in mandibular-deficient patients treated with Bionator and Farmand appliances. METHODS: This study included 54 subjects treated for class II division I malocclusion. All subjects fulfilled the following criteria: ANB>5°, SNB<77°, and overjet >5 mm. The Bionator group consisted of 27 patients (15 girls, 12 boys) with the mean age of 11 (SD 1) years and the Farmand group consisted of 27 patients (17 girls, 10 boys) with the mean age of 11.1 (SD 1.4) years. Statistical analyses were performed using t-test, paired t-test, Wilcoxon, and Mann-Whitney test. RESULTS: In the Farmand group, SNB significantly increased from 74.3° (SD 1.7) to 77.6° (SD 2.3) and ANB decreased by 3.2° (SD 1.7) (p<0.001). In the Bionator group, SNB significantly increased from 75.5° (SD 0.9) to 79° (SD 0.9), and ANB decreased by 3.3° (SD 1.3) (p<0.001). The increase in IMPA showed that the lower incisors were significantly tipped using both appliances. T-test did not show any significant differences between the two groups. CONCLUSION: Despite the different designs of the appliances, both were successful in the treatment of class II division 1 malocclusion in mandibular-deficient patients.