Preoperative Implementation of Transverse Thoracic Muscle Plane Block and Rectus Sheath Block Combination for Pediatric Cardiac Surgery.

Systemic intravenous administration of opioids is the main treatment strategy for intraoperative and postoperative pain management in patients undergoing cardiac surgery with sternotomy. However, using lower doses of opioids may achieve the well-established benefits of the fast-track approach, with minimal opioid-related side effects. Postoperative pain is coupled with a long stay in the intensive care unit. Although neuraxial anesthesia has some benefits, its use remains controversial due to the potential development of epidural hematoma after anticoagulation for cardiopulmonary bypass and coagulopathy after cardiac surgery. Therefore, there is a need for other effective postoperative analgesic strategies, such as peripheral nerve blocks other than neuraxial anesthesia, for cardiac surgery with sternotomy. The effects of real-time ultrasound-guided transverse thoracic muscle plane (TTP) block on postoperative pain after sternotomy have been reported; however, the pain and discomfort in the epigastric area caused by chest drainage tubes placed through the rectus abdominis muscle also are major postoperative problems after cardiac surgery. Herein, the authors report on a preoperative combination of TTP block and rectus sheath block (RSB) for postoperative pain management after cardiac surgery with sternotomy that addresses pain in both the chest and epigastric areas. Considering previous studies, it is presumed that preemptive analgesic effects can be expected via a combination of the TTP block and RSB, and indeed, the preemptive effect was observed in the present study's patients. In this article, the procedure and tips for combining the TTP block and RSB are introduced.

Locus-specific ancestry to detect recent response to selection in admixed Swiss Fleckvieh cattle.

Identification of selection signatures is one of the current endeavors of evolutionary genetics. Admixed populations may be used to infer post-admixture selection. We calculated local ancestry for Swiss Fleckvieh, a composite of Simmental (SI) and Red Holstein Friesian (RHF), to infer such signals. Illumina Bovine SNP50 BeadChip data for 300 admixed, 88 SI and 97 RHF bulls were used. The average RHF ancestry across the whole genome was 0.70. To identify regions with high deviation from average, we considered two significance thresholds, based on a permutation test and extreme deviation from normal distribution. Regions on chromosomes 13 (46.3-47.3 Mb) and 18 (18.7-25.9 Mb) passed both thresholds in the direction of increased SI. Extended haplotype homozygosity within (iHS) and between (Rsb) populations was calculated to explore additional patterns of pre- and post-admixture selection signals. The Rsb score of admixed and SI was significant in a wide region of chromosome 18 (6.6-24.6 Mb) overlapped with one area of strong local ancestry deviation. FTO, with pleiotropic effect on milk and fertility, NOD2 on dairy and NKD1 and SALL1 on fertility traits are located there. Genetic differentiation of RHF and SI (Fst ), an alternative indicator of pre-admixture selection in pure populations, was calculated. No considerable overlap of peaks of local ancestry deviations and Fst was observed. We found two regions with significant signatures of post-admixture selection in this very young composite, applying comparatively stringent significance thresholds. The signals cover relatively large genomic areas and did not allow pinpointing of the gene(s) responsible for the apparent shift in ancestry proportions.

Identification of selection signatures in Capra hircus and Capra aegagrus in Iran.

Identification of selection signatures may provide a better understanding of domestication process and candidate genes contributing to this process. In this study, two populations of domestic and wild goats from Iran were analyzed to identify selection signatures. RSB, iHS, and XP-EHH statistics were used in order to identify robust selection signatures in the goat genome. Genotype data of domestic and wild goats from the NextGen project was used. The data was related to 18 Capra aegagrus (wild goat) and 20 Capra hircus (domestic goat) from Iran. The iHS method indicated 675 and 441 selection signatures in C. aegagrus and C. hircus, respectively. RSB and XP-EHH methods showed about 370 and 447 selection signatures in C. aegagrus and C. hircus, respectively. These selection signatures were mainly associated with milk production, fleece trait, mammary epithelial cells, reproduction, and immune system.

Impact of nutrients on the function of the chlamydial Rsb partner switching mechanism.

The obligate intracellular bacterial pathogen Chlamydia trachomatis is a leading cause of sexually transmitted infections and infectious blindness. Chlamydia undergo a biphasic developmental cycle alternating between the infectious elementary body (EB) and the replicative reticulate body (RB). The molecular mechanisms governing RB growth and RB-EB differentiation are unclear. We hypothesize that the bacterium senses host cell and bacterial energy levels and metabolites to ensure that development and growth coincide with nutrient availability. We predict that a partner switching mechanism (PSM) plays a key role in the sensing and response process acting as a molecular throttle sensitive to metabolite levels. Using purified wild type and mutant PSM proteins, we discovered that metal type impacts enzyme activity and the substrate specificity of RsbU and that RsbW prefers ATP over GTP as a phosphate donor. Immunoblotting analysis of RsbV1/V2 demonstrated the presence of both proteins beyond 20 hours post infection and we observed that an RsbV1-null strain has a developmental delay and exhibits differential growth attenuation in response to glucose levels. Collectively, our data support that the PSM regulates growth in response to metabolites and further defines biochemical features governing PSM-component interactions which could help in the development of novel PSM-targeted therapeutics.

[Phosphorus Adsorption Characteristics of Different Biochar Types and Its Influencing Factors].

In order to understand the resource utilization of plant biomass, five types of biomass materials were used to produce biochar to treat wastewater containing phosphorus. The phosphorus adsorption capacity of five materials was preliminarily compared through laboratory experiments, and two materials with strong phosphorus adsorption capacity were screened out. The physicochemical characteristics of the selected biochar were analyzed using scanning electron microscopy and a BET specific surface area analyzer, and the effects of different pH values on phosphorus adsorption of the biochar were investigated. Furthermore, the phosphorus adsorption characteristics of the selected biochar were analyzed via isothermal adsorption and adsorption kinetics models. The results showed that among the five biochar materials, only rice straw and corn straw biochar had the ability to adsorb phosphorus. The Langmuir isothermal adsorption curve showed that the adsorption capacity of rice straw biochar for phosphorus in wastewater was stronger than that of corn straw biochar, and the theoretical maximum adsorption capacity was as follows:rice straw biochar (9.78 mg·g-1)>corn straw biochar (0.39 mg·g-1). The specific surface area (148.30 m2·g-1) and total pore volume (0.11 cm3·g-1) of rice straw biochar were much higher than those of corn straw biochar (8.26 m2·g-1 and 0.03 cm3·g-1, respectively), and the contents of Mg, Ca, Fe, and Al were higher in rice straw biochar. The best pH for phosphorus adsorption of rice straw biochar and corn straw biochar was acidic. In different pH ranges (3.0-11.0), the phosphorus adsorption capacity of rice straw and corn straw biochar decreased with the increase in pH. These results indicated that rice straw biochar has strong phosphorus adsorption capacity and has a better application prospect in wastewater treatment.

Probability scoring system of intravascular large B-cell lymphoma for the application of random skin biopsy: A retrospective cohort study.

Background: Intravascular large B-cell lymphoma (IVLBCL) is rare and fatal when diagnosed late in the disease course. Random skin biopsy (RSB) is useful for early diagnosis, but criteria for its application are not well established. Objective: To develop an IVLBCL-probability scoring system for stratifying patients and investigate its feasibility and capability for RSB application. Methods: A retrospective cohort of 77 consecutive patients with suspected IVLBCL who underwent RSB was included in this study. All patients were classified into 3 IVLBCL-probability groups according to the IVLBCL-probability scoring system comprising the following 4 components: general symptoms, organ-specific symptoms, serum soluble-interleukin-2 receptor levels, and serum lactate-dehydrogenase levels. Results: The high (score 7-10), intermediate (score 4-6) and low (score 1-3) IVLBCL-probability groups contained 32, 30, and 15 patients, respectively. All 5 patients with IVLBCL were stratified into the high IVLBCL probability group. Accuracies in the diagnosis of IVLBCL were 100%, 100%, and 93.8% for the low, intermediate, and high IVLBCL-probability groups. The positive detection rate in the high IVLBCL-probability group increased to 9.4% from 3.9% across all groups. Conclusions: The newly-developed IVLBCL-probability scoring system has good capability for stratification of patients and could allow limiting application of RSB for diagnosis only to high-probability groups.

TAPB and RSB protects cardiac diastolic function in elderly patients undergoing abdominopelvic surgery: a retrospective cohort study.

BACKGROUND: Diastolic dysfunction, an early manifestation and clinical symptom of heart failure with preserved ejection fraction, can be influenced by various anesthesia management strategies. Trans-esophageal echocardiography was used to undertake to assess left ventricular diastolic function during anesthesia maintenance using sevoflurane alone and sevoflurane combining with transversus abdominis plane block and rectus sheath block in elderly patients with diastolic dysfunction undergoing abdominopelvic surgery. METHODS: Thirty-eight patients were divided into two groups in this retrospective study, sevoflurane and sevoflurane combining with TAPB and RSB according to employing different anesthesia maintenance schemes. The parameters HR, MAP, CVP, E, A, E/A, e, a, e/a, and E/a were obtained immediately after anesthesia induction hemodynamics stability (HR1, MAP1, CVP1, E1, A1, E1/A1, e1, a1, e1/a1, and E1/a1) and 1 hour later (HR2, MAP2, CVP2, E2, A2, E2/A2, e2, a2, e2/a2, and E2/a2). RESULTS: Transmitral diastolic Doppler flow characteristics illustrated E/A significant decreases in the S group but increases in the ST group (p = 0.02 < 0.05) 1 hour after anesthesia induction hemodynamic stability. Tissue Doppler imaging characteristics showed a more significant increase e/a (P = 0.005 < 0.05) and decreases in a value (p = 0.009 < 0.05) in the ST group 1 hour after anesthesia induction hemodynamics stability. CONCLUSIONS: Maintaining anesthesia with sevoflurane combining with TAPB and RSB was more suitable for protecting cardiac diastolic function than sevoflurane alone in elderly patients with diastolic dysfunction undergoing open abdominal and pelvic surgery.

Rice straw biochar modified by aluminum chloride enhances the dewatering of the sludge from municipal sewage treatment plant.

Enhancement of the dewatering of the sludge by using rice straw biochar (RSB) modified by aluminum chloride (AlCl3) was investigated, and the possible enhancing mechanisms were discussed. Results showed that the settled volume after 30 min (SV30%), specific resistance to filtration (SRF), moisture content (MC) and capillary suction time (CST) of the sludge were decreased and the net sludge solids yield (YN) was increased by the increasing raw or modified RSB, which indicated a higher sludge dewaterability. When the dosage of the modified RSB was adjusted to 0.3 g(RSB)/g(dry sludge), SV30%, SRF, MC and CST were decreased to 79.8%, 1.2 × 1012 m/kg, 81.4% and 38 s, respectively, YN was increased to 19.4 kg/(m2·h). Furthermore, performance of the modified RSB in the dewatering of the sludge was significantly better than that of the raw RSB. For the enhancing mechanisms, charge neutralization occurred when the modified RSB (loaded with positively charged aluminum species on its surface) was dosed into the sludge system, thus destroying the stable sludge colloidal system, thus far easier to congregate the sludge particles, which enhanced the dewatering of the sludge. Another main enhancing mechanism was that after conditioned by the modified RSB, certain skeleton structures were formed in sludge cake to make water pass through easily by decreasing the extracellular polymeric substances (EPS) of the sludge. We found that the effectiveness of using the modified RSB to enhance the dewatering of the sludge is substantial and promising.

rehh 2.0: a reimplementation of the R package rehh to detect positive selection from haplotype structure.

Identifying genomic regions with unusually high local haplotype homozygosity represents a powerful strategy to characterize candidate genes responding to natural or artificial positive selection. To that end, statistics measuring the extent of haplotype homozygosity within (e.g. EHH, iHS) and between (Rsb or XP-EHH) populations have been proposed in the literature. The rehh package for r was previously developed to facilitate genome-wide scans of selection, based on the analysis of long-range haplotypes. However, its performance was not sufficient to cope with the growing size of available data sets. Here, we propose a major upgrade of the rehh package, which includes an improved processing of the input files, a faster algorithm to enumerate haplotypes, as well as multithreading. As illustrated with the analysis of large human haplotype data sets, these improvements decrease the computation time by more than one order of magnitude. This new version of rehh will thus allow performing iHS-, Rsb- or XP-EHH-based scans on large data sets. The package rehh 2.0 is available from the CRAN repository (http://cran.r-project.org/web/packages/rehh/index.html) together with help files and a detailed manual.

Retained Surgical Foreign Bodies after Surgery.

The problem of retained surgical bodies (RSB) after surgery is an issue for surgeons, hospitals and the entire medical team. They have potentially harmful consequences for the patient as they can be life threatening and usually, a further operation is necessary. The incidence of RSB is between 0.3 to 1.0 per 1,000 abdominal operations, and they occur due to a lack of organisation and communication between surgical staff during the process. Typically, the RSB are surgical sponges and instruments located in the abdomen, retroperitoneum and pelvis.

Synthesis of three rimantadine schiff bases and their biological effects on serum albumin.

Three new rimantadine Schiff bases (RSBs) were prepared, and then the interaction of RSBs with bovine serum albumin (BSA) was investigated using fluorescence, synchronous fluorescence, UV-vis absorption spectroscopy under physiological conditions. The results showed that the three RSBs effectively quenched the intrinsic fluorescence of BSA via static quenching. Binding constant (K a), number of binding sites (n), and the binding distance (r) between three RSBs and BSA were calculated by Stern-Volmer equation and Förster's theory in this study. According to the results of displacement experiments of site probes, it was considered that the binding sites were located in hydrophobic cavities in sub-domains IIA of BSA. What is more, synchronous fluorescence studies indicated that the hydrophobicity around tryptophan residues was increased with the addition of rimantadine-o-vanillin (ROV) and rimantadine-4-methoxy-salicylaldehyde (RMS), while there was no apparent change with the addition of rimantadine-salicylaldehyde (RS).

Binge drinking: conductas sexuales de riesgo y drogas facilitadoras del asalto sexual en jóvenes españoles / Binge drinking: Risky sexual behaviors and drug facilitated sexual assault in spanish youths

El uso de drogas -alcohol incluido- como facilitadoras del asalto sexual y las conductas sexuales de riesgo son dos fenómenos relevantes desde una perspectiva sociosanitaria. El objetivo de la presente investigación es comparar las actitudes hacia estas variables en una muestra de 164 jóvenes en condiciones de intoxicación etílica frente a sobriedad. La muestra está compuesta por 82 varones y 82 mujeres. Su media de edad era 27.50 ± 63.72. Contestaron un cuestionario en el que se recogen datos sociodemográficos, información del consumo de drogas y la Escala de Conductas Sexuales; además, se emplearon varios etilómetros Digital Zaphir Deluxe para determinar la alcoholemia. Se trata de un estudio cuasiexperimental realizado sobre un diseño intraindividual. El muestreo es no probabilístico de tipo "bola de nieve". Los resultados muestran unas actitudes más positivas y una mayor intencionalidad hacia el empleo de drogas como facilitadoras del asalto sexual y hacia las conductas sexuales de riesgo de los sujetos que se encuentran bajo el efecto del alcohol en contextos recreativos, independientemente del sexo de la muestra. Se destaca, por un lado, la importancia de investigar sobre el uso de drogas como facilitadoras del asalto sexual (tema ampliamente ignorado en España) y se profundiza en cómo el consumo de drogas afecta al uso de métodos anticonceptivos, y por otro, la necesidad de incluir información en los programas preventivos sobre cómo el consumo de alcohol (y otras drogas) está relacionado con la actividad sexual.

Drug use (alcohol included) as a sexual-assault facilitator and risky sexual behavior are two important issues from a social and health perspective. This study aims to compare the attitudes towards these variables in a sample of 164 young people in conditions of intoxication vs sobriety. The sample consisted of 82 men and 82 women. Their mean age was 27.50 (SD = 3.72). Participants answered a sociodemographic questionnaire, a drug information questionnaire, and the Sexual Behaviors Scale. and moreover, Several Zaphir Deluxe Digital breathalyzers were also used to monitor alcohol level. This is a quasiexperimental study conducted using a within-subject design. Non-probabilistic snowball sampling was used. The results showed more positive attitudes and greater intentions towards the use of drugs as facilitators of sexual assault and risky sexual behaviors in those who are under the influence of alcohol in recreational contexts, regardless of the sex of the sample. These results showed, on the one hand, the importance of studies into the use of drug facilitated sexual assault -a largely ignored issue in Spain- and to determine how drug use affects the use of contraceptive methods. On the other hand, the results show the need to include information in preventive programs about the way alcohol (and other drugs) use is related to sexual activity.

Dimensionamento do volume do reator seqüencial em batelada (RSB) com enchimento estático / Sizing of the sequential batch reactor (SBR) with static filling

Este trabalho teve como objetivo propor uma metodologia de dimensionamento para o volume do RSB. O desenvolvimento do modelo matemático para calcular o volume do reator foi realizado a partir da modelagem fenomenológica do comportamento do lodo. A metodologia ora proposta foi aplicada em estudo de caso para comparação com metodologias já consolidadas no dimensionamento do sistema de lodos ativados em batelada. A partir da metodologia apresentada neste trabalho, a determinação do volume do reator e do ciclo operacional mostrou que é possível contribuir para o dimensionamento do RSB sem transgredir o conhecimento da ação do lodo sobre a matéria orgânica e sem admitir fluxo contínuo no comportamento hidráulico do reator.

The purpose of this study was to propose a methodology for sizing SBR volumes. The mathematical model to calculate reactor volume was developed by modeling sludge behavior phenomena. The methodology proposed here was applied to a case study in order to compare it to already consolidated methods used to size the activated sludge batch system. The reactor volume and operational cycle were determined based on the method presented here, showing that it is possible to help size the SBR without challenging knowledge regarding the action of sludge on organic matter, and without allowing continuous flow into the hydraulic compartment of the reactor.

Eficiência do reator seqüencial em batelada (RSB) na remoção de nitrogênio no tratamento de esgoto doméstico com DQO baixa / The sequencing batch reactor (SBR) efficiency in the removal of nitrogen on the treatment of domestic sewage with low COD

Este trabalho tem como objetivo avaliar a eficiência e a estabilidade do RSB na remoção de nitrogênio no tratamento de esgoto doméstico com DQO baixa. O reator utilizado no experimento possui volume de trabalho de 600 L e trata 1200 L/d de esgoto bruto em três bateladas de oito horas. A partir dos dados obtidos na pesquisa, observou-se que o reator seqüencial em bateladapossibilitou a remoção média de nitrogênio total igual a 88 % no tratamento de esgoto doméstico com DQO média de 257 mg/L. A remoção de DQO foi de 90 %, a média da alcalinidade total no efluente foi 72 mgCaCO3/L e o índice volumétrico de lodo médio ficou em 86 mL/g. Estes resultados indicam que é possível utilizar RSB para o tratamento de esgoto doméstico com matéria orgânica reduzida sem comprometer a qualidade do efluente, a remoção de nitrogênio e a estabilidade operacional do sistema.

This work had the objective of evaluating the SBR efficiency and stability in the removal of nitrogen on the treatment of domestic sewage with low COD. The reactor used in the experiment has a working volume of 600 L, and treats 1200 L/d of raw sewage in three 8-hour cycles. From the data gathered during the research, itwas realized that the SBR fostered an average removal of total nitrogen equal to 88% in the treatment of a domestic sewage with an average COD of 257 mg/L. The COD removal was 90%, the final effluent total alkalinity was 72 mgCaCO3/L, and the sludge volumetricindex was 86 mL/g. The results indicate that is possible to use SBR for the treatment of domestic sewage with low organic matter without compromising the final effluent quality, the nitrogen removal ability, and the stability of the system.