Anaesthetic nurse specialist role in perioperative anaesthetic management of patients who are morbidly obese.

This integrative literature review examined the role of an anaesthetic nurse specialist (ANS) in the perioperative anaesthetic nursing management of morbidly obese patients associated with elective orthopaedic surgery. The responsibility of the ANS is to provide high-quality perioperative anaesthetic care to ensure patient safety. Morbid obesity is increasing globally, with significant implications for healthcare delivery, care and treatment, including perioperative care. The Association of Anaesthetists of Great Britain and Ireland emphasises that the perioperative management of these patients presents significant organisational and practical issues. However, there are limited data or guidelines on whether surgeons, anaesthetists and nurses routinely take special precautions in managing morbidly obesity patients undergoing elective orthopaedic operative procedures. The authors carried out a search of databases, followed by an integrated literature review and synthesis of 11 studies. The main findings revealed significant clinical challenges and resource requirements for perioperative anaesthetic management of this patient group. Recommendations are made to prepare for and manage these surgical patients, from preoperative assessment to postoperative care.

Aging disrupts spatiotemporal regulation of germline stem cells and niche integrity.

A major factor driving stem cell decline is stem cell niche aging, but its molecular mechanism remains elusive. We use the Caenorhabditis elegans distal tip cell (DTC), the mesenchymal niche that employs Notch signaling to regulate germline stem cells (GSCs), as an in vivo niche aging model and delineate the molecular details of the DTC/niche aging process. Here, we demonstrate that a drastic decrease in C. elegans germline fecundity, which begins even in early adulthood, is mainly due to an age-induced disruption in spatial regulation of Notch-dependent transcription in the germline combined with a moderate reduction in Notch transcription at both tissue and cellular levels. Consequently, the Notch-responsive GSC pool shifts from the distal end of the gonad to a more proximal region, disrupting the distal-to-proximal germline polarity. We find that this GSC pool shift is due to a dislocation of the DTC/niche nucleus, which is associated with age-induced changes in the structure and morphology of the DTC/niche. Our findings reveal a critical link between physiological changes in the aging niche, their consequences in stem cell regulation, and germline tissue functions.

Molecular structure, NLO properties and vibrational analysis of l-Histidine tetra fluro borate by experimental and computational spectroscopic techniques.

l-histidine tetra fluroborate (L-HTFB) is a semi-organic NLO material. Ab-initio computations were performed at CAM-B3LYP/ 6-311++g(d,p) level of theory to arrive at the structures, energies, and vibrational wave numbers. The experimental FT-IR and FT-Raman spectra of L-HTFB have been recorded and analyzed. It is compared with the simulated spectra. The scaled wave numbers obtained are in good agreement with the experimental values. Hirshfeld surface analysis represented in the 2D fingerprint plot reveals the interaction within the compound. Optimized geometry reveals that the complexes l -histidine (L-H) and tetrafluoroborate (TFB) are linked by H-F bond which provides inter and intra molecular hydrogen bonded interactions such as N10-H16⋯F25, N11-H17⋯F22, N11-H14⋯F24, N11-H14⋯N10 and N11-H15⋯O12. The inter-molecular distances H17⋯F22, H14⋯F24 and H16⋯F25 are in between 1.82 Šand 2.53 Å. The intra molecular distances H14⋯N10 and H15⋯O12 are found to be at 2.17 Šand 1.71 Šwhich stabilizes lone pair electron of N10 and O12 with energies 11.89 and 59.91 KJ/mol respectively. The intra and inter molecular hyperconjugations responsible for the stability of the molecule are well identified theoretically using the NBO analysis. Third order optical nonlinearity is measured by means of the open aperture Z-scan technique which reveals that the crystal has optical limiting property. Photoluminescence results clearly indicate the use of L-HTFB as a new violet-light emitting material.