Effect of Inorganic Fillers on Electrical and Mechanical Properties of Ceramizable Silicone Rubber.

Ceramizable silicone rubber (CSR) composed of silicone rubber matrix and inorganic fillers can be transformed into a dense flame-retardant ceramic upon encountering high temperatures or flames. Conventionally, CSR can be sintered into a dense ceramic at temperatures above 1000 °C, which is higher than the melting point of a copper conductor used in a power cable. In this study, the vulcanization process and mass ratio of inorganic fillers of CSR were studied to lower its ceramization temperature to 950 °C. The electrical and mechanical properties of CSRs and their ceramic bulks were studied with various ratios of wollastonite and muscovite. It was found that the CSR samples could be successfully fabricated using a two-step vulcanization technique (at 120 °C and 150 °C, respectively). As a high ratio of muscovite filler was introduced into the CSR, the sample presented a high dc electrical resistivity of 6.713 × 1014 Ω·cm, and a low dielectric constant of 4.3 and dielectric loss of 0.025 at 50 Hz. After the thermal sintering (at 950 °C for 1 h) of the CSR sample with a high ratio of muscovite, the ceramic sample exhibits a dense microstructure without any pores. The ceramic also demonstrates excellent insulating properties, with a volume resistivity of 8.69 × 1011 Ω·cm, and a low dielectric loss of 0.01 at 50 Hz. Meanwhile, the three-point bending strength of the ceramic sample reaches a value of 110.03 MPa. This study provides a potential route to fabricate CSR used for fire-resistant cables.

Combined influence of nutritional and inflammatory status and depressive symptoms on mortality among US cancer survivors: Findings from the NHANES.

BACKGROUND: Inflammation and nutrition and depression are interrelated, and both are related to changes in mortality rates. We investigated the association of nutritional and inflammation index or depressive symptoms with the risk of all-cause mortality or cause-specific mortality among cancer survivors. METHODS: A prospective cohort of a nationally representative sample of cancer survivors, aged 40 years or older (n = 2331; weighted population, 15 248 255; 67.6 ± 11.0 years; 50.6 % males), were recruited from the US National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. Advanced lung cancer inflammation index (ALI) reflected inflammation and nutritional status and Patient Health Questionnaire 9 (PHQ-9) demonstrated depressive symptoms. The independent and joint associations of ALI and PHQ-9 score with mortality outcomes were examined among cancer survivors and Cox regression analysis based on weights was used to calculate the relative risk. RESULTS: We identified 605 all-cause deaths (cancer, 204; non-cancer, 401) over a median of 6.2 years of follow-up (15,385 person-years; interquartile range, 3.3-9.8 years). High ALI was observed to be consistently associated with lower risks of all-cause (hazard ratio [HR], 0.516; 95 % CI, 0.400-0.667) and non-cancer (HR, 0.414; 95 % CI, 0.291-0.588) mortality compared with low ALI in a series of adjusted models. Meanwhile, lower PHQ-9 score (0-4) was associated with lower risks of all-cause (HR, 0.686; 95 % CI, 0.521-0.903) and non-cancer (HR, 0.686; 95 % CI, 0.474-0.992) mortality compared with higher PHQ-9 score (≥10). Furthermore, joint analyses showed that high ALI was associated with a decreased risk of death among cancer survivors who were not depressive. Specifically, survivors with high ALI but not depressive symptoms had the lowest overall (HR, 0.404; 95 % CI, 0.228-0.715) risks. CONCLUSION: In this cohort study, we observed impact of nutritional and inflammatory status and depressive symptoms on mortality among cancer survivors, with the lowest risks of death from both all causes and non-cancer being noted among the combination of high level ALI with no depression.

Low-dose nalmefene pretreatment reduces etomidate-induced myoclonus: A randomized, double-blind controlled trial.

BACKGROUND: This study compared the effectiveness of nalmefene and fentanyl in reducing the incidence and severity of etomidate-induced myoclonus. METHODS: One hundred fifty patients were randomized to receive 0.25ug/kg of nalmefene, 1ug/kg of fentanyl, or the same volume of normal saline 3 minutes prior to etomidate-induced anesthesia. The primary observational indexes were the severity level and incidence of etomidate-induced myoclonus, and the secondary observational index included blood pressure, heart rate, and the incidence of adverse effects from anesthesia induction to resuscitation, such as cough, chest wall rigidity, dizziness, nausea, pain after awakening, and intraoperative awareness. RESULTS: The incidence of myoclonus was significantly lower in the nalmefene group (8.0%) than in the fentanyl group (32.0%) (P = .003) and in the normal saline group (72.0%) (P = .000). The severity level of myoclonus in the nalmefene group was significantly lower than the fentanyl group (P = .001) and normal saline group (P = .000). Meanwhile, the incidences of cough and chest wall rigidity during anesthesia induction were significantly lower in the nalmefene group compared with the fentanyl group (P = .003, P = .027). There were no statistically significant differences in heart rate and mean arterial pressure among the 3 gruops (P > .05). There was no difference in the incidence of adverse effects among the 3 groups during recovery from anesthesia (P > .05). CONCLUSION: Intravenous injection of 0.25ug/kg of nalmefene 3 minutes prior to etomidate is more effective in preventing etomidate-induced myoclonus during general anesthesia than 1ug/kg of fentanyl.

Application Value of Early Warning Nursing Model with "Evidence-based Concept" as the Core in Peri-anesthesia Period for Gastric Cancer.

Objective: To assess the effectiveness of an evidence-based early warning nursing model in reducing postoperative complications and enhancing care satisfaction for gastric cancer (GC) patients undergoing elective surgery. Methods: A retrospective analysis was performed on patients who received laparoscopic assisted radical gastrectomy in Tumor Hospital Affiliated To Nantong University from January 2020 to January 2022 as the research subjects. According to the anesthesia plan, the patients were divided into a comprehensive (intervention plans that received an early warning care model centered on evidence-based concepts) and a conventional group (routine evidence-based nursing plan). The postoperative anesthesia recovery, complications, pain level at 24 hours after surgery, anxiety at different times after surgery, and nursing satisfaction were compared between the two groups. Results: The postoperative spontaneous breathing time, consciousness recovery time, tracheal removal time, and defecation recovery time in the patients who received the early warning nursing based on the evidence-based concept were lower than those receiving only evidence-based care (P < .05). The total incidence of postoperative complications in the patients who received the early warning nursing based on the evidence-based concept were lower than those receiving only evidence-based care (P < .05). The postoperative pain levels of patients receiving the early warning nursing model were significantly lower than those receiving only evidence-based care (Z = -2.199, P = .028). After the intervention of different peri-anesthesia nursing modes, the anxiety scores of the two groups showed a downward trend with time (Ftime = 8.552, Ptime < .05), and the decrease in the comprehensive were greater than that in the routine group (F groups = 135.100, Ptime < .05), and there were no interaction (Finteraction = 2.424, Pinteraction < .05). Patients in the group that received the comprehensive early warning nursing model had significantly higher satisfaction with peri-anesthesia care compared to those receiving only evidence-based care (Z = -1.965, P < .05). Conclusion: Under the evidence-based early warning nursing model, nurses accurately assess patients' conditions during the peri-anesthesia period, leading to improved care plans that reduce complications and postoperative pain while enhancing patient satisfaction.

Analgesia quality index improves the quality of postoperative pain management: a retrospective observational study of 14,747 patients between 2014 and 2021.

BACKGROUND: The application of artificial intelligence patient-controlled analgesia (AI-PCA) facilitates the remote monitoring of analgesia management, the implementation of mobile ward rounds, and the automatic recording of all types of key data in the clinical setting. However, it cannot quantify the quality of postoperative analgesia management. This study aimed to establish an index (analgesia quality index (AQI)) to re-monitor and re-evaluate the system, equipment, medical staff and degree of patient matching to quantify the quality of postoperative pain management through machine learning. METHODS: Utilizing the wireless analgesic pump system database of the Cancer Hospital Affiliated with Nantong University, this retrospective observational study recruited consecutive patients who underwent postoperative analgesia using AI-PCA from June 1, 2014, to August 31, 2021. All patients were grouped according to whether or not the AQI was used to guide the management of postoperative analgesia: The control group did not receive the AQI guidance for postoperative analgesia and the experimental group received the AQI guidance for postoperative analgesia. The primary outcome was the incidence of moderate-to-severe pain (numeric rating scale (NRS) score ≥ 4) and the second outcome was the incidence of total adverse reactions. Furthermore, indicators of AQI were recorded. RESULTS: A total of 14,747 patients were included in this current study. The incidence of moderate-to-severe pain was 26.3% in the control group and 21.7% in the experimental group. The estimated ratio difference was 4.6% between the two groups (95% confidence interval [CI], 3.2% to 6.0%; P < 0.001). There were significant differences between groups. Otherwise, the differences in the incidence of total adverse reactions between the two groups were nonsignificant. CONCLUSIONS: Compared to the traditional management of postoperative analgesia, application of the AQI decreased the incidence of moderate-to-severe pain. Clinical application of the AQI contributes to improving the quality of postoperative analgesia management and may provide guidance for optimum pain management in the postoperative setting.

Structural Changes and Very-Low-Frequency Nonlinear Dielectric Response of XLPE Cable Insulation under Thermal Aging.

The structural changes and very-low-frequency (VLF) nonlinear dielectric responses are measured to evaluate the aging state of cross-linked polyethylene (XLPE) in power cables under various thermal aging conditions. For this purpose, the accelerated thermal aging experiments were performed on XLPE insulation materials at 90 °C, 120 °C and 150 °C with different durations of 240 h, 480 h and 720 h, respectively. The Fourier transform infrared spectrum (FTIR) characterization and differential scanning calorimeter (DSC) were tested to analyze the influence of different aging on physicochemical properties of XLPE insulation. Besides, the VLF dielectric spectra show that the permittivity and dielectric loss change significantly in the VLF range from 1 mHz to 0.2 Hz. A voltage-current (U-I) hysteresis curve referring to a standard sinusoidal voltage and the response current were introduced to characterize the nonlinear dielectric properties of XLPE insulation caused by thermal aging.

Postoperative Pain in Patients Undergoing Cancer Surgery and Intravenous Patient-Controlled Analgesia Use: The First and Second 24 h Experiences.

INTRODUCTION: Postoperative cancer pain imposes severe physical and psychological problems. We aimed to investigate the pain experiences of patients with cancer after surgery, analyze the impact of infusion volume by patient-controlled analgesia (PCA), and explore the variations between day 1 and day 2. METHODS: Data were retrospectively extracted from a large health data platform. Descriptive statistics were presented for the demographic and clinical profiles of patients. Multiple logistic regression analyses were performed to evaluate associations between intensity of pain and PCA use after adjustment for risk factors. RESULTS: Among 11,383 patients with cancer, the incidence of pain (moderate to severe pain) was 93.3% (18.3%) at the first 24 h after operation, while the respect values decreased to 91.1% and 9.5% at the second 24 h. Further, female patients consistently experienced higher risk of pain over the whole 48 h postoperatively. Surgical sites were related to pain risk, with the highest risk among the respiratory system (OR 2.077, 95% CI 1.392-3.100). High doses of continuous volume (OR 2.453, 95% CI 1.742-3.456) and total volume (OR 2.830, 95% CI 2.037-3.934) of infusions were related to 1-3-fold elevated pain risk. Additionally, the observed associations were mostly repeated and could be up to over 10 times when pain was evaluated with number of PCA pump compressions instead of Numerical Rating Scale (NRS). CONCLUSIONS: High risk of postoperative cancer pain, particularly among the high PCA dose group, could possibly indicate inadequate pain control, and presence of modifiable risk factors warrants more aggressive pain management strategies perioperatively.

The effect of bupivacaine on analgesia and safety in patients undergoing hemorrhoidectomy: a meta-analysis.

Aim: There is no meta-analysis reporting the analgesic effect and safety of bupivacaine in patients undergoing hemorrhoidectomy. This meta-analysis provides quantitative evidence of the effect of bupivacaine in hemorrhoidectomy. Methods: Studies were searched from PubMed, Embase, the Cochrane Library, and the Web of Science. Standardized mean difference (SMD), weighted mean difference (WMD), and odds ratios (ORs) with 95% confidence interval (CI) were used as effect indicators. Heterogeneity was assessed using the I 2 index, and sensitivity analysis was conducted to determine the effect of the single study on the pooled results. Results: A total of 18 studies were included in this meta-analysis. The pain level at 48 h was lower in the bupivacaine-combined other drug group than in the other drug group (WMD = -0.65, 95% CI: 1.18 to -0.11, and I2 = 37.50%). Compared to the bupivacaine group, the odds of pruritus (OR = 12.11, 95% CI: 1.49-98.59, and I2 = 0%) and urinary retention (OR = 4.45, 95% CI: 1.12-17.70, and I2 = 0%) were higher, and the pain level at 6 h (WMD = -2.13, 95% CI: 3.22 to -1.04, and I2 = 64.30%), at 12 h (WMD = -1.55, 95% CI: 2.19 to -0.90, and I2 = 56.10%), and at 24 h (SMD = -1.15, 95% CI: 1.89 to -0.42, and I2 = 82.5%) were lower in the bupivacaine-combined other drug group. Conclusion: Bupivacaine-combined other drugs had a good analgesic effect after hemorrhoidectomy, but the adverse reactions should be considered.

Ultrasound-Triggered on Demand Lidocaine Release Relieves Postoperative Pain.

Safe and non-invasive on-demand relief is a crucial and effective treatment for postoperative pain because it considers variable timing and intensity of anesthetics. Ultrasound modulation is a promising technique for this treatment because it allows convenient timed and non-invasive controlled drug release. Here, we created an ultrasound-triggered lidocaine (Lido) release platform using an amino acid hydrogel functioning as three-dimensional (3D) scaffold material (Lido-PPIX@ER hydrogel). It allows control of the timing, intensity and duration of lidocaine (Lido) to relieve postoperative pain. The hydrogel releases Lido due to the elevated reactive oxygen species (ROS) levels generated by PPIX under ultrasound triggering. The Lido-PPIX@ER hydrogel under individualized ultrasound triggering released lidocaine and provided effective analgesia for more than 72 h. The withdrawal threshold was higher than that in the control group at all time points measured. The hydrogel showed repeatable and adjustable ultrasound-triggered nerve blocks in vivo, the duration of which depended on the extent and intensity of insonation. On histopathology, no systemic effect or tissue reaction was observed in the ultrasound-triggered Lido-PPIX@ER hydrogel-treated group. The Lido-PPIX@ER hydrogel with individualized (highly variable) ultrasound triggering is a convenient and effective method that offers timed and spatiotemporally controlled Lido release to manage postoperative pain. This article presents the delivery system for a new effective strategy to reduce pain, remotely control pain, and offer timed and spatiotemporally controlled release of Lido to manage postoperative pain.

Review: The Emerging Role of Neutrophil Extracellular Traps in Sepsis and Sepsis-Associated Thrombosis.

Patients with sepsis commonly suffer from coagulation dysfunction and lead to the formation of thrombus. During the development of sepsis, neutrophils migrate from the circulating blood to infected tissues and mediate the formation of neutrophil extracellular traps (NETs) that kill pathogens. However, the overactivation of neutrophils can promote the formation of immunothrombosis and even cause disseminated intravascular coagulation (DIC), which damages microcirculation. The outcome of sepsis depends on early recognition and intervention, so clinical evaluation of NETs function may be a valuable biomarker for early diagnosis of sepsis. The interaction of NETs with platelets, complement, and endothelium mediates the formation of immunothrombosis in sepsis. Inhibiting the formation of NETs is also considered to be one of the potential treatments for sepsis. In this review, we will discuss the key role of neutrophils and NETs in sepsis and septic thrombosis, in order to reveal new mechanisms for thrombosis treatment of sepsis.

G protein-coupled receptor GPR151 is involved in trigeminal neuropathic pain through the induction of Gßγ/extracellular signal-regulated kinase-mediated neuroinflammation in the trigeminal ganglion.

ABSTRACT: Trigeminal nerve injury-induced neuropathic pain is a debilitating chronic orofacial pain syndrome but lacks effective treatment. G protein-coupled receptors (GPCRs), especially orphan GPCRs (oGPCRs) are important therapeutic targets in pain medicine. Here, we screened upregulated oGPCRs in the trigeminal ganglion (TG) after partial infraorbital nerve transection (pIONT) and found that Gpr151 was the most significantly upregulated oGPCRs. Gpr151 mRNA was increased from pIONT day 3 and maintained for more than 21 days. Furthermore, GPR151 was expressed in the neurons of the TG after pIONT. Global mutation or knockdown of Gpr151 in the TG attenuated pIONT-induced mechanical allodynia. In addition, the excitability of TG neurons was increased after pIONT in wild-type (WT) mice, but not in Gpr151-/- mice. Notably, GPR151 bound to Gαi protein, but not Gαq, Gα12, or Gα13, and activated the extracellular signal-regulated kinase (ERK) through Gßγ. Extracellular signal-regulated kinase was also activated by pIONT in the TG of WT mice, but not in Gpr151-/- mice. Gene microarray showed that Gpr151 mutation reduced the expression of a large number of neuroinflammation-related genes that were upregulated in WT mice after pIONT, including chemokines CCL5, CCL7, CXCL9, and CXCL10. The mitogen-activated protein kinase inhibitor (PD98059) attenuated mechanical allodynia and reduced the upregulation of these chemokines after pIONT. Collectively, this study not only revealed the involvement of GPR151 in the maintenance of trigeminal neuropathic pain but also identified GPR151 as a Gαi-coupled receptor to induce ERK-dependent neuroinflammation. Thus, GPR151 may be a potential drug target for the treatment of trigeminal neuropathic pain.