Antimicrobial resistance patterns, virulence genes, and biofilm formation in enterococci strains collected from different sources.

BACKGROUND: Currently, antibiotic-resistant strains of Enterococcus are considered to be one of the critical health challenges globally. This study aimed to investigate the antibiotic susceptibility pattern, biofilm formation capacity, and virulence genes of enterococci isolated from different sources. METHODS: In this cross-sectional study, environmental and fecal samples were collected from the hospital environment, volunteers, and hospital staff from October 2018 to August 2019. The isolates were identified by morphological and biochemical tests (gram staining, catalase, bile resistance, esculin hydrolysis, carbohydrate fermentation, growth in 6.5% NaCl, Pyrrolidonyl arylamidase, arginine dehydrolase), and PCR for ddl gene. An antimicrobial susceptibility test was performed by the standard disk agar diffusion method according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. Quantitative microplate assays were used to assess biofilm production. The bacterial DNAs were extracted by alkaline lysis method and polymerase chain reaction technique was used detect the esp, ace, and efaA virulence genes. RESULTS: Out of 145 isolates, 84 (57.9%) were identified as E. faecalis and 61 (42.1%) as E. faecium. Resistance to kanamycin and quinupristin-dalfopristin was 82.1% (69/84) and 85.7% (72/84), respectively, in E. faecalis isolates. Out of 61 E. faecalis isolates, 38 (62.4%) were resistant to kanamycin. Among the E. faecalis isolates, esp was the most dominant virulence gene (73.80%), followed by efaA, and ace, which were detected in 60.71%, and 30.95% isolates, respectively. In total, 68.27% of the strains were biofilm producers. Further, esp and efaA genes were more frequently found among E. faecalis strains with moderate and strong biofilm biomass. CONCLUSIONS: According to the findings of our study, enterococci strains isolated from different samples possess distinctive patterns of virulence genes. The esp, ace, and efaA genes were more prevalent among E. faecalis than E. faecium. Besides, the high level antibiotic resistance of normal flora and environmental enterococci strains is alarming the researchers.

Design a New D-π-A Formation Dyes as Dye-sensitized Solar Cells Applications/ a DFT and TD-DFT Study.

Dye-sensitized solar cells (DSSCs) have garnered significant interest among researchers in the field of photovoltaics due to their promising performance, low cost and easy process of fabrication. In this study, we have designed new D-π-A systems as derivatives of the reference (Ref. A) D-A-D scaffold, incorporating different π-bridges to enhance and optimize their efficiency as sensitizing dyes for DSSCs applications. Density functional theory (DFT) and time-dependent DFT (TD-DFT) methods were employed to investigate the geometrical and electronic structures, chemical reactivity indices, optical properties, exciton binding energy, and electrochemical properties of these dyes. We also examined the preferred adsorption process of the two selected dyes on a (TiO2)15 cluster model. The results demonstrate that all the dyes exhibit improved open-circuit photovoltage, enhanced light-harvesting efficiencies, higher electron injection efficiency, and excellent photovoltaic efficiency. Moreover, there is evidence of electron injection occurring from each studied dye to the conduction band of TiO2, followed by efficient regeneration. The introduced bridges in the molecular systems play a crucial role in facilitating electron transfer from the donor to the acceptor region. Comparatively, the D-π-D systems exhibit superior performance in DSSCs compared to Ref. A, which can be attributed to their higher energy levels of the lowest unoccupied molecular orbital and larger oscillator strengths for the most excited states involving intramolecular electron transfer and the electron injection process occurring from each examined molecule to the conduction band of TiO2, followed by subsequent regeneration. Overall, the results of our study highlight the potential of all the D-π-A systems as promising sensitizers for DSSCs applications, owing to their favorable optical and electronic properties and impressive photovoltaic parameters.

An insulin-like signalling pathway model for Fasciola gigantica.

BACKGROUND: The insulin/insulin-like signalling (IIS) pathway is common in mammals and invertebrates, and the IIS pathway is unknown in Fasciola gigantica. In the present study, the IIS pathway was reconstructed in F. gigantica. We defined the components involved in the IIS pathway and investigated the transcription profiles of these genes for all developmental stages of F. gigantica. In addition, the presence of these components in excretory and secretory products (ESPs) was predicted via signal peptide annotation. RESULTS: The core components of the IIS pathway were detected in F. gigantica. Among these proteins, one ligand (FgILP) and one insulin-like molecule binding protein (FgIGFBP) were analysed. Interestingly, three receptors (FgIR-1/FgIR-2/FgIR-3) were detected, and a novel receptor, FgIR-3, was screened, suggesting novel functions. Fg14-3-3ζ, Fgirs, and Fgpp2a exhibited increased transcription in 42-day-old juveniles and 70-day-old juveniles, while Fgilp, Fgigfb, Fgsgk-1, Fgakt-1, Fgir-3, Fgpten, and Fgaap-1 exhibited increased transcription in metacercariae. FgILP, FgIGFBP, FgIR-2, FgIR-3, and two transcription factors (FgHSF-1 and FgSKN-1) were predicted to be present in FgESPs, indicating their exogenous roles. CONCLUSIONS: This study helps to elucidate the signal transduction pathway of IIS in F. gigantica, which will aid in understanding the interaction between flukes and hosts, as well as in understanding fluke developmental regulation, and will also lay a foundation for further characterisation of the IIS pathways of trematodes.

A comparison of the effects of thoracolumbar interfascial plane (TLIP) block and erector spinae plane (ESP) block in postoperative acute pain in spinal surgery.

PURPOSE: Spinal surgeries are a very painful procedure. New regional techniques for postoperative pain management are being considered. The present study aimed to evaluate the hypothesis that the ultrasound-guided erector spinae plane (ESP) block would lead to lower opioid consumption compared to the thoracolumbar interfascial plane (TLIP) block after lumbar disk surgery. The study's primary objective was to compare postoperative total opioid consumption, and the secondary objective was to assess postoperative pain scores. METHODS: Sixty-eight patients who underwent elective lumbar disk surgery were randomly assigned to either the ESP block group or the TLIP block group. The current pain status of the patients in both the ESP and TLIP block groups was assessed using the Numerical Rating Scale (NRS) at specific time intervals (30 min, 1, 6, 12 and 24 h) during the postoperative period. The number of times patients administered a bolus dose of patient-controlled analgesia, (PCA) within the first 24 h was recorded. RESULTS: In the ESP group, the total opioid consumption in terms of morphine equivalents was found to be significantly lower (ESP group: 7.7 ± 7.0; TLIP group: 13.0 ± 10.1; p < 0.05). The NRS scores were similar between the groups at 30 min, 1, 6, and 12 h, but at 24 h, they were significantly lower in the ESP group. Moreover, the groups had no significant difference regarding observed side effects. CONCLUSION: This study demonstrated the analgesic efficacy of both techniques, revealing that the ESP block provides more effective analgesia in patients undergoing lumbar disk surgery.

A Critical Review of the Propagation Models Employed in LoRa Systems.

LoRa systems are emerging as a promising technology for wireless sensor networks due to their exceptional range and low power consumption. The successful deployment of LoRa networks relies on accurate propagation models to facilitate effective network planning. Therefore, this review explores the landscape of propagation models supporting LoRa networks. Specifically, we examine empirical propagation models commonly employed in communication systems, assessing their applicability across various environments such as outdoor, indoor, and within vegetation. Our investigation underscores the prevalence of logarithmic decay in most empirical models. In addition, we survey the relationship between model parameters and environmental factors, clearing their nuanced interplay. Analyzing published measurement results, we extract the log-distance model parameters to decipher environmental influences comprehensively. Drawing insights from published measurement results for LoRa, we compare them with the model's outcomes, highlighting successes and limitations. We additionally explore the application of multi-slope models to LoRa measurements to evaluate its effectiveness in enhancing the accuracy of path loss prediction. Finally, we propose new lines for future research in propagation modelling to improve empirical models.

Eco-friendly and sustainable process for recovery of sulfate from paper mill mixed salt: Recycling of sulfate for dye fixation process.

Paper mill Electrostatic Precipitator (ESP) ash contains a mixture of alkali metal chloride (34.2 %) and sulfate (84.2 %) which has serious negative effects on the environment and makes it more expensive and constrained to dispose ESP ash. Therefore, handling and recycling ESP ash demands extra thought when disposing of it. Present study, aimed to separate chloride and sulfate from ESP ash using electrochemical membrane technology. Three different concentrations of ESP ash solution such as 200 g L-1, 320 g L-1 and 450 g L-1 were used as the electrolyte. Ti/TiO2-IrO2-RuO2 and titanium (Ti) are used as anode and cathode respectively. Caustic and sulfate solutions were recovered at the respective compartments. The collected sulfate solution was dried by solar light to convert 99 % sulfate salts as confirmed by Energy-dispersive X-ray analysis (EDAX) analysis. Recovered sulfate salt was used for the dye fixing process, in which the colour fixing difference of ΔE value was about 2.10 and the strength of the dye was about 86.72 %. Therefore, the textile industry can repurpose the recovered sulfate salt for the dye fixing process.

Comparison of analgesic efficacy of ultrasound-guided quadratus lumborum block versus erector spinae plane block in children undergoing elective open pyeloplasty - A randomized, double-blinded, controlled study.

Background and Aims: Comparison of analgesic efficacy of ultrasound-guided transmuscular quadratus lumborum block (QL-3) and erector spinae block (ESP) in children undergoing open pyeloplasty was done in this study. Material and Methods: This was a randomized, double-blinded, controlled study conducted in a tertiary care center, operating rooms, post-anesthesia care unit (PACU), and paediatric surgical ward. Sixty children of age 1-6 years, with American Society of Anesthesiologists (ASA) status I or II, undergoing elective open pyeloplasty were included in the study. Patients were randomized into two groups: group I (QL block-3) and group II (ESP). Both blocks were performed under USG guidance using 0.5 ml/kg of 0.25% ropivacaine after induction of general anesthesia. Postoperative Modified Objective Pain Score (MOPS), perioperative hemodynamic parameters, perioperative time for first rescue analgesia, total rescue analgesia, and incidence of complications were recorded. Statistical tests were applied as follows: (i) quantitative variables were compared using independent t-test/Mann-Whitney test (when the data sets were not normally distributed) between the two groups, and repeated measure analysis of variance (ANOVA)/Friedman test was used for comparison between different time intervals within the same group and (ii) qualitative variables were correlated using the Chi-square test/Fisher's exact test. A P value of <0.05 was considered statistically significant. Results: Pain was assessed using MOPS in the postoperative period at 0, 30 min, 1, 2, 4, 6, 12, and 24 h. Overall, the pain scores were low and showed a decreasing trend toward baseline as time progressed. Group I showed lower score, but was statistically significant only at the sixth hour. Highest mean score was 2.4 ± 2.01 in group I and 2.67 ± 2.32 in group II. Perioperative hemodynamic parameters were comparable. Total rescue analgesia during the perioperative period was not statistically significant (intraoperative P = 0.075 and postoperative P = 0.928). Also, 63.33% patients in group I and 63% patients in group II required rescue analgesia in the postoperative period and were comparable. Mean ± standard deviation (SD) for first rescue analgesia time was 6.32 ± 12.57 in group I and 16.67 ± 31.25 in group II, but not significant. The distribution in group II was skewed, hence the larger value for group II, but when compared to group I, this was statistically not significant. Conclusion: Both ultrasound-guided ESP block and QL block using 0.25% ropivacaine 0.5 ml/kg provided adequate analgesia during the first 24 h post-surgery in children undergoing open pyeloplasty. The fentanyl requirement during the first 24-h postoperative period was also decreased.

Prognostic significance of positive peritoneal cytology in endometrial carcinoma based on ESGO/ESTRO/ESP risk classification: A multicenter retrospective study.

OBJECTIVE: This study aimed to determine the prognostic significance of positive peritoneal cytology (PC) on endometrial carcinoma (EC) patients under the ESGO/ESTRO/ESP risk classification. METHODS: This study retrospectively analyzed EC patients from 27 medical centers in China from 2000 to 2019. Patients were divided into three ESGO risk groups: low-risk, intermediate-risk and high-intermediate risk, and high-risk groups. The covariates were balanced by using the propensity score-based inverse probability of treatment weighting (PS-IPTW). The prognostic significance of PC was assessed by Kaplan-Meier curves and multivariate Cox regression analysis. RESULTS: A total of 6313 EC patients with PC results were included and positive PC was reported in 384 women (6.1%). The multivariate Cox analysis in all patients showed the positive PC was significantly associated with decreased PFS (hazard ratio [HR] 2.20, 95% confidence interval [CI] 1.55-3.13, P < 0.001) and OS (HR 2.25, 95% CI 1.49-3.40, P < 0.001),and the Kaplan-Meier curves also showed a poor survival in the intermediate and high-intermediate risk group (5-year PFS: 75.5% vs. 93.0%, P < 0.001; 5-year OS: 78.3% vs. 96.4%, P < 0.001); While in the low-risk group, there were no significant differences in PFS and OS between different PC status (5-year PFS: 93.1% vs. 97.3%, P = 0.124; 5-year OS: 98.6% vs. 98.2%, P = 0.823); in the high-risk group, significant difference was only found in PFS (5-year PFS: 62.5% vs. 77.9%, P = 0.033). CONCLUSION: Positive PC was an adverse prognostic factor for EC, especially in the intermediate and high-intermediate risk patients. Gynecologic oncologists should reconsider the effect of positive PC on different ESGO risk groups.

Outcomes in pediatric liver transplant recipients receiving bilateral continuous erector spinae plane blocks.

BACKGROUND: Regional anesthesia allows for opioid-sparing and enhanced recovery after many major surgeries. Erector spinae blockade, with reduced bleeding risk and the option for continuous infusion, offers an opportunity to promote this principle in pediatric liver transplant patients. Our goal was to evaluate pain scores, opioid use, and return of bowel function following continuous ESP blockade in pediatric liver transplant recipients. METHODS: This retrospective cohort study included extubated patients who received a liver transplant at St. Louis Children's Hospital from July 2016 to July 2021. The control group, which did not meet the criteria for ESP blockade and received standard analgesia regimens, was compared to the group receiving continuous ESP blockade. Measured outcomes included pain scores, opioid consumption through postoperative day two, date of first bowel movement, and length of stay in the ICU and the hospital. RESULTS: Patient demographics between control and ESP groups showed no significant differences. Pain scores between control and ESP groups also showed no significant differences. Intraoperative and postoperative opioid requirements, studied in oral morphine equivalents per kilogram (OME/kg), were significantly lower for patients with ESP blockade. Time to first bowel movement was also significantly earlier for the ESP group. No significant differences were found in length of ICU or hospital stay. There were no safety concerns or complications related to ESP blockade. CONCLUSIONS: Use of continuous ESP blockade resulted in reduced opioid consumption through postoperative day two and earlier return of bowel function.

In silico drug repurposing for coronavirus (COVID-19): screening known HCV drugs against the SARS-CoV-2 spike protein bound to angiotensin-converting enzyme 2 (ACE2) (6M0J).

In this study, FDA-approved HCV antiviral drugs and their structural analogues-several of them in clinical trials-were tested for their inhibitory properties toward the SARS-CoV-2 spike protein bound to angiotensin-converting enzyme 2 (6M0J) using a virtual screening approach and computational chemistry methods. The most stable structures and the corresponding binding affinities of thirteen such antiviral compounds were obtained. Frontier molecular orbital theory, global reactivity descriptors, molecular docking calculations and electrostatic potential analysis were used to hypothesize the bioactivity of these drugs against 6M0J. It is found that an increased affinity for the protein is shown by inhibitors with large compound volume, relatively higher electrophilicity index, aromatic rings and heteroatoms that participate in hydrogen bonding. Among the tested drugs, four compounds 10-13 showed excellent results-binding affinities - 11.2 to - 11.5 kcal mol-1. These four top scoring compounds may act as lead compounds for further experimental validation, clinical trials and even for the development of more potent antiviral agents against the SARS-CoV-2. Approved HCV drugs and analogues were tested for their bioactivity towards the SARS-CoV-2 (6M0J) using virtual screening, ESP and MD analysis.

Utilization of Truncal Fascial Plane Nerve Blocks for Chronic Pain Management: A Narrative Review.

PURPOSE OF REVIEW: Nerve blocks constitute an integral portion in the management of chronic pain. The widespread use of ultrasound imaging opened the door to a flood of newer blocks especially truncal plane nerve blocks. We reviewed the current medical literature for studies and case reports utilizing the two most common truncal plane nerve blocks, transversus abdominis plane and erector spinae plane blocks, to manage chronic pain. RECENT FINDINGS: We found some evidence, mostly in case reports and retrospective observational studies, that supports the use of transversus abdominis plane and erector spinae plane nerve blocks, usually with steroids, as a safe and valuable part of interdisciplinary management of chronic abdominal and chest walls pain. Ultrasound-guided truncal fascial plane nerve blocks are safe, easy to learn, and proven to help with post-operative acute pain management. Although limited, our current review provides evidence from the current medical literature regarding the utility of these blocks to manage some of the challenging chronic and cancer-related pain conditions of the trunk region.

Pharmacophore Oriented MP2 Characterization of Charge Distribution for Anti-SARS-CoV-2 Inhibitor Nirmatrelvir.

Quantum mechanical second order Møller-Plesset (MP2) perturbation theory and density functional theory (DFT) Becke, 3-parameter, Lee-Yang-Parr (B3LYP) and Minnesota 2006 local functional (M06L) calculations were performed to optimize structure of nirmatrelvir and compute the Merz-Kollman electrostatic potential (MK ESP), natural population analysis (NPA), Hirshfeld, charge model 5 (CM5), and mulliken partial charges. The mulliken partial charge distribution of nirmatrelvir exhibits a poor correlation with the MK ESP charges in MP2, B3LYP, and M06L calculations respectively. The NPA, Hirshfeld, and CM5 partial charge scheme of nirmatrelvir indicate a reasonable correlation with MK ESP charge assignments in B3LYP and M06L calculations. The above correlations were not improved by the inclusion of implicit solvation model. The MK ESP and CM5 partial charges show a strong correlation between the results of MP2 and two DFT methods. The three optimized structures present a certain degree of differences from the crystal bioactive conformation of nirmatrelvir, suggesting the nirmatrelvir-enzyme complex is formed in the induced-fit model. The Reactivity of warhead electrophilic nitrile is justified by the relatively weaker strength of π bonds in the MP2 calculations. The nirmatrelvir hydrogen bond acceptors consistently show strong delocalization of lone pair electrons in three calculations, whereas hydrogen bond donors are found to have high polarization on the heavy nitrogen atoms in MP2 computations. This work helps to parametrize the force field of nirmatrelvir and improve accuracy of molecular docking and rational inhibitor design.

Design and Implementation of ESP32-Based IoT Devices.

The Internet of Things (IoT) has become a transformative technology with great potential in various sectors, including home automation, industrial control, environmental monitoring, agriculture, wearables, health monitoring, and others. The growing presence of IoT devices stimulates schools and academic institutions to integrate IoT into the educational process, since IoT skills are in demand in the labor market. This paper presents educational IoT tools and technologies that simplify the design, implementation, and testing of IoT applications. The article presents the introductory IoT course that students perform initially and then presents some of the projects that they develop and implement on their own later in the project.

TLS Protocol Analysis Using IoTST-An IoT Benchmark Based on Scheduler Traces.

The Internet of Things (IoT) envisions billions of everyday objects sharing information. As new devices, applications and communication protocols are proposed for the IoT context, their evaluation, comparison, tuning and optimization become crucial and raise the need for a proper benchmark. While edge computing aims to provide network efficiency by distributed computing, this article moves towards sensor nodes in order to explore efficiency in the local processing performed by IoT devices. We present IoTST, a benchmark based on per-processor synchronized stack traces with the isolation and precise determination of the introduced overhead. It produces comparable detailed results and assists in determining the configuration that has the best processing operating point so that energy efficiency can also be considered. On benchmarking applications which involve network communication, the results can be influenced by the constant changes that occur in the state of the network. In order to circumvent such problems, different considerations or assumptions were used in the generalization experiments and the comparison to similar studies. To present IoTST usage on a real problem, we implemented it on a commercial off the-shelf (COTS) device and benchmarked a communication protocol, producing comparable results that are unaffected by the current network state. We evaluated different Transport-Layer Security (TLS) 1.3 handshake cipher suites at different frequencies and with various numbers of cores. Among other results, we could determine that the selection of a specific suite (Curve25519 and RSA) can improve the computation latency by up to four times over the worst suite candidate (P-256 and ECDSA), while both providing the same security level (128 bits).

Rapid IoT Prototyping: A Visual Programming Tool and Hardware Solutions for LoRa-Based Devices.

LoRa technology has gained popularity as one of the most widely used standards for device interconnection due to its ability to cover long distances and energy efficiency, making it a suitable choice for various Internet of Things (IoT) monitoring and control applications. In this sense, this work presents the development of a visual support tool for creating IoT devices with LoRa and LoRaWAN connectivity. This work significantly advances the state of the art in LoRa technology by introducing a novel visual support tool tailored for creating IoT devices with LoRa and LoRaWAN connectivity. By simplifying the development process and offering compatibility with multiple hardware solutions, this research not only facilitates the integration of LoRaWAN technology within educational settings but also paves the way for rapid prototyping of IoT nodes. The incorporation of block programming for LoRa and LoRaWAN using the Arduinoblocks framework as a graphical environment enhances the capabilities of the tool, positioning it as a comprehensive solution for efficient firmware generation. In addition to the visual tool for firmware generation, multiple compatible hardware solutions enable easy, economical, and stable development, offering a comprehensive hardware and software solution. The hardware proposal is based on an ESP32 microcontroller, known for its power and low cost, in conjunction with an RFM9x module that is based on SX127x LoRa transceivers. Finally, three successfully tested use cases and a discussion are presented.

Development a Low-Cost Wireless Smart Meter with Power Quality Measurement for Smart Grid Applications.

Developing a low-cost wireless energy meter with power quality measurements for smart grid applications represents a significant advance in efficient and accurate electric energy monitoring. In increasingly complex and interconnected electric systems, this device will be essential for a wide range of applications, such as smart grids, by introducing a real-time energy monitoring system. In light of this, smart meters can offer greater opportunities for sustainable and efficient energy use and improve the utilization of energy sources, especially those that are nonrenewable. According to the 2020 International Energy Agency (IEA) report, nonrenewable energy sources represent 65% of the global supply chain. The smart meter developed in this work is based on the ESP32 microcontroller and easily accessible components since it includes a user-friendly development platform that offers a cost-effective solution while ensuring reliable performance. The main objective of developing the smart meters was to enhance the software and simplify the hardware. Unlike traditional meters that calculate electrical parameters by means of complex circuits in hardware, this project performed the calculations directly on the microcontroller. This procedure reduced the complexity of the hardware by simplifying the meter design. Owing to the high-performance processing capability of the microcontroller, efficient and accurate calculations of electrical parameters could be achieved without the need for additional circuits. This software-driven approach with simplified hardware led to benefits, such as reduced production costs, lower energy consumption, and a meter with improved accuracy, as well as updates on flexibility. Furthermore, the integrated wireless connectivity in the microcontroller enables the collected data to be transmitted to remote monitoring systems for later analysis. The innovative feature of this smart meter lies in the fact that it has readily available components, along with the ESP32 chip, which results in a low-cost smart meter with performance that is comparable to other meters available on the market. Moreover, it is has the capacity to incorporate IoT and artificial intelligence applications. The developed smart meter is cost effective and energy efficient, and offers benefits with regard to flexibility, and thus represents an innovative, efficient, and versatile solution for smart grid applications.

Low-Power Long-Term Ambulatory Electrocardiography Monitor of Three Leads with Beat-to-Beat Heart Rate Measurement in Real Time.

A low-power long-term ambulatory ECG monitor was developed for the acquisition, storage and processing of three simultaneous leads DI, aVF and V2 with a beat-to-beat heart rate measurement in real time. It provides long-term continuous ECG recordings until 84 h. The monitor uses a QRS complex detection algorithm based on the continuous wavelet transform with splines, which automatically selects the scale for the analysis of ECG records with different sampling frequencies. It includes a lead-off detection to continuously monitor the electrode connections and a real-time system of visual and acoustic alarms to alert users of abnormal conditions in its operation. The monitor presented is based in an ADS1294 analogue front end with four channels, 24-bit analog-to-digital converters and programmable gain amplifiers, a low-power dual-core ESP32 microcontroller, a microSD memory for data storage in a range of 4 GB to 32 GB and a 1.4 in thin-film transistor liquid crystal display (LCD) variant with a resolution of 128 × 128 pixels. It has programmable sampling rates of 250, 500 and 1000 Hz; a bandwidth of 0 Hz to 50% of the selected sampling rate; a CMRR of -105 dB; an input margin of ±2.4 V; a resolution of 286 nV; and a current consumption of 50 mA for an average battery life of 84 h. The ambulatory ECG monitor was evaluated with the commercial data-acquisition system BIOPAC MP36 and its module for ECG LABEL SS2LB, simultaneously comparing the morphologies of two ECG records and obtaining a correlation of 91.78%. For the QRS detection in real time, the implemented algorithm had an error less than 5%. The developed ambulatory ECG monitor can be used for the analysis of the dynamics of the heart rate variability in long-term ECG records and for the development of one's own databases of ECG recordings of normal subjects and patients with cardiovascular and noncardiovascular diseases.

A Novel Experience Of Ultrasound-Guided Erector Spinae Plane Block With Sedation In Breast Cancer Surgery: A Case Report.

We report the anaesthetic management of a breast cancer patient, at a high risk for undergoing general anaesthesia, using a single-shot ultrasound-guided Erector Spinae Plane Block (ESPB) with monitored sedation. Targetted at T4, 20 mL of 0.375% bupivacaine provided complete surgical anaesthesia in 15 minutes. Concurrent sedation was administered with target controlled infusion of propofol with entropy monitoring throughout the procedure. The surgery lasted 90 minutes and the patient remained pain free and haemodynamically stable throughout. At the end of the surgery, the patient received 1 g of paracetamol intravenously, and did not require any further analgesics other than routinely administered paracetamol until her discharge from the hospital. On top of the successful execution of our plan, this case was especially interesting as her postoperative analgesia remained completely opioid-free.

[Retrospective on ESP Courses in the Global English Era].

With the rise of the medical tourism industry in Taiwan and changes in the country's population structure, nurses are facing greater challenges than ever before. Both professional knowledge and English proficiency are indispensable. Various types of English for Specific Purposes (ESP) courses have emerged to assist healthcare professionals to build their English abilities and cope with the changing demands of their profession. However, related research indicates that the deficient state of English communication skills among nurses in Taiwan may hinder the country's ability to effectively promote medical internationalization and handle ongoing changes in its population structure. To effectively face this predicament, educators must re-examine the current design of ESP courses. Therefore, this article was developed to explore ESP courses from the three perspectives of language descriptions, needs analysis, and learning theories. Furthermore, the concepts and research related to these three perspectives, including the nurse-patient relationship, community of practice, situated learning, and English as a medium of instruction, were reviewed. Some insights into how these concepts may be applied to ESP courses are also proposed with the goals of better incorporating the needs of learners into course designs and placing learners at the center of language learning.

PP2ACdc55 dephosphorylates Pds1 and inhibits spindle elongation in S. cerevisiae.

PP2ACdc55 (the form of protein phosphatase 2A containing Cdc55) regulates cell cycle progression by reversing cyclin-dependent kinase (CDK)- and polo-like kinase (Cdc5)-dependent phosphorylation events. In S. cerevisiae, Cdk1 phosphorylates securin (Pds1), which facilitates Pds1 binding and inhibits separase (Esp1). During anaphase, Esp1 cleaves the cohesin subunit Scc1 and promotes spindle elongation. Here, we show that PP2ACdc55 directly dephosphorylates Pds1 both in vivo and in vitro Pds1 hyperphosphorylation in a cdc55 deletion mutant enhanced the Pds1-Esp1 interaction, which played a positive role in Pds1 nuclear accumulation and in spindle elongation. We also show that nuclear PP2ACdc55 plays a role during replication stress to inhibit spindle elongation. This pathway acted independently of the known Mec1, Swe1 or spindle assembly checkpoint (SAC) checkpoint pathways. We propose a model where Pds1 dephosphorylation by PP2ACdc55 disrupts the Pds1-Esp1 protein interaction and inhibits Pds1 nuclear accumulation, which prevents spindle elongation, a process that is elevated during replication stress.