Halloysite nanotubes-based hybrid silica monolithic spin tip for hydrophilic solid-phase extraction of sulbactam, cefoperazone, and cefuroxime in whole blood.

In this study, we proposed a novel method utilizing polyethyleneimine (PEI)-modified halloysite nanotubes (HNTs)-based hybrid silica monolithic spin tip to analyze hydrophilic ß-lactam antibiotics and ß-lactamases inhibitors in whole blood samples for the first time. HNTs were incorporated directly into the hybrid silica monolith via a sol-gel method, which improved the hydrophilicity of the matrix. The as-prepared monolith was further modified with PEI by glutaraldehyde coupling reaction. It was found that the PEI-modified HNTs-based hybrid silica monolith enabled a large adsorption capacity of cefoperazone at 35.7 mg g-1. The monolithic spin tip-based purification method greatly reduced the matrix effect of whole blood samples and had a detection limit as low as 0.1 - 0.2 ng mL-1. In addition, the spiked recoveries of sulbactam, cefuroxime, and cefoperazone in blank whole blood were in the range of 89.3-105.4 % for intra-day and 90.6-103.5 % for inter-day, with low relative standard deviations of 1.3-7.2 % and 4.9-10.5 %, respectively. This study introduces a new strategy for preparing nanoparticles incorporated in a hybrid silica monolith with a high adsorption capacity. Moreover, it offers a valuable tool to monitor sulbactam, cefoperazone, and cefuroxime in whole blood from pregnant women with the final aim of guiding their administration.

Guaranteed minimum withdrawal benefits with high-water mark fee structure.

The Guaranteed Minimum Withdrawal Benefit (GMWB), an adjunct incorporated within variable annuities, commits to reimbursing the entire initial investment regardless of the performance of the underlying funds. While extensive research exists in financial and actuarial literature regarding the modeling and valuation techniques of GMWBs, much of it is founded on a static fee structure. Our study introduces an innovative fee structure based on the high-water mark (HWM) principle and a regime-switch jump-diffusion model for the pricing of GMWBs, employing numerical solutions through the Monte Carlo method for solving the stochastic differential equation (SDE). Furthermore, a companion piece of research addresses the risk management of GMWBs within the same analytical framework as the pricing component, an aspect that has received limited attention in the existing literature. In assessing the necessary capital reserves for unforeseen losses, our methodology involves the computation of two risk metrics associated with the tail distribution of net liability from the insurer's perspective, Value-at-Risk (VaR) and Conditional-Tail-Expectation (CTE). Comprehensive numerical results and sensitivity analyses are also provided.

What is hindering Chinese women from participating in combat sports?

With the awakening of female consciousness, women's participation in sports has gradually gained autonomy and agency. However, Chinese women still face numerous restrictions in combat sports, hindering the development of this industry. Based on years of practice and research experience in the field, we summarize some general and specific issues, such as stigmatization and the constraints of traditional Chinese thinking. These issues need attention and consideration in the pursuit of gender equality in sports in the future.

Biogenesis of Rab14-positive endosome buds at Golgi-endosome contacts by the RhoBTB3-SHIP164-Vps26B complex.

Early endosomes (EEs) are crucial in cargo sorting within vesicular trafficking. While cargoes destined for degradation are retained in EEs and eventually transported to lysosomes, recycled cargoes for the plasma membrane (PM) or the Golgi undergo segregation into specialized membrane structures known as EE buds during cargo sorting. Despite this significance, the molecular basis of the membrane expansion during EE bud formation has been poorly understood. In this study, we identify a protein complex comprising SHIP164, an ATPase RhoBTB3, and a retromer subunit Vps26B, which promotes the formation of EE buds at Golgi-EE contacts. Our findings reveal that Vps26B acts as a novel Rab14 effector, and Rab14 activity regulates the association of SHIP164 with EEs. Depletion of SHIP164 leads to enlarged Rab14+ EEs without buds, a phenotype rescued by wild-type SHIP164 but not the lipid transfer-defective mutants. Suppression of RhoBTB3 or Vps26B mirrors the effects of SHIP164 depletion. Together, we propose a lipid transport-dependent pathway mediated by the RhoBTB3-SHIP164-Vps26B complex at Golgi-EE contacts, which is essential for EE budding.

PINN Model of Diffusion Coefficient Identification Problem in Fick's Laws.

This study tackles the complex task of determining diffusion coefficients in inverse problems, addressing the challenges of instability and computational demands. The primary objective is to introduce an efficient model for estimating diffusion coefficients under specific conditions. Through a unique fusion of Fick's laws and a Neural Network framework, a physics-informed neural network (PINN) is developed for the diffusion coefficient identification problem. The model accommodates scenarios where both diffusion flux and concentration gradient are known, where diffusion flux is known while the concentration gradient is unknown, and where diffusion flux is unknown while the concentration gradient is known. Results demonstrate the model's efficiency, obtaining diffusion coefficients in less than 1000, 2000, and 3000 iterations for the respective scenarios. Sensitivity analysis underscores the model's validity across conditions, highlighting the positive impact of a higher proportion of effective data on convergence and alignment with general diffusion coefficient patterns. In conclusion, the PINN model stands out as a powerful tool for accurately estimating diffusion coefficients under varying conditions.

Elucidating the role of RBM5 in osteoclastogenesis: a novel potential therapeutic target for osteoporosis.

Osteoporosis is a prevalent bone disease with multigene involved, and the molecular mechanisms of its pathogenesis are not entirely understood. This study aims to identify novel key genes involved in osteoporosis to discover potential pharmacological targets. We analyzed three microarray datasets and identified four differentially expressed genes. The LASSO model indicated that RNA-binding motif protein 5 (RBM5) is associated with osteoporosis and is a potential drug target. We conducted the Spearman correlation analysis and found 52 genes that were significantly related to RBM5. Enrichment analysis showed that these genes were primarily involved in RNA splicing and osteoclast differentiation pathways. By using lentivirus-based shRNA, we successfully knocked down RBM5 expression in RAW264.7 cell line, which showed that RBM5 knockdown significantly impaired their differentiation potential to mature osteoclasts and significantly inhibited bone-resorbing activity. RT-qPCR analyses revealed the expression of osteoclastogenesis marker genes was downregulated along with RBM5 expression. These findings suggest that RBM5 plays a crucial role in the pathogenesis of osteoporosis and provides a new potential pharmacological target.

Relationship between career maturity, psychological separation, and occupational self-efficacy of postgraduates: moderating effect of registered residence type.

BACKGROUND: With the slowdown of economic growth and the increasing pressure of employment competition worldwide during the normalized epidemic prevention and control, the job-hunting intention and behavior of college graduates deserve in-depth study. This study explores the relationship between the career maturity, psychological separation and occupational self-efficacy of postgraduates, and provides a theoretical basis for improving their career maturity. METHODS: A questionnaire survey was carried out on postgraduates with 584 valid data in China by using the Career Maturity Scale, Psychological Separation Scale and the Occupational Self-efficacy Scale. A structural equation model and bias-corrected self-sampling method were adopted to explore their relationship. The moderating effect of registered residence type was tested. RESULTS: The results show that: (1) The higher the level of psychological separation of postgraduates, the higher their career maturity. (2) Occupational self-efficacy plays a mediating role in the process of psychological separation promoting career maturity. (3) The registered residence type moderates the latter half of the mediating process of psychological separation, occupational self-efficacy, and career maturity. Moreover, occupational self-efficacy plays a more significant role in promoting the career maturity of postgraduates with rural registered residence. CONCLUSIONS: This study reveals the relationship between the career maturity, psychological separation and occupational self-efficacy of postgraduates. At the same time, it also verifies the mediating role of occupational self-efficacy and the moderating role of registered residence type. The result is helpful for postgraduates to understand the level of their career maturity and improve their career decision-making level and career development ability.

Estimating BDS-3 Satellite Differential Code Biases with the Single-Frequency Uncombined PPP Model.

Differential Code Bias (DCB) is a crucially systematic error in satellite positioning and ionospheric modeling. This study aims to estimate the BeiDou-3 global navigation satellite system (BDS-3) satellite DCBs by using the single-frequency (SF) uncombined Precise Point Positioning (PPP) model. The experiment utilized BDS-3 B1 observations collected from 25 International GNSS Service (IGS) stations located at various latitudes during March 2023. The results reveal that the accuracy of estimating B1I-B3I DCBs derived from single receiver exhibits latitude dependence. Stations in low-latitude regions show considerable variability in the root mean square (RMS) of absolute offsets for satellite DCBs estimation, covering a wide range of values. In contrast, mid- to high-latitude stations demonstrate a more consistent pattern with relatively stable RMS values. Moreover, it has been observed that the stations situated in the Northern Hemisphere display a higher level of consistency in the RMS values when compared to those in the Southern Hemisphere. When incorporating estimates from all 25 stations, the RMS of the absolute offsets in satellite DCBs estimation consistently remained below 0.8 ns. Notably, after excluding 8 low-latitude stations and utilizing data from the remaining 17 stations, the RMS of absolute offsets in satellite DCBs estimation decreased to below 0.63 ns. These enhancements underscore the importance of incorporating a sufficient number of mid- and high-latitude stations to mitigate the effects of ionospheric variability when utilizing SF observations for satellite DCBs estimation.

Analysis of risk factors for serous exudation of biodegradable material calcium sulfate in the treatment of fracture-related infections.

Objective: To explore the related risk factors of serous exudation after antibiotic-loaded calcium sulfate treatment of fracture-related infections and to provide a theoretical basis for clinical treatment and prevention of serous exudation complications. Methods: The clinical data of 145 patients with limb fracture-related infection treated with antibiotic-loaded calcium sulfate in Xi'an Honghui Hospital from January 2019 to December 2022 were retrospectively analyzed. All patients were diagnosed with fracture-related infection by preoperative magnetic resonance examination, bacterial culture and gene detection and received antibiotic-loaded calcium sulfate implantation. The postoperative serous exudation was recorded through hospitalization observation, outpatient review or follow-up. The collected clinical data were sorted out, and the patient data were divided into serous exudation groups and non-exudation groups. Firstly, the clinical data of the two groups were compared by single-factor analysis to screen out the risk factors. Then multivariate binary Logistic regression analysis determined the independent risk factors and protective factors. Results: 1) According to the inclusion and exclusion criteria, there were 145 cases with complete clinical data, including 27 cases in the non-infectious exudation group and 118 cases in the non-exudative group; 2) Univariate analysis showed that the history of diabetes, smoking history, calcium sulfate implantation, drainage time, combined flap surgery, geometric shape of implanted calcium sulfate, and thickness of soft tissue covered by the surgical area were all associated with the occurrence of non-infectious exudation after antibiotic-loaded calcium sulfate implantation (p < 0.05); 3) The amount of implanted calcium sulfate was more [OR = 5.310, (1.302-21.657), p = 0.020], combined with flap surgery [OR = 3.565, (1.195-10.641), p = 0.023], and the thickness of soft tissue coverage in the operation area was thinner [OR = 5.305, (1.336-21.057), p = 0.018]. Longer drainage time [OR = 0.210, (0.045-0.967), p = 0.045] was a protective factor for non-infectious exudation after antibiotic-loaded calcium sulfate implantation. Conclusion: 1) The probability of serous exudation in patients with fracture-associated infection after antibiotic-loaded calcium sulfate surgery was 18.62%. This complication may cause a heavier economic and psychological burden on patients; 2) With the increase of bone infection area and the application of more calcium sulfate, the incidence of serous exudation after antibiotic-loaded calcium sulfate surgery in patients with the fracture-related infection will increase, so we should use the amount of calcium sulfate reasonably on the premise of sufficient control of infection in clinical work, and the incidence of serous exudation will also increase due to the recent skin flap surgery and the thinner soft tissue coverage of calcium sulfate implantation area; 3) Under the premise of being able to drain the drainage from the surgical area, the longer drainage time of the drainage tube has a positive effect on preventing the occurrence of serous exudation.

Identification of mitophagy-related biomarkers in human osteoporosis based on a machine learning model.

Background: Osteoporosis (OP) is a chronic bone metabolic disease and a serious global public health problem. Several studies have shown that mitophagy plays an important role in bone metabolism disorders; however, its role in osteoporosis remains unclear. Methods: The Gene Expression Omnibus (GEO) database was used to download GSE56815, a dataset containing low and high BMD, and differentially expressed genes (DEGs) were analyzed. Mitochondrial autophagy-related genes (MRG) were downloaded from the existing literature, and highly correlated MRG were screened by bioinformatics methods. The results from both were taken as differentially expressed (DE)-MRG, and Gene Ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis were performed. Protein-protein interaction network (PPI) analysis, support vector machine recursive feature elimination (SVM-RFE), and Boruta method were used to identify DE-MRG. A receiver operating characteristic curve (ROC) was drawn, a nomogram model was constructed to determine its diagnostic value, and a variety of bioinformatics methods were used to verify the relationship between these related genes and OP, including GO and KEGG analysis, IP pathway analysis, and single-sample Gene Set Enrichment Analysis (ssGSEA). In addition, a hub gene-related network was constructed and potential drugs for the treatment of OP were predicted. Finally, the specific genes were verified by real-time quantitative polymerase chain reaction (RT-qPCR). Results: In total, 548 DEGs were identified in the GSE56815 dataset. The weighted gene co-expression network analysis(WGCNA) identified 2291 key module genes, and 91 DE-MRG were obtained by combining the two. The PPI network revealed that the target gene for AKT1 interacted with most proteins. Three MRG (NELFB, SFSWAP, and MAP3K3) were identified as hub genes, with areas under the curve (AUC) 0.75, 0.71, and 0.70, respectively. The nomogram model has high diagnostic value. GO and KEGG analysis showed that ribosome pathway and cellular ribosome pathway may be the pathways regulating the progression of OP. IPA showed that MAP3K3 was associated with six pathways, including GNRH Signaling. The ssGSEA indicated that NELFB was highly correlated with iDCs (cor = -0.390, p < 0.001). The regulatory network showed a complex relationship between miRNA, transcription factor(TF) and hub genes. In addition, 4 drugs such as vinclozolin were predicted to be potential therapeutic drugs for OP. In RT-qPCR verification, the hub gene NELFB was consistent with the results of bioinformatics analysis. Conclusion: Mitophagy plays an important role in the development of osteoporosis. The identification of three mitophagy-related genes may contribute to the early diagnosis, mechanism research and treatment of OP.

Clinical Manifestations, Diagnosis, Treatment and Prognosis of Uveitis Induced by Anticancer Drugs: A Review of Literature.

There are increasing reports that anticancer drugs, especially immunotherapy and specific targeted therapy, can cause uveitis, but it is not fully understood whether the clinical features of this drug-induced uveitis differ from those of other types of uveitis and whether there are differences between these drugs. We retrospectively reviewed the published cases and case series in PubMed, Embase, Web of Science, and Cochrane from January 2011 to October 2020. We analysed the data, including patients' basic information, medications used, duration of use, time to onset, clinical manifestations, diagnosis, treatment, and prognosis of uveitis. We focused on the differences in uveitis caused by immunotherapy and specific targeted therapy. Altogether 93 cases (43 men, 48 women, and 2 cases whose gender was not mentioned) reported in 55 articles were included in this study. The average age was 59.6 ± 13.5 years. Eighty percent of the patients had bilateral involvement. Sixty cases were caused by immunotherapy (64.5%), and twenty-six were caused by specific targeted therapy (27.9%). No significant difference was found in the mean time from treatment to onset between the two groups. Anticancer drug-induced uveitis can involve all parts of the uvea from anterior to posterior, manifested as anterior chamber flare, anterior chamber cells, papillitis, macular oedema, subretinal fluid, and choroidal effusion. Anterior uveitis (24 cases, 40.0%) was more common in immunotherapy, and intermediate uveitis (8 cases, 30.8%) was more common in specific targeted therapy. The mean LogMAR visual acuity in specific targeted therapy at presentation was lower than in immunotherapy, but it was not statistically significant. Corticosteroid therapy can effectively control uveitis induced by anticancer drugs. However, the survival prognosis was poor. Among the 19 patients with reported cancer prognosis, seven (36.8%) had no cancer progression, eight (42.1%) had further metastases, and four (21.0%) died of cancer. In conclusion, uveitis caused by anticancer drugs involves both eyes and manifests as various types of uveitis. Patients with specific targeted therapy are more likely to have intermediate uveitis and low vision, and immunotherapy patients are more likely to have anterior uveitis. Corticosteroids are effective against uveitis caused by anticancer drugs.

The APC/CFZY-1/Cdc20 Complex Coordinates With OMA-1 to Regulate the Oocyte-to-Embryo Transition in Caenorhabditis elegans.

During oocyte maturation and the oocyte-to-embryo transition, key developmental regulators such as RNA-binding proteins coordinate translation of particular messenger RNA (mRNAs) and related developmental processes by binding to their cognate maternal mRNAs. In the nematode Caenorhabditis elegans, these processes are regulated by a set of CCCH zinc finger proteins. Oocyte maturation defective-1 (OMA-1) and OMA-2 are two functionally redundant CCCH zinc finger proteins that turnover rapidly during the first embryonic cell division. These turnovers are required for proper transition from oogenesis to embryogenesis. A gain-of-function mutant of OMA-1, oma-1(zu405), stabilizes and delays degradation of OMA-1, resulting in delayed turnover and mis-segregation of other cell fate determinants, which eventually causes embryonic lethality. We performed a large-scale forward genetic screen to identify suppressors of the oma-1(zu405) mutant. We show here that multiple alleles affecting functions of various anaphase promoting complex/cyclosome (APC/C) subunits, including MAT-1, MAT-2, MAT-3, EMB-30, and FZY-1, suppress the gain-of-function mutant of OMA-1. Transcriptome analysis suggested that overall transcription in early embryos occurred after introducing mutations in APC/C genes into the oma-1(zu405) mutant. Mutations in APC/C genes prevent OMA-1 enrichment in P granules and correct delayed degradation of downstream cell fate determinants including pharynx and intestine in excess-1 (PIE-1), posterior segregation-1 (POS-1), muscle excess-3 (MEX-3), and maternal effect germ-cell defective-1 (MEG-1). We demonstrated that only the activator FZY-1, but not FZR-1, is incorporated in the APC/C complex to regulate the oocyte-to-embryo transition. Our findings suggested a genetic relationship linking the APC/C complex and OMA-1, and support a model in which the APC/C complex promotes P granule accumulation and modifies RNA binding of OMA-1 to regulate the oocyte-to-embryo transition process.

An Interface Heterostructure of NiO and CeO2 for Using Electrolytes of Low-Temperature Solid Oxide Fuel Cells.

Interface engineering can be used to tune the properties of heterostructure materials at an atomic level, yielding exceptional final physical properties. In this work, we synthesized a heterostructure of a p-type semiconductor (NiO) and an n-type semiconductor (CeO2) for solid oxide fuel cell electrolytes. The CeO2-NiO heterostructure exhibited high ionic conductivity of 0.2 S cm-1 at 530 °C, which was further improved to 0.29 S cm-1 by the introduction of Na+ ions. When it was applied in the fuel cell, an excellent power density of 571 mW cm-1 was obtained, indicating that the CeO2-NiO heterostructure can provide favorable electrolyte functionality. The prepared CeO2-NiO heterostructures possessed both proton and oxygen ionic conductivities, with oxygen ionic conductivity dominating the fuel cell reaction. Further investigations in terms of electrical conductivity and electrode polarization, a proton and oxygen ionic co-conducting mechanism, and a mechanism for blocking electron transport showed that the reconstruction of the energy band at the interfaces was responsible for the enhanced ionic conductivity and cell power output. This work presents a new methodology and scientific understanding of semiconductor-based heterostructures for advanced ceramic fuel cells.

1-Ethyl-3-methylimidazolium acetate ionic liquid as simple and efficient catalytic system for the oxidative depolymerization of alkali lignin.

The oxidative depolymerization of alkali lignin (AL) in 1-ethyl-3-methylimidazolium acetate ([C2C1im]OAc) system without additional catalyst was investigated under mild conditions (initial O2 pressure of 1.5 MPa, 80 °C-100 °C). Compared with other ionic liquids (ILs), the cooperation of imidazolium cation and acetate anion successfully enhanced AL conversion. Among the investigated imidazolium acetate ILs with ethyl- to octyl-side chains, [C2C1im]OAc presented the best catalytic capacity for AL oxidative depolymerization. Adding an appropriate amount of water to [C2C1im]OAc can further improve the reaction efficiency. In the [C2C1im]OAc system with the addition of 0.10-0.25 mL of water, approximately 77 wt% AL was depolymerized into small molecule soluble products at 100 °C for 2 h. The extracted oil was composed mainly of phenolic derived compounds. With the use of the [C2C1im]OAc-based system, the specific inter-unit linkages of lignin were broken down, and residual lignin with low molecular weight and narrow polydispersity index (1.88-1.96) was obtained. Compared with that in AL conversion with fresh [C2C1im]OAc, only a minimal decrease (~3.2%) was observed with the recovered IL until the fifth cycle. These findings revealed that [C2C1im]OAc-based system is a simple and efficient catalytic system for lignin oxidative depolymerization.

Epidemiology of 2000 Chinese uveitis patients from Northeast China.

AIMS: To study the clinical characteristics of 2000 patients with uveitis admitted to the ophthalmology centre of the Second Hospital of Jilin University. METHODS: We retrospectively analysed 2000 patients with uveitis who were admitted to the uveitis clinic of the Second Hospital of Jilin University from July 2010 to June 2019 and analysed data on sex, onset age, onset season, anatomical classification, visual acuity and compared the results with those of other investigation studies. RESULTS: Among 2000 uveitis patients, the mean age of onset was 39.9±14.9 years. There were 946 male patients (47.3%) and 1054 female patients (52.7%). By anatomical classification, panuveitis was the most common (986 cases, 49.3%), followed by anterior uveitis (786 cases, 39.3%), posterior uveitis (119 cases, 6.0%) and intermediate uveitis (109 cases, 5.5%). Among anterior uveitis cases, ankylose spondylitis (207 cases, 26.34%), Fuchs syndrome (74 cases, 9.41%) and viral uveitis (71 cases, 9.03%) were the most common. Among panuveitis cases, Vogt-Koyanagi-Harada syndrome (372 cases, 37.73%), Behcet's disease (142 cases, 14.40%) and sympathetic ophthalmitis (33 cases, 3.35%) were the most common. Uveitis often occurs during the autumn-winter transition period. The prevalence of anterior uveitis is highest in November, and statistical analysis shows that the incidence of uveitis has a significant correlation with the month. Panuveitis has the most significant effect on vision. CONCLUSION: Panuveitis and anterior uveitis are the most common anatomical classifications of uveitis, which has a significant impact on vision, and their incidence is related to seasonal changes.

A new classification and its value evaluation for intermediate column fractures of the distal radius.

BACKGROUND: Intermediate column fractures of the distal radius (ICF) are fractures only or mainly limited to the lunate fossa of the distal radius. There are no classification systems and its value evaluation for ICF in the literature. METHODS: According to the characteristics of ICF, ICF were divided into the volar, dorsal, split, collapse, and collapse with split types. Inter- and intra-observer agreements were analyzed with kappa statistics. Seventy-four patients with ICF were retrospectively studied from January 2008 to June 2016. Surgical approach and reduction-fixation method were taken under the guidelines of the classification in 54 patients with displaced fractures, while conservative treatment was taken in 16 patients with non-obvious displaced fractures and 4 patients with displaced fractures who declined surgery. RESULTS: The inter- and intra-observer kappa coefficients were 0.875~0.925 and 0.900~0.950, respectively. All patients were followed up for 13~36 months (average, 18.4 months). At the last follow-up, according to Gartland and Werley score of the functional recovery of wrist, all except 3 patients had excellent or good results (the excellent and good rate was 95.95%). CONCLUSION: The classification reflects the characteristics of ICF and may provide an important reference for choosing treatment and evaluating prognosis.

Successful Neuraxial Analgesia After Recent Epidural Blood Patch.

Epidural blood patch is a frequently successful treatment for postdural puncture headache. It is not clear whether a recent epidural blood patch affects subsequent neuraxial analgesia. We describe the case of a patient who received an epidural blood patch for postdural puncture headache and returned 3 days later in active labor, requesting epidural analgesia. The patient successfully received analgesia from a combined spinal epidural without further complications. We discuss the anesthetic considerations for providing neuraxial analgesia after a recent epidural blood patch.

The effect of perioperative ketorolac on pain control in pregnancy termination.

BACKGROUND: The study was conducted to evaluate the effect of perioperative ketorolac on pain associated with first-trimester aspiration abortion. STUDY DESIGN: A double-blind, randomized, placebo-controlled trial was performed involving pregnant women up to 14 weeks' gestation who desired pregnancy termination. Subjects were randomized to receive ketorolac 30 mg intravenously (n=31) or placebo (n=45) at the time of induction of anesthesia. Postoperative pain was assessed using a visual analog scale (VAS). The primary outcome was pain control as determined by VAS score. Secondary measures of patient use of supplemental postoperative pain medications and patient satisfaction were assessed. RESULTS: Subjects in the ketorolac group had lower postoperative pain scores on the VAS at all time points compared to the placebo group, but the difference was not statistically significant. The ketorolac group used less postoperative acetaminophen compared to the placebo group (6.5% versus 35.6%), respectively. Subjects in the placebo group and the ketorolac group had similar requirements for postoperative narcotics in the recovery room (22.2% versus 19.4%). Patient satisfaction with pain level was equivalent between the groups at all postoperative end points. There was no observed difference in perioperative blood loss observed between the two groups. CONCLUSION: Perioperative ketorolac has the same effect on postoperative pain as determined by VAS as placebo. The use of ketorolac at the 30-mg dose cannot be recommended for better pain control for patients undergoing first-trimester pregnancy termination by suction curettage. The only positive effect of the use of ketorolac compared to placebo was a reduction in the use of acetaminophen. Ketorolac use does not appear to change blood loss in the operating room or through postoperative day 1 compared to placebo.