Significantly earlier ambulation and reduced risk of near-falls with continuous infusion nerve blocks: a retrospective pilot study of adductor canal block compared to femoral nerve block in total knee arthroplasty.

BACKGROUND: Near-falls should be detected to prevent falls related to the earlier ambulation after Total knee arthroplasty (TKA). The quadriceps weakness with femoral nerve block (FNB) has led to a focus on adductor canal block (ACB). We purposed to examine the risk of falls and the earlier ambulation in each continuous infusion nerve block. METHODS: Continuous infusion nerve block (FNB or ACB) was performed until postoperative day (POD) 2 or 3. Pain levels and falls/near-falls with knee-buckling were monitored from POD 1 to POD 3. The score on the manual muscle test, MMT (0 to 5, 5 being normal), of the patients who could ambulate on POD 1, was investigated. RESULTS: A total of 73 TKA cases, 36 FNB and 37 ACB, met the inclusion criteria. No falls were noted. But episodes of near-falls with knee-buckling were witnessed in 14 (39%) cases in the FNB group and in 4 (11%) in the ACB group (p = 0.0068). In the ACB group, 81.1% of patients could ambulate with parallel bars on POD 1, while only 44.4% of FNB patients could do so (p = 0.0019). The quadriceps MMT values in the ACB group was 2.82, significantly higher than 1.97 in the FNB group (p = 0.0035). There were no significant differences in pain as measured with a numerical rating scale (NRS) and rescue analgesia through POD 3. CONCLUSION: ACB was associated with significantly less knee-buckling and earlier ambulation post-TKA, with better quadriceps strength. Our study indicated the incidence of falls and near-falls with continuous infusion nerve blocks, and support the use of ACB to reduce the risk of falls after TKA. It is suggested that a certain number of the patients even with continuous ACB infusion should be considered with the effect of motor branch to prevent falls.

An all ambient, room temperature-processed solar cell from a bare silicon wafer.

Solar cells are a promising optoelectronic device for the simultaneous solution of energy resource and environmental problems. However, their high cost and slow, laborious production process so far severely hinder a sufficient widespread of clean, renewable photovoltaic energy as a major alternative electricity generator. This undesirable situation is mainly attributed to the fact that photovoltaic devices have been manufactured through a series of vacuum and high-temperature processes. Here we realize a poly(3,4-ethylenedioxythiophene)-poly(styrenesulfonate) (PEDOT:PSS)/Si heterojunction solar cell fabricated only in ambient and room temperature conditions from a plain Si wafer, with an over 10% energy conversion efficiency. Our production scheme is based on our finding that PEDOT:PSS photovoltaic layers actively operate even on highly doped Si substrates, which substantially mitigates the condition requirements for electrode implementation. Our approach may pave the way for facile, low-cost, high-throughput solar cell fabrication, useful in various fields even including developing countries and educational sites.

Supermassive black hole feeding and feedback observed on subparsec scales.

Active galaxies contain a supermassive black hole at their center that grows by accreting matter from the surrounding galaxy. The accretion process in about the central 10 parsecs has not been directly resolved in previous observations because of the small apparent angular sizes involved. We observed the active nucleus of the Circinus Galaxy using submillimeter interferometry. A dense inflow of molecular gas was evident on subparsec scales. We calculated that less than 3% of this inflow is accreted by the black hole, with the rest being ejected by multiphase outflows, providing feedback to the host galaxy. Our observations also reveal a dense gas disk surrounding the inflow that is gravitationally unstable, which drives the accretion into about the central 1 parsec.

N2O emission factors for organic amendments in Japan from measurement campaign and systematic review.

Organic amendments are important sources of nitrous oxide (N2O) emissions from agricultural soils. In 2020, the total amount of N in organic amendments applied to Japanese agricultural soils (440 ktN) was larger than that of synthetic fertilizer (374 ktN). However, N2O emissions from organic amendments were estimated by using the country-specific N2O emission factor (EF) for synthetic fertilizer (0.31 % for rice paddy, 2.9 % for tea, and 0.62 % for other crops) in the National Greenhouse Gas Inventory Report of Japan. Thus, we conducted a N2O flux measurement campaign at 12 different experimental sites across Japan to estimate fertilizer-induced N2O EFs for major organic amendments in Japan, that is, poultry manure compost, swine manure compost, cattle manure compost, and organic fertilizer pellets. In addition, we conducted systematic review of N2O emissions and EFs for organic amendments, including data from our measurement campaign and published data from peer-reviewed papers in Japan. The final dataset, including the field measurement campaign and published data, resulted in 404 observations (including synthetic fertilizer and zero-N control) in 29 sites. Results showed that soil type affected EFs, that is, the mean EF of Andosols was lower than that of non-Andosols, which is similar to the case of EFs for synthetic fertilizer. Mean EFs for poultry manure compost, swine manure compost, cattle manure (compost and slurry), and non-animal manure organic fertilizers were 0.83 % (uncertainty range of 2.5th and 97.5th percentile: 0.09 % to 3.46 %), 0.70 % (0.02 % to 2.45 %), 0.39 % (0.00 % to 1.62 %), and 1.16 % (0.41 % to 3.03 %), respectively, when weighted by area of soil types. The mean EF of all organic amendments was 0.84 % (0.00 % to 2.91 %), when the area of soil type and amount of organic amendment used in Japan were considered. Our study provides country-specific EFs to estimate N2O emission from organic amendments in Japan.

Lipid droplet-associated proteins protect renal tubular cells from fatty acid-induced apoptosis.

Proteinuria is a major cause of tubulointerstitial kidney damage, and free fatty acids bound to albumin are thought to play an important role in its pathogenesis. However, the mechanism whereby proteinuria causes tubulointerstitial damage to the kidney is unclear. Using primary human renal proximal tubular cells, we observed that albumin replete with fatty acids (rBSA) and defatted albumin (dBSA) complexed with linoleic acid (LA) induced significantly more apoptosis than did defatted albumin alone. Oxidative stress was partially involved in apoptotic induction by LA/dBSA but not by rBSA. Administration of fatty acid-bound BSA increased the number of lipid droplets (LDs) and the LD-associated proteins, adipocyte differentiation-related protein and TIP47. LDs are organelles that store esterified fatty acids, and the LD-associated proteins are presumed to facilitate LD formation. Knockdown of adipocyte differentiation-related protein or TIP47 by RNA interference enhanced induction of apoptosis by both rBSA and LA/dBSA. Apoptotic induction was observed similarly when either rBSA or LA/dBSA was applied to only the apical surfaces of polarized LLC-PK1 cells. The present results suggest that LDs and LD-associated proteins have protective effects against apoptosis induced by fatty acid-bound albumin by sequestering free fatty acids. Therapeutic manipulation of these LD-associated proteins could aid in the amelioration of nephritic diseases.

Enhancement of antibacterial activity of beta-lactam antibiotics by [P2W18O62]6-, [SiMo12O40]4-, and [PTi2W10O40]7- against methicillin-resistant and vancomycin-resistant Staphylococcus aureus.

The enhancement of antibacterial activity of beta-lactam antibiotics by polyoxometalates against methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant S. aureus (VRSA) was investigated by using K6[P2W18O62] . 14H2O (P2W18), K4[SiMo12O40] . 3H2O (SiMo12), and K7[PTi2W10O40] . 6H2O (PTi2W10). Susceptibility test by a beta-lactam-disk method showed the synergistic effect of the polyoxometalates in combination with oxacillin against both MRSA and VRSA. Energy dispersive X-ray analysis of the strain treated with P2W18 revealed localization of the polyoxometalate-tungsten atoms at the periphery of the cell, and the biological reduction of P2W18 and SiMo12 proceeded within both cells of MRSA and VRSA as far as they keep alive. These results indicate that the polyoxometalates can penetrate through the cell wall consisting of peptidoglycan layers and reach cytoplasmic membrane. The inhibitory effect of the polyoxometalates on both mecA- and pbp-induced mRNA expression of both MRSA and VRSA cells, verified by the RT-PCR-electrophoresis analysis, is observed, and the mechanism of the synergistic effect by the polyoxometalates is discussed in terms of the depression of penicillin-binding protein 2' (PBP2') coded by mecA gene.

Caveolin-1 in mesangial cells suppresses MAP kinase activation and cell proliferation induced by bFGF and PDGF.

BACKGROUND: Caveolin is a principal component of caveolae and regulates signaling in caveolae. Mesangial cells contain many caveolae, and thus manipulation of caveolin-1 expression level might be useful to control mesangial cell proliferation, which is an important aggravating factor in many renal diseases. METHODS: In the present study, we transfected caveolin-1 cDNA to rat primary mesangial cells and MES13 cells, and examined the effects on Raf-extracellular signal-regulated protein kinase (ERK) kinase (MEK)-mitogen-activated protein (MAP) kinase pathway and cell proliferation stimulated by basic fibroblast growth factor (bFGF) and platelet-derived growth factor (PDGF). Activity of the kinases was analyzed by immunofluorescence labeling and Western blot analysis. RESULTS: The overexpression of caveolin-1 inhibited the activation of Raf-1, MEK-1/2, and MAP kinase induced by either bFGF or PDGF. Furthermore, it suppressed the cell proliferation caused by the cytokines. The effect was specific to the Raf-MEK-MAP kinase pathway, because it did not influence activation of Smad2 induced by transforming growth factor-beta (TGF-beta). On the contrary, expression of a dominant-negative caveolin mutant, DGV-caveolin, augmented activation of MAP kinase. CONCLUSION: The result showed that overexpression of caveolin-1 in mesangial cells suppresses MAP kinase activation and cell proliferation induced by bFGF and PDGF. Because bFGF and PDGF are two major cytokines involved in the mesangioproliferative nephritis, the result implies that introduction of caveolin-1 expression vector is a potential therapeutic tool for the disease.

Effects of human soluble thrombomodulin on experimental glomerulonephritis.

BACKGROUND: Coagulation and inflammation are both important processes that contribute to glomerular injury. The present study was performed to evaluate the effects of recombinant human soluble thrombomodulin (RHS-TM) in a lethal model of thrombotic glomerulonephritis and to investigate the possible mechanisms. METHODS: Thrombotic glomerulonephritis was induced in rats by administration of lipopolysaccharide and rabbit anti-rat glomerular basement membrane antibody. One hour later, RHS-TM or heparin was administered, and the histological findings, renal functions, and coagulation parameters were evaluated. To evaluate the contribution of carboxypeptidase R (CPR) to the results obtained in rats treated with RHS-TM, plasma CPR levels were measured. Then, carboxypeptidase inhibitor (CPI), which prevents the function of CPR, was administered. RESULTS: Massive glomerular thrombosis and lung hemorrhage developed within five hours of disease induction, and all rats died within 24 hours. RHS-TM (3 mg/kg) prevented the progression of the disease and all rats survived. Heparin (250 U/kg/h) showed similar anti-thrombotic effect, but induced massive hemorrhage in the lungs or stomach. RHS-TM attenuated leukocyte/neutrophil infiltration in the glomerulus but heparin did not, suggesting that RHS-TM has anti-inflammatory properties. CPR levels in plasma were about threefold higher in rats treated with RHS-TM compared to those in rats treated with heparin. Furthermore, the inhibitory effect of RHS-TM on leukocyte/neutrophil infiltration was significantly diminished by injection of CPI. CONCLUSION: RHS-TM effectively attenuates the injuries of thrombotic glomerulonephritis in rats. The results indicate that RHS-TM, in addition to its anti-thrombotic action, may exert its anti-inflammatory properties by converting proCPR to CPR, which then inactivates anaphylatoxins. RHS-TM is a potential novel therapeutic tool for thrombotic glomerular injury and related disorders.