Elastic Textile Threads for Fog Harvesting.

The potential applications of textile materials in fog harvesting have long been demonstrated. This work designed novel fog harvesters according to the distinct features of elastic textile threads (ETTs) to enhance droplet capture, large-droplet growth, and droplet pouring and improve fog harvesting efficiency. We prepared m@ETTs (modified ETTs) using three novel chemical and physical methods. First, we prepared spandex elastic threads with a non-uniform rough surface containing silica nanoparticles and titanium particles through the sol-gel triethoxymethylsilane method. Second, we prepared a rubber/polyester thread with a rough surface by breaking the thread shell with toluene solution, creating knots on the surface of the rubber core. Third, we prepared a polyurethane thread with a bumpy superhydrophobic surface by spraying a tetrafluoroethylene adhesive and silica nanoparticles on the thread. Furthermore, we connected ETTs to an automatic stretching-recovery system to obtain auto-ETTs as another group of harvesters. We obtained auto-i@ETTs by introducing elastic bumps/knots onto the auto-ETT surface. The fog harvesting efficiencies of m@ETTs were approximately 60-120% greater than those of the ETTs. The water harvesting rate of the auto-i@ETT was 2.5 times that of the ETT, with the highest water harvesting rate of auto-i@ETT reaching 3.35 g/h/cm2. Moreover, several novel principles of droplet behavior and thread elasticity were revealed. The elastic elongation level of the ETTs was proportional to their water harvesting efficiency. The stretching-recovery state of the elastic thread did not influence the water contact angle but affected the droplet state on the thread surface. The temporary slack/stick state of adjacent elastic threads on auto-ETTs contributed to droplet convergence and pouring. Overall, this novel approach demonstrates the significant potential of elastic threads in fog harvesting applications.

The Buddy Study: Local reach, adoption and implementation following a randomised controlled trial of conservative management of fifth metacarpal neck fractures.

OBJECTIVE: To understand the reach, adoption and implementation of the evidence that buddy strapping for uncomplicated fifth metacarpal neck fractures is non-inferior to plaster casting. METHODS: Mixed-method study using clinical audit of the years before and after the original randomised controlled study was published (2019) and staff questionnaires/semi-structured interviews. RESULTS: Sixty-nine percent of questionnaire respondents were aware of the original study findings (i.e. reach) and 57% had adopted the research findings. The proportion of patients receiving buddy strapping was 6% in 2014-2016 and 28% in 2019-2021 (implementation). Qualitative data provided insight into ongoing barriers to adoption and implementation including fear of reprisal, the need for permission, opinions of senior decision makers, perceptions about patient preferences, and an overall tendency to 'play it safe'. CONCLUSIONS: Even in a department where primary research is conducted, implementation requires ongoing attention to factors impacting reach and adoption.

Mechanical Properties of Ternary Composite from Waste Leather Fibers and Waste Polyamide Fibers with Acrylonitrile-Butadiene Rubber.

This study aimed to improve the mechanical properties of a composite material consisting of waste leather fibers (LF) and nitrile rubber (NBR) by partially replacing LF with waste polyamide fibers (PA). A ternary recycled composite NBR/LF/PA was produced by a simple mixing method and vulcanized by compression molding. The mechanical properties and dynamic mechanical properties of the composite were investigated in detail. The results showed that the mechanical properties of NBR/LF/PA increased with an increase in the PA ratio. The highest tensile strength value of NBR/LF/PA was found to have increased about 1.26 times, that is from 12.9 MPa of LF50 to 16.3 MPa of LF25PA25. Additionally, the ternary composite demonstrated high hysteresis loss, which was confirmed by dynamic mechanical analysis (DMA). The presence of PA formed a non-woven network that significantly enhanced the abrasion resistance of the composite compared to NBR/LF. The failure mechanism was also analyzed through the observation of the failure surface using scanning electron microscopy (SEM). These findings suggest that the utilization of both waste fiber products together is a sustainable approach to reducing fibrous waste while improving the qualities of recycled rubber composites.

Three-Dimensional Multilayer Vertical Filament Meshes for Enhancing Efficiency in Fog Water Harvesting.

Novel types of vertical filament mesh (VFM) fog harvesters, 3D VFM fog harvesters, and multilayer 3D VFM fog harvesters were developed by mimicking the water-harvesting nature of desert beetles and the spider silks from fog. Four different types of polymer filaments with different hydrophilic-hydrophobic properties were used. The polymer filaments were modified with the polyurethane-sodium alginate (PU-SA) mixture solution, and a simple spraying method was used to form alternating 3D PU-SA microbumps. Polymer VFMs exhibited a higher fog-harvesting efficiency than the vertical metal meshes. Moreover, the hydrophobic VFM was more efficient in fog harvesting than the hydrophilic VFM. Notably, the fog-harvesting efficiency of all VFMs increased by 30-80% after spraying with the mixed PU-SA solution to form a 3D geometric surface structure (3D PU-SA microbumps), which mimicked the desert beetle back surface. This modification caused the fog-harvesting efficiency of PTFE 3D VFM to be thrice higher than that of Fe VFM. This increase was attributed to the improved synergistic effects of fog capturing, droplet growing, and droplet shedding. The multilayer VFMs were more efficient in fog harvesting than the single-layer VFMs because of a larger droplet capture area. The fog-harvesting efficiency of two-layer and four-layer polymer VFMs was approximately 35% and about 45% higher than that of the single-layer polymer VFMs, respectively. The four-layer PTFE 3D VFM with the type B PU-SA bump surface (bump/PU-SA) had the highest efficiency of 287.6 mL/m2/h. Besides the high fog-harvesting efficiency, the proposed polymer VFMs are highly stable, cost-effective, rust-free, and easy to install in practical applications. These advantages are ascribed to the elasticity of the polymer filaments. This work provides new ideas and methods for developing high-performance fog harvesters such as the 3D VFM.

Epidemiological characterization of pityriasis versicolor and distribution of Malassezia species among students in Hai Phong city, Vietnam.

BACKGROUND AND PURPOSE: Pityriasis versicolor (PV) is a common fungal skin infection caused by Malassezia species. Previous studies have shown that the prevalence of PV is influenced by geographic factors. The aim of the current study was to find the epidemiological characteristics of PV and distribution of Malassezia species in the secondary school students living in Hai Phong city, Vietnam. MATERIALS AND METHODS: This study was conducted on 1357 students within the age range of 10 - 16 years selected from four secondary schools in Hai Phong city. The students were screened for PV skin lesions from August 2016 to December 2017. The isolates of Malassezia from PV patients were analyzed by performing direct microscopy and culturing on modified Dixon agar plates, containing gentamicin, at 32oC for 7 days. In the next stage, the fungal strains obtained from patients with positive fungal cultures were identified using the CHROMagarTM Malassezia medium, polymerase chain reaction-restriction fragment length polymorphism techniques, and D1/D2 rDNA genome sequencing. RESULTS: Pityriasis versicolor was diagnosed in 305 (22.48%) students and confirmed by clinical appearance and direct examination. A total of 293 (96.07%) samples grew on modified Dixon agar. With regard to demographic characteristics, 50.49% of the PV cases were female, and 57.38% of cases resided in urban areas. Furthermore, 88.52% of the subjects had the illness duration of more than 6 months. Hypopigmented and erythematous skin lesions were also observed in the research participants, with hypopigmentation being the most frequent condition (97.05%). Most of the Malassezia fungal strains were isolated from the back (39.56%), face (23.99%), and chest (16.51%). Malassezia furfur and M. japonica accounted for PV in 96.25% and 3.75% of the cases, respectively. Furthermore, Malassezia furfur was distributed in both rural and urban areas, while M. japonica was found only in the urban areas. CONCLUSION: The findings of the present study were indicative of the high prevalence of Malassezia yeasts, mostly M. furfur, among the students in Hai Phong city, Vietnam.

A randomized trial of the effect of automated ventricular capture on device longevity and threshold measurement in pacemaker patients.

BACKGROUND: An automatic capture (AC) algorithm adjusts ventricular pacing output to capture the ventricle while optimizing output to 0.5 V above threshold. AC maintains this output and confirms capture on a beat-to-beat basis in bipolar and unipolar pacing and sensing. OBJECTIVE: To assess the AC algorithm and its impact on device longevity. METHODS: Patients implanted with a pacemaker were randomized 1:1 to have the AC feature on or off for 12 months. Two threshold tests were conducted at each visit- automatic threshold and manual threshold. Average ventricular voltage output and projected device longevity were compared between AC on and off using nonparametric tests. RESULTS: Nine hundred ten patients were enrolled and underwent device implantation. Average ventricular voltage output was 1.6 V for the AC on arm (n = 444) and 3.1 V for the AC off arm (n = 446) (P < 0.001). Projected device longevity was 10.3 years for AC on and 8.9 years for AC off (P < 0.0001), or a 16% increase in longevity for AC on. The proportion of patients in whom there was a difference between automatic threshold and manual threshold of

Eutectic mixture of local anesthetic (EMLA) decreases pain during humeral block placement in nonsedated patients.

BACKGROUND: We evaluated the potential role of an euctectic mixture of local anesthetic (EMLA) cream application before performing midhumeral block. METHODS: Sixty patients undergoing surgery distal to the elbow amenable to a humeral block were prospectively recruited for the study. The patients were randomly allocated to 1 of 3 groups: Group E: topical EMLA cream 60 min before block plus 2 mL IV normal saline 5 min before procedure; Group P: topical sham cream plus 2 mL IV normal saline, and Group S: topical sham cream plus 0.1 microg/kg of sufentanil in 2 mL solution IV. Pain experienced during skin puncture, and overall pain for the whole procedure were rated using a 100-mm visual analog scale (0: no pain to 100: worst pain). RESULTS: Patients in Group E experienced less pain compared with those in Groups P and S (5 +/- 3 mm vs 33 +/- 20 mm and 30 +/- 18 mm, respectively, P < 0.0001). The pain experienced throughout the complete humeral block was more substantial in Group P than in Group E (P = 0.01). CONCLUSION: The patients who received EMLA cream had less pain with needle puncture as well as throughout the performance of humeral block.

Infraclavicular brachial plexus block versus humeral block in trauma patients: a comparison of patient comfort.

In this prospective randomized study, we compared humeral block (HB) and infraclavicular brachial plexus block (ICB) with pain caused by the block as a primary outcome, assuming that ICB would cause less pain than HB. Patients undergoing emergency upper limb surgery were included in this study and received either ICB (group I, n = 52 patients) or HB (group H, n = 52 patients). Patients were asked to quantify the severity of the pain during the procedure using a visual analog scale from 0 to 100 mm and to identify which of the 4 components of the procedure was most unpleasant (skin transfixion, needle redirection in search of the nerves, local anesthetic injections, or electrical stimulation). The block was assessed every 5 min for 30 min after completion of the block. Overall visual analog scale scores for the block were 35 +/- 27 mm in group H versus 19 +/- 18 mm in group I (P < 0.0011). Electrical stimulation was the most unpleasant part of the block (group H, 29 +/- 15 mm versus group I, 15 +/- 10 mm) (P < 0.019). Time to perform the block was significantly shorter in group I (ICB, 6 +/- 4 min versus HB, 10 +/- 4 min; P < 0.0001). The onset time was 13 +/- 7 min for ICB and 9 +/- 3 min for HB (P < 0.05). No serious complications were observed. In summary, ICB is less painful, compared with HB, with a similar success rate.

Spinal anesthesia using single injection small-dose bupivacaine versus continuous catheter injection techniques for surgical repair of hip fracture in elderly patients.

Aging and disease may make elderly patients particularly susceptible to hypotension during spinal anesthesia. We compared the hemodynamic effect of continuous spinal anesthesia (CSA) and small dose single injection spinal anesthesia (SA) regarding the incidence of hypotension. Seventy-four patients aged >75 yr undergoing surgical repair of hip fracture were randomized into 2 groups of 37 patients each. Group CSA received a continuous spinal anesthetic with a titration of 2.5 mg boluses every 15 min of isobaric bupivacaine, while group SA received a single injection spinal anesthetic with 7.5 mg of isobaric bupivacaine. The overall variations in noninvasive automated arterial blood pressure were not statistically significantly different in the 2 groups at baseline and after CSA or SA (not significant). In the SA group, 68% of patients experienced at least one episode of hypotension (decrease in systolic arterial blood pressure greater than 20% of baseline value) versus 31% of patients in the CSA group (P = 0.005). In the SA group, 51% of patients experienced at least one episode of severe hypotension (decrease in systolic arterial blood pressure more than 30% of baseline value) versus 8% of patients in the CSA group (P < 0.0001). In the CSA group, 4.5 +/- 2 mg of ephedrine was injected versus 11 +/- 2 mg in the SA group (P = 0.005). In the CSA group, 5 mg (2.5-10) of anesthetic solution was required versus 7.5 mg in the SA group (P < 0.0001). We conclude that, in elderly patients undergoing hip fracture repair, CSA provides fewer episodes of hypotension and severe hypotension compared with a single intrathecal injection of 7.5 mg bupivacaine.

[Propofol to facilitate spinal anesthesia in the lateral position in patients with femoral neck fracture]. / Le propofol pour réaliser une rachianesthésie en position latérale chez les victimes d'une fracture du fémur.

PURPOSE: The aim of this study was to assess the feasibility and efficacy of propofol before positioning elderly patients with a femoral neck fracture in the lateral decubitus position, to perform a spinal anesthetic. METHODS: In this prospective and descriptive study, 79 consecutive patients, > 75 yr old, with a femoral neck fracture were included. Propofol, 0.5 mg x kg(-1), was administered. If loss of consciousness was not obtained (Ramsay score < or = 3/6), then additional doses of 0.25 mg x kg(-1) were given until a Ramsay score of 4 or 5 was attained. Then, the patient was turned to the lateral decubitus position, the fractured side up. The efficacy of propofol was assessed by observing a grimace during positioning and asking the patients if they had recall of pain. Hemodynamic data and oxygen saturation were collected. RESULTS: Forty-three patients required a single injection, 34 required two injections and only two patients required three injections. No grimace and no recall of pain were recorded during the study. There was no desaturation (SpO(2) < 92 %), and hypotension, defined as a systolic blood pressure decrease > 30% from baseline, was observed. CONCLUSION: Propofol is a simple and efficacious means of providing comfort while positioning elderly patients with a femoral head fracture before performing spinal anesthesia.

Hemangiosarcomas, medulloblastomas, and other tumors in Ink4c/p53-null mice.

Ink4 proteins inhibit the enzymatic activities of cyclin D-dependent kinases, thereby governing transcriptional programs that depend on the activities of the retinoblastoma protein and other retinoblastoma family members (p107 and p130). Mice lacking Ink4c and p53 spontaneously develop a broad spectrum of neoplasms, usually presenting with multiple tumors of different histological types and dying of cancer by 6 months of age. Whereas thymic lymphomas or pituitary tumors predominate in mice lacking p53 or Ink4c, respectively, animals lacking both genes develop many vascular tumors and also present with medulloblastomas not observed in the parental strains. Unlike p53, loss of the Arf tumor suppressor did not contribute to the appearance of vascular or cerebellar tumors. Vascular tumors ranged in severity from angiomas to hemangiosarcomas, some of which could be transplanted into immunocompromised mice. Intriguingly, loss of Ink4c but maintenance of at least one Ink4d allele was required for formation of medulloblastomas in p53-null mice. In situ hybridization revealed that, in newborn mice, Ink4c is detected in the pia mater and in an adjacent layer of rapidly dividing cells within the cerebellar external granule layer (EGL), whereas Ink4d is primarily expressed in Purkinje neurons. Because the pia mater and Purkinje cells sandwich the cerebellar EGL from which medulloblastomas are presumed to arise, Ink4 proteins might function in a cell-autonomous manner in governing neuronal cell cycle exit as well as in a non-cell-autonomous manner in controlling the production of diffusible mitogens and chemokines that influence postnatal development of the cerebellar EGL.

[Epidural hematoma after hemorrhagic shock in a parturient]. / Hématome péridural chez une parturiente au décours d'un choc hémorragique.

PURPOSE: Epidural hematoma is a rare but serious complication of epidural anesthesia. We report a case of epidural hematoma, occurring in an obstetric patient after the epidural catheter had been withdrawn accidentally after an episode of hemorrhagic shock leading to a hypocoagulable state. CLINICAL FEATURES: A patient had the epidural catheter inserted during labour when coagulation was normal. She had a postpartum hemorrhage with alteration of coagulation (platelets 16 x 10(-9) x L(-1), thrombin time: 85 sec. Vital signs returned to normal after a general anesthetic, transfusion of blood products, volume repletion and ligation of hypogastric arteries. It was then noticed that the epidural catheter had been withdrawn inadvertently while the patient was hypocoagulable. The patient then developed neurological signs consistent with spinal cord compression due to an epidural hematoma. A hematoma extending from T3 to L5 was diagnosed by magnetic resonance imaging. Because the cord had minimal compression, no specific action was undertaken, other than clinical and radiological follow-up. There were no long-term sequelae. CONCLUSION: In the presence of an epidural hematoma, surgery for emergency cord decompression is usually required. Another option that receives increasing attention is to monitor neurological function, but the indications for this expectant treatment are not well defined.

A modified coracoid approach to infraclavicular brachial plexus blocks using a double-stimulation technique in 300 patients.

Infraclavicular brachial plexus block is used less than other techniques of regional anesthesia for upper-limb surgery. We describe a modified coracoid approach to the infraclavicular brachial plexus using a double-stimulation technique and assess its efficacy. Patients undergoing orthopedic surgery of the upper limb were included in this prospective study. The landmarks used were the coracoid process and the clavicle. The needle was inserted in the direction of the top of the axillary fossa (in relation to the axillary artery), with an angle of 45 degrees. Using nerve stimulation, the musculocutaneous nerve was identified first and blocked with 10 mL of 1.5% lidocaine with 1:400,000 epinephrine. The needle was then withdrawn and redirected posteriorly and medially. The radial, ulnar, or median nerve was then blocked. The block was tested every 5 min for 30 min. The overall success rate, i.e., adequate sensory block in the 4 major nerve distributions at 30 min, was 92%, and 6% of the patients required supplementation. Five patients required general anesthesia. No major complications were observed. This modified infraclavicular brachial plexus block using a double-stimulation technique was easy to perform, had frequent success, and was safe in this cohort.

Pacing in the middle cardiac vein in a patient with tricuspid prosthesis.

A man with acute endocarditis developed complete heart block several days after the tricuspid and aortic valve replacement. Several weeks after implantation, his epimyocardial pacing leads developed a high threshold and failed to capture the ventricle at the maximal pulse width and output of the pacemaker. An angled-tip lead was placed in the middle cardiac vein for ventricular pacing. The pacing and sensing thresholds of this lead were within the expected range during follow-up. Therefore, in patients with prosthetic tricuspid valve, pacing in the middle cardiac vein should be considered before open-chest placement of the epimyocardial lead.

Boerhaave's syndrome after postoperative vomiting.

UNLABELLED: Postoperative nausea and vomiting are common after general anesthesia but rarely produce life-threatening conditions. We report a case of postoperative vomiting complicated by esophageal rupture (Boerhaave's syndrome). As this complication is quite rare and can have varied and atypical presentations, anesthesiologists may fail to consider this diagnosis. IMPLICATIONS: We report a case of postoperative vomiting complicated by esophageal rupture (Boerhaave's syndrome). As this complication is quite rare, anesthesiologists may fail to consider this diagnosis.