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Regional Anesthesia Complications and Contraindications. Anesthesiol Clin 2024; 42:329-344. [PMID: 38705680 DOI: 10.1016/j.anclin.2023.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
Regional anesthesia has a strong role in minimizing post-operative pain, decreasing narcotic use and PONV, and, therefore, speeding discharge times. However, as with any procedure, regional anesthesia has both benefits and risks. It is important to identify the complications and contraindications related to regional anesthesia, which patient populations are at highest risk, and how to mitigate those risks to the greatest extent possible. Overall, significant complications secondary to regional anesthesia remain low. While a variety of different regional anesthesia techniques exist, complications tend to fall within 4 broad categories: block failure, bleeding/hematoma, neurological injury, and local anesthetic toxicity.
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Coherent Control of the Fine-Structure Qubit in a Single Alkaline-Earth Atom. PHYSICAL REVIEW LETTERS 2024; 132:150606. [PMID: 38682979 DOI: 10.1103/physrevlett.132.150606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 03/11/2024] [Indexed: 05/01/2024]
Abstract
We report on the first realization of a novel neutral atom qubit encoded in the spin-orbit coupled metastable states ^{3}P_{0} and ^{3}P_{2} of a single ^{88}Sr atom trapped in an optical tweezer. Raman coupling of the qubit states promises rapid single-qubit rotations on par with the fast Rydberg-mediated two-body gates. We demonstrate preparation, readout, and coherent control of the qubit. In addition to driving Rabi oscillations bridging an energy gap of more than 17 THz using a pair of phase-locked clock lasers, we also carry out Ramsey spectroscopy to extract the transverse qubit coherence time T_{2}. When the tweezer is tuned into magic trapping conditions, which is achieved in our setup by tuning the tensor polarizability of the ^{3}P_{2} state via an external control magnetic field, we measure T_{2}=1.2 ms. A microscopic quantum mechanical model is used to simulate our experiments including dominant noise sources. We identify the main constraints limiting the observed coherence time and project improvements to our system in the immediate future. Our Letter opens the door for a so-far-unexplored qubit encoding concept for neutral atom-based quantum computing.
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Beam me up, Scotty! Apple Vision Pro highlights how we could teleport ultrasound-guided regional anesthesia education into the future. Reg Anesth Pain Med 2024:rapm-2024-105424. [PMID: 38580337 DOI: 10.1136/rapm-2024-105424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 03/22/2024] [Indexed: 04/07/2024]
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Evaluating residual anti-Xa levels following discontinuation of treatment-dose enoxaparin in patients presenting for elective surgery: an infographic. Reg Anesth Pain Med 2024; 49:102-103. [PMID: 37591616 DOI: 10.1136/rapm-2023-104873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 08/02/2023] [Indexed: 08/19/2023]
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Incidence of persistent opioid use following traumatic injury: an infographic. Reg Anesth Pain Med 2024; 49:87. [PMID: 37451824 DOI: 10.1136/rapm-2023-104812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 07/03/2023] [Indexed: 07/18/2023]
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Danger, Danger, Gaston Labat! Does zero-shot artificial intelligence correlate with anticoagulation guidelines recommendations for neuraxial anesthesia? Reg Anesth Pain Med 2024:rapm-2023-104868. [PMID: 38253610 DOI: 10.1136/rapm-2023-104868] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 09/18/2023] [Indexed: 01/24/2024]
Abstract
INTRODUCTION Artificial intelligence and large language models (LLMs) have emerged as potentially disruptive technologies in healthcare. In this study GPT-3.5, an accessible LLM, was assessed for its accuracy and reliability in performing guideline-based evaluation of neuraxial bleeding risk in hypothetical patients on anticoagulation medication. The study also explored the impact of structured prompt guidance on the LLM's performance. METHODS A dataset of 10 hypothetical patient stems and 26 anticoagulation profiles (260 unique combinations) was developed based on American Society of Regional Anesthesia and Pain Medicine guidelines. Five prompts were created for the LLM, ranging from minimal guidance to explicit instructions. The model's responses were compared with a "truth table" based on the guidelines. Performance metrics, including accuracy and area under the receiver operating curve (AUC), were used. RESULTS Baseline performance of GPT-3.5 was slightly above chance. With detailed prompts and explicit guidelines, performance improved significantly (AUC 0.70, 95% CI (0.64 to 0.77)). Performance varied among medication classes. DISCUSSION LLMs show potential for assisting in clinical decision making but rely on accurate and relevant prompts. Integration of LLMs should consider safety and privacy concerns. Further research is needed to optimize LLM performance and address complex scenarios. The tested LLM demonstrates potential in assessing neuraxial bleeding risk but relies on precise prompts. LLM integration should be approached cautiously, considering limitations. Future research should focus on optimization and understanding LLM capabilities and limitations in healthcare.
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Role of neuromodulation in acute pain settings. Reg Anesth Pain Med 2023; 48:338-342. [PMID: 37080583 DOI: 10.1136/rapm-2022-103837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 11/15/2022] [Indexed: 04/22/2023]
Abstract
Peripheral nerve stimulation (PNS), a type of neuromodulatory technique, is increasingly used to treat chronic pain syndromes. PNS has also recently gained popularity as a viable adjunct analgesic modality in acute pain settings, where the practice primarily relies on using boluses or infusion of local anesthetics for nerve blockade, followed by stimulation to extend the analgesia. There is some early promise in PNS for perioperative analgesic control, but considerable obstacles must be addressed before it can be implemented into standard practice. In this daring discourse, we explore the possibilities and constraints of using the PNS paradigm in acute pain.
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Mortality associated with long-term opioid use after lung cancer surgery: an infographic. Reg Anesth Pain Med 2022; 47:rapm-2022-103966. [PMID: 36096684 DOI: 10.1136/rapm-2022-103966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 08/26/2022] [Indexed: 11/03/2022]
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Recommendations for anatomical structures to identify on ultrasound for the performance of intermediate and advanced blocks in ultrasound-guided regional anesthesia. Reg Anesth Pain Med 2022; 47:762-772. [DOI: 10.1136/rapm-2022-103738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 08/17/2022] [Indexed: 11/03/2022]
Abstract
Recent recommendations describe a set of core anatomical structures to identify on ultrasound for the performance of basic blocks in ultrasound-guided regional anesthesia (UGRA). This project aimed to generate consensus recommendations for core structures to identify during the performance of intermediate and advanced blocks. An initial longlist of structures was refined by an international panel of key opinion leaders in UGRA over a three-round Delphi process. All rounds were conducted virtually and anonymously. Blocks were considered twice in each round: for “orientation scanning” (the dynamic process of acquiring the final view) and for “block view” (which visualizes the block site and is maintained for needle insertion/injection). A “strong recommendation” was made if ≥75% of participants rated any structure as “definitely include” in any round. A “weak recommendation” was made if >50% of participants rated it as “definitely include” or “probably include” for all rounds, but the criterion for strong recommendation was never met. Structures which did not meet either criterion were excluded. Forty-one participants were invited and 40 accepted; 38 completed all three rounds. Participants considered the ultrasound scanning for 19 peripheral nerve blocks across all three rounds. Two hundred and seventy-four structures were reviewed for both orientation scanning and block view; a “strong recommendation” was made for 60 structures on orientation scanning and 44 on the block view. A “weak recommendation” was made for 107 and 62 structures, respectively. These recommendations are intended to help standardize teaching and research in UGRA and support widespread and consistent practice.
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Same Day Joint Replacement Surgery: Patient Selection and Perioperative Management. Anesthesiol Clin 2022; 40:537-545. [PMID: 36049880 DOI: 10.1016/j.anclin.2022.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Joint replacements are increasingly performed as outpatient surgeries. The push toward ambulatory joint arthroplasty is driven in part by the changing current health care economics and reimbursement models. Patients' selection and well-designed perioperative care pathways are critical for the success of these procedures. The rate of complications after outpatient joint arthroplasty is comparable to the rate of complications in the ambulatory setting. Patient education, adequate social support, multimodal analgesia, regional anesthesia are key ingredients to the ambulatory care pathway after joint arthroplasty. Motor sparing nerve blocks are often used in these settings. Implementation of the elements of fast protocols can result in overall improvement of outcome metrics for all patients undergoing joint arthroplasty, including reduced length of stay and increased rate of home discharge.
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Effects of hypnosis versus enhanced standard of care on postoperative opioid use after total knee arthroplasty: the HYPNO-TKA randomised clinical trial-an infographic. Reg Anesth Pain Med 2022; 47:rapm-2022-103892. [PMID: 35858718 DOI: 10.1136/rapm-2022-103892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 07/11/2022] [Indexed: 11/04/2022]
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Antiviral Therapy in Cytomegalovirus-Associated Biliary Atresia. Indian J Pediatr 2022; 89:732. [PMID: 35258790 DOI: 10.1007/s12098-022-04093-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 01/11/2022] [Indexed: 11/05/2022]
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Association of opioid exposure before surgery with opioid consumption after surgery: an infographic. Reg Anesth Pain Med 2022; 47:345. [DOI: 10.1136/rapm-2022-103586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 03/10/2022] [Indexed: 11/04/2022]
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Retrospective cohort study of peripheral nerve blocks and general anesthesia versus general anesthesia alone: an infographic. Reg Anesth Pain Med 2022; 47:rapm-2022-103781. [PMID: 35636780 DOI: 10.1136/rapm-2022-103781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 05/19/2022] [Indexed: 11/03/2022]
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Evaluating the incidence of spinal cord injury after spinal cord stimulator implant: an updated retrospective review - an infographic. Reg Anesth Pain Med 2022; 47:rapm-2022-103640. [PMID: 35534021 DOI: 10.1136/rapm-2022-103640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 04/27/2022] [Indexed: 11/04/2022]
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Abstract
Regional anesthesia has a strong role in minimizing post-operative pain, decreasing narcotic use and PONV, and, therefore, speeding discharge times. However, as with any procedure, regional anesthesia has both benefits and risks. It is important to identify the complications and contraindications related to regional anesthesia, which patient populations are at highest risk, and how to mitigate those risks to the greatest extent possible. Overall, significant complications secondary to regional anesthesia remain low. While a variety of different regional anesthesia techniques exist, complications tend to fall within 4 broad categories: block failure, bleeding/hematoma, neurological injury, and local anesthetic toxicity.
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Frequency dependence of dielectric permittivity and conductivity of functionalized carbon nanotube-nematic liquid crystal nanocomposite. J Mol Liq 2022. [DOI: 10.1016/j.molliq.2021.118168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Recommendations for effective documentation in regional anesthesia: an expert panel Delphi consensus project. Reg Anesth Pain Med 2022; 47:301-308. [PMID: 35193970 PMCID: PMC8961753 DOI: 10.1136/rapm-2021-103136] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 01/10/2022] [Indexed: 01/09/2023]
Abstract
Background and objectives Documentation is important for quality improvement, education, and research. There is currently a lack of recommendations regarding key aspects of documentation in regional anesthesia. The aim of this study was to establish recommendations for documentation in regional anesthesia. Methods Following the formation of the executive committee and a directed literature review, a long list of potential documentation components was created. A modified Delphi process was then employed to achieve consensus amongst a group of international experts in regional anesthesia. This consisted of 2 rounds of anonymous electronic voting and a final virtual round table discussion with live polling on items not yet excluded or accepted from previous rounds. Progression or exclusion of potential components through the rounds was based on the achievement of strong consensus. Strong consensus was defined as ≥75% agreement and weak consensus as 50%–74% agreement. Results Seventy-seven collaborators participated in both rounds 1 and 2, while 50 collaborators took part in round 3. In total, experts voted on 83 items and achieved a strong consensus on 51 items, weak consensus on 3 and rejected 29. Conclusion By means of a modified Delphi process, we have established expert consensus on documentation in regional anesthesia.
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Reviving the medical lecture: practical tips for delivering effective lectures–an infographic. Reg Anesth Pain Med 2022; 47:342. [DOI: 10.1136/rapm-2022-103540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 02/10/2022] [Indexed: 11/04/2022]
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Complications after outpatient total joint arthroplasty with neuraxial versus general anesthesia: an infographic. Reg Anesth Pain Med 2022; 47:293. [DOI: 10.1136/rapm-2021-103411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 01/11/2022] [Indexed: 11/04/2022]
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Comparison of computer-generated sentiment analysis to traditional meta-analysis: an infographic. Reg Anesth Pain Med 2022; 47:500. [PMID: 35022264 DOI: 10.1136/rapm-2021-103381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 12/29/2021] [Indexed: 11/04/2022]
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Use of provider education, intra-operative decision support, and an email-feedback system in improving compliance with sugammadex dosage guideline and reducing drug expenditures. J Clin Anesth 2022; 77:110627. [PMID: 34990997 DOI: 10.1016/j.jclinane.2021.110627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 12/01/2021] [Accepted: 12/02/2021] [Indexed: 10/19/2022]
Abstract
STUDY OBJECTIVE Due to excessive sugammadex expenditures at our institution, we designed dosing guidelines that utilize adjusted body weight and informatics-based tools aimed at reducing variability in dosing practices. DESIGN We retrospectively reviewed rates of high-dose sugammadex administration in three phases: Pre-intervention - May 2018 to November 2018; First intervention - November 2018 to April 2019; and Second intervention - April 2019 to July 2019. SETTING Academic medical center in the United States - Vanderbilt University Medical Center (VUMC) PATIENTS: N/A INTERVENTIONS: First, anesthesia providers were educated on adjusted body weight-based dosing guidelines. Providers also received intraoperative decision support displaying a patient's actual and adjusted body weight along with rates of high-dose (>200 mg) sugammadex administration for each respective provider. Second, we implemented an email-feedback system to remind providers of the new guidelines. MEASUREMENTS Weekly rate of high-dose sugammadex cases. MAIN RESULTS During the pre-intervention stage, 1556 (12.3%) cases involved high-dose sugammadex. Comparatively, 550 (4.3%) and 187 (3.1%) high-dose sugammadex cases occurred during the first and second intervention stages, respectively. Segmented regression analysis demonstrated a significant rate change of -3.51% (95% CI: -5.64%, -1.38%) in sugammadex dosing practices after provider education and the implementation of digital improvement initiatives but failed to reveal a significant change after implementation of the email-feedback system. Overall, our interventions were associated with $2563.05 in estimated weekly savings of sugammadex expenditures. CONCLUSIONS Provider education and digital quality improvement was associated with reduced rates of high-dose sugammadex administration, generating cost savings at a large academic medical institution.
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Evidence for a we-representation in monkeys when acting together. Cortex 2022; 149:123-136. [DOI: 10.1016/j.cortex.2021.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 10/30/2021] [Accepted: 12/13/2021] [Indexed: 11/16/2022]
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Impact of ultrasound-guided erector spinae plane block on outcomes after lumbar spinal fusion: a retrospective propensity score-matched study of 242 patients-an infographic. Reg Anesth Pain Med 2021; 47:87-88. [PMID: 34887341 DOI: 10.1136/rapm-2021-103306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 11/23/2021] [Indexed: 11/04/2022]
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Recent cannabis use and nightly sleep duration in adults: an infographic. Reg Anesth Pain Med 2021; 47:105. [PMID: 34873025 DOI: 10.1136/rapm-2021-103294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 11/06/2021] [Indexed: 11/03/2022]
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Refractive index of graphene AA and AB stacked bilayers under the influence of relative planar twisting. JOURNAL OF PHYSICS. CONDENSED MATTER : AN INSTITUTE OF PHYSICS JOURNAL 2021; 34:015302. [PMID: 34614485 DOI: 10.1088/1361-648x/ac2d5f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 10/06/2021] [Indexed: 06/13/2023]
Abstract
The optical properties of graphene in monolayer and bilayer structure is essential for the development of optical devices viz surface plasmon resonance (SPR) based bio-sensors. The band structure of the twisted bilayer graphene (BLG) is remarkably different than the normal AA or AB stacking. This provides an opportunity to control the optical and electrical properties of BLG by applying an in-plane twist to one of the layer relative to other in a BLG system. Here, we calculated the refractive index (RI) of AA and AB stacking of BLG system using density functional theory. Though the spectrum for AA stacking shows some similarity with that of monolayer graphene, the spectrum for AB stacking was found to be remarkably different. The spectrum of AB stacked layer is red-shifted and the absorption peaks in low energy regime increases nearly by three-folds. A large dependency of the twist angle on RI of twisted BLG were found. Based on the calculation, a schematic of phase diagram showing material behavior of such twisted BLG systems as a function of twist angle and photon energy was constructed. The twisted AA stacked BLG shows largely dielectric behavior whereas the twisted AB stacked BLG shows predominately semimetallic and semiconducting behavior. This study presents a RI landscape of twisted BLG dependent on important parameters viz photon energy and inplane relative twist angle. Our studies will be very useful for the design and development of optical devices employing BLG systems particularly SPR based bio-sensors which essentially measures change in RI due to adsorption of analytes.
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Bariatric surgery and total knee/hip arthroplasty: an analysis of the impact of sequence and timing on outcomes: an infographic. Reg Anesth Pain Med 2021; 46:946. [PMID: 34493623 DOI: 10.1136/rapm-2021-103134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 08/28/2021] [Indexed: 11/04/2022]
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Impact of COVID-19 induced lockdown and unlock down phases on the ambient air quality of Delhi, capital city of India. URBAN CLIMATE 2021; 39:100945. [PMID: 34377634 PMCID: PMC8339501 DOI: 10.1016/j.uclim.2021.100945] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 07/17/2021] [Accepted: 07/31/2021] [Indexed: 05/05/2023]
Abstract
The present study deals with the impact of the pandemic outbreak of COVID-19 on the ambient air quality in the capital city of India. Real-time data were collected from eight continuous ambient air quality monitoring stations measuring important air quality parameters (NO2, PM10 and PM2.5). Results revealed that the city's air quality had improved significantly during the lockdown period due to COVID-19 outbreak. The concentration of gaseous and particulate matter during the lockdown period (March-May 2020) declined significantly compared with the preceding years' data from the same timeframe. However, the ambient air quality deteriorates with the onset of unlocking phases and post-monsoon season (October 2020). Higher concentration of NO2, PM10 and PM2.5 were recorded at industrial (S1 and S2) and hotspot (S4 and S5) sites. The lowest concentrations of studied pollutants were observed during the first phase of lockdown (March 24 - May 14, 2020). The present study, once again, establishes the direct effect of anthropogenic activities and deteriorating ambient air quality of Delhi.
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Comparison of continuous intravenous lidocaine versus TAP block for kidney transplant: an infographic. Reg Anesth Pain Med 2021; 46:954. [PMID: 34452982 DOI: 10.1136/rapm-2021-103095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 08/21/2021] [Indexed: 11/03/2022]
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Comparison of Bone-Patellar Tendon-Bone Graft, Semitendinosus-Gracilis Graft and Semitendinosus-Gracilis with Preserved Tibial Insertion Graft in Anterior Cruciate Ligament Reconstruction in Sports Persons. Malays Orthop J 2021; 15:12-17. [PMID: 34429817 PMCID: PMC8381676 DOI: 10.5704/moj.2107.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 04/04/2021] [Indexed: 11/05/2022] Open
Abstract
Introduction Bone-patellar tendon-bone (BPTB) and semitendinosus-gracilis (STG) are the commonest grafts used for ACL reconstruction. However even after having been debated for years, there is no consensus about the ideal graft. Moreover, the literature is deficient about STG graft with preserved tibial insertion (STGPI) which preserves the proprioception. Our aim is to compare the outcome of BPTB, free STG and STGPI grafts after ACL reconstruction in professional sports persons. We compared the outcome in terms of mechanical stability, functional outcome, return to sports activity and degenerative changes. Material and Methods Professional sports persons aged between 16-50 years operated for ACL tear using BPTB, free STG and STGPI grafts with minimum follow-up of two years were identified from hospital records. Patients with associated knee injuries were excluded. Patients, divided in three groups according to graft used, were compared in terms of mechanical stability (arthrometric examination KT-1000 score), functional outcome (Lysholm Score), return to sports activity (Tegner score and difference in thigh circumference) and degenerative changes (KL grading). Results BPTB graft group was found to be better than free STG and STGPI graft groups in terms of KT-1000 score. There was no statistically significant difference among the groups in terms of Lysholm score, Tegner score, difference in thigh circumference and KL grading. Conclusion BPTB graft is better than free STG and STGPI grafts in terms of knee stability. When compared for patient reported outcome, return to sports activity, osteoarthritic changes and graft failure there is no significant difference among the three types of grafts.
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Waking up in pain: an infographic. Reg Anesth Pain Med 2021; 46:947. [PMID: 34408069 DOI: 10.1136/rapm-2021-103009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 07/27/2021] [Indexed: 11/04/2022]
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Simple screening model for identifying the risk of sleep apnea in patients on opioids for chronic pain: an infographic. Reg Anesth Pain Med 2021; 46:892. [PMID: 34373346 DOI: 10.1136/rapm-2021-103010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 07/29/2021] [Indexed: 11/03/2022]
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Local anesthetic systemic toxicity in children: a review of recent case reports and current literature - an infographic. Reg Anesth Pain Med 2021; 46:915. [PMID: 34230193 DOI: 10.1136/rapm-2021-102993] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 06/26/2021] [Indexed: 11/04/2022]
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Femoral triangle block plus iPACK block versus local infiltration analgesia for anterior cruciate ligament reconstruction: an infographic. Reg Anesth Pain Med 2021; 47:64. [PMID: 34145055 DOI: 10.1136/rapm-2021-102942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 06/09/2021] [Indexed: 11/03/2022]
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Opioid Prescribing to Medicare Part D Enrollees, 2013-2017: Shifting Responsibility to Pain Management Providers. PAIN MEDICINE 2021; 21:1400-1407. [PMID: 31904839 DOI: 10.1093/pm/pnz344] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To examine opioid prescribing frequency and trends to Medicare Part D enrollees from 2013 to 2017 by medical specialty and provider type. METHODS We conducted a retrospective, cross-sectional, specialty- and provider-level analysis of Medicare Part D prescriber data for opioid claims from 2013 to 2017. We analyzed opioid claims and prescribing trends for specialties accounting for ≥1% of all opioid claims. RESULTS From 2013 to 2017, pain management providers increased Medicare Part D opioid claims by 27.3% to 1,140 mean claims per provider in 2017; physical medicine and rehabilitation providers increased opioid claims 16.9% to 511 mean claims per provider in 2017. Every other medical specialty decreased opioid claims over this period, with emergency medicine (-19.9%) and orthopedic surgery (-16.0%) dropping opioid claims more than any specialty. Physicians overall decreased opioid claims per provider by -5.2%. Meanwhile, opioid claims among both dentists (+5.6%) and nonphysician providers (+10.2%) increased during this period. CONCLUSIONS From 2013 to 2017, pain management and PMR increased opioid claims to Medicare Part D enrollees, whereas physicians in every other specialty decreased opioid prescribing. Dentists and nonphysician providers also increased opioid prescribing. Overall, opioid claims to Medicare Part D enrollees decreased and continue to drop at faster rates.
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Postoperative opioid consumption after spine surgery: 24 hours or midnight to midnight? An infographic. Reg Anesth Pain Med 2021; 46:822. [PMID: 33853881 DOI: 10.1136/rapm-2021-102761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 04/08/2021] [Indexed: 11/04/2022]
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Post Vaccination Epidemiology and Genotyping of Rotavirus Gastroenteritis at a Tertiary Care Centre of North-East Rajasthan. Indian J Pediatr 2021; 88:90-96. [PMID: 33247377 DOI: 10.1007/s12098-020-03569-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 11/09/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To estimate the proportion of rotavirus diarrhea among hospitalized children aged under-five years, to determine the circulating rotavirus genotypes and to know impact rotavirus vaccine on prevalence and severity of rotavirus diarrhea. METHODS This study was a hospital based cross-sectional observational study conducted over a period of 29 mo (September 2017 through January 2020). Stool samples were collected from children who fall within the age range of 0-59 mo with acute diarrhea attending emergency or needing admission. Stool samples were tested for rotavirus by the enzyme linked immune-sorbent assay (ELISA) and genotyped using published methods. RESULTS Out of 1480 samples, 360 (24.32%) cases were positive for rotavirus by ELISA, majority of them were male (62.97%). Maximum rotavirus positivity was found in the age group of <11 mo (55.27%). Statistically significance difference was seen in episodes of diarrhea and experience of vomiting in rotavirus diarrhea cases. Highest prevalence has been seen during winter season. The most prevalent G and P type combinations were G3P [8] strains [122 (34.08%)], G2P [4] [83 (23.18%)], G1P [8] [27 (7.54%)] and G9P [4] [20 (5.59%)]. Mixed strains contribute a significant proportion of stool sample. CONCLUSIONS Rotavirus is an important cause of diarrhea in hospitalized children. There is continued circulation of G9 and G12 strains and the emergence of G3P [8] as most common strain.
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Dual Microbial Inoculation, a Game Changer? - Bacterial Biostimulants With Multifunctional Growth Promoting Traits to Mitigate Salinity Stress in Spring Mungbean. Front Microbiol 2021; 11:600576. [PMID: 33584566 PMCID: PMC7874087 DOI: 10.3389/fmicb.2020.600576] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 12/16/2020] [Indexed: 11/13/2022] Open
Abstract
Soil microbes play a vital role in improving plant growth, soil health, ameliorate biotic/abiotic stress and enhance crop productivity. The present study was aimed to investigate a coordinated effect of compatible consortium [salt tolerating Rhizobium and rhizobacterium with 1-aminocyclopropane-1-carboxylate (ACC) deaminase] in enhancing plant growth promoting (PGP) traits, symbiotic efficiency, nutrient acquisition, anti-oxidative enzymes, grain yield and associated profitability in spring mungbean. We identified a non-pathogenic compatible Rhizobium sp. LSMR-32 (MH644039.1) and Enterococcus mundtii LSMRS-3 (MH644178.1) from salt affected areas of Punjab, India and the same were assessed to develop consortium biofertilizer based on salt tolerance, multifarious PGP traits, antagonistic defense activities and presence of nifH, acds, pqq, and ipdc genes. Indole Acetic acid (IAA), P-solubilization, biofilm formation, exo-polysaccharides, siderophore, salt tolerance, ACC deaminase activities were all found highly significant in dual inoculant (LSMR-32 + LSMRS-3) treatment compared to LSMR-32 alone. Under saline soil conditions, dual inoculant showed a higher seed germination, plant height, biomass, chlorophyll content and macro and micro-nutrient uptake, than un-inoculated control. However, symbiotic (nodulation, nodule biomass and leghaemoglobin content) and soil quality parameters (phosphatase and soil dehydrogenase enzymes) increased numerically with LSMR-32 + LSMRS-3 over Rhizobium sp. LSMR-32 alone. Dual bacterial inoculation (LSMR-32 + LSMRS-3) increased the proline content (2.05 fold), anti-oxidative enzymes viz., superoxide dismutase (1.50 fold), catalase (1.43 fold) and peroxidase (3.88 folds) in contrast to control treatment. Decreased Na+ accumulation and increased K+ uptake resulted in favorable K+/Na+ ratio through ion homeostasis. Co-inoculation of Rhizobium sp. LSMR-32 and Enterococcus mundtii LSMRS-3 significantly improved the grain yield by 8.92% and led to superior B: C ratio over Rhizobium sp. alone under salt stress. To best of our knowledge this is perhaps the first field report from Indian soils that largely describes dual inoculation of Rhizobium sp. LSMR-32 and Enterococcus mundtii LSMRS-3 and the same can be considered as a game-changer approach to simultaneously induce salt tolerance and improve productivity in spring mungbean under saline stress conditions.
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Carbon removal from a mirror-like gold surface by UV light, RF plasma, and IR laser exposure: a comparative study. APPLIED OPTICS 2021; 60:89-97. [PMID: 33362083 DOI: 10.1364/ao.400508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 12/05/2020] [Indexed: 06/12/2023]
Abstract
A decrease in photon intensity due to carbon contamination on optical elements is a serious issue in synchrotron radiation (SR) beamlines. Photon intensity can be regained by refurbishment of optical elements using suitable techniques. In the literature, three suitable techniques [radio frequency (RF) plasma, ultraviolet (UV) radiation (λ=172nm), and infrared (IR) laser (λ=1064nm) exposure] are reported to remove carbon contaminations from optical elements. These techniques are used independently to remove carbon, and, to the best of our knowledge, no systematic study is available on their relative efficiencies and effects on a mirror surface. We have applied these techniques independently for removal of carbon contamination from a gold surface, and detailed surface characterizations are carried out using soft x-ray reflectivity, x-ray photoelectron spectroscopy, Raman spectroscopy, and atomic force microscopy techniques. Characterization results suggest that all three techniques are capable of removing carbon contamination with certain limitations. Here, detailed relative effects on a gold surface after cleaning experiments with three techniques are discussed.
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Neutralising antibodies in Spike mediated SARS-CoV-2 adaptation. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020:2020.12.05.20241927. [PMID: 33398302 PMCID: PMC7781345 DOI: 10.1101/2020.12.05.20241927] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
SARS-CoV-2 Spike protein is critical for virus infection via engagement of ACE2, and amino acid variation in Spike is increasingly appreciated. Given both vaccines and therapeutics are designed around Wuhan-1 Spike, this raises the theoretical possibility of virus escape, particularly in immunocompromised individuals where prolonged viral replication occurs. Here we report chronic SARS-CoV-2 with reduced sensitivity to neutralising antibodies in an immune suppressed individual treated with convalescent plasma, generating whole genome ultradeep sequences by both short and long read technologies over 23 time points spanning 101 days. Although little change was observed in the overall viral population structure following two courses of remdesivir over the first 57 days, N501Y in Spike was transiently detected at day 55 and V157L in RdRp emerged. However, following convalescent plasma we observed large, dynamic virus population shifts, with the emergence of a dominant viral strain bearing D796H in S2 and ΔH69/ΔV70 in the S1 N-terminal domain NTD of the Spike protein. As passively transferred serum antibodies diminished, viruses with the escape genotype diminished in frequency, before returning during a final, unsuccessful course of convalescent plasma. In vitro, the Spike escape double mutant bearing ΔH69/ΔV70 and D796H conferred decreased sensitivity to convalescent plasma, whilst maintaining infectivity similar to wild type. D796H appeared to be the main contributor to decreased susceptibility, but incurred an infectivity defect. The ΔH69/ΔV70 single mutant had two-fold higher infectivity compared to wild type and appeared to compensate for the reduced infectivity of D796H. Consistent with the observed mutations being outside the RBD, monoclonal antibodies targeting the RBD were not impacted by either or both mutations, but a non RBD binding monoclonal antibody was less potent against ΔH69/ΔV70 and the double mutant. These data reveal strong selection on SARS-CoV-2 during convalescent plasma therapy associated with emergence of viral variants with reduced susceptibility to neutralising antibodies.
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Initiative to accelerate guideline distribution using the smartphone app ASRA Coags V.2.0. Reg Anesth Pain Med 2020; 46:354-355. [PMID: 33127809 DOI: 10.1136/rapm-2020-101921] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 10/02/2020] [Accepted: 10/06/2020] [Indexed: 11/04/2022]
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Facile ultrathin film of silver nanoparticles for bacteria sensing. Colloids Surf B Biointerfaces 2020; 196:111335. [PMID: 32927339 DOI: 10.1016/j.colsurfb.2020.111335] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 08/13/2020] [Accepted: 08/17/2020] [Indexed: 12/29/2022]
Abstract
Silver nanoparticles (AgNPs) exhibit excellent anti-microbial and bactericidal properties. Due to bacterial abhorrence for AgNPs, it is difficult to develop a label-free, sensitive and low-cost bacteria sensor using them. In the present article, we report that an ultrathin and uniform Langmuir-Schaefer (LS) film of AgNPs can be employed for bacteria sensing effectively as compared to that of non-uniform and randomly distributed AgNPs in spin coated film. The uniformly distributed AgNPs in the LS film offer a relatively larger contact surface for bacteria as compared to that of spin coated film. Due to higher contact surface, adsorption of the bacteria on LS film is strongly preferable as compared to that of spin coated film leading to an enhanced sensing performance of the LS film than that of spin coated film. Soil bacteria was grown by the standard protocol and were utilized as model system for bacteria sensing application. The soil bacteria sensing was done by monitoring the piezoresponse and dissipation parameters using a quartz crystal microbalance, simultaneously. Our study indicates that the LS film of AgNPs not only facilitates the adsorption of the soil bacteria but also kills them.
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Morphological transformation in the supramolecular assembly of discotic liquid crystal molecules using silver nanoparticles and its sensing application. NANOTECHNOLOGY 2020; 31:365605. [PMID: 32422619 DOI: 10.1088/1361-6528/ab93eb] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Triphenylene based discotic liquid crystal (TP) molecules are rich in π-electrons which facilitate π-stacking interaction of the molcules leading to formation of one dimensional nanowires. These nanowires can assemble to form nanoribbons due to a lateral cohesive force among the nanowires. The flat nanoribons undergo a morphological transformation due to incorporation of silver nanoparticles (SNP) into the matrix of TP molecules. The presence of SNP induces a chiral twisting to the nanoribbons and therefore the flat nanoribbons transform into a helical nanoribbon structure. The global chiral structure exhibited by the composition of achiral constituents is due to the creation of topological defects like disclination and dislocation. These defects can lead to a geometrical frustration in the nanoribbons which relaxes with the formation of twisted helical nanoribbons. A minor change in morphology of the supramolecular assembly can have a remarkable effect on the physicochemical properties of the nanoribbons. In this article, we demonstrate that even a minor change in the geometry of aliphatic chains on the surface of nanoribbons can be employed for sensing organic solvents such as acetone and ethanol. The sensing was performed at room temperature. Relative humidity has no effect on the sensing response.
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Human Immunodeficiency Virus-1 Viral Load Is Elevated in Individuals With Reverse-Transcriptase Mutation M184V/I During Virological Failure of First-Line Antiretroviral Therapy and Is Associated With Compensatory Mutation L74I. J Infect Dis 2020; 222:1108-1116. [PMID: 31774913 PMCID: PMC7459140 DOI: 10.1093/infdis/jiz631] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 11/26/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND M184V/I cause high-level lamivudine (3TC) and emtricitabine (FTC) resistance and increased tenofovir disoproxil fumarate (TDF) susceptibility. Nonetheless, 3TC and FTC (collectively referred to as XTC) appear to retain modest activity against human immunodeficiency virus-1 with these mutations possibly as a result of reduced replication capacity. In this study, we determined how M184V/I impacts virus load (VL) in patients failing therapy on a TDF/XTC plus nonnucleoside reverse-transcriptase inhibitor (NNRTI)-containing regimen. METHODS We compared VL in the absence and presence of M184V/I across studies using random effects meta-analysis. The effect of mutations on virus reverse-transcriptase activity and infectiousness was analyzed in vitro. RESULTS M184I/V was present in 817 (56.5%) of 1445 individuals with virologic failure (VF). Virus load was similar in individuals with or without M184I/V (difference in log10 VL, 0.18; 95% confidence interval, .05-.31). CD4 count was lower both at initiation of antiretroviral therapy and at VF in participants who went on to develop M184V/I. L74I was present in 10.2% of persons with M184V/I but absent in persons without M184V/I (P < .0001). In vitro, L74I compensated for defective replication of M184V-mutated virus. CONCLUSIONS Virus loads were similar in persons with and without M184V/I during VF on a TDF/XTC/NNRTI-containing regimen. Therefore, we did not find evidence for a benefit of XTC in the context of first-line failure on this combination.
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Baseline PI susceptibility by HIV-1 Gag-protease phenotyping and subsequent virological suppression with PI-based second-line ART in Nigeria. J Antimicrob Chemother 2020; 74:1402-1407. [PMID: 30726945 PMCID: PMC6477990 DOI: 10.1093/jac/dkz005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 12/14/2018] [Accepted: 12/31/2018] [Indexed: 12/24/2022] Open
Abstract
Objectives Previous work showed that gag-protease-derived phenotypic susceptibility to PIs differed between HIV-1 subtype CRF02_AG/subtype G-infected patients who went on to successfully suppress viral replication versus those who experienced virological failure of lopinavir/ritonavir monotherapy as first-line treatment in a clinical trial. We analysed the relationship between PI susceptibility and outcome of second-line ART in Nigeria, where subtypes CRF02_AG/G dominate the epidemic. Methods Individuals who experienced second-line failure with ritonavir-boosted PI-based ART were matched (by subtype, sex, age, viral load, duration of treatment and baseline CD4 count) to those who achieved virological response (‘successes’). Successes were defined by viral load <400 copies of HIV-1 RNA/mL by week 48. Full-length Gag-protease was amplified from patient samples for in vitro phenotypic susceptibility testing, with PI susceptibility expressed as IC50 fold change (FC) relative to a subtype B reference strain. Results The median (IQR) lopinavir IC50 FC was 4.04 (2.49–7.89) for virological failures and 4.13 (3.14–8.17) for virological successes (P = 0.94). One patient had an FC >10 for lopinavir at baseline and experienced subsequent virological failure with ritonavir-boosted lopinavir as the PI. There was no statistically significant difference in single-round replication efficiency between the two groups (P = 0.93). There was a moderate correlation between single-round replication efficiency and FC for lopinavir (correlation coefficient 0.32). Conclusions We found no impact of baseline HIV-1 Gag-protease-derived phenotypic susceptibility on outcomes of PI-based second-line ART in Nigeria.
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How Twitter conversations using hashtags #regionalanesthesia and #regionalanaesthesia have changed in the COVID-19 era. Reg Anesth Pain Med 2020; 45:765-766. [PMID: 32616566 PMCID: PMC7513259 DOI: 10.1136/rapm-2020-101747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 06/17/2020] [Accepted: 06/19/2020] [Indexed: 11/29/2022]
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Cubitus Valgus with Tardy Ulnar Nerve Palsy - Functional Outcome of Milch Osteotomy without Anterior Transposition of Ulnar Nerve. Malays Orthop J 2020; 14:120-125. [PMID: 32983386 PMCID: PMC7513644 DOI: 10.5704/moj.2007.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Introduction: To assess the results of Milch osteotomy in terms of deformity correction and functional outcome in the absence of ulnar nerve transposition. Material and Methods: Nine patients with cubitus valgus deformity greater than 20° with tardy ulnar nerve palsy (TUNP) operated between 2012 and 2017 were evaluated. Correction by Milch osteotomy and fixation was done in each case, without osteosynthesis of the non-union lateral condyle humerus or transposition of the ulnar nerve. At one year post-operatively, carrying angle, elbow function (Mayo Elbow Performance Score) and ulnar nerve symptoms were assessed. Results: The mean carrying angle pre-operatively was 30.8° on the affected side which improved to a mean of 8.3° postoperatively with an average correction of 22.5°. The mean elbow flexion pre-operatively was 129.4° which improved to 133.3° post-operatively. The mean preoperative MEP score was 76.7 which improved to a mean of 92.2 post-operatively (p < 0.01). TUNP recovered completely in all the patients. Conclusion: Milch osteotomy is an effective procedure for cubitus valgus deformity correction and its associated tardy ulnar nerve palsy without a decrease in elbow ROM. Correction of even severe valgus deformities without concurrent anterior transposition of the ulnar nerve is likely to improve ulnar nerve symptoms.
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The #ASRASpring20 conference was canceled due to COVID-19 but the science survives and thrives. Reg Anesth Pain Med 2020; 46:374-375. [PMID: 32409515 DOI: 10.1136/rapm-2020-101645] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 04/30/2020] [Indexed: 11/03/2022]
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Facile Synthesis of Bio-Templated Tubular Co₃O₄ Microstructure and Its Electrochemical Performance in Aqueous Electrolytes. JOURNAL OF NANOSCIENCE AND NANOTECHNOLOGY 2020; 20:3182-3194. [PMID: 31635663 DOI: 10.1166/jnn.2020.17414] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Template-assisted facile synthesis of tubular Co₃O₄ microstructures and its electrochemical performance was studied to understand its use as a potential electrode material for supercapacitors. Tubular porous Co₃O₄ microstructures were synthesized using cotton fibers as bio-template. The as-obtained templated Co₃O₄ structure inherits the morphology and microstructure of cotton fiber. The electrochemical performance of the electrode made up of tubular Co₃O₄ structure was evaluated in 3 M KOH, NaOH, and LiOH aqueous electrolytes. The large-surface-area of tubular Co₃O₄ microstructure has a noticeable pseudocapacitive performance with a capacitance of 401 F/g at 1 A/g and 828 F/g at 2 mV/s, a Coulombic efficiency averaging ~100%, and excellent cycling stability with capacitance retention of about 80% after 5,000 cycles. Overall, the tubular Co₃O₄ microstructure displayed superior electrochemical performance in 3 M KOH electrolyte with peak power density reaching 5,500 W/kg and energy density exceeding 22 Wh/kg. The superior performance of tubular Co₃O₄ microstructure electrode is attributed to its high surface area and adequate pore volume distribution, which allows effective redox reaction and diffusion of hydrated ions. The facile synthesis method can be adapted for preparing various metal oxide microstructures for possible applications in catalysis, electrochemical, sensors, and fuel cells applications.
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