Objectives The pectoral nerve block type II (PECS II block) is widely used for postoperative analgesia after breast surgery. This study evaluated the analgesic efficacy of PECS II block in patients undergoing breast-conserving surgery (BCS) and sentinel lymph node biopsy (SNB). Methods Patients were randomized to the control group (n=40) and the PECS II group (n=40). An ultrasound-guided PECS II block was performed after induction of anesthesia. The primary outcome measure was opioid consumption, and the secondary outcome was pain at the breast and axillary measured using the Numerical Rating Scale (NRS) 24 hours after surgery. Opioid requirement was assessed according to tumor location. Results Opioid requirement was lower in the PECS II than in the control group (43.8 ± 28.5 µg versus 77.0 ± 41.9 µg, p < 0.001). However, the frequency of rescue analgesics did not differ between these groups. Opioid consumption in the PECS II group was significantly lower in patients with tumors in the outer area than that in patients with tumors in the inner area (32.5 ± 23.0 µg versus 58.0 ± 29.3 µg, p=0.007). The axillary NRS was consistently lower through 24 hr in the PECS II group. Conclusion Although the PECS II block seemed to reduce pain intensity and opioid requirements for 24 h after BCS and SNB, these reductions may not be clinically significant. This trial is registered with Clinical Research Information Service KCT0002509.

The combined epidural adhesiolysis and balloon decompression with a ZiNeu catheter led to significant pain relief and functional improvement in a subset of patients with refractory spinal stenosis.

When we drink green tea infusion, we believe we are drinking the extract of the green tea leaves. While practically each tea bag infused in 300 mL water contains about 50 mg of suspended green tea leaf particles. What is the role of these particles in the green tea effect is the objective of this study. These particles (three different size ranges) were isolated via varying speed centrifugation and their respective inputs evaluated. Live oral bacterial samples from human volunteers have been screened against green tea extracts and macro, micro and nano sized green tea particles. The results showed that the presence/absence of the macro and mico sized tea particles in the green tea extract did not contribute much. However, the nano sized particles were characterized to be nature’s nano stores of the bioactive catechins. Eradication of these nano tea particles resulted in decrease in the bactericidal property of the green tea extracts. This is a curtain raiser investigation, busting the nano as well as green tea leaf particle contribution in green tea extracts.

A new electroluminescence (EL) polymer utilizing a new backbone, poly (2,6-(4,4-bis(2ethylhexyl)-4H-cyclopenta-[def]phenanthrene)) (PCPP), with stabilized blue emission is reported. PCPP was synthesized from 4H-cyclopenta[def]phenanthrene over five steps. The photoluminescence (PL) spectra of PCPP did not show any peak in the long wavelength region even after annealing for 18 h at 150 °C in air. The OLED with the configuration of ITO/PEDOT:PSS/PCPP/Al generates EL emission with a maximum peak at 400 nm, low turn-on voltage (6.0 V), and excellent CIE coordinates (x ) 0.17, y ) 0.12) for the blue color without any filtering. The maximum brightness of the OLEDs using PCPP was 1500 cd/m 2 at 14 V. The maximum luminescence efficiency of the polymer LEDs with PCPP was 0.70 cd/A at 180 mA/cm 2 . In addition to this, PCPP displays stabilized blue EL emission without any low-energy emission band in the region of 500-600 nm even after annealing for 18 h at 150 °C or operation of the device for 40 min in air.

No abstract

BACKGROUND: Male patients undergoing transurethral resection of bladder tumors (TURBT) are prone to suffer from catheter-related bladder discomfort (CRBD). Lidocaine administration has been widely performed to reduce postoperative pain. Here, the effect of intravenous lidocaine administration on moderate-to-severe CRBD was evaluated in male patients undergoing TURBT. METHODS: Patients were randomly allocated to receive intravenous lidocaine (1.5 mg/kg bolus dose followed by a 2 mg/kg/h continuous infusion during the intraoperative period, which was continued for 1 hour postsurgery; group L) or placebo (normal saline; group C). The primary outcome was moderate-to-severe CRBD at 0 hour postsurgery (on admission to the postanesthetic care unit), analyzed using the χ2 test. The secondary outcome was opioid requirement during the 24-hour postoperative period. None, mild, and moderate-to-severe CRBD at 1, 2, and 6 hours postsurgery, postoperative pain, patient satisfaction, side effects of lidocaine and rescue medications (tramadol and fentanyl), and surgical complications were also assessed. RESULTS: A total of 132 patients were included in the study (66 patients in each group). The incidence of moderate-to-severe CRBD at 0 hour postsurgery was significantly lower in group L than in group C (25.8% vs 66.7%, P < .001, relative risk: 0.386, 95% confidence interval: 0.248–0.602). Opioid requirements during the 24-hour postoperative period were significantly lower in group L than in group C (10.0 mg [interquartile range (IQR), 5.0–15.0 mg] vs 13.8 mg [IQR, 10.0–20.0 mg], P = .005). At 1 and 2 hours postsurgery (but not at 6 hours), the incidence of moderate-to-severe CRBD was significantly lower in group L than in group C (1 hour: 10.6% vs 27.3%, P = .026; 2 hours: 0.0% vs 15.2%, P = .003). Patient satisfaction was significantly greater in group L than in group C (5.0 [IQR, 4.8–6.0] vs 4.0 [IQR, 4.0–5.0], P < .001). No lidocaine-related side effects were reported. Rescue medication-related side effects and surgical complications did not differ significantly between the 2 groups. CONCLUSIONS: Intravenous lidocaine administration resulted in lower incidence of moderate-to-severe CRBD, lower opioid requirement, and higher patient satisfaction in male patients undergoing TURBT without evidence of significant side effects.

S imulation is an ideal way to predict behavior in complex systems that we cannot otherwise test. For example, imagine trying to predict the behavior of a weapons system or a set of flood warning sensors by testing the real thing. Simulation offers definite advantages-safety and controlled circumstances, for instance-over the limited testing we could perform with an actual wartime battle or a real flood. The behavioral complexity that such large-scale modern systems can exhibit, however, demands computing power that exceeds current desktop technology. To meet such a challenge, we need high-resolution, large-scale representations of systems composed of both naturally occurring and manmade elements.In this article we describe a high-performance simulation environment we developed to model complex systems. We also discuss results we obtained by modeling and simulating a watershed. Environment overviewThe simulation environment we developed is called DEVS-C++. It is based on a modeling formalism called DEVS, which stands for Discrete-Event System Specification, as we will explain.We can characterize a high-performance, simulationbased design environment with two levels of intensive information processing:♦ At the decision-making level, the environment searches many alternative designs and associated models.♦ At the execution level, simulations generate and evaluate complex candidate model behaviors, possibly interacting with human participants in real time.Our simulation environment has four layers: simulation (lowest), modeling, optimization, and decision making (highest). Each builds on lower layers to implement its functionality.As Figure 1 shows, processes execute concurrently in a heterogeneous, distributed computing environment. 1 We use genetic algorithms in the optimization layer to search through a model space to find models that will effectively predict system behavior.The functions of a GA are distributed among software components called agents. Each GA agent has access to a simulator for executing experiments. Experiments consist of several trials, testing how well a particular structure works in a problem environment. We represent the environment as a simulation model, controlled and ♦ ♦ ♦ DEVS-C++, a high-performance environment for modeling large-scale systems at high resolution, uses a discrete-event formalism called DEVS to represent both continuous and discrete processes. A prototype suggests that the DEVS formalism can combine with genetic algorithms running in parallel to serve as the basis of a very general, very fast class of simulation environments.♦ .

We present a new expression for the energy of the lowest collective states in even-even nuclei throughout the entire periodic table. Our empirical formula holds universally for all of the natural parity even multipole states and describes the overall trends. This formula depends only on the mass number and the valence nucleon numbers with six parameters. The parameters are determined unambiguously from the data for each multipole state. We discuss the validity of our empirical formula by comparing our results with those of other studies and also by estimating the average and the dispersion of the logarithmic errors of the calculated excitation energies with respect to the measured ones.