After several months of personal journey towards accepting that the coronavirus pandemic is real (see Jandrić 2020a, b), in early March, it dawned on me that the pandemic does not need only so-called essential workers. Self-quarantined after returning from abroad weeks before the Croatian government locked down the country, I immediately wrote an editorial for Postdigital Science and Education and argued that 'While doctors, nurses, politicians, food suppliers, and many other brave people self-sacrifice to support our daily survival, this editorial argues that academics have a unique opportunity, and a moral duty, to immediately start conducting in-depth studies of current events.' (Jandrić 2020c: 234) I had no idea how to even approach these studies, yet I had a strong feeling that something needed to be done urgently. So, I just did what I know best and issued calls for 3 different types of Covid-19-related material to be published in Postdigital Science and Education: short testimonies, longer commentary articles, and full-length original articles. I had no idea how much material I would receive, what this material would look like, and what I would do with this material. I just had a deep gut feeling that we are witnessing a unique time in human history, a once-in-a-lifetime event, that needs to be recorded as it unfolds. For better or for worse, I decided to follow that feeling. This general vision, without a clear idea of what I was doing, paved a bumpy road for the development of this collection. On 17 March 2020, I shared the Call for Testimonies on Postdigital Science and Education social network sites and I emailed it to the journal's mailing list. Based on my previous experience with similar calls, I expected to receive 10 to 15 contributions and produce a standard-length collective article aiming at postdigital dialogue (Jandrić et al. 2019) about the pandemic. Yet my call went 'viral', at least for academic standards, and a couple of weeks later, I had more than 50,000 words written by more than 80 authors. So how do I make sense of all that material? My dear friend and Associate Editor of Postdigital Science and Education, Sarah Hayes, came to my rescue. We first tried to make sense of the contributions using critical discourse
Bispectral analysis (BIS) of the electroencephalogram (EEG) has been shown in retrospective studies to predict whether patients will move in response to skin incision. This prospective multicenter study was designed to evaluate the real-time utility of BIS in predicting movement response to skin incision using a variety of general anesthetic techniques. Three hundred patients from seven study sites received an anesthetic regimen expected to give an approximately 50% movement response at skin incision. EEG was continuously recorded via an Aspect B-500 monitor and BIS was calculated in real time from bilateral frontocentral channels displayed on the monitor. Half of the patients were randomized to a treatment group in which anesthetic drug doses were increased to produce a lower BIS. In the control group, BIS was recorded, but no action taken on the data displayed. A determination of movement in response to skin incision was made in the 2 min succeeding incision. Retrospective pharmacodynamic modeling was performed using STANPUMP to estimate effect-site concentrations of intravenously administered anesthetics. BIS values were significantly higher in the control group (66 +/- 19) versus the BIS-guided group, in which additional anesthesia was administered to produce a lower BIS (51 +/- 19). The movement response rate was significantly higher in the control group at 43% compared with 13% in the BIS-guided group, but response rates were low at sites which used larger doses of opioids. Logistic regression analysis showed that BIS, estimated opioid effect-site concentrations, and heart rate (in that order) were the best predictors of movement at skin incision. This study demonstrates that dosing anesthetic drugs to lower BIS values achieves a lower probability of movement in response to surgical stimulation. BIS is a significant predictor of patient response to incision, but the utility of the BIS depends on the anesthetic technique being used. When drugs such as propofol or isoflurane are used as the primary anesthetic, changes in BIS correlate with the probability of response to skin incision. When opioid analgesics are used, the correlation to patient movement becomes much less significant, so that patients with apparently "light" EEG profiles may not move or otherwise respond to incision. Therefore, the adjunctive use of opioid analgesics confounds the use of BIS as a measure of anesthetic adequacy when movement response to skin incision is used as the primary end point.
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