Opioid-Free Total Intravenous Anesthesia for Morbidly Obese Patient Undergoing Gastric Bypass with a History of Postoperative Nausea and Vomiting

Postoperative nausea and vomiting (PONV) is a common undesirable effect from general anesthesia. PONV is nausea and/or vomiting that occurs either in the post-anesthesia care unit (PACU), or up until 48 hours after surgery. Increased salivation, retching, and tachycardia are common when one experiences nausea. Since the typical surgical patient is volumed depleted from being NPO, vomiting can exacerbate other issues especially fluid and electrolyte balances. To mitigate PONV, anesthesia providers are avoiding agents that trigger nausea and vomiting, especially opioids and volatile inhalation anesthetics. This requires the use of total intravenous anesthesia, or TIVA, with multimodal opioid-free analgesic adjuncts. In this evidence-based case study, a 34-year-old morbidly obese female with a history of PONV presented to the hospital for gastric bypass surgery. The literature in this case study will examine the utilization of opioid-free TIVA in reducing the incidence of PONV in a highly susceptible morbidly obese, young, female patient presenting for laparoscopic surgery

The strength of the shell of the mussel Mytilus edulis under compressive and cyclic loading

A crab uses its chelae to repeatedly apply force to a bivalve's shell over a period of time. Doing this creates small fractures in the shell, which causes the failure of the material at subcritical loads. This strategy, called cyclical loading, enables a crab to consume prey that is large and strong without expending excessive energy. The effect of cyclical loading by the shore crab Carcinus maenas was simulated on valves of the blue mussel, Mytilus edulis. The hypothesis that the left and right valves were statistically the same in terms of height, thickness, compressive displacement, and compressive force was tested and later accepted. Valves from individual mussels underwent compression tests, which applied an increasing force at a rate of 1 mm/min until the valve broke. Other valves underwent cyclical loading tests, in which a force of 100 N was applied at a rate of 0.1 mm/sec, released, and repeated for 10 cycles. The hypothesis that cyclical loading would reduce the integrity of the shell and reduce the breaking force of the valves was tested using compression followed by cyclical loading tests. Left and right valves were randomly assigned to a compression test or to a cyclical loading test followed by a compression test to compare the breaking force for each group of valves. No effect of cyclical loading was found on the breaking strengths of valves when compared to strength under simple compressive loading

Diamond Team Management: A Web and Mobile-based Tool for Baseball Team Management

Baseball has quickly become a more analytics-driven game that requires new technology and tools to remain competitive. This paper introduces a solution to provide effective team management and analytics to baseball teams that do not have custom, inhouse solutions. The system, Diamond Team Management, aims to aid coaches with team management and empower data-driven decision making. Diamond Team Management provides a suite of management and analytic functionalities through both web and mobile applications to empower coaches' decision making before, during, and after games. Diamond Team Management also provides analytics dashboards for coaches and players to promote data visibility and transparency for game results. This paper details the entirety of the development process including background and past work, requirements specifications, project management, system design, system implementation, and system testing. The resulting system fills a gap in the current landscape of baseball management applications and addresses the needs of baseball teams to manage, collect results, and leverage analytics effectively

FAC Sheet March 2024

Issue of FAC Sheet, a newsletter published by the University of Scranton Faculty Affairs Council, an affiliate of the American Association of University Professors

The Changing Role of Occupational Therapy In Neonatal Care [Library Research Essay]

Research essay written by University of Scranton graduate students Gabrielle Allen and Julianna Lunt, describing the research process for their OT 544 paper, titled 'The Changing Role of Occupational Therapy In Neonatal Care.' Allen and Lunt were selected by a panel of faculty and staff as the winners of the University's 2024 Bonnie W. Oldham Library Research Prize, in the Graduate category

Anesthetic Management of Emergent Coronary Artery Bypass Grafting in the Setting of Pulmonary Hypertension and Non-ST Elevation Myocardial Infarction: A Case Report

This case involves the anesthetic management of a patient requiring emergent coronary artery bypass grafting with multiple cardiac comorbidities including, pulmonary hypertension, aortic stenosis, and acute right heart failure. Following induction, the patient experienced cardiovascular collapse requiring cardiopulmonary resuscitation and emergent initiation of bypass. The events of this case led to a careful consideration in choice of induction agents, vasopressor support, and inodilator adjuncts. A literature review was conducted to examine current evidence on the best induction agent and vasopressor choice for patients with these disease states. This review also highlighted the emergence of a novel agent levosimendan, which is approved outside the U.S. where is currently remains in Phase III development

Accurate Recognition and Management of Suspected Local Anesthetic Systemic Toxicity of a Patient Undergoing ORIF of a Right Femur Fracture: A Case Study

Local anesthetics are frequently used as part of a multimodal analgesic approach to manage postoperative pain and decrease the adverse effects of opioids, such as respiratory depression, hypoxemia, nausea, vomiting, dependency, itching, drowsiness, constipation, and abuse. Local anesthetics are administered for major surgeries and are often used in orthopedic procedures. They are given as peripheral nerve block, local infiltration of wound, and neuraxial anesthesia. Many local anesthetics provide a quick onset of analgesia, and effects can last from a few hours to more than twenty-four hours. Although cocaine is known for its dependency and abuse, it is the origin of local anesthetics. Even though derivatives of this local anesthetics are safe, there are serious adverse effects that can happen from allergic reactions to systemic toxicity (Sekimoto et al., 2017; Dagenais et al., 2018). Granting local anesthetics systemic toxicity (LAST) is rare, the effects can be detrimental, such as causing cardiac arrest and death. In this case study, a 96-year-old female underwent an open reduction and internal fixation (ORIF) of a right femur fracture after a fall. She received regional anesthesia, specifically a fascia iliaca compartment block (FICB) and spinal anesthesia. She was found to be agonal breathing with severe hypotension in the post-anesthesia care unit (PACU) after her surgery, requiring lipid rescue and admission to the intensive care unit (ICU). This paper will discuss the classic and atypical signs and symptoms of LAST and appropriate treatment. A literature review was conducted for best practices for the safe administration of local anesthetics, risk factors for developing LAST, and recognition and treatment of LAST

Effects of Huperzine A on Learning and Memory Behaviors and Acetylcholinesterase Activity in Blaptica dubias

This experiment analyzed the effect of Huperzine A on learning and memory behaviors among Blaptica dubias based on the completion of a maze and acetylcholinesterase activity. The impact of Huperzine A was first studied on the behavioral level, by training each cockroach for a 12-day duration to complete a Y-maze. This behavior was initiated and motivated through the use of a food reward. After the training process, the food reward was removed from the maze, and the control group was treated with PBS while the drug group was treated with Huperzine A. A longer period spent in the reward zone would indicate the task has been learned, therefore, the velocity, distance traveled, and time spent in the reward zone was recorded for each of the cockroaches. Then, the impact of Huperzine A was studied on the molecular level through extraction of the ganglia, protein quantification, and measurement of the acetylcholinesterase activity. It was hypothesized that there would be an increase in the learning behaviors and a decrease of acetylcholinesterase activity in the drug group (Huperzine A). Though the behavioral and acetylcholinesterase activity data showed that there was no statistical significance between the control and drug groups, there were noticeable trends. The drug group did have a greater average velocity, distance traveled, and time spent in the reward zone. However, the average acetylcholinesterase activity was greater in the drug group compared to the control group, making the data opposite of the hypothesized result

BlogTakes: A Next-Generation Social Media App

In 2024, most social media applications require or strongly encourage that users make their posts short. Additionally, recommendation feeds on these applications are endless and serve as the primary way of discovering content. These features encourage content that is overly simplistic or lacks nuance, and it attracts unhealthy amounts of engagement and screen time1. BlogTakes aims to be a social media app which encourages the opposite type of content - content that is longer, more nuanced, and attracts intellectual discussion. To accomplish this goal, BlogTakes is designed with several features in mind. Posts are structured using flexible blocks, which can be reordered and support various types of content as typically seen in blogs. BlogTakes also features tagging, and, in the data model, users can label posts as relevant for each tag individually. This will make content more easily searchable and will enable users to consume content more deliberately. In addition to developing a working system, BlogTakes's development focused heavily on the software engineering process. To ensure that design decisions have been justified, this project has researched and evaluated alternative designs and technologies to the ones chosen. Implementing the core functionality while maintaining good code quality has been another focus of this project. Finally, this project aimed to account for security and scalability. The chosen development stack supports these goals, and consists of Go, Express.js, PostgreSQL, MinIO, Docker, and Bootstrap