Patient-controlled intravenous morphine analgesia combined with transcranial direct current stimulation for post-thoracotomy pain: A cost-effectiveness study and a feasibility for its future implementation

This prospective randomized study aims to evaluate the feasibility and cost-effectiveness of combining transcranial direct current stimulation (tDCS) with patient controlled intravenous morphine analgesia (PCA-IV) as part of multimodal analgesia after thoracotomy. Patients assigned to the active treatment group (a-tDCS

Super-Earths: A New Class of Planetary Bodies

Super-Earths, a class of planetary bodies with masses ranging from a few Earth-masses to slightly smaller than Uranus, have recently found a special place in the exoplanetary science. Being slightly larger than a typical terrestrial planet, super-Earths may have physical and dynamical characteristics similar to those of Earth whereas unlike terrestrial planets, they are relatively easier to detect. Because of their sizes, super-Earths can maintain moderate atmospheres and possibly dynamic interiors with plate tectonics. They also seem to be more common around low-mass stars where the habitable zone is in closer distances. This article presents a review of the current state of research on super-Earths, and discusses the models of the formation, dynamical evolution, and possible habitability of these objects. Given the recent advances in detection techniques, the detectability of super-Earths is also discussed, and a review of the prospects of their detection in the habitable zones of low-mass stars is presented.Comment: A (non-technical) review of the literature on the current state ofresearch on super-Earths. The topics include observation, formation, dynamical evolution, habitability, composition, interior dynamics, magnetic field, atmosphere, and propsect of detection. The article has 44 pages, 27 figures, and 203 references. It has been accepted for publication in the journal Contemporary Physics (2011

The fusion protein SS18-SSX1 employs core Wnt pathway transcription factors to induce a partial Wnt signature in synovial sarcoma.

Expression of the SS18/SYT-SSX fusion protein is believed to underlie the pathogenesis of synovial sarcoma (SS). Recent evidence suggests that deregulation of the Wnt pathway may play an important role in SS but the mechanisms whereby SS18-SSX might affect Wnt signaling remain to be elucidated. Here, we show that SS18/SSX tightly regulates the elevated expression of the key Wnt target AXIN2 in primary SS. SS18-SSX is shown to interact with TCF/LEF, TLE and HDAC but not β-catenin in vivo and to induce Wnt target gene expression by forming a complex containing promoter-bound TCF/LEF and HDAC but lacking β-catenin. Our observations provide a tumor-specific mechanistic basis for Wnt target gene induction in SS that can occur in the absence of Wnt ligand stimulation

Effect of transcranial direct current stimulation combined with patient-controlled intravenous morphine analgesia on analgesic use and post-thoracotomy pain. A prospective, randomized, double-blind, sham-controlled, proof-of-concept clinical trial

Background: Transcranial direct current stimulation (tDCS) is used for various chronic pain conditions, but experience with tDCS for acute postoperative pain is limited. This study investigated the effect of tDCS vs. sham stimulation on postoperative morphine consumption and pain intensity after thoracotomy. Methods: This is a single-center, prospective, randomized, double-blind, sham-controlled trial in lung cancer patients undergoing thoracotomy under general anesthesia. All patients received patient-controlled (PCA) intravenous morphine and intercostal nerve blocks at the end of surgery. The intervention group (a-tDCS, n = 31) received anodal tDCS over the left primary motor cortex (C3-Fp2) for 20 min at 1.2 mA, on five consecutive days; the control group (n = 31) received sham stimulation. Morphine consumption, number of analgesia demands, and pain intensity at rest, with movement and with cough were recorded at the following intervals: immediately before (T1), immediately after intervention (T2), then every hour for 4 h (Т3-Т6), then every 6 h (Т7-Т31) for 5 days. We recorded outcomes on postoperative days 1 and 5 and conducted a phone interview inquiring about chronic pain 1 year later (NCT03005548). Results: A total of 62 patients enrolled, but tDCS was prematurely stopped in six patients. Fifty-five patients (27 a-tDCS, 28 sham) had three or more tDCS applications and were included in the analysis. Cumulative morphine dose in the first 120 h after surgery was significantly lower in the tDCS [77.00 (54.00-123.00) mg] compared to sham group [112.00 (79.97-173.35) mg, p = 0.043, Cohen\u27s d = 0.42]. On postoperative day 5, maximum visual analog scale (VAS) pain score with cough was significantly lower in the tDCS group [29.00 (20.00-39.00) vs. 44.50 (30.00-61.75) mm, p = 0.018], and pain interference with cough was 80% lower [10.00 (0.00-30.00) vs. 50.00 (0.00-70.00), p = 0.013]. One year after surgery, there was no significant difference between groups with regard to chronic pain and analgesic use. Conclusion: In lung cancer patients undergoing thoracotomy, three to five tDCS sessions significantly reduced cumulative postoperative morphine use, maximum VAS pain scores with cough, and pain interference with cough on postoperative day 5, but there was no obvious long-term benefit from tDCS

Role of preferential weak hybridization between the surface-state of a metal and the oxygen atom in the chemical adsorption mechanism

We report on the chemical adsorption mechanism of atomic oxygen on the Pt(111) surface using angle-resolved-photoemission spectroscopy (ARPES) and density functional calculations. The detailed band structure of Pt(111) from ARPES reveals that most of the bands near the Fermi level are surface-states. By comparing band maps of Pt and O/Pt, we identify that dxz (dyz) and dz2 orbitals are strongly correlated in the surface-states around the symmetry point M and K, respectively. Additionally, we demonstrate that the s- or p-orbital of oxygen atoms hybridizes preferentially with the dxz (dyz) orbital near the M symmetry point. This weak hybridization occurs with minimal charge transfer

Chronic pain and chronic opioid use after intensive care discharge - Is it time to change practice?

Almost half of patients treated on intensive care unit (ICU) experience moderate to severe pain. Managing pain in the critically ill patient is challenging, as their pain is complex with multiple causes. Pharmacological treatment often focuses on opioids, and over a prolonged admission this can represent high cumulative doses which risk opioid dependence at discharge. Despite analgesia the incidence of chronic pain after treatment on ICU is high ranging from 33–73%. Measures need to be taken to prevent the transition from acute to chronic pain, whilst avoiding opioid overuse. This narrative review discusses preventive measures for the development of chronic pain in ICU patients. It considers a number of strategies that can be employed including non-opioid analgesics, regional analgesia, and non-pharmacological methods. We reason that individualized pain management plans should become the cornerstone for critically ill patients to facilitate physical and psychological well being after discharge from critical care and hospital

Life Beyond the Solar System: Space Weather and Its Impact on Habitable Worlds

The search of life in the Universe is a fundamental problem of astrobiology and a major priority for NASA. A key area of major progress since the NASA Astrobiology Strategy 2015 (NAS15) has been a shift from the exoplanet discovery phase to a phase of characterization and modeling of the physics and chemistry of exoplanetary atmospheres, and the development of observational strategies for the search for life in the Universe by combining expertise from four NASA science disciplines including heliophysics, astrophysics, planetary science and Earth science. The NASA Nexus for Exoplanetary System Science (NExSS) has provided an efficient environment for such interdisciplinary studies. Solar flares, coronal mass ejections and solar energetic particles produce disturbances in interplanetary space collectively referred to as space weather, which interacts with the Earth upper atmosphere and causes dramatic impact on space and ground-based technological systems. Exoplanets within close in habitable zones around M dwarfs and other active stars are exposed to extreme ionizing radiation fluxes, thus making exoplanetary space weather (ESW) effects a crucial factor of habitability. In this paper, we describe the recent developments and provide recommendations in this interdisciplinary effort with the focus on the impacts of ESW on habitability, and the prospects for future progress in searching for signs of life in the Universe as the outcome of the NExSS workshop held in Nov 29 - Dec 2, 2016, New Orleans, LA. This is one of five Life Beyond the Solar System white papers submitted by NExSS to the National Academy of Sciences in support of the Astrobiology Science Strategy for the Search for Life in the Universe.Comment: 5 pages, the white paper was submitted to the National Academy of Sciences in support of the Astrobiology Science Strategy for the Search for Life in the Univers

The role of adsorbed ions during electrocatalysis in ionic liquids

The effects of electrode–adsorbate interactions on electrocatalysis at Pt in ionic liquids are described. The ionic liquids are diethylmethylammonium trifluoromethanesulfonate, [dema][TfO], dimethylethylammonium trifluoromethanesulfonate, [dmea][TfO], and diethylmethylammonium bis(trifluoromethanesulfonyl)imide, [dema][Tf2N]. Electrochemical analysis indicates that a monolayer of hydrogen adsorbs onto Pt during potential cycling in [dema][[TfO] and [dmea][TfO]. In addition, a prepeak is observed at lower potentials than that of the main oxidation peak during CO oxidation in the [TfO]−-based liquids. In contrast, hydrogen does not adsorb onto Pt during potential cycling in [dema][Tf2N] and no prepeak is observed during CO oxidation. By displacing adsorbed ions on Pt surfaces with CO at a range of potentials, and measuring the charge passed during ion displacement, the potentials of zero total charge of Pt in [dema][TfO] and [dmea][TfO] were measured as 271 ± 9 and 289 ± 10 mV vs RHE, respectively. CO displacement experiments also indicate that the [Tf2N]− ion is bound to the Pt surface at potentials above −0.2 V and the implications of ion adsorption on electrocatalysis of the CO oxidation reaction and O2 reduction reaction in the protic ionic liquids are discussed

Morphology of supported polymer electrolyte ultra-thin films: a numerical study

Morphology of polymer electrolytes membranes (PEM), e.g., Nafion, inside PEM fuel cell catalyst layers has significant impact on the electrochemical activity and transport phenomena that determine cell performance. In those regions, Nafion can be found as an ultra-thin film, coating the catalyst and the catalyst support surfaces. The impact of the hydrophilic/hydrophobic character of these surfaces on the structural formation of the films has not been sufficiently explored yet. Here, we report about Molecular Dynamics simulation investigation of the substrate effects on the ionomer ultra-thin film morphology at different hydration levels. We use a mean-field-like model we introduced in previous publications for the interaction of the hydrated Nafion ionomer with a substrate, characterized by a tunable degree of hydrophilicity. We show that the affinity of the substrate with water plays a crucial role in the molecular rearrangement of the ionomer film, resulting in completely different morphologies. Detailed structural description in different regions of the film shows evidences of strongly heterogeneous behavior. A qualitative discussion of the implications of our observations on the PEMFC catalyst layer performance is finally proposed

Atomic-resolution spectroscopic imaging of ensembles of nanocatalyst particles across the life of a fuel cell

The thousandfold increase in data-collection speed enabled by aberration-corrected optics allows us to overcome an electron microscopy paradox - how to obtain atomic-resolution chemical structure in individual nanoparticles, yet record a statistically significant sample from an inhomogeneous population. This allowed us to map hundreds of Pt-Co nanoparticles to show atomic-scale elemental distributions across different stages of the catalyst aging in a proton-exchange-membrane fuel cell, and relate Pt-shell thickness to treatment, particle size, surface orientation, and ordering.Comment: 28 pages, 5 figures, accepted, nano letter