Safety and clinical outcomes of regional anaesthesia in Chinese patients with non-small cell lung cancer undergoing non-intubated lobectomy

Purpose: To determine the safety and clinical outcomes of epidural anaesthesia (EA) relative to internal intercostal nerve block (INB) in Chinese patients with non-small cell lung cancer (NSCLC) who were undergoing non-intubated thoracoscopic lobectomy.Methods: Chinese patients with NSCLC (stage I or II) with no evidence of metastasis were given either EA or INB, with equal number of patients in both groups. The peri-operative outcomes determined were duration of anaesthesia /duration of surgery, SpO2/PaCO2 levels, cases of hypotension, and blood loss. The post-operative outcome indices measured were pain score (determined using visual analogue scale (VAS), post-operative complications, chest drainage, duration of hospital stay, and deaths/mortality.Multiple regression analysis was used to confirm the results obtained in this study by adjusting potential covariates. Peri-operative and post-operative complications were compared between the two groups. The results obtained from 220 patients were subjected to statistical analysis.Results: Peri-operative results showed that patients who underwent INB had shorter duration of anaesthesia (12.3 vs 31.4 min, p < 0.05) and shorter duration of surgery (164.4 vs 197.2 min, p < 0.05) than patients who underwent EA for non-intubated lobectomy. Post-operative results showed that patients who underwent INB had significantly lower number of post-operative complications than those who received EA (29 vs 44 %, p < 0.05). The most common post-operative complications among patients in both treatment groups were nausea, vomiting, emphysema and pulmonary complications. Patients who underwent INB had shorter hospital stay than those who underwent EA (5.1 vs 7.5 days, p < 0.05). These results were confirmed through multiple regression analysis.Conclusion: These findings favour the use of INB for regional anaesthesia in NSCLC patients undergoing non-intubated lobectomy

Solidification texture dependence of the anisotropy of mechanical properties and damping capacities of an AZ31 Mg-based alloy fabricated via wire-arc additive manufacturing

Wire-arc additive manufacturing (WAAM) offers a brand-new method for short process and rapid manufacturing of large magnesium alloy components, which can avoid the formability dilemma faced by Mg alloys due to their poor plasticity. In this study, the relationships between the solidification texture and the anisotropy of mechanical properties/damping capacities of an AZ31 Mg-based alloy fabricated by the WAAM process were studied. The results revealed that the crystallographic texture with the (0001) basal plane along the building direction was promoted by the preferential growth of dendrite arms along the direction of the HCP crystal structure. The (0001) basal texture had a strong influence on the anisotropy of mechanical properties and damping capacities. Compared to the sample with a tensile axis perpendicular to the building direction, the sample with a tensile axis along the building direction displays a simultaneous increase in tensile strength and ductility, which is related to the smaller Schmid factor (SF) for basal slip and better plasticity deformation via non-basal slip and twinning. However, the smaller SF for basal slip also results in a smaller resolved shear stress factor for the breakaway stress during the damping response testing, resulting in lower damping capacities. This work is helpful for further optimizing the mechanical properties and damping capacities of WAAM-processed Mg-based alloys

Assessing the causal effects of adipokines on uric acid and gout: A two-sample mendelian randomization study

Previous observational studies have highlighted associations between adipokines and hyperuricemia, as well as gout, but the causality and direction of these associations are not clear. Therefore, we attempted to assess whether there are causal effects of specific adipokines (such as adiponectin (ADP) and soluble leptin receptors (sOB-R)) on uric acid (UA) or gout in a two-sample Mendelian randomization (MR) analysis, based on summary statistics from large genome-wide association studies. The inverse-variance weighted (IVW) method was performed as the primary analysis. Sensitivity analyses (including MR-Egger regression, weighted median, penalized weighted median, and MR pleiotropy residual sum and outlier methods) were also performed, to ensure reliable results. In the IVW models, no causal effect was found for sOB-R (odds ratios (OR), 1.002; 95% confidence intervals (CI), 0.999–1.004; p = 0.274) on UA, or ADP (OR, 1.198; 95% CI, 0.865–1.659; p = 0.277) or sOB-R (OR, 0.988; 95% CI, 0.940–1.037; p = 0.616) on gout. The results were confirmed in sensitivity analyses. There was no notable directional pleiotropy or heterogeneity. This study suggests that these specific adipokines may not play causal roles in UA or gout development

Assessing the Causal Effects of Adipokines on Uric Acid and Gout: A Two-Sample Mendelian Randomization Study

Previous observational studies have highlighted associations between adipokines and hyperuricemia, as well as gout, but the causality and direction of these associations are not clear. Therefore, we attempted to assess whether there are causal effects of specific adipokines (such as adiponectin (ADP) and soluble leptin receptors (sOB-R)) on uric acid (UA) or gout in a two-sample Mendelian randomization (MR) analysis, based on summary statistics from large genome-wide association studies. The inverse-variance weighted (IVW) method was performed as the primary analysis. Sensitivity analyses (including MR-Egger regression, weighted median, penalized weighted median, and MR pleiotropy residual sum and outlier methods) were also performed, to ensure reliable results. In the IVW models, no causal effect was found for sOB-R (odds ratios (OR), 1.002; 95% confidence intervals (CI), 0.999–1.004; p = 0.274) on UA, or ADP (OR, 1.198; 95% CI, 0.865–1.659; p = 0.277) or sOB-R (OR, 0.988; 95% CI, 0.940–1.037; p = 0.616) on gout. The results were confirmed in sensitivity analyses. There was no notable directional pleiotropy or heterogeneity. This study suggests that these specific adipokines may not play causal roles in UA or gout development