Effects of Preoperative Sublingual Misoprostol on Uterine Tone during Isoflurane Anesthesia for Cesarean Section

SummaryBackground and objectivesMisoprostol would reduce the uterine bleeding after cesarean delivery without harmful effects on either mother or baby. We aimed to evaluate the effects of preoperative misoprostol on maternal blood loss, uterine tone, and the need for additional oxytocin after cesarean delivery under isoflurane anesthesia.MethodsAfter ethical approval, 366 patients scheduled for elective cesarean delivery were randomly allocated to receive either sublingual misoprostol 400μg (n=179) or placebo tablet (n=187) after intubation. Anesthesia was maintained with 0.5–0.7 MAC isoflurane with nitrous oxide. All patients received intravenous infusion of 10IU of oxytocin after placental delivery. Perioperative estimated blood loss, uterine tone, need for supplementary oxytocin, hematocrit, Apgar scores at 1 and 5 min and adverse effects were recorded.ResultsAfter induction, patients receiving sublingual misoprostol had significant less perioperative estimated blood loss (202±383.1 vs. 708±204.3mL, p<0.001), need for oxytocin (p<0.001), higher hematocrit levels (p<0.001) and uterine tone (p<0.02). The incidence of shivering was higher in the misoprostol group (p=0.04). There were no differences between the two groups as regarding Apgar scores, nausea and vomiting, gastrointestinal disturbances and pyrexia.ConclusionPreoperative administration of sublingual misoprostol 400μg is safe and effective in attenuating the maternal bleeding and uterine atony from isoflurane anesthesia for cesarean delivery

“ The Effect of Technology on Outdoor Furniture “

There is no doubt that technological development in all its scientific fields seeks the effective truth in meeting human needs and in all scientific, technical and applied aspects. The areas that have been greatly affected by advanced technology and techniques, and furniture is an integral and inherent element of architecture, and its design depends a lot on its function and the space in which it will be placed, and from this becomes clear the importance of outdoor furniture, used for gardens, streets and external public places, which is subject to conditions in manufacturing that take into account factors Several of them are: durability, the ability to withstand the natural factors of the site in which it will be placed, suitability for the function for which it was designed, and be environmentally friendly. The research problem is that the traditional outdoor furniture has become not fulfilling the requirements of the modern era, and the research aims to clarify some types of smart outdoor furniture. Versatile, as each piece of furniture can perform more than one function, and it is solar powered A need for special electronic equipment, as it relies in its design on integrating sensors and a data processor in its parts that are connected within central networks, and it is also made of smart materials, and one of the most important features of these materials is the ability to take variable reactions to meet performance needs Its functional purpose, to achieve comfort, safety and well-being for members of society, while shedding light on some types of traditional furniture, then presenting some types of smart furniture with a brief explanation of the characteristics and advantages of each, and in the end the conclusions and recommendations

Influence of Advanced Technologies in The Design of Modern Facades “

Architectural and interior design has been influenced by the enormous technological evolution of the world. Designers have begun to use the latest technologies available in the design and implementation of architectural products, particularly in the design of building interfaces, which rely mainly on technology in all its formal and functional aspects.The problem of research is the paucity of comprehensive and technology-oriented intellectual and applied studies in the design of building interfaces. Research aims to illustrate the impact of advanced techniques as a key variable in the design of functional as well as formal interfaces. To achieve the objective of research, research has relied on explaining and clarifying the types of vocabulary. Glass has been instrumental and influential in the design of facades. The evolution of the concept of glass use has been of great importance and influence to modern architects in trying to adapt external facades and solve their problems, as these materials have features that are not available from other ores. They have the capacity to acquire and distribute the greatest amount of light and rays in the directions required by the utility of design, as well as to reach the upper limit in terms of design. (Aesthetic) and functional for use in the design of external interfaces, with examples of modern interfaces tailored to advanced techniques, and concluded with theoretical and applied conclusions and recommendations.Research problem:The research problem is represented in the lack of comprehensive intellectual and applied studies directed towards the impact of technology in the design of the external facades of buildings.Research goal:The research aims to clarify the impact of advanced technologies as a key variable in the design of external interfaces in terms of the functional aspect of the interfaces as well as the formality.research importance:Emphasizing the role of technological progress and how to take advantage of modern technological methods and apply them in architecture, interior and exterior desig

Serotype Distribution and Drug Resistance in Streptococcus pneumoniae, Palestinian Territories

To determine antimicrobial drug resistance of Streptococcus pneumoniae serotypes, we analyzed isolates from blood cultures of sick children residing in the West Bank before initiation of pneumococcal vaccination. Of 120 serotypes isolated, 50.8%, 73.3%, and 80.8% of the bacteremia cases could have been prevented by pneumococcal conjugate vaccines. Serotype 14 was the most drug-resistant serotype isolated

Retrieval of Cu2+ and Cd2+ ions from aqueous solutions using sustainable guar gum/PVA/montmorillonite nanocomposite films: effect of temperature and adsorption isotherms

Uncontrolled or improperly managed wastewater is considered toxic and dangerous to plants, animals, and people, as well as negatively impacting the ecosystem. In this research, the use of we aimed to prepare polymer nanocomposites (guar gum/polyvinyl alcohol, and nano-montmorillonite clay) for eliminating heavy metals from water-based systems, especially Cu2+ and Cd2+ ions. The synthesis of nanocomposites was done by the green method with different ratios of guar gum to PVA (50/50), (60/40), and (80/20) wt%, in addition to glycerol that acts as a cross-linker. Fourier-transform infrared spectroscopy (FT-IR) analysis of the prepared (guar gum/PVA/MMT) polymeric nano-composites’ structure and morphology revealed the presence of both guar gum and PVA’s functional groups in the polymeric network matrix. Transmission electron microscopy (TEM) analysis was also performed, which verified the creation of a nanocomposite. Furthermore, theromgravimetric analysis (TGA) demonstrated the biocomposites’ excellent thermal properties. For those metal ions, the extreme uptake was found at pH 6.0 in each instance. The Equilibrium uptake capacities of the three prepared nanocomposites were achieved within 240 min. The maximal capacities were found to be 95, 89 and 84 mg/g for Cu2+, and for Cd2+ were found to be 100, 91, 87 mg/g for guar gum (80/20, 60/40 and 50/50), respectively. The pseudo-2nd-order model with R2 &gt; 0.98 was demonstrated to be followed by the adsorption reaction, according to the presented results. In less than 4 hours, the adsorption equilibrium was reached. Furthermore, a 1% EDTA solution could be used to revitalize the metal-ion-loaded nanocomposites for several cycles. The most promising nanocomposite with efficiency above 90% for the removal of Cu2+ and Cd2+ ions from wastewater was found to have a guar (80/20) weight percentage, according to the results obtained

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

MUSiC : a model-unspecific search for new physics in proton-proton collisions at root s=13TeV

Results of the Model Unspecific Search in CMS (MUSiC), using proton-proton collision data recorded at the LHC at a centre-of-mass energy of 13 TeV, corresponding to an integrated luminosity of 35.9 fb(-1), are presented. The MUSiC analysis searches for anomalies that could be signatures of physics beyond the standard model. The analysis is based on the comparison of observed data with the standard model prediction, as determined from simulation, in several hundred final states and multiple kinematic distributions. Events containing at least one electron or muon are classified based on their final state topology, and an automated search algorithm surveys the observed data for deviations from the prediction. The sensitivity of the search is validated using multiple methods. No significant deviations from the predictions have been observed. For a wide range of final state topologies, agreement is found between the data and the standard model simulation. This analysis complements dedicated search analyses by significantly expanding the range of final states covered using a model independent approach with the largest data set to date to probe phase space regions beyond the reach of previous general searches.Peer reviewe

Measurement of prompt open-charm production cross sections in proton-proton collisions at root s=13 TeV

The production cross sections for prompt open-charm mesons in proton-proton collisions at a center-of-mass energy of 13TeV are reported. The measurement is performed using a data sample collected by the CMS experiment corresponding to an integrated luminosity of 29 nb(-1). The differential production cross sections of the D*(+/-), D-+/-, and D-0 ((D) over bar (0)) mesons are presented in ranges of transverse momentum and pseudorapidity 4 < p(T) < 100 GeV and vertical bar eta vertical bar < 2.1, respectively. The results are compared to several theoretical calculations and to previous measurements.Peer reviewe

Combined searches for the production of supersymmetric top quark partners in proton-proton collisions at root s=13 TeV

A combination of searches for top squark pair production using proton-proton collision data at a center-of-mass energy of 13 TeV at the CERN LHC, corresponding to an integrated luminosity of 137 fb(-1) collected by the CMS experiment, is presented. Signatures with at least 2 jets and large missing transverse momentum are categorized into events with 0, 1, or 2 leptons. New results for regions of parameter space where the kinematical properties of top squark pair production and top quark pair production are very similar are presented. Depending on themodel, the combined result excludes a top squarkmass up to 1325 GeV for amassless neutralino, and a neutralinomass up to 700 GeV for a top squarkmass of 1150 GeV. Top squarks with masses from 145 to 295 GeV, for neutralino masses from 0 to 100 GeV, with a mass difference between the top squark and the neutralino in a window of 30 GeV around the mass of the top quark, are excluded for the first time with CMS data. The results of theses searches are also interpreted in an alternative signal model of dark matter production via a spin-0 mediator in association with a top quark pair. Upper limits are set on the cross section for mediator particle masses of up to 420 GeV

Measurement of B-c(2S)(+) and B-c*(2S)(+) cross section ratios in proton-proton collisions at root s=13 TeV

Peer reviewe