Esketamine opioid-free intravenous anesthesia versus opioid intravenous anesthesia in spontaneous ventilation video-assisted thoracic surgery: a randomized controlled trial

BackgroundOpioid-free anesthesia (OFA) provides adequate analgesia and can reduce postoperative opioid consumption, but its efficacy in spontaneous ventilation video-assisted thoracic surgery (SV-VATS) has not been demonstrated. We aimed to investigate the hypothesis that OFA could provide the same perioperative pain control as opioid anesthesia (OA), maintain safe and stable respiration and hemodynamics during surgery, and improve postoperative recovery.MethodsSixty eligible patients (OFA group: n=30; OA group: n=30) treated between September 15, 2022, and December 15, 2022, at The First Hospital of Guangzhou Medical University were included. They were randomized to receive standard balanced OFA with esketamine or OA with remifentanil combined with sufentanil. The primary outcome was the pain numeric rating score (NRS) at postoperative 24 h, and the secondary outcomes were intraoperative respiratory and hemodynamic data, opioid consumption, vasoactive drug dosage, and recovery in the post-anesthesia care unit and ward.ResultsThere was no significant difference in the postoperative pain scores and recovery quality between the two groups. The OFA group had a significantly lower dose of phenylephrine (P=0.001) and a lower incidence of hypotension (P=0.004) during surgery. The OFA group resumed spontaneous respiration faster (P<0.001) and had a higher quality of lung collapse (P=0.02). However, the total doses of propofol and dexmetomidine were higher (P=0.03 and P=0.02), and the time to consciousness was longer (P=0.039) in the OFA group.ConclusionsOFA provides the same level of postoperative pain control as OA, but it is more advantageous in maintaining circulatory and respiratory stability and improving the quality of pulmonary collapse in SV-VATS

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Does Copyright Law Promote Creativity? An Empirical Analysis of Copyright\u27s Bounty

Modern copyright law is based upon a theory: increase copyright protection and you increase the number of creative works available to society. This theory has been the driving force behind an economic vision that has expanded, beyond all recognition, the original law created by the Statute of Anne. And with this expansion, we are told that the costs associated with copyright are worthwhile because of the bounty it produces. What if this theory could be tested? After all, this is not a question of faith or morality, nor is it a statement on how humans should behave; it is a theory about how humans do behave. In this Article, we use statistical analysis to test the theory that increasing copyright protection usually increases the number of new creative works. Relying upon U.S. copyright registrations from 1870 through 2006 as a proxy for the number of works created, we consider how four variables- population, the economy, legal changes, and technology-influenced subsequent copyright registrations. Our findings cast serious doubt on the idea that with copyright law, one size fits all. While individual legal changes may be associated with changes in subsequent copyright registrations, the overall relationship between changes in copyright law and registrations is neither consistent nor completely predictable

Does Copyright Law Promote Creativity? An Empirical Analysis of Copyright\u27s Bounty

Modern copyright law is based upon a theory: increase copyright protection and you increase the number of creative works available to society. This theory has been the driving force behind an economic vision that has expanded, beyond all recognition, the original law created by the Statute of Anne. And with this expansion, we are told that the costs associated with copyright are worthwhile because of the bounty it produces. What if this theory could be tested? After all, this is not a question of faith or morality, nor is it a statement on how humans should behave; it is a theory about how humans do behave. In this Article, we use statistical analysis to test the theory that increasing copyright protection usually increases the number of new creative works. Relying upon U.S. copyright registrations from 1870 through 2006 as a proxy for the number of works created, we consider how four variables- population, the economy, legal changes, and technology-influenced subsequent copyright registrations. Our findings cast serious doubt on the idea that with copyright law, one size fits all. While individual legal changes may be associated with changes in subsequent copyright registrations, the overall relationship between changes in copyright law and registrations is neither consistent nor completely predictable

A Robot Hybrid Hierarchical Network for Sensing Environmental Variables of a Smart Grid

With the rapid development of the social economy, high-voltage transmission lines as power supply infrastructure are increasing, subsequently presenting a new challenge to the effective monitoring of transmission lines. The dynamic sensor network integrated with robots can effectively solve the elastic monitoring of transmission lines, but the problems of real-time performance, energy consumption and economy of the network need to be solved. To solve this problem, a dynamic network deployment method based on the hybrid hierarchical network (HHN) is proposed to realize a low-cost, energy-saving and real-time dynamic sensing system for overhead high-voltage transmission lines. Through case analysis and simulation, combined with the vague set multi-attribute decision-making method (MADM) with scheme preference, the network deployment and optimization results under multi-parameter constraints are obtained