Comparison of complications of spinal and general anesthasia in percutaneous kidney stone removal

While the complications of spinal anesthesia are much less than general anesthesia, percutaneous nephrolithotomy (PCNL) is still performed under general anesthesia in most centers. Therefore, in this study spinal anesthesia is compared with general anesthesia in patients undergoing PCNL. This research was a double-blind clinical trial study which was conducted on 130 patients with inclusion criteria. Patients were nonrandomly assigned into two general anesthesia (n=65) and spinal anesthesia (n=65) groups and underwent PCNL surgery.In group A, patients were given intravenously midazolam (2 mg), fentanyl (100 μg), atracurium (0.5 mg/kg), propofol (2 mg/kg) and morphine (10 mg) and then were incubated. In group B, Marcaine 0.5% (15 mg) was injected into the L3-L4 or L4-L5 lumbar spinal space in a sitting position. Patient’s blood pressure was measured and recorded at various times and in recovery as well as in the surgery room. Intra-operative bleeding, pain in the surgery area, nausea and vomiting, shortness of breath and sore throat were recorded for the two groups in the ward and during hospitalization.Changes of blood pressure were the same in both groups. In the general anesthesia group, intra-operative bleeding, pain at the site of the surgery, nausea and vomiting, shortness of breath and sore throat and duration of hospitalization were significantly higher. Changes in other tests were equal in both groups. Spinal anesthesia might be a safer method than general anesthesia for PCNL surgery.Keywords: Complication, Spinal Anesthesia, General Anesthesia, Kidney Stone Removal, Percutaneou

Biomedical waste management by using nanophotocatalysts: The need for new options

Biomedical waste management is getting significant consideration among treatment technologies, since insufficient management can cause danger to medicinal service specialists, patients, and their environmental conditions. The improvement of waste administration protocols, plans, and policies are surveyed, despite setting up training programs on legitimate waste administration for all healthcare service staff. Most biomedical waste substances do not degrade in the environment, and may also not be thoroughly removed through treatment processes. Therefore, the long-lasting persistence of biomedical waste can effectively have adverse impact on wildlife and human beings, as well. Hence, photocatalysis is gaining increasing attention for eradication of pollutants and for improving the safety and clearness of the environment due to its great potential as a green and eco-friendly process. In this regard, nanostructured photocatalysts, in contrast to their regular counterparts, exhibit significant attributes such as non-toxicity, low cost and higher absorption efficiency in a wider range of the solar spectrum, making them the best candidate to employ for photodegradation. Due to these unique properties of nanophotocatalysts for biomedical waste management, we aim to critically evaluate various aspects of these materials in the present review and highlight their importance in healthcare service settings

Assessment of Bond Strength between Metal Brackets and Non-Glazed Ceramic in Different Surface Treatment Methods

Objective: The aim of this study was to evaluate the bond strength between metal brackets and non-glazed ceramic with three different surface treatment methods.Materials and Methods: Forty-two non-glazed ceramic disks were assigned into three groups. Group I and II specimens were etched with 9.5% hydrofluoric acid. Subsequently in group I, silane and adhesive were applied and in group II, bonding agent was used only.In group III, specimens were treated with 35% phosphoric acid and then silane and adhesive were applied. Brackets were bonded with light-cured composites. The specimens were stored in water in room temperature for 24 hours and then thermocycled 500 times between 5°C and 55°C.Results: The difference of tensile bond strength between groups I and III was not significant(P=0.999). However, the tensile bond strength of group II was significantly lower than groups I, and III (P<0.001). The adhesive remnant index scores between the threegroups had statistically significant differences (P<0.001).Conclusion: With the application of scotch bond multi-purpose plus adhesive, we can use phosphoric acid instead of hydrofluoric acid for bonding brackets to non-glazed ceramic restorations

Quantitative assessment of pain-related thermal dysfunction through clinical digital infrared thermal imaging

BACKGROUND: The skin temperature distribution of a healthy human body exhibits a contralateral symmetry. Some nociceptive and most neuropathic pain pathologies are associated with an alteration of the thermal distribution of the human body. Since the dissipation of heat through the skin occurs for the most part in the form of infrared radiation, infrared thermography is the method of choice to study the physiology of thermoregulation and the thermal dysfunction associated with pain. Assessing thermograms is a complex and subjective task that can be greatly facilitated by computerised techniques. METHODS: This paper presents techniques for automated computerised assessment of thermal images of pain, in order to facilitate the physician's decision making. First, the thermal images are pre-processed to reduce the noise introduced during the initial acquisition and to extract the irrelevant background. Then, potential regions of interest are identified using fixed dermatomal subdivisions of the body, isothermal analysis and segmentation techniques. Finally, we assess the degree of asymmetry between contralateral regions of interest using statistical computations and distance measures between comparable regions. RESULTS: The wavelet domain-based Poisson noise removal techniques compared favourably against Wiener and other wavelet-based denoising methods, when qualitative criteria were used. It was shown to improve slightly the subsequent analysis. The automated background removal technique based on thresholding and morphological operations was successful for both noisy and denoised images with a correct removal rate of 85% of the images in the database. The automation of the regions of interest (ROIs) delimitation process was achieved successfully for images with a good contralateral symmetry. Isothermal division complemented well the fixed ROIs division based on dermatomes, giving a more accurate map of potentially abnormal regions. The measure of distance between histograms of comparable ROIs allowed us to increase the sensitivity and specificity rate for the classification of 24 images of pain patients when compared to common statistical comparisons. CONCLUSIONS: We developed a complete set of automated techniques for the computerised assessment of thermal images to assess pain-related thermal dysfunction

Quality assessment of services provided by health centers in Mashhad, Iran: SERVQUAL versus HEALTHQUAL scales

Background: Primary health care is the entry point to the health-care system and regarded as an essential step to achieving universal health coverage. The present study aimed at evaluating the quality of health-care services provided in health centers in Mashhad, Iran. Methods: This was a cross-sectional study implemented among 200 health service users who were referring to four health centers in Mashhad during January to June 2019. The quality of services in health centers was evaluated with the SERVQUAL and HEALTHQUAL models. Data was analyzed by employing paired t-test and independent sample t-test using SPSS version 16 software. The Levene test was used for examining the equality of variance (homogeneity). Significance level of all the tests was considered when p � 0.05. Results: According to the results of SERVQUAL questionnaire, the average scores of health service users� expectations and perceptions were 4.97 and 3.26, respectively, and the quality gap in the provided services was equal to � 1.7. Based on HEALTHQUAL questionnaire, the average scores of health service users� perception and expectations were 4.72 and 3.25, respectively, and the quality gap in the provided services was equal to � 1.16. Empathy was the highest quality dimension (� 2.019) based on SERVQUAL model, and efficiency dimension was the highest based on HEALTHQUAL model (� 1.761). Conclusions: The findings of the current study showed a negative gap between the service users� expectations and perceptions in both models. Therefore, the results of this study helps the health managers and policymakers to plan effective interventions for improving the provided services emphasizing the dimensions with the wider gaps. © 2021, The Author(s)

Cross-linked amylose bio-plastic: A transgenic-based compostable plastic alternative

Bio-plastics and bio-materials are composed of natural or biomass derived polymers, offering solutions to solve immediate environmental issues. Polysaccharide-based bio-plastics represent important alternatives to conventional plastic because of their intrinsic biodegradable nature. Amylose-only (AO), an engineered barley starch with 99% amylose, was tested to produce cross-linked all-natural bioplastic using normal barley starch as a control. Glycerol was used as plasticizer and citrate cross-linking was used to improve the mechanical properties of cross-linked AO starch extrudates. Extrusion converted the control starch from A-type to Vh- and B-type crystals, showing a complete melting of the starch crystals in the raw starch granules. The cross-linked AO and control starch specimens displayed an additional wide-angle diffraction reflection. Phospholipids complexed with Vh-type single helices constituted an integrated part of the AO starch specimens. Gas permeability tests of selected starch-based prototypes demonstrated properties comparable to that of commercial Mater-Bi© plastic. The cross-linked AO prototypes had composting characteristics not different from the control, indicating that the modified starch behaves the same as normal starch. The data shows the feasibility of producing all-natural bioplastic using designer starch as raw material

Addition of fructooligosaccharides and dried plum to soy-based diets reverses bone loss in the ovariectomized rat

Dietary bioactive components that play a role in improving skeletal health have received considerable attention in complementary and alternative medicine practices as a result of their increased efficacy to combat chronic diseases. The objectives of this study were to evaluate the additive or synergistic effects of dried plum and fructooligosaccharides (FOS) and to determine whether dried plum and FOS or their combination in a soy protein-based diet can restore bone mass in ovarian hormone deficient rats. For this purpose, 72 3-month-old female Sprague-Dawley rats were divided into six groups (n = 12) and either ovariectomized (Ovx, five groups) or sham-operated (sham, one group). The rats were maintained on a semipurified standard diet for 45 days after surgery to establish bone loss. Thereafter, the rats were placed on one of the following dietary treatments for 60 days: casein-based diet (Sham and Ovx), soy-based diet (Ovx + soy) or soy-based diet with dried plum (Ovx + soy + plum), FOS (Ovx + soy + FOS) and combination of dried plum and FOS (Ovx + soy + plum + FOS). Soy protein in combination with the test compounds significantly improved whole-body bone mineral density (BMD). All test compounds in combination with soy protein significantly increased femoral BMD but the combination of soy protein, dried plum and FOS had the most pronounced effect in increasing lumbar BMD. Similarly, all of the test compounds increased ultimate load, indicating improved biomechanical properties. The positive effects of these test compounds on bone may be due to their ability to modulate bone resorption and formation, as shown by suppressed urinary deoxypyridinoline excretion and enhanced alkaline phosphatase activity.Peer reviewedNutritional Science

Folate catabolites in spot urine as non-invasive biomarkers of folate status during habitual intake and folic acid supplementation.

Folate status, as reflected by red blood cell (RCF) and plasma folates (PF), is related to health and disease risk. Folate degradation products para-aminobenzoylglutamate (pABG) and para-acetamidobenzoylglutamate (apABG) in 24 hour urine have recently been shown to correlate with blood folate. Since blood sampling and collection of 24 hour urine are cumbersome, we investigated whether the determination of urinary folate catabolites in fasted spot urine is a suitable non-invasive biomarker for folate status in subjects before and during folic acid supplementation. Immediate effects of oral folic acid bolus intake on urinary folate catabolites were assessed in a short-term pre-study. In the main study we included 53 healthy men. Of these, 29 were selected for a 12 week folic acid supplementation (400 µg). Blood, 24 hour and spot urine were collected at baseline and after 6 and 12 weeks and PF, RCF, urinary apABG and pABG were determined. Intake of a 400 µg folic acid bolus resulted in immediate increase of urinary catabolites. In the main study pABG and apABG concentrations in spot urine correlated well with their excretion in 24 hour urine. In healthy men consuming habitual diet, pABG showed closer correlation with PF (rs = 0.676) and RCF (rs = 0.649) than apABG (rs = 0.264, ns and 0.543). Supplementation led to significantly increased folate in plasma and red cells as well as elevated urinary folate catabolites, while only pABG correlated significantly with PF (rs = 0.574) after 12 weeks. Quantification of folate catabolites in fasted spot urine seems suitable as a non-invasive alternative to blood or 24 hour urine analysis for evaluation of folate status in populations consuming habitual diet. In non-steady-state conditions (folic acid supplementation) correlations between folate marker (RCF, PF, urinary catabolites) decrease due to differing kinetics

Radio Location of Partial Discharge Sources: A Support Vector Regression Approach

Partial discharge (PD) can provide a useful forewarning of asset failure in electricity substations. A significant proportion of assets are susceptible to PD due to incipient weakness in their dielectrics. This paper examines a low cost approach for uninterrupted monitoring of PD using a network of inexpensive radio sensors to sample the spatial patterns of PD received signal strength. Machine learning techniques are proposed for localisation of PD sources. Specifically, two models based on Support Vector Machines (SVMs) are developed: Support Vector Regression (SVR) and Least-Squares Support Vector Regression (LSSVR). These models construct an explicit regression surface in a high dimensional feature space for function estimation. Their performance is compared to that of artificial neural network (ANN) models. The results show that both SVR and LSSVR methods are superior to ANNs in accuracy. LSSVR approach is particularly recommended as practical alternative for PD source localisation due to it low complexity

Paired plasma lipidomics and proteomics analysis in the conversion from mild cognitive impairment to Alzheimer's disease.

Alzheimer's disease (AD) is a neurodegenerative condition for which there is currently no available medication that can stop its progression. Previous studies suggest that mild cognitive impairment (MCI) is a phase that precedes the disease. Therefore, a better understanding of the molecular mechanisms behind MCI conversion to AD is needed. Here, we propose a machine learning-based approach to detect the key metabolites and proteins involved in MCI progression to AD using data from the European Medical Information Framework for Alzheimer's Disease Multimodal Biomarker Discovery Study. Proteins and metabolites were evaluated separately in multiclass models (controls, MCI and AD) and together in MCI conversion models (MCI stable vs converter). Only features selected as relevant by 3/4 algorithms proposed were kept for downstream analysis. Multiclass models of metabolites highlighted nine features further validated in an independent cohort (0.726 mean balanced accuracy). Among these features, one metabolite, oleamide, was selected by all the algorithms. Further in-vitro experiments in rodents showed that disease-associated microglia excreted oleamide in vesicles. Multiclass models of proteins stood out with nine features, validated in an independent cohort (0.720 mean balanced accuracy). However, none of the proteins was selected by all the algorithms. Besides, to distinguish between MCI stable and converters, 14 key features were selected (0.872 AUC), including tTau, alpha-synuclein (SNCA), junctophilin-3 (JPH3), properdin (CFP) and peptidase inhibitor 15 (PI15) among others. This omics integration approach highlighted a set of molecules associated with MCI conversion important in neuronal and glia inflammation pathways