Aberrant right subclavian artery in a cadaver: a case report of an aortic arch anomaly

In early embryogenesis, aortic anomalies occur as a consequence of disorders in the development of the primitive aortic arches system. Aberrant right subclavian artery, also known as arteria lusoria, is one of the important congenital anomalies of the aortic arch, in which the right subclavian artery arises from the arch of aorta instead of the brachiocephalic trunk. During routine dissection of a female cadaver, we observed retro-oesophageal aberrant right subclavian artery arising as the fourth branch from the aortic arch. In this case, the brachiocephalic trunk was absent. Early detection of aortic arch anomalies through diagnostic interventions is helpful to avoid complications during surgical procedures

A Polymer-Rich Quaternary Composite Solid Electrolyte for Lithium Batteries

All-solid-state batteries continue to grow as an alternative to replace the traditional liquid-based ones not only because they provide increased safety but also higher power and energy densities. However, current solid-state electrolytes are either ceramics that are brittle but highly conducting (e.g. Li0.33La0.55TiO3, LLTO) or polymer electrolytes that are poorly conducting but form flexible films with desired mechanical properties (e.g. Poly(ethylene oxide):Lithium bis(trifluoromethanesulfonyl)imide, PEO:LiTFSI). In this work, we have developed quaternary composite solid-state electrolytes (CSEs) to combine the benefits of the two types along with Succinonitrile (SN) as a solid plasticizer. CSEs with different compositions have been fully characterized over the whole compositional range. Guided by neural network simulation results it has been found that a polymer-rich CSE film gives the optimal ionic conductivity (>10−3 S cm−1 at 55 °C) and mechanical properties (Tensile strength of 16.1 MPa; Elongation-at-break of 2360%). Our solid-state coin-type cell which employs our in-house made cathode shows good cycling performance at C/20 and 55 °C maintaining specific discharge capacity at 143.2 mAh g−1 after 30 cycles. This new approach of formulating quaternary CSEs is proven to give the best combination of properties and should be universal and be applied to other CSEs with different chemistry

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 < 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

Unraveling the phase diagram-ion transport relationship in aqueous electrolyte solutions and correlating conductivity with concentration and temperature by semi-empirical modeling

Abstract The relationship between structure and ion transport in liquid electrolyte solutions is not well understood over the whole concentration and temperature ranges. In this work, we have studied the ionic conductivity (κ) as a function of molar fraction (x) and Temperature (T) for aqueous solutions of salts with nitrate anion and different cations (proton, lithium, calcium, and ammonium) along with their liquid-solid phase diagrams. The connection between the known features in the phase diagrams and the ionic conductivity isotherms is established with an insight on the conductivity mechanism. Also, known isothermal (κ vs.. x) and iso-compositional (κ vs.. T) equations along with a proposed two variables semi-empirical model (κ = f (x, T)) were fitted to the collected data to validate their accuracy. The role of activation energy and free volume in controlling ionic conductivity is discussed. This work brings us closer to the development of a phenomenological model to describe the structure and transport in liquid electrolyte solutions