Circulatory responses to propofol-ketamine combination compared to propofol alone for sedation during spinal anesthesia

The present study was undertaken to establish the efficacy of low dosepropofol-ketamine infusion in maintaining hemodynamic stability when used for sedation as compared to propofol alone during spinal anesthesia. Sixty adult patients of either sex, belonging to ASA physical status I and II undergoing urological procedures were studied in a randomized manner. After administering spinal anesthesia with 0.5% bupivacaine,patients were assigned to two groups of 30 patients each. Group I (propofol-ketamine combination) received intial loading dose of propofol and ketamine followed by a continuous infusion of low dose propofol and ketamine whereas group II (propofol alone) received a bolus dose of propofol followed by a continuous infusion of propofol only. Hemodynamic parameters like heart rate, systolic blood pressure, diastolic blood pressure and sedation scores rated on a five point scale were recorded at baseline and at the predetermined intervals of 5, 10, 15, 20, 25, 30, 45, 60, 75 and 90 minutes after spinal anesthesia. It was found that heart rate, systolic and diastolic blood pressure was significantly higher in group I patients at various intervals as compared to group II patients, however sedation scores revealed no significant difference at different timeintervals between the two groups. In conclusion propofol-ketamine combination was found to confer hemodynamic stability during spinal anesthesia as compared to propofol alone

Comparison of causes and manifestations of pain in Parkinson’s disease patients to healthy controls

Objective To assess the manifestations of pain in PD (Parkinson’s disease ) patients versus healthy controls.Methods Data on pain was collected from 127 patients and an equivalent number of controls using two self-report questionnaires: the Brief Pain Inventory (BPI) and a custom-made questionnaire focusing on specific details not covered by the former. Additional analysis was conducted within the patient group only to analyze the potential effects of factors relating to PD on the various measure of interest relating to pain.Results Parkinson disease patients had lower odds of experiencing pain in both arms (ExpB=0.061, p<0.001), greater probability of demonstrating pain in both legs (ExpB=2.409, p=0.024), and an increase difficulty in localizing pain (ExpB=2.958, p=0.030). There was no relationship between duration of pain (F=12.414, p=0.001) or arthritis (ExpB=0.724, p=0.309) and pain in PD. The likelihood of experiencing nagging pain (ExpB=3.533, p=0.028), but not other forms, was much more strongly associated with PD patients than normal controls. When all other types of pain were controlled for, pain in PD is more likely associated with akathesic pain (ExpB=9.046, p<0.001).Conclusion There are major differences between pain in PD patients and pain in normal controls, which could have implications on the pathophysiology and adequate management of pain in different populations.Key words: Healthy controls, movement disorders, pain, Parkinson’s diseas

Noiseless nonreciprocity in a parametric active device

Nonreciprocal devices such as circulators and isolators belong to an important class of microwave components employed in applications like the measurement of mesoscopic circuits at cryogenic temperatures. The measurement protocols usually involve an amplification chain which relies on circulators to separate input and output channels and to suppress backaction from different stages on the sample under test. In these devices the usual reciprocal symmetry of circuits is broken by the phenomenon of Faraday rotation based on magnetic materials and fields. However, magnets are averse to on-chip integration, and magnetic fields are deleterious to delicate superconducting devices. Here we present a new proposal combining two stages of parametric modulation emulating the action of a circulator. It is devoid of magnetic components and suitable for on-chip integration. As the design is free of any dissipative elements and based on reversible operation, the device operates noiselessly, giving it an important advantage over other nonreciprocal active devices for quantum information processing applications.Comment: 17 pages, 4 figures + 12 pages Supplementary Informatio

A random cell motility gradient downstream of FGF controls elongation of amniote embryos

Vertebrate embryos are characterized by an elongated antero-posterior (AP) body axis, which forms by progressive cell deposition from a posterior growth zone in the embryo. Here, we used tissue ablation in the chicken embryo to demonstrate that the caudal presomitic mesoderm (PSM) has a key role in axis elongation. Using time-lapse microscopy, we analysed the movements of fluorescently labelled cells in the PSM during embryo elongation, which revealed a clear posterior-to-anterior gradient of cell motility and directionality in the PSM. We tracked the movement of the PSM extracellular matrix in parallel with the labelled cells and subtracted the extracellular matrix movement from the global motion of cells. After subtraction, cell motility remained graded but lacked directionality, indicating that the posterior cell movements associated with axis elongation in the PSM are not intrinsic but reflect tissue deformation. The gradient of cell motion along the PSM parallels the fibroblast growth factor (FGF)/mitogen-activated protein kinase (MAPK) gradient1, which has been implicated in the control of cell motility in this tissue2. Both FGF signalling gain- and loss-of-function experiments lead to disruption of the motility gradient and a slowing down of axis elongation. Furthermore, embryos treated with cell movement inhibitors (blebbistatin or RhoK inhibitor), but not cell cycle inhibitors, show a slower axis elongation rate. We propose that the gradient of random cell motility downstream of FGF signalling in the PSM controls posterior elongation in the amniote embryo. Our data indicate that tissue elongation is an emergent property that arises from the collective regulation of graded, random cell motion rather than by the regulation of directionality of individual cellular movements

Gene network effects on brain microstructure and intellectual performance identified in 472 twins

A major challenge in neuroscience is finding which genes affect brain integrity, connectivity, and intellectual function. Discovering influential genes holds vast promise for neuroscience, but typical genome-wide searches assess approximately one million genetic variants one-by-one, leading to intractable false positive rates, even with vast samples of subjects. Even more intractable is the question of which genes interact and how they work together to affect brain connectivity. Here, we report a novel approach that discovers which genes contribute to brain wiring and fiber integrity at all pairs of points in a brain scan. We studied genetic correlations between thousands of points in human brain images from 472 twins and their nontwin siblings (mean age: 23.7 ± 2.1 SD years; 193 male/279 female). We combined clustering with genome-wide scanning to find brain systems with common genetic determination. We then filtered the image in a new way to boost power to find causal genes. Using network analysis, we found a network of genes that affect brain wiring in healthy young adults. Our new strategy makes it computationally more tractable to discover genes that affect brain integrity. The gene network showed small-world and scale-free topologies, suggesting efficiency in genetic interactions and resilience to network disruption. Genetic variants at hubs of the network influence intellectual performance by modulating associations between performance intelligence quotient and the integrity of major white matter tracts, such as the callosal genu and splenium, cingulum, optic radiations, and the superior longitudinal fasciculus

Integrated geospatial approach for adaptive rainwater harvesting site selection under the impact of climate change

The impact of global climate change on water resources is a pressing concern, particularly in arid and semi-arid regions, where water shortages are becoming increasingly severe. Rainwater harvesting (RWH) offers a promising solution to address these challenges. However, the process of selecting suitable RWH sites is complex. This paper introduces a comprehensive methodology that leverages various technologies and data sources to identify suitable RWH locations in the northern region of Iraq, considering both historical and future scenarios. The study employs remote sensing and geographic information systems to collect and process geospatial data, which are essential for the site selection process. AHP is utilized as a decision-making tool to assess and rank potential RWH locations based on multiple criteria, helping to prioritize the most suitable sites. The WLC approach is used to combine and weigh various factors, enabling a systematic evaluation of site suitability. To account for the uncertainty associated with future climate conditions, a stochastic weather generator is employed to simulate historical and future precipitation data for period (1980–2022) and (2031–2100). This ensures that the assessment considers changing climate patterns. Historical precipitation values ranged from 270 to 490 mm, while future projections indicate a decrease, with values varying from 255 to 390 mm. This suggests a potential reduction in available water resources due to climate change. The runoff for historical rainfall values ranged from 190 mm (poor) to 490 mm (very good). In the future projections, runoff values vary from 180 mm (very poor) to 390 mm (good). This analysis highlights the potential impact of reduced precipitation on water availability. There is a strong correlation between rainfall and runoff, with values of 95% for historical data and 98.83% for future projections. This indicates that changes in precipitation directly affect water runoff. The study incorporates several criteria in the model, including soil texture, historical and future rainfall data, land use/cover, slope, and drainage density. These criteria were selected based on the nature of the study region and dataset availability. The suitability zones are classified into four categories for both historical potential and future projections of RWH zones: very high suitability, covering approximately 8.2%. High suitability, encompassing around 22.6%. Moderate suitability, constituting about 37.4%. Low suitability, accounting for 31.8% of the study region. For the potential zones of RWH in the future projection, the distribution is as follows: very high suitability, approximately 6.1%. High suitability, around 18.3%. Moderate suitability, roughly 31.2%. Low suitability, making up about 44.4% of the study region. The research's findings have significant implications for sustainable water resource management in the northern region of Iraq. As climate change exacerbates water scarcity, identifying suitable RWH locations becomes crucial for ensuring water availability. This methodology, incorporating advanced technology and data sources, provides a valuable tool for addressing these challenges and enhancing the future of water management to face of climate change. However, more investigations and studies need to be conducted in near future in the study region

Money in Islamic banking system

The idea of revisiting currency and the gold dinar from an Islamic standpoint is an interesting topic of discussion in the context of the current monetary system. This chapter examines the historical aspects and supremacy of a gold currency and the weakness of fiat money using a maslahah-mafsadah approach. It considers some possible alternative forms of gold as money and then discusses some obstacles and barriers in the hope of finding a model of gold as money to implement in the current economic system. A deductive method is used to explore the implementation of a gold currency based on historical study and library research. The findings reveal that money is not limited to gold and silver. However, by deriving new law from original law process, the law (hukm) of gold or silver as money is permissible