Postdischarge Nausea and Vomiting Remains Frequent After Le Fort I Osteotomy Despite Implementation of a Multimodal Antiemetic Protocol Effective in Reducing Postoperative Nausea and Vomiting

Purpose—To assess the prevalence of postdischarge nausea and vomiting (PDNV) after Le Fort I osteotomy with and without the use of a multimodal antiemetic protocol shown to decrease postoperative nausea and vomiting (PONV). Materials and Methods—Consecutive patients undergoing Le Fort I osteotomy with or without additional procedures at a single academic institution formed the intervention cohort for an institutional review board–approved prospective clinical trial with a retrospective comparison group. The intervention cohort was managed with a multimodal antiemetic protocol. The comparison group consisted of consecutive patients who underwent similar surgical procedures at the same institution before protocol implementation. All patients were asked to complete a postdischarge diary documenting the occurrence of nausea and vomiting. Those who completed the diaries were included in this analysis. Data were analyzed with the Fisher exact test and the Wilcoxon rank sum test. A P value less than .05 was considered significant. Results—Diaries were completed by 85% of patients in the intervention group (79 of 93) and 75% of patients in the comparison group (103 of 137). Patients in the intervention (n = 79) and comparison (n = 103) groups were similar in the proportion of patients with validated risk factors for PDNV, including female gender, history of PONV, age younger than 50 years, opioid use in the postanesthesia care unit (PACU), and nausea in the PACU (P = .37). The prevalence of PDNV was unaffected by the antiemetic protocol. After discharge, nausea was reported by 72% of patients in the intervention group and 60% of patients in the comparison group (P = .13) and vomiting was reported by 22% of patients in the intervention group and 29% of patients in the comparison group (P = .40). Conclusion—Modalities that successfully address PONV after Le Fort I osteotomy might fail to affect PDNV, which is prevalent in this population. Future investigation will focus on methods to minimize PDNV

Botrytis-Resistenzen auf Erdbeeren

Der Wachstumstest 2018 zeigte bei 43 Prozent aller untersuchten Botrytisstämme mehr als fünf Resistenzen auf. Das genetische Resistenzpotenzial bei einjährigen Erdbeerpflanzen lag bei 61 Prozent

Genome characteristics of facultatively symbiotic Frankia sp. strains reflect host range and host plant biogeography

Soil bacteria that also form mutualistic symbioses in plants encounter two major levels of selection. One occurs during adaptation to and survival in soil, and the other occurs in concert with host plant speciation and adaptation. Actinobacteria from the genus Frankia are facultative symbionts that form N2-fixing root nodules on diverse and globally distributed angiosperms in the “actinorhizal” symbioses. Three closely related clades of Frankia sp. strains are recognized; members of each clade infect a subset of plants from among eight angiosperm families. We sequenced the genomes from three strains; their sizes varied from 5.43 Mbp for a narrow host range strain (Frankia sp. strain HFPCcI3) to 7.50 Mbp for a medium host range strain (Frankia alni strain ACN14a) to 9.04 Mbp for a broad host range strain (Frankia sp. strain EAN1pec.) This size divergence is the largest yet reported for such closely related soil bacteria (97.8%–98.9% identity of 16S rRNA genes). The extent of gene deletion, duplication, and acquisition is in concert with the biogeographic history of the symbioses and host plant speciation. Host plant isolation favored genome contraction, whereas host plant diversification favored genome expansion. The results support the idea that major genome expansions as well as reductions can occur in facultative symbiotic soil bacteria as they respond to new environments in the context of their symbioses

Comparing failure tests on pharmaceutical tablets: Interpretation using experimental results and a numerical approach with cohesive zone models

The mechanical strength is an important quality attribute of pharmaceutical tablets. It can be determined using different failure tests like the Brazilian test or the three-point bending test. Nevertheless, literature shows that different failure tests often give conflicting values of tensile strengths (TS), which are generally calculated using the maximum stress criterion as a failure criterion. This work started from the hypothesis that these discrepancies are in fact due to the application of this criterion which is not suited to study pharmaceutical tablets, first due to heterogeneity of the stress distributions during the tests and second due to the quasi-brittle nature of pharmaceutical tablets. As an alternative, a numerical fracture criterion which is known to be well-suited for quasi-brittle solids (cohesive zone model, CZM) was used and calibrated using experiments. Using this approach, the breaking forces obtained numerically were shown to be in fair agreement with the experimental ones. Above all, the numerical results made it possible to catch the trends when comparing the different failure tests one to another. Especially, the model made it possible to retrieve the factor 2 between the TS obtained by three-point bending and by diametral compression found in the literature

Résistances aux botrytis sur fraise

Im Frühsommer 2017 wurden in einer Machbarkeitsstudie 66 Botrytis-Stämme aus Erdbeerfrüchten isoliert und auf Fungizidresistenzen untersucht. Bei über 50 Prozent aller Stämme konnten fünf oder mehr Resistenzen nachgewiesen werden

Selective Cytopheretic Inhibitory Device With Regional Citrate Anticoagulation and Portable Sorbent Dialysis

Selective cytopheretic inhibitory device (SCD) therapy is an immunomodulatory treatment provided by a synthetic biomimetic membrane in an extracorporeal circuit, which has shown promise in preclinical large animal models of severe sepsis as well as in clinical trials treating patients with acute kidney injury and multiple organ failure. During SCD therapy, citrate is administered to lower ionized calcium levels in blood for anticoagulation and inhibition of leukocyte activation. Historically, citrate has been known to interfere with sorbent dialysis, therefore, posing a potential issue for the use of SCD therapy with a portable dialysis system. This sorbent dialysis SCD (sorbent SCD) would be well suited for battlefield and natural disaster applications where the water supply for standard dialysis is limited, and the types of injuries in those settings would benefit from SCD therapy. In order to explore the compatibility of sorbent and SCD technologies, a uremic porcine model was tested with the Allient sorbent dialysis system (Renal Solutions Incorporated, Fresenius Medical Care, Warrendale, PA, USA) and concurrent SCD therapy with regional citrate anticoagulation. The hypothesis to be assessed was whether the citrate load required by the SCD could be metabolized prior to recirculation from systemic blood back into the therapeutic circuit. Despite the fact that the sorbent SCD maintained urea clearance without any adverse hematologic events, citrate load for SCD therapy caused an interaction with the sorbent column resulting in elevated, potentially toxic aluminum levels in dialysate and in systemic blood. Alternative strategies to implement sorbent‐SCD therapy will be required, including development of alternate urease‐sorbent column binding chemistry or further changes to the sorbent‐SCD therapeutic circuit along with determining the minimum citrate concentration required for efficacious SCD treatment.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/96390/1/aor1541.pd

Reply to Comment by Vincent et al.

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/143706/1/tect20719.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/143706/2/tect20719_am.pd

Multimodal Protocol Reduces Postoperative Nausea and Vomiting in Patients Undergoing Le Fort I Osteotomy

To assess the impact of a multimodal antiemetic protocol on postoperative nausea and vomiting (PONV) after LeFort I osteotomy

Rapid Pliocene exhumation of the central Greater Caucasus constrained by low‐temperature thermochronometry

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/94839/1/tect2241.pd

An investigation of ribosomal protein L10 gene in autism spectrum disorders

<p>Abstract</p> <p>Background</p> <p>Autism spectrum disorders (ASD) are severe neurodevelopmental disorders with the male:female ratio of 4:1, implying the contribution of X chromosome genetic factors to the susceptibility of ASD. The ribosomal protein L10 (RPL10) gene, located on chromosome Xq28, codes for a key protein in assembling large ribosomal subunit and protein synthesis. Two non-synonymous mutations of <it>RPL10</it>, L206M and H213Q, were identified in four boys with ASD. Moreover, functional studies of mutant RPL10 in yeast exhibited aberrant ribosomal profiles. These results provided a novel aspect of disease mechanisms for autism – aberrant processes of ribosome biosynthesis and translation. To confirm these initial findings, we re-sequenced <it>RPL10 </it>exons and quantified mRNA transcript level of <it>RPL10 </it>in our samples.</p> <p>Methods</p> <p>141 individuals with ASD were recruited in this study. All <it>RPL10 </it>exons and flanking junctions were sequenced. Furthermore, mRNA transcript level of <it>RPL10 </it>was quantified in B lymphoblastoid cell lines (BLCL) of 48 patients and 27 controls using the method of SYBR Green quantitative PCR. Two sets of primer pairs were used to quantify the mRNA expression level of <it>RPL10</it>: RPL10-A and RPL10-B.</p> <p>Results</p> <p>No non-synonymous mutations were detected in our cohort. Male controls showed similar transcript level of RPL10 compared with female controls (RPL10-A, U = 81, P = 0.7; RPL10-B, U = 61.5, P = 0.2). We did not observe any significant difference in RPL10 transcript levels between cases and controls (RPL10-A, U = 531, P = 0.2; RPL10-B, U = 607.5, P = 0.7).</p> <p>Conclusion</p> <p>Our results suggest that RPL10 has no major effect on the susceptibility to ASD.</p