Deltoid, triceps, or both responses improve the success rate of the interscalene catheter surgical block compared with the biceps response

Background The influence of the muscular response elicited by neurostimulation on the success rate of interscalene block using a catheter (ISC) is unknown. In this investigation, we compared the success rate of ISC placement as indicated by biceps or deltoid, triceps, or both twitches. Methods Three hundred (ASA I-II) patients presenting for elective arthroscopic rotator cuff repair were prospectively randomized to assessment by biceps (Group B) or deltoid, triceps, or both twitches (Group DT). All ISCs were placed with the aid of neurostimulation. The tip of the stimulating needle was placed after disappearance of either biceps or deltoid, triceps, or both twitches at 0.3 mA. The catheter was advanced 2-3 cm past the tip of the needle and the block was performed using 40 ml ropivacaine 0.5%. Successful block was defined as sensory block of the supraclavicular nerve and sensory and motor block involving the axillary, radial, median, and musculocutaneous nerves within 30 min. Results Success rate was 98.6% in Group DT compared with 92.5% in Group B (95% confidence interval 0.01-0.11; P<0.02). Supplemental analgesics during handling of the posterior part of the shoulder capsule were needed in two patients in Group DT and seven patients in Group B. Three patients in Group B had an incomplete radial nerve distribution anaesthesia necessitating general anaesthesia. One patient in Group B had an incomplete posterior block extension of the supraclavicular nerve. No acute or late complications were observed. Conclusions Eliciting deltoid, triceps, or both twitches was associated with a higher success rate compared with eliciting biceps twitches during continuous interscalene bloc

Long-term data reveal contrasting impacts of native versus invasive nest predators in Iceland

Bird species on islands are strongly impacted by biological invasions, with the Icelandic common eider (Somateria mollissima borealis) being particularly threatened. Down collection by local families in Breiðafjörður, West Iceland, provided long-term datasets of nests from two archipelagos, covering 95 islands over 123 years and 39 islands over 27 years, respectively. Using these exceptional datasets, we found that the arrival of the invasive semi-aquatic American mink (Neogale vison) was a more impactful driver of population dynamics than climate. This invasive predator heavily reduced eider nest numbers by ca. 60% in the Brokey archipelago. In contrast, we detected an apparently adaptive response to the return of the native fox in the Purkey archipelago, with dense nests on islands inaccessible to the fox and no apparent impact on eider populations. This difference might be due to the eiders lacking a joint evolutionary history with the mink and therefore lacking appropriate antipredator responses

Improving parsing of spontaneous speech with the help of prosodic boundaries

Parsing can be improved in automatic speech understanding if prosodic boundary marking is taken into account, because syntactic boundaries are often marked by prosodic means. Because large databases are needed for the training of statistical models for prosodic boundaries, we developed a labeling scheme for syntactic-prosodic boundaries within the German VERBMOBIL project (automatic speech-to-speech translation). We compare the results of classifiers (multi-layer perceptrons and language models) trained on these syntactic-prosodic boundary labels with classifiers trained on perceptual-prosodic and purely syntactic labels. Recognition rates of up to 96% were achieved. The turns that we need to parse consist of 20 words on the average and frequently contain sequences of partial sentence equivalents due to restarts, ellipsis, etc. For this material, the boundary scores computed by our classifiers can successfully be integrated into the syntactic parsing of word graphs; currently, they improve the parse time by 92% and reduce the number of parse trees by 96%. This is achieved by introducing a special Prosodic Syntactic Clause Boundary symbol (PSCB) into our grammar and guiding the search for the best word chain with the prosodic boundary scores

Molecular serum signature of treatment resistant depression

Rationale: A substantial number of patients suffering from major depressive disorder (MDD) do not respond to multiple trials of anti-depressants, develop a chronic course of disease and become treatment resistant. Most of the studies investigating molecular changes in treatment-resistant depression (TRD) have only examined a limited number of molecules and genes. Consequently, biomarkers associated with TRD are still lacking. Objectives: This study aimed to use recently advanced high-throughput proteomic platforms to identify peripheral biomarkers of TRD defined by two staging models, the Thase and Rush staging model (TRM) and the Maudsley Staging Model (MSM). Methods: Serum collected from an inpatient cohort of 65 individuals suffering from MDD was analysed using two different mass spectrometric-based platforms, label-free liquid chromatography mass spectrometry (LC-MSE) and selective reaction monitoring (SRM), as well as a multiplex bead based assay. Results: In the LC-MSE analysis, proteins involved in the acute phase response and complement activation and coagulation were significantly different between the staging groups in both models. In the multiplex bead-based assay analysis TNF-α levels (log(odds) = −4.95, p = 0.045) were significantly different in the TRM comparison. Using SRM, significant changes of three apolipoproteins A–I (β = 0.029, p = 0.035), M (β = −0.017, p = 0.009) and F (β = −0.031, p = 0.024) were associated with the TRM but not the MSM. Conclusion: Overall, our findings suggest that proteins, which are involved in immune and complement activation, may represent potential biomarkers that could be used by clinicians to identify high-risk patients. Nevertheless, given that the molecular changes between the staging groups were subtle, the results need to be interpreted cautiously

Ammonia Decomposition in the Process Chain for a Renewable Hydrogen Supply

This review article deals with the challenge to identify catalyst materials from literature studies for the ammonia decomposition reaction with potential for application in large-scale industrial processes. On the one hand, the requirements on the catalyst are quite demanding. Of central importance are the conditions for the primary reaction that have to be met by the catalyst. Likewise, the catalytic performance, i.e., an ideally quantitative conversion, and a high lifetime are critical as well as the consideration of requirements on the product properties in terms of pressure or by-products for potential follow-up processes, in this case synthesis gas applications. On the other hand, the evaluation of the multitude of literature studies poses difficulties due to significant varieties in catalytic testing protocols

Mapping Tumor Spheroid Mechanics in Dependence of 3D Microenvironment Stiffness and Degradability by Brillouin Microscopy

Altered biophysical properties of cancer cells and of their microenvironment contribute to cancer progression. While the relationship between microenvironmental stiffness and cancer cell mechanical properties and responses has been previously studied using two-dimensional (2D) systems, much less is known about it in a physiologically more relevant 3D context and in particular for multicellular systems. To investigate the influence of microenvironment stiffness on tumor spheroid mechanics, we first generated MCF-7 tumor spheroids within matrix metalloproteinase (MMP)-degradable 3D polyethylene glycol (PEG)-heparin hydrogels, where spheroids showed reduced growth in stiffer hydrogels. We then quantitatively mapped the mechanical properties of tumor spheroids in situ using Brillouin microscopy. Maps acquired for tumor spheroids grown within stiff hydrogels showed elevated Brillouin frequency shifts (hence increased longitudinal elastic moduli) with increasing hydrogel stiffness. Maps furthermore revealed spatial variations of the mechanical properties across the spheroids’ cross-sections. When hydrogel degradability was blocked, comparable Brillouin frequency shifts of the MCF-7 spheroids were found in both compliant and stiff hydrogels, along with similar levels of growth-induced compressive stress. Under low compressive stress, single cells or free multicellular aggregates showed consistently lower Brillouin frequency shifts compared to spheroids growing within hydrogels. Thus, the spheroids’ mechanical properties were modulated by matrix stiffness and degradability as well as multicellularity, and also to the associated level of compressive stress felt by tumor spheroids. Spheroids generated from a panel of invasive breast, prostate and pancreatic cancer cell lines within degradable stiff hydrogels, showed higher Brillouin frequency shifts and less cell invasion compared to those in compliant hydrogels. Taken together, our findings contribute to a better understanding of the interplay between cancer cells and microenvironment mechanics and degradability, which is relevant to better understand cancer progression

Polyhedral units and network connectivity in calcium aluminosilicate glasses from high-energy x-ray diffraction

Structure factors for Cax/2AlxSi1-xO2 glasses (x=0,0.25,0.5,0.67) extended to a wave vector of magnitude Q= 40 1/A have been obtained by high-energy x-ray diffraction. For the first time, it is possible to resolve the contributions of Si-O, Al-O and Ca-O coordination polyhedra to the experimental atomic pair distribution functions (PDF). It has been found that both Si and Al are four-fold coordinated and so participate in a continuous tetrahedral network at low values of x. The number of network breaking defects in the form of non-bridging oxygens (NBO's) increases slowly with x until x=0.5 (NBO's ~ 10% at x=0.5). By x=0.67 the network breaking defects become significant as evidenced by the significant drop in the average coordination number of Si. By contrast, Al-O tetrahedra remain free of NBO's and fully integrated in the Al/Si-O network for all values of x. Calcium maintains a rather uniform coordination sphere of approximately 5 oxygen atoms for all values of x. The results suggest that not only Si/Al-O tetrahedra but Ca-O polyhedra, too, play a role in determining the glassy structure

Cancer patients’ experiences of using an Interactive Health Communication Application (IHCA)

Interactive Health Communication Applications (IHCAs) are increasingly used in health care. Studies document that IHCAs provide patients with knowledge and social support, enhance self- efficacy and can improve behavioural and clinical outcomes. However, research exploring patients’ experiences of using IHCAs has been scarce. The aim of this study was to explore cancer patients’ perspectives and experiences related to the use of an IHCA called WebChoice in their homes. Qualitative interviews were conducted with infrequent, medium and frequent IHCA users—six women and four men with breast and prostate cancer. The interviews were transcribed and analyzed inspired by interactionistic perspectives. We found that some patients’ perceived WebChoice as a “friend,” others as a “stranger.” Access to WebChoice stimulated particularly high frequency users to position themselves as “information seeking agents,” assuming an active patient role. However, to position oneself as an “active patient” was ambiguous and emotional. Feelings of “calmness”, “normalization of symptoms”, feelings of “being part of a community”, feeling “upset” and “vulnerable”, as well as “feeling supported” were identified. Interaction with WebChoice implied for some users an increased focus on illness. Our findings indicate that the interaction between patients and an IHCA such as WebChoice occurs in a variety of ways, some of which are ambivalent or conflicting. Particularly for frequent and medium frequency users, it offers support, but may at the same time reinforce an element of uncertainty in their life. Such insights should be taken into consideration in the future development of IHCAs in healthcare in general and in particular for implementation into patients’ private sphere

Promoter effect on the reduction behavior of wuestite-based catalysts for ammonia synthesis

Ammonia synthesis remains one of the most important catalytic processes since it enables efficient hydrogen storage and provides the basis for the production of fertilizers. Herein, complementary bulk and local analytical techniques were combined to investigate the effect of selected promoters (Al, K, Ca) on the reduction of wuestite into α-iron and their catalytic performance for ammonia synthesis. The use of promoters appears to have a positive effect on the wuestite-derived catalyst in ammonia synthesis. The promoters seemingly act as a binder for wuestite grains and impede the reduction and disproportionation events of wuestite precursors resulting in an increased catalytic performance. This effect is associated with an increase of surface area and mesoporosity. The study delivers new insights into the interplay of structure and promoters in wuestite-based catalysts