Femoral Nerve Block in Total Knee Arthroplasty: Utilization of Technique by Certified Registered Nurse Anesthetists

Postoperative pain control is an important component to patient rehabilitation. The multi-modal approach to pain management includes the use of peripheral nerve blocks to improve the perception of postoperative pain. The purpose of this study was to determine Certified Registered Nurse Anesthetist (CRNA) practice experience with the use of femoral nerve block (FNB) for pain control in patients receiving total knee arthroplasty. CRNA’s experienced with providing anesthesia for total knee arthroplasty were surveyed to determine their utilization of the femoral nerve block technique and their perceptions of efficacy of the technique. A quota sample of CRNA’s from major hospitals in a midwestern state, were asked to participate in completing a questionnaire. The utilization of FNB in the study was 17.2% of TKA patients. Those CRNA’s that received both formal and other training in nerve block technique were more likely to use FNB for pain control than their peers who received only one type of training or no training at all. The literature review data regarding the absolute efficacy of the FNB technique was limited. The study did reveal, however, that 60% of CRNA’s who do perform FNB, reported the TKA patients’ pain control in the post anesthesia care unit (PACU), when using general anesthesia, as fair or poor. Barriers to the use of FNB revealed the most significant barrier to performing the procedure to be the anesthesiologist preference

Ecological principles to guide the development of crop variety mixtures

Crop variety mixtures can provide many benefits, including pathogen suppression and increased yield and yield stability. However, these benefits do not necessarily occur in all mixtures, and the benefits of diversity may be compromised by disadvantages due to increased crop heterogeneity. In-field development of mixtures by assembling many combinations of crop genotypes without prior expectation about which genotypes need to be combined to produce well-performing mixtures results in prohibitively large designs. Therefore, effective tools are required to narrow down the number of promising variety mixtures, and to then identify in experiments which of these deliver the highest benefits. Here, we first review current knowledge about the mechanisms underlying effects in ecological diversity experiments and in current agricultural applications. We then discuss some of the principal difficulties arising in the application of this knowledge to develop good variety mixtures. We also discuss non-conventional approaches to solve some of these issues. In particular, we highlight the potential and limitations of trait-based methods to determine good variety mixing partners, and argue that nontraditional traits and trait-derived metrics may be needed for the trait-based approach to deliver its full potential. Specifically, we argue that good mixing partners can be identified using modern genetic and genomic approaches. Alternatively, good mixtures may be obtained by combining varieties that respond differently to environmental variation; such varieties could easily be identified in standard variety testing trials. Preliminary analyses show that niche differences underlying the different environmental responses can indicate functional complementarity and promote mixture yield and yield stability

IDEAL Symposium on the East African Lakes

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/94975/1/eost9699.pd

Employed Parents of Children With Mental Health Disorders: Achieving Work–Family Fit, Flexibility, and Role Quality

Extensive interviews with 60 employed parents of school-age children treated for mental health problems explored work–family fit, flexibility, family support, and work–life strategies in relation to role quality. Role quality was measured as employment and parenting rewards and concerns. Work–family fit was positively related to family flexibility but not work flexibility. Higher flexibility in work and family predicted lower job concerns, and work flexibility and work–family fit were predictors of job rewards. Parental concerns were dependent on flexibility and work–family strategies. Single parents had significantly fewer sources of family support and used fewer work–family strategies than caregivers with partners. Human services providers should collaborate with families by jointly exploring new flexibility and support strategies in work and family domains

Injuries, Sequelae, and Treatment of Lightning-Induced Injuries: 10 Years of Experience at a Swiss Trauma Center

Principals. Lightning is one of the most powerful and spectacular natural phenomena. Lightning strikes to humans are uncommon but can cause devastating injuries. We analyzed lightning-related admissions to our emergency department from January 2000 to December 2010 to review and highlight the main features of lightning-related injuries. Methods. All data were collected prospectively and entered in the emergency department' database (Qualicare Switzerland) and retrospectively analyzed. Results. Nine patients with lightning-related injuries presented to our emergency department. Four were female, and five were male. The most common site of injury was the nervous system (6 out of 9 patients) followed by the cardiovascular system (5 out of 9 patients). The third most common injuries occurred to the skin (3 out of 9 patients). Four of the patients had to be hospitalized for further observation. Conclusion. Reports of lightning strikes and related injuries are scarce. The establishment of an international register would therefore benefit the understanding of their injury patterns and facilitate specific treatment

A plant biodiversity effect resolved to a single chromosomal region

Despite extensive evidence that biodiversity promotes plant community productivity, progress towards understanding the mechanistic basis of this effect remains slow, impeding the development of predictive ecological theory and agricultural applications. Here, we analysed non-additive interactions between genetically divergent Arabidopsis accessions in experimental plant communities. By combining methods from ecology and quantitative genetics, we identify a major effect locus at which allelic differences between individuals increase the above-ground productivity of communities. In experiments with near-isogenic lines, we show that this diversity effect acts independently of other genomic regions and can be resolved to a single region representing less than 0.3% of the genome. Using plant–soil feedback experiments, we also demonstrate that allelic diversity causes genotype-specific soil legacy responses in a consecutive growing period, even after the original community has disappeared. Our work thus suggests that positive diversity effects can be linked to single Mendelian factors, and that a range of complex community properties can have a simple cause. This may pave the way to novel breeding strategies, focusing on phenotypic properties that manifest themselves beyond isolated individuals; that is, at a higher level of biological organization

Increasing plant group productivity through latent genetic variation for cooperation

Historic yield advances in the major crops have, to a large extent, been achieved by selection for improved productivity of groups of plant individuals such as high-density stands. Research suggests that such improved group productivity depends on “cooperative” traits (e.g., erect leaves, short stems) that—while beneficial to the group—decrease individual fitness under competition. This poses a problem for some traditional breeding approaches, especially when selection occurs at the level of individuals, because “selfish” traits will be selected for and reduce yield in high-density monocultures. One approach, therefore, has been to select individuals based on ideotypes with traits expected to promote group productivity. However, this approach is limited to architectural and physiological traits whose effects on growth and competition are relatively easy to anticipate. Here, we developed a general and simple method for the discovery of alleles promoting cooperation in plant stands. Our method is based on the game-theoretical premise that alleles increasing cooperation benefit the monoculture group but are disadvantageous to the individual when facing noncooperative neighbors. Testing the approach using the model plant Arabidopsis thaliana, we found a major effect locus where the rarer allele was associated with increased cooperation and productivity in high-density stands. The allele likely affects a pleiotropic gene, since we find that it is also associated with reduced root competition but higher resistance against disease. Thus, even though cooperation is considered evolutionarily unstable except under special circumstances, conflicting selective forces acting on a pleiotropic gene might maintain latent genetic variation for cooperation in nature. Such variation, once identified in a crop, could rapidly be leveraged in modern breeding programs and provide efficient routes to increase yields

Precision machining, polishing and measurement of mechanical and toxicological properties of lead tungstate crystals for the CMS electromagnetic calorimeter

We have developed new machining and polishing techniques that have previously been applied to large scintillating crystal arrays for high energy physics experiments such as the Barium Fluoride Electromagnetic Calorimeter for the GEM Detector at SSCL, the LCsI Electromagnetic Calorimeter for the BaBar Detector at PEP-II B Factory at SLAC and the 110,000 crystal CMS Lead Tungstate Electromagnetic Calorimeter at LHC at CERN. We discuss earlier results achieved with diamond machining and polishing methods and present new results on diamond machining of lead tungstate crystals. Additionally we present new results on mechanical properties of lead tungstate including toxicological data important for the safe handling and processing of this material