177 research outputs found

    The efficacy and safety of paravertebral block for postoperative analgesia in renal surgery: A systematic review and meta-analysis of randomized controlled trials

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    BackgroundParavertebral block (PVB) has been widely used in postoperative analgesia, especially in thoracic and breast surgery. However, the efficacy and safety of PVB for analgesia after renal surgery remains uncertain. Therefore, this study aimed to determine the postoperative analgesic efficacy and safety of PVB in renal surgery.MethodsPubMed, Web of Science, Embase, and the Cochrane Library databases were systematically searched up to December 20, 2021. All randomized controlled trials (RCTs) evaluating the postoperative analgesic efficacy of PVB in renal surgery were collected. The meta-analysis was performed using RevMan 5.4 and Stata/MP 14.0 software.ResultsA total of 16 RCTs involving 907 patients were included in the meta-analysis. Ten studies investigated patients under percutaneous nephrolithotomy (PCNL), and six studies were done for patients under other renal surgery (nephrectomy or pyeloplasty). Compared with control groups (no block, sham block, or other nerve blocks), meta-analysis showed that PVB reduced 24-hour postoperative opioid consumption significantly (SMD = −0.99, 95%CI: −1.60–0.38, p = 0.001, I2 = 92%) and reduced pain scores at various time points within 24 h at rest and 1 h, 4 h, and 24 h at movement after renal surgery, furthermore, PVB prolonged the time to first postoperative analgesic requirement (SMD = 2.16, 95%CI: 0.94–3.39, p = 0.005, I2 = 96%) and reduced the incidence of postoperative additional analgesia (OR = 0.14, 95%CI: 0.06∼0.33, p < 0.00001, I2 = 50%). Subgroup analysis revealed that the postoperative analgesia effect of PVB was more significant in PCNL, and the use of bupivacaine for PVB seemed to have a better performance. Besides, there was no difference in the incidence of postoperative nausea, vomiting, and itching between PVB and control groups.ConclusionThis study indicates that PVB may provide effective postoperative analgesia in patients under renal surgery, especially PCNL patients. Moreover, PVB is a safe analgesic method without significant analgesia-related complications

    Integrated supply chain design for commodity chemicals production via woody biomass fast pyrolysis and upgrading

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    This study investigates the optimal supply chain design for commodity chemicals (BTX, etc.) production via woody biomass fast pyrolysis and hydroprocessing pathway. The locations and capacities of distributed preprocessing hubs and integrated biorefinery facilities are optimized with a mixed integer linear programming model. In this integrated supply chain system, decisions on the biomass chipping methods (roadside chipping vs. facility chipping) are also explored. The economic objective of the supply chain model is to maximize the profit for a 20-year chemicals production system. In addition to the economic objective, the model also incorporates an environmental objective of minimizing life cycle greenhouse gas emissions, analyzing the trade-off between the economic and environmental considerations. The capital cost, operating cost, and revenues for the biorefinery facilities are based on techno-economic analysis, and the proposed approach is illustrated through a case study of Minnesota, with Minneapolis-St. Paul serving as the chemicals distribution hub

    Determination of QPO properties in the presence of strong broad-band noise: a case study on the data of MAXI J1820+070

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    Accurate calculation of the phase lags of quasi-periodic oscillations (QPOs) will provide insight into their origin. In this paper we investigate the phase lag correction method which has been applied to calculate the intrinsic phase lags of the QPOs in MAXI J1820+070. We find that the traditional additive model between BBN and QPOs in the time domain is rejected, but the convolution model is accepted. By introducing a convolution mechanism in the time domain, the Fourier cross-spectrum analysis shows that the phase lags between QPOs components in different energy bands will have a simple linear relationship with the phase lags between the total signals, so that the intrinsic phase lags of the QPOs can be obtained by linear correction. The power density spectrum (PDS) thus requires a multiplicative model to interpret the data. We briefly discuss a physical scenario for interpreting the convolution. In this scenario, the corona acts as a low-pass filter, the Green's function containing the noise is convolved with the QPOs to form the low-frequency part of the PDS, while the high-frequency part requires an additive component. We use a multiplicative PDS model to fit the data observed by Insight-HXMT. The overall fitting results are similar compared to the traditional additive PDS model. Neither the width nor the centroid frequency of the QPOs obtained from each of the two PDS models were significantly different, except for the r.m.s. of the QPOs. Our work thus provides a new perspective on the coupling of noise and QPOs.Comment: 13 pages, 8 figure

    A Variable Ionized Disk Wind in the Black Hole Candidate EXO 1846–031

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    After 34 yr, the black hole candidate EXO 1846–031 went into outburst again in 2019. We investigate its spectral properties in the hard intermediate and the soft states with NuSTAR and Insight-HXMT. A reflection component has been detected in the two spectral states but possibly originating from different illumination spectra: in the intermediate state, the illuminating source is attributed to a hard coronal component, which has been commonly observed in other X-ray binaries, whereas in the soft state, the reflection is probably produced by disk self-irradiation. Both cases support EXO 1846–031 as a low-inclination system of ~40°. An absorption line is clearly detected at ~7.2 keV in the hard intermediate state, corresponding to a highly ionized disk wind (log} ξ > 6.1) with a velocity of up to 0.06c. Meanwhile, quasi-simultaneous radio emissions have been detected before and after the X-rays, implying the coexistence of disk winds and jets in this system. If only the high-flux segment of the NuSTAR observation is considered, the observed wind appears to be magnetically driven. The absorption line disappeared in the soft state and a narrow emission line appeared at ~6.7 keV on top of the reflection component, which may be evidence for disk winds, but data with higher spectral resolution are required to examine this

    Potential of Core-Collapse Supernova Neutrino Detection at JUNO

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    JUNO is an underground neutrino observatory under construction in Jiangmen, China. It uses 20kton liquid scintillator as target, which enables it to detect supernova burst neutrinos of a large statistics for the next galactic core-collapse supernova (CCSN) and also pre-supernova neutrinos from the nearby CCSN progenitors. All flavors of supernova burst neutrinos can be detected by JUNO via several interaction channels, including inverse beta decay, elastic scattering on electron and proton, interactions on C12 nuclei, etc. This retains the possibility for JUNO to reconstruct the energy spectra of supernova burst neutrinos of all flavors. The real time monitoring systems based on FPGA and DAQ are under development in JUNO, which allow prompt alert and trigger-less data acquisition of CCSN events. The alert performances of both monitoring systems have been thoroughly studied using simulations. Moreover, once a CCSN is tagged, the system can give fast characterizations, such as directionality and light curve

    Detection of the Diffuse Supernova Neutrino Background with JUNO

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    As an underground multi-purpose neutrino detector with 20 kton liquid scintillator, Jiangmen Underground Neutrino Observatory (JUNO) is competitive with and complementary to the water-Cherenkov detectors on the search for the diffuse supernova neutrino background (DSNB). Typical supernova models predict 2-4 events per year within the optimal observation window in the JUNO detector. The dominant background is from the neutral-current (NC) interaction of atmospheric neutrinos with 12C nuclei, which surpasses the DSNB by more than one order of magnitude. We evaluated the systematic uncertainty of NC background from the spread of a variety of data-driven models and further developed a method to determine NC background within 15\% with {\it{in}} {\it{situ}} measurements after ten years of running. Besides, the NC-like backgrounds can be effectively suppressed by the intrinsic pulse-shape discrimination (PSD) capabilities of liquid scintillators. In this talk, I will present in detail the improvements on NC background uncertainty evaluation, PSD discriminator development, and finally, the potential of DSNB sensitivity in JUNO

    Real-time Monitoring for the Next Core-Collapse Supernova in JUNO

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    Core-collapse supernova (CCSN) is one of the most energetic astrophysical events in the Universe. The early and prompt detection of neutrinos before (pre-SN) and during the SN burst is a unique opportunity to realize the multi-messenger observation of the CCSN events. In this work, we describe the monitoring concept and present the sensitivity of the system to the pre-SN and SN neutrinos at the Jiangmen Underground Neutrino Observatory (JUNO), which is a 20 kton liquid scintillator detector under construction in South China. The real-time monitoring system is designed with both the prompt monitors on the electronic board and online monitors at the data acquisition stage, in order to ensure both the alert speed and alert coverage of progenitor stars. By assuming a false alert rate of 1 per year, this monitoring system can be sensitive to the pre-SN neutrinos up to the distance of about 1.6 (0.9) kpc and SN neutrinos up to about 370 (360) kpc for a progenitor mass of 30M⊙M_{\odot} for the case of normal (inverted) mass ordering. The pointing ability of the CCSN is evaluated by using the accumulated event anisotropy of the inverse beta decay interactions from pre-SN or SN neutrinos, which, along with the early alert, can play important roles for the followup multi-messenger observations of the next Galactic or nearby extragalactic CCSN.Comment: 24 pages, 9 figure
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