Effects of combined general anesthesia and thoracic epidural analgesia on cytokine response in patients undergoing laparoscopic cholecystectomy

Background: Severe postoperative pain is not often experienced in laparoscopic cholecystectomy. Anesthesia, surgery, and pain are stressful and cause different reactions in neuro‑immuno‑endocrine systems. Many factors such as the pharmacological effect of the drugs used, as well as the type and depth of anesthesia, can affect these reactions.Objective: The aim of this study was to evaluate the effect of the combination of general anesthesia and thoracic epidural analgesia (TEA) on cytokine reaction in laparoscopic cholecystectomy.Study Design: Prospective, randomized clinical comparative study.Materials and Methods: Sixty adult patients scheduled for elective laparoscopic cholecystectomy were divided into four groups. Group saline (Group S), group fentanyl (Group F), group bupivacaine (Group B), and group levobupivacaine (Group L) were infused with saline, saline and fentanyl, bupivacaine and fentanyl, and levobupivacaine and fentanyl, respectively, via epidural catheter before surgical incision.Results: There were no differences among groups in the demographic features, heart rate, mean arterial pressure, and peripheral oxygen saturation values. Group L had lower visual analogue scale value compared to the other postoperative groups (P < 0.01). In all groups, interleukin‑6 (IL‑6), IL‑8, and IL‑10 levels started to increase at 2 h and returned to the basal level at 24 h. IL levels increased in most of the epidural saline‑administered group compared to other groups (P < 0.05).Conclusion: Combined general anesthesia and TEA provided pain control and hemodynamic stability more efficiently during the first 24 h of the intraoperative and postoperative period by suppressing cytokine levels. However, we determined that this effect was more obvious with the local anesthetic and opioid combination.Keywords: Bupivacaine, combined‑general‑epidural anesthesia, inflammatory cytokines, laparoscopic cholecystectomy, levobupivacain

AudioInceptionNeXt: TCL AI LAB Submission to EPIC-SOUND Audio-Based-Interaction-Recognition Challenge 2023

This report presents the technical details of our submission to the 2023 Epic-Kitchen EPIC-SOUNDS Audio-Based Interaction Recognition Challenge. The task is to learn the mapping from audio samples to their corresponding action labels. To achieve this goal, we propose a simple yet effective single-stream CNN-based architecture called AudioInceptionNeXt that operates on the time-frequency log-mel-spectrogram of the audio samples. Motivated by the design of the InceptionNeXt, we propose parallel multi-scale depthwise separable convolutional kernels in the AudioInceptionNeXt block, which enable the model to learn the time and frequency information more effectively. The large-scale separable kernels capture the long duration of activities and the global frequency semantic information, while the small-scale separable kernels capture the short duration of activities and local details of frequency information. Our approach achieved 55.43% of top-1 accuracy on the challenge test set, ranked as 1st on the public leaderboard. Codes are available anonymously at https://github.com/StevenLauHKHK/AudioInceptionNeXt.git

On Some Complex Aspects of the (2+1)-dimensional Broer-Kaup-Kupershmidt System

The improved Bernoulli sub-equation function method is used in extracting some new exponential function solutions to the (2+1)-dimensional Broer-Kaup-Kupershmidt system. It is of vital effort to look for more solutions of the (2+1)-dimensional Broer-Kaup-Kupershmidt system, which are very helpful for coastal and civil engineers to apply the nonlinear water models in a harbor and coastal design. All the obtained solutions satisfied the (2+1)-dimensional Broer-Kaup-Kupershmidt system. The two- and three-dimensional shapes of all the obtained solutions in this paper are also presented. All the computations and the graphics plots in this study are carried out with the aid of the Wolfram Mathematica 9

Starting-up unregistered and firm performance in Turkey

© 2016 The Author(s) Recent years have seen a questioning of the negative representation of informal sector entrepreneurship and an emergent view that it may offer significant benefits. This paper advances this rethinking by evaluating the relationship between business registration and future firm performance. Until now, the assumption has been that starting-up unregistered is linked to weaker firm performance. Using World Bank Enterprise Survey data on 2494 formal enterprises in Turkey, and controlling for other determinants of firm performance as well as the endogeneity of the registration decision, the finding is that formal enterprises that started-up unregistered and spent longer unregistered have significantly higher subsequent annual sales and productivity growth rates compared with those registered from the outset. This is argued to be because in such weak institutional environments, the advantages of registering from the outset are outweighed by the benefits of deferring business registration and the low risks of detection and punishment. The resultant implication is that there is a need to shift away from the conventional eradication approach based on the negative depiction of informal entrepreneurship as poorly performing, and towards a more facilitating approach that improves the benefits of business registration and tackles the systemic formal institutional deficiencies that lead entrepreneurs to decide to delay the registration of their ventures