Patient-controlled epidural Levobupicvacaine with or without Fentanyl for post-cesarean section pain relief

Purpose. The purpose of this study was to compare the analgesic properties of levobupivacaine with or without fentanyl for patient-controlled epidural analgesia after Cesarean section in a randomized, double-blinded study. Methods. We enrolled American Society of Anesthesiologists class I/II, full-term pregnant women at National Taiwan University Hospital who received patient-controlled epidural analgesia after Cesarean section between 2009 and 2010. Eighty women were randomly assigned into two groups. In group A, the 40 subjects received drug solutions made of 0.6 mg/ml levobupivacaine plus 2 mcg/ml fentanyl, and in group B the 40 subjects received 1 mg/ml levobupivacaine. Maintenance was self-administered boluses and a continuous background infusion. Results. There were no significant differences in the resting and dynamic pain scales and total volume of drug used between the two groups. Patient satisfaction was good in both groups. Conclusion. Our study showed that pure epidural levobupivacaine can provide comparative analgesic properties to the levobupivacaine-fentanyl combination after Cesarean section. Pure levobupivacaine may serve as an alternative pain control regimen to avoid opioid-related adverse events in parturients

Finding a Fair Land Dispute Settlement Mechanism Between Adat Law Community Vs. Investor

Land utilization for investment in local areas raises various land related problems that ends with conflicts within the community. A conflict that occurs, usually begins with the management of communal land “tanah ulayat” within the adat law community environment, and in this case, land utilization that is managed by the third party (investors). The basic problem is the difference of perception and expectations toward the company that exists in the land which is claimed by the community. Both parties have their own claim on the land based on each legal systems, in this situation adat law or local law faced with state law which is used by investors. So far, the Indonesian government has yet to have legal grounds in giving a directions for land dispute/conflict settlement mechanism. This paper attempts to give an input regarding a land dispute settlement mechanism that can be accepted for all disputing parties. The paper features critical analysis using legal pluralism approach towards related government policies and technical regulations in the ministerial level. These regulations, among others are, Minister of Agrarian Regulation No. 5 of 1999 on the Guidance for Dispute Settlement of Communal Land Rights, and Ministry of Agrarian and Spatial Affairs Regulation No. 9 of 2015 on Procedures of Appointment of Communal Land Rights for Adat Law Community and Communities Located in certain regions, also the draft of Law regarding Recognition and Protection of Adat Law Community

The 2005 Ilan earthquake doublet and seismic crisis in northeastern Taiwan: evidence for dyke intrusion associated with on-land propagation of the Okinawa Trough

Northern Taiwan underwent mountain building in the early stage of the Taiwan orogeny but is currently subjected to post-collisional crustal extension. It may be related to gravitational collapse or to the rifting of the Okinawa Trough, which lies offshore northeastern Taiwan. The Ilan Plain, northeastern Taiwan, which is bounded by the normal fault systems and filled up with thick Pliocene–Pleistocene sedimentary sequences, formed under such an extension environment. Over there on 2005 March 5 two earthquakes with about the same magnitude (M_L = 5.9) occurred within 68 s and produced intense aftershocks activity according to the records of Central Weather Bureau Seismic Network of Taiwan. We relocated the earthquake sequence by the three-dimension earthquake location algorithm with the newly published 3-D Vp and Vp/Vs velocity model, and determined the first-polarity focal mechanisms of the earthquake doublet. One major cluster of aftershocks which trends E–W and dips steeply to the south can be identified and picked up as a potential fault plane. The focal mechanisms of the two main shocks are both classified as normal type by first-polarity but strike-slip by centroid moment tensor inversion; however two methods both yield consistent E–W strike. Static coseismic deformation was additionally determined from Global Positioning System (GPS) daily solutions at a set of continuous GPS stations and from strong-motion seismographs. These data show NW–SE extension at high angle to the fault plane, which cannot be explained from a simple strike-slip double-couple mechanism. On the other hand, the small vertical displacements and steep fault plane cannot be explained from a simple normal event as well. We present from elastic dislocation modelling that the geodetic data are best explained by significant component of tensile source with centimetre-scale of opening on a 15-km-long fault extending from 1 to 13 km depth. We therefore interpret the crisis as the result of dyke intrusion at the very tip of the Okinawa Trough, which is reasonably driven by backarc spreading

Multi-scale symbolic entropy analysis provides prognostic prediction in patients receiving extracorporeal life support

Introduction: Extracorporeal life support (ECLS) can temporarily support cardiopulmonary function, and is occasionally used in resuscitation. Multi-scale entropy (MSE) derived from heart rate variability (HRV) is a powerful tool in outcome prediction of patients with cardiovascular diseases. Multi-scale symbolic entropy analysis (MSsE), a new method derived from MSE, mitigates the effect of arrhythmia on analysis. The objective is to evaluate the prognostic value of MSsE in patients receiving ECLS. The primary outcome is death or urgent transplantation during the index admission. Methods: Fifty-seven patients receiving ECLS less than 24 hours and 23 control subjects were enrolled. Digital 24-hour Holter electrocardiograms were recorded and three MSsE parameters (slope 5, Area 6–20, Area 6–40) associated with the multiscale correlation and complexity of heart beat fluctuation were calculated. Results: Patients receiving ECLS had significantly lower value of slope 5, area 6 to 20, and area 6 to 40 than control subjects. During the follow-up period, 29 patients met primary outcome. Age, slope 5, Area 6 to 20, Area 6 to 40, acute physiology and chronic health evaluation II score, multiple organ dysfunction score (MODS), logistic organ dysfunction score (LODS), and myocardial infarction history were significantly associated with primary outcome. Slope 5 showed the greatest discriminatory power. In a net reclassification improvement model, slope 5 significantly improved the predictive power of LODS; Area 6 to 20 and Area 6 to 40 significantly improved the predictive power in MODS. In an integrated discrimination improvement model, slope 5 added significantly to the prediction power of each clinical parameter. Area 6 to 20 and Area 6 to 40 significantly improved the predictive power in sequential organ failure assessment. Conclusions: MSsE provides additional prognostic information in patients receiving ECLS. Electronic supplementary material The online version of this article (doi:10.1186/s13054-014-0548-3) contains supplementary material, which is available to authorized users

Prediction Model of End Mill Cutting Edge Based on Material Properties and Cutting Conditions

In machining, the cutting performance of the tool depends on the tool material, tool structure, tool geometry, properties of workpiece materials, and cutting conditions. If the user chooses an inappropriate cutting tool for the machining of the workpiece material, this will cause energy loss and severe tool wear. This study aims to investigate the influence of mechanical properties of workpiece material and cutting conditions on the tool geometry and to establish a polynomial network for the prediction of a reasonable normal relief angle and a normal wedge angle based on experimental data. Experimental results indicate that the cutting of high hardness and high strength workpiece materials requires a larger normal wedge angle to increase the cutting edge strength. In addition, the design of the normal relief angle is related to Young\u27s modulus and the toughness of the workpiece material, mainly to avoid material elastic recovery during the cutting process. In terms of cutting parameters, as the radial depth of cut increases, the contact area between the tool and the chip increases, which causes the heat to concentrate at the tip of the tool; hence, it is necessary to increase the normal wedge angle. In addition, the feed per tooth had a negligible effect on the normal wedge angle. Finally, the prediction model was verified by five untested workpiece materials. The results of the cutting tests showed that the flatness of the cutting edge was less than 15 μm, which indicates that a normal cutting phenomenon occurred on the flank

THE EFFECT OF TENNIS RACKET STRING VIBRATION ABSORBER PLACEMENT ON TENNIS RACKET VIBRATIONS

The purpose of this research was to analyze the vibration effect of tennis racket caused by impact on different locative vibration absorber and locations. In this experiment, The tennis racket was fixed and kept the face horizontalized to the ground with 50 Ib on strings. A tennis ball was dropped from one meter height to impact three locations of the racket. The different locative vibration absorber was fixed on the racket. It was installed an accelerometer to capture the vibration signal of the handle of the racket. After the experiment, the data was used logarithmic decrement to calculate damping ratio. It was illustrated when the vibration absorber in Back and Tip to have obvious effect. But in Side, it could not effectively decrease the vibration compared with the racket without absorber

Nearest Neighbor Speculative Decoding for LLM Generation and Attribution

Large language models (LLMs) often hallucinate and lack the ability to provide attribution for their generations. Semi-parametric LMs, such as kNN-LM, approach these limitations by refining the output of an LM for a given prompt using its nearest neighbor matches in a non-parametric data store. However, these models often exhibit slow inference speeds and produce non-fluent texts. In this paper, we introduce Nearest Neighbor Speculative Decoding (NEST), a novel semi-parametric language modeling approach that is capable of incorporating real-world text spans of arbitrary length into the LM generations and providing attribution to their sources. NEST performs token-level retrieval at each inference step to compute a semi-parametric mixture distribution and identify promising span continuations in a corpus. It then uses an approximate speculative decoding procedure that accepts a prefix of the retrieved span or generates a new token. NEST significantly enhances the generation quality and attribution rate of the base LM across a variety of knowledge-intensive tasks, surpassing the conventional kNN-LM method and performing competitively with in-context retrieval augmentation. In addition, NEST substantially improves the generation speed, achieving a 1.8x speedup in inference time when applied to Llama-2-Chat 70B

Pin1 positively affects tumorigenesis of esophageal squamous cell carcinoma and correlates with poor survival of patients

BACKGROUND: Pin1 promotes oncogenesis by regulating multiple oncogenic signaling. In this study, we investigated the involvement of Pin1 in tumor progression and in the prognosis of human esophageal squamous cell carcinoma (ESCC). RESULTS: We observed that proliferation, clonogenicity and tumorigenesis of CE81T cells were inhibited by Pin1 knockdown. We next analyzed Pin1 expression in clinical ESCC specimens. When compared to the corresponding non-tumor part, Pin1 protein and mRNA levels in tumor part were higher in 84% and 62% patients, respectively. By immunohistochemistry, we identified that high Pin1 expression was associated with higher primary tumor stage (p = 0.035), higher overall cancer stage (p = 0.047) and poor overall survival (p < 0.001). Furthermore, the association between expression of Pin1 and levels of β-catenin and cyclin D in cell line and clinical specimens was evaluated. β-catenin and cyclin D1 were decreased in CE81T cells with Pin1 knockdown. Cyclin D1 level correlated with Pin1 expression in clinical ESCC specimens. CONCLUSIONS: Pin1 upregulation was associated with advanced stage and poor prognosis of ESCC. Pin1 knockdown inhibited aggressiveness of ESCC cells. β-catenin and cyclin D1 were positively regulated by Pin1. These results indicated that targeting Pin1 pathway could represent a potential modality for treating ESCC

Enhancing the Insulation of Wide-Range Spectrum in the PVA/N Thin Film by Doping ZnO Nanowires

In this study, polyvinyl alcohol/nitrogen (PVA/N) hybrid thin films doped with sharp-sword ZnO nanowires with insulating effect and wide-range spectrum are demonstrated for the first time. PVA/N doped ZnO nanocomposites were developed by blending PVA and N-doped ZnO nanowires in water at room temperature. Measurements from the field emission scanning electron microscopy (FE-SEM), X-ray diffraction (XRD), Raman, and photoluminescence emission (PL) spectra of the products show that nitrogen is successfully doped into the ZnO wurtzite crystal lattice. In addition, the refractive index of PVA/N doped ZnO hybrid thin films can be controlled by varying the doped ZnO nanowires under different NH3 concentrations. It is believed that PVA/N doped ZnO hybrid thin films are a suitable candidate for emerging applications like heat-shielding coatings on smart windows