Analgesia for total knee arthroplasty: a meta-analysis comparing local infiltration and femoral nerve block

Patients frequently experience postoperative pain after a total knee arthroplasty; such pain is always challenging to treat and may delay the patient’s recovery. It is unclear whether local infiltration or a femoral nerve block offers a better analgesic effect after total knee arthroplasty.We performed a systematic review and meta-analysis of randomized controlled trials to compare local infiltration with a femoral nerve block in patients who underwent a primary unilateral total knee arthroplasty. We searched Pubmed, EMBASE, and the Cochrane Library through December 2014. Two reviewers scanned abstracts and extracted data. The data collected included numeric rating scale values for pain at rest and pain upon movement and opioid consumption in the first 24 hours. Mean differences with 95% confidence intervals were calculated for each end point. A sensitivity analysis was conducted to evaluate potential sources of heterogeneity.While the numeric rating scale values for pain upon movement (MD-0.62; 95%CI: -1.13 to -0.12; p=0.02) in the first 24 hours differed significantly between the patients who received local infiltration and those who received a femoral nerve block, there were no differences in the numeric rating scale results for pain at rest (MD-0.42; 95%CI:-1.32 to 0.47; p=0.35) or opioid consumption (MD 2.92; 95%CI:-1.32 to 7.16; p=0.18) in the first 24 hours.Local infiltration and femoral nerve block showed no significant differences in pain intensity at rest or opioid consumption after total knee arthroplasty, but the femoral nerve block was associated with reduced pain upon movement

A reference-grade wild soybean genome

Wild relatives of crop plants are invaluable germplasm for genetic improvement. Here, Xie et al. report a reference-grade wild soybean genome and show that it can be used to identify structural variation and refine quantitative trait loci

A reference-grade wild soybean genome

Efficient crop improvement depends on the application of accurate genetic information contained in diverse germplasm resources. Here we report a reference-grade genome of wild soybean accession W05, with a final assembled genome size of 1013.2 Mb and a contig N50 of 3.3 Mb. The analytical power of the W05 genome is demonstrated by several examples. First, we identify an inversion at the locus determining seed coat color during domestication. Second, a translocation event between chromosomes 11 and 13 of some genotypes is shown to interfere with the assignment of QTLs. Third, we find a region containing copy number variations of the Kunitz trypsin inhibitor (KTI) genes. Such findings illustrate the power of this assembly in the analysis of large structural variations in soybean germplasm collections. The wild soybean genome assembly has wide applications in comparative genomic and evolutionary studies, as well as in crop breeding and improvement programs

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

A Memristor-Based High-Resolution A/D Converter

Based on the voltage threshold adaptive memristor (VTEAM) model, this paper proposes a circuit design of a memristor-based A/D converter, which can achieve high-resolution conversion by simple configuration. For this A/D converter, there are the input voltage stage and the reference voltage stage in one conversion. According to the memristance change in the two stages, the input analog voltage is converted as the corresponding digital value. In the input voltage stage, the memristance increases from the initial memristance. Meanwhile, the counter rises its value from zero to the maximum. Next, the memristance returns to the initial memristance in the reference voltage stage. At the same time, the counting value starts to increase from zero again. Then, the input analog voltage is mapped to the eventual counting value of the reference voltage stage. The simulations of the memristor-based A/D converter demonstrate that it has good conversion performance. The proposed memristor-based A/D converter not only has more brilliant performance than the CMOS A/D converter, but also has the advantages over existing memristor-based A/D converters of anti-interference ability and high resolution

Projective Synchronization of Nonidentical Fractional-Order Memristive Neural Networks

This paper investigates projective synchronization of nonidentical fractional-order memristive neural networks (NFMNN) via sliding mode controller. Firstly, based on the sliding mode control theory, a new fractional-order integral sliding mode controller is designed to ensure the occurrence of sliding motion. Furthermore, according to fractional-order differential inequalities and fractional-order Lyapunov direct method, the trajectories of the system converge to the sliding mode surface to carry out sliding mode motion, and some sufficient criteria are obtained to achieve global projective synchronization of NFMNN. In addition, the conclusions extend and improve some previous works on the synchronization of fractional-order memristive neural networks (FMNN). Finally, a simulation example is given to verify the effectiveness and correctness of the obtained results

IoT-Based Heartbeat Rate-Monitoring Device Powered by Harvested Kinetic Energy

Remote patient-monitoring systems are helpful since they can provide timely and effective healthcare facilities. Such online telemedicine is usually achieved with the help of sophisticated and advanced wearable sensor technologies. The modern type of wearable connected devices enable the monitoring of vital sign parameters such as: heart rate variability (HRV) also known as electrocardiogram (ECG), blood pressure (BLP), Respiratory rate and body temperature, blood pressure (BLP), respiratory rate, and body temperature. The ubiquitous problem of wearable devices is their power demand for signal transmission; such devices require frequent battery charging, which causes serious limitations to the continuous monitoring of vital data. To overcome this, the current study provides a primary report on collecting kinetic energy from daily human activities for monitoring vital human signs. The harvested energy is used to sustain the battery autonomy of wearable devices, which allows for a longer monitoring time of vital data. This study proposes a novel type of stress- or exercise-monitoring ECG device based on a microcontroller (PIC18F4550) and a Wi-Fi device (ESP8266), which is cost-effective and enables real-time monitoring of heart rate in the cloud during normal daily activities. In order to achieve both portability and maximum power, the harvester has a small structure and low friction. Neodymium magnets were chosen for their high magnetic strength, versatility, and compact size. Due to the non-linear magnetic force interaction of the magnets, the non-linear part of the dynamic equation has an inverse quadratic form. Electromechanical damping is considered in this study, and the quadratic non-linearity is approximated using MacLaurin expansion, which enables us to find the law of motion for general case studies using classical methods for dynamic equations and the suitable parameters for the harvester. The oscillations are enabled by applying an initial force, and there is a loss of energy due to the electromechanical damping. A typical numerical application is computed with Matlab 2015 software, and an ODE45 solver is used to verify the accuracy of the method

WISP1 mediates lung injury following hepatic ischemia reperfusion dependent on TLR4 in mice

Abstract Background Hepatic ischemia-reperfusion injury (IRI) is a common pathological phenomenon, which causes hepatic injury as well as remote organ injuries such as the lung. Several mediators, such as oxidative stress, Ca2+ overload and neutrophil infiltration, have been implied in the pathogenesis of liver and remote organ injuries following reperfusion. WNT1 inducible signaling pathway protein 1 (WISP1) is an extracellular matrix protein that has been associated with the onset of several malignant diseases. Previous work in our group has demonstrated WISP1 is upregulated and contributes to proinflammatory cascades in hepatic IRI. However, the role of WISP1 in the pathogenesis of lung injury after hepatic IRI still remains unknown. Methods Male C57BL/6 mice were used to examine the expression and role of WISP1 in the pathogenesis of lung injuries after hepatic IRI and explore its potential mechanisms in mediating lung injuries. Results We found WISP1 was upregulated in lung tissues following hepatic IRI. Treatment with anti-WISP1 antibody ameliorated lung injuries with alteration of cytokine profiles. Administration with rWISP1 aggravated lung injuries following hepatic IRI through excessive production of proinflammatory cytokines and inhibition of anti-inflammatory cytokines. Conclusions In this study, we concluded that WISP1 contributed to lung injuries following hepatic IRI through TLR4 pathway