Utility of bilateral superficial cervical plexus block in thyroidectomy patients for post-operative analgesia

Background: Thyroidectomy is painful procedure hence multimodal analgesia is required. Superficial cervical plexus block can be used for analgesia in thyroid surgeries. USG guided cervical plexus block administration is safe and latest technique as a part of multimodal analgesia for thyroid surgery.Methods: After obtaining consent 60 ASA grade I-II adult patients undergoing elective thyroid surgery were included and randomly divided into two groups (group B)-0.25% bupivacaine and (group S)-normal saline. Induction and maintenance under general anesthesia carried out as per standard protocol. After Induction USG guided block was administered with the drug solution as per allocated group. After surgery, patients were extubated and shifted to recovery room. Vital parameters were monitored. Patients were asked about their pain based on the 11-point numerical rating scales (NRS) score. The NRS score and other variables were documented at 3rd hour, 6th hour, 12th hour, and 24th hour at wards after the end of surgery. Time since the end of surgery to the first analgesia request was documented together with total analgesia consumed in the first 24 hours. If NRS score was ≥4 inj. Tramadol iv in incremental doses of 25 mg was given until pain relieved.Results: Time to first dose of analgesia was higher in group B compared to group S. Total analgesic dose of tramadol during first 24 hours was lower in group B compared to group SConclusions: bilateral superficial cervical plexus block can be used as a part of multi-modal analgesia in patients of thyroidectoy

Prediction of forest aboveground biomass using multitemporal multispectral remote sensing data

Forest aboveground biomass (AGB) is a prime forest parameter that requires global level estimates to study the global carbon cycle. Light detection and ranging (LiDAR) is the state-of-the-art technology for AGB prediction but it is expensive, and its coverage is restricted to small areas. On the contrary, spaceborne Earth observation data are effective and economical information sources to estimate and monitor AGB at a large scale. In this paper, we present a study on the use of different spaceborne multispectral remote sensing data for the prediction of forest AGB. The objective is to evaluate the effects of temporal, spectral, and spatial capacities of multispectral satellite data for AGB prediction. The study was performed on multispectral data acquired by Sentinel-2, RapidEye, and Dove satellites which are characterized by different spatial resolutions, temporal availability, and number of spectral bands. A systematic process of least absolute shrinkage and selection operator (lasso) variable selection generalized linear modeling, leave-one-out cross-validation, and analysis was accomplished on each satellite dataset for AGB prediction. Results point out that the multitemporal data based AGB models were more effective in prediction than the single-time models. In addition, red-edge and short wave infrared (SWIR) channel dependent variables showed significant improvement in the modeling results and contributed to more than 50% of the selected variables. Results also suggest that high spatial resolution plays a smaller role than spectral and temporal information in the prediction of AGB. The overall analysis emphasizes a good potential of spaceborne multispectral data for developing sophisticated methods for AGB prediction especially with specific spectral channels and temporal informatio

Sodium and Specialty Cyanides Production Facility

Sodium cyanide and specialty cyanide production are essential operations for various industrial processes, with primary applications in mining and mineral processing. Sodium cyanide, despite the high toxicity inherent in the material and its production process, is expected to grow 5% annually, with a projected global demand of 1.1 million tonnes in 2018. This report details a process design for producing sodium cyanide through the use of two intermediate reactions and successive downstream separations. The first major step is the production of hydrogen cyanide gas from ammonia and methane derived from natural gas, via the industry standard Andrussow reaction over a platinum-rhodium gauze catalyst. Aqueous sodium cyanide is produced via a neutralization reaction of absorbed hydrogen cyanide gas with aqueous sodium hydroxide. Downstream processes include the crystallization of solid sodium cyanide from the aqueous product, with the solid product being removed from slurry and brought to low-moisture content through a series of solid-liquid separations. The low-moisture solids are formed into the final briquette product, which is 97.7% sodium cyanide by mass at a capacity of 61.5M tonnes/year, and containing sodium carbonate as the principal impurity. Unconverted ammonia is recovered and recycled back to the feed of the HCN reactor, increasing the molar percent yield of hydrogen cyanide gas on the basis of fed ammonia from 60% to 70.9%. The project requires $35.6MM in Total Capital Investment and produces a Net Present Value of$72.5MM after 15 operating years and presents an Internal Rate of Return of 48.4%. The project will break even in its third operating year when it hits full production capacity. The design is recommended due to its strong return on investment and high resilience to market fluctuations

A comparison of intrathecal dexmedetomidine and clonidine as adjuvants to hyperbaric bupivacaine for gynecological surgery

Background: Various adjuvants are being used with local anesthetics for prolongation of intraoperative and post-operative analgesia. Dexmedetomidine, a highly selective alpha2 adrenergic agonist, is a new neuraxial adjuvant gaining popularity. The purpose of this study was to compare the onset, duration of sensory and motor block, hemodynamic effects, post-operative analgesia, and adverse effects of dexmedetomidine and clonidine with hyperbaric 0.5% bupivacaine for spinal anesthesia.Methods: 60 patients belonging to ASA Grade 1 and 2 undergoing elective gynecological surgery under spinal anesthesia were studied in this prospective. The patients were allocated in two groups (30 patients each). Group bupivacaine + clonidine (BC) received 17.5 mg of bupivacaine supplemented 45 mcg clonidine and Group bupivacaine + dexmedetomidine (BD) received 17.5 mg bupivacaine supplemented 5 mcg dexmedetomidine. The onset time of sensory and motor level, time to reach peak sensory and motor level, the regression time of sensory and motor level, hemodynamic changes, and side effects were recorded.Results: Patients in Group BD had significantly longer sensory and motor block time than patients in Group BC. The onset time to reach dermatome T4 and modified Bromage3 motor block were not significantly different between two groups. Dexmedetomidine group showed significantly less and delayed requirement of rescue analgesic.Conclusion: Intrathecal dexmedetomidine is associated with prolonged motor and sensory block, hemodynamic stability and reduced demand of rescue analgesic in 24 hrs as compared to clonidine

Single-Pot Rapid Synthesis of Colloidal Core/Core-Shell Quantum Dots: A Novel Polymer-Nanocrystal Hybrid Material

Colloidal core and core shell Quantum Dots (QD's) are unique and important optoelectronic materials because properties of these QD's can be tailored by configuring core and optimizing shell thickness. In this research work, lead selenide (PbSe) core and PbSe-CdSe (Core-shell) QD's are synthesized using oleic acid as a capping ligand by colloidal route. This simpler, cost-effective and rapid single pot synthesis route for colloidal core-shell quantum dots unlike conventional double-pot approach like cation-exchange and SILAR process has been reported for the very first time. Phase formation of prepared quantum dots is confirmed by XRD analysis, capping ligand presence by IR spectroscopy and morphological information by Scanning electron microscopy respectively. These synthesized inorganic quantum dots are dispersed in Poly (3-hexyl thiophene) polymer for formation of their respective nanocomposites. From PL quenching studies, it was inferred that PbSe-CdSe core-shell quantum dots showed enhanced rate of PL quenching and hence higher value of Stern-Volmer constant (K-SV) than PbSe Core QD's. This confirms that CdSe shell formation on PbSe core significantly passivates the core-surface, increases the stability and enhances the charge transfer mechanism for its potential application in Hybrid Solar cells

Comorbidities, complications and mortality in people of South Asian ethnicity with type 1 diabetes compared with other ethnic groups : a systematic review

Objective The aim of this systematic review is to explore the association of South Asian (SA) ethnicity on comorbidities, microvascular and macrovascular complications and mortality compared with other ethnic groups in people with type 1 diabetes mellitus (T1DM). Design Systematic review. Method A systematic literature search strategy was designed and carried out using Medline and Embase for full-text and abstract studies published in English from 1946 to February 2016. The initial search identified 4722 papers. We assessed 305 full-text articles in detail for potential inclusion. Ten papers met the inclusion criteria for review and an additional one paper was included from our secondary search strategy using the bibliography of included studies. In total, 11 studies were included. Eligibility criteria for selecting studies Studies were included if they were published in English, involved SA participants with T1DM and compared them with non- SA participants and assessed one of the outcomes of comorbidities, microvascular complications, macrovascular complications and mortality. Results SA with T1DM have higher mortality compared with white Europeans (WE), mainly contributed to by excess cardiovascular disease. SA have significantly higher glycated haemoglobin (HbA1c), lower high-density lipoprotein (HDL) and lower rates of neuropathy compared with WE. There were no differences in rates of retinopathy and nephropathy. Compared with Africans, SA had lower levels of microalbuminuria, HbA1c and systolic blood pressure and higher HDL levels. There were no significant differences in the remaining outcomes: cardiovascular disease, retinopathy, neuropathy and body mass index. Furthermore, SA have higher HbA1c levels than Malay and Chinese and higher waist hip ratio and lower HDL levels compared with Chinese only. Conclusion Our analysis highlights ethnic disparity in macrovascular outcomes that is so evident for type 2 diabetes mellitus may also be present for SA patients with T1DM. We highlight the need for a large, prospective, cohort study exploring the effect of ethnicity in a uniform healthcare setting

Precession of timelike bound orbits in Kerr spacetime

Astrometric observations of S-stars provide a unique opportunity to probe the nature of Sagittarius-A* (Sgr-A*). In view of this, it has become important to understand the nature and behavior of timelike bound trajectories of particles around a massive central object. It is known now that whereas the Schwarzschild black hole does not allow the negative precession for the S-stars, the naked singularity spacetimes can admit the positive as well as negative precession for the bound timelike orbits. In this context, we study the perihelion precession of a test particle in the Kerr spacetime geometry. Considering some approximations, we investigate whether the timelike bound orbits of a test particle in Kerr spacetime can have negative precession. In this paper, we only consider low eccentric timelike equatorial orbits. With these considerations, we find that in Kerr spacetimes, negative precession of timelike bound orbits is not allowed.Comment: 12 pages, 18 figure

Krüppel-Like Transcription Factor KLF1 Is Required for Optimal γ- and β-Globin Expression in Human Fetal Erythroblasts

In human adult erythroid cells, lower than normal levels of Krüppel-like transcription factor 1 (KLF1) are generally associated with decreased adult β- and increased fetal γ-globin gene expression. KLF1 also regulates BCL11A, a known repressor of adult γ-globin expression. In seeming contrast to the findings in adult cells, lower amounts of KLF1 correlate with both reduced embryonic and reduced fetal β-like globin mRNA in mouse embryonic erythroid cells. The role of KLF1 in primary human fetal erythroid cells, which express both γ- and β-globin mRNA, is less well understood. Therefore, we studied the role of KLF1 in ex vivo differentiated CD34+ umbilical cord blood cells (UCB erythroblasts), representing the fetal milieu. In UCB erythroblasts, KLF1 binds to the β-globin locus control region (LCR), and the β-globin promoter. There is very little KLF1 binding detectable at the γ-globin promoter. Correspondingly, when cultured fetal UCB erythroblasts are subjected to lentiviral KLF1 knockdown, the active histone mark H3K4me3 and RNA pol II recruitment are diminished at the β- but not the γ-globin gene. The amount of KLF1 expression strongly positively correlates with β-globin mRNA and weakly positively correlates with BCL11A mRNA. With modest KLF1 knockdown, mimicking haploinsufficiency, γ-globin mRNA is increased in UCB erythroblasts, as is common in adult cells. However, a threshold level of KLF1 is evidently required, or there is no absolute increase in γ-globin mRNA in UCB erythroblasts. Therefore, the role of KLF1 in γ-globin regulation in fetal erythroblasts is complex, with both positive and negative facets. Furthermore, in UCB erythroblasts, diminished BCL11A is not sufficient to induce γ-globin in the absence of KLF1. These findings have implications for the manipulation of BCL11A and/or KLF1 to induce γ-globin for therapy of the β-hemoglobinopathies

Krüppel-Like Transcription Factor KLF1 Is Required for Optimal γ- and β-Globin Expression in Human Fetal Erythroblasts

In human adult erythroid cells, lower than normal levels of Krüppel-like transcription factor 1 (KLF1) are generally associated with decreased adult β- and increased fetal γ-globin gene expression. KLF1 also regulates BCL11A, a known repressor of adult γ-globin expression. In seeming contrast to the findings in adult cells, lower amounts of KLF1 correlate with both reduced embryonic and reduced fetal β-like globin mRNA in mouse embryonic erythroid cells. The role of KLF1 in primary human fetal erythroid cells, which express both γ- and β-globin mRNA, is less well understood. Therefore, we studied the role of KLF1 in ex vivo differentiated CD34+ umbilical cord blood cells (UCB erythroblasts), representing the fetal milieu. In UCB erythroblasts, KLF1 binds to the β-globin locus control region (LCR), and the β-globin promoter. There is very little KLF1 binding detectable at the γ-globin promoter. Correspondingly, when cultured fetal UCB erythroblasts are subjected to lentiviral KLF1 knockdown, the active histone mark H3K4me3 and RNA pol II recruitment are diminished at the β- but not the γ-globin gene. The amount of KLF1 expression strongly positively correlates with β-globin mRNA and weakly positively correlates with BCL11A mRNA. With modest KLF1 knockdown, mimicking haploinsufficiency, γ-globin mRNA is increased in UCB erythroblasts, as is common in adult cells. However, a threshold level of KLF1 is evidently required, or there is no absolute increase in γ-globin mRNA in UCB erythroblasts. Therefore, the role of KLF1 in γ-globin regulation in fetal erythroblasts is complex, with both positive and negative facets. Furthermore, in UCB erythroblasts, diminished BCL11A is not sufficient to induce γ-globin in the absence of KLF1. These findings have implications for the manipulation of BCL11A and/or KLF1 to induce γ-globin for therapy of the β-hemoglobinopathies