Deltoid, triceps, or both responses improve the success rate of the interscalene catheter surgical block compared with the biceps response

Background The influence of the muscular response elicited by neurostimulation on the success rate of interscalene block using a catheter (ISC) is unknown. In this investigation, we compared the success rate of ISC placement as indicated by biceps or deltoid, triceps, or both twitches. Methods Three hundred (ASA I-II) patients presenting for elective arthroscopic rotator cuff repair were prospectively randomized to assessment by biceps (Group B) or deltoid, triceps, or both twitches (Group DT). All ISCs were placed with the aid of neurostimulation. The tip of the stimulating needle was placed after disappearance of either biceps or deltoid, triceps, or both twitches at 0.3 mA. The catheter was advanced 2-3 cm past the tip of the needle and the block was performed using 40 ml ropivacaine 0.5%. Successful block was defined as sensory block of the supraclavicular nerve and sensory and motor block involving the axillary, radial, median, and musculocutaneous nerves within 30 min. Results Success rate was 98.6% in Group DT compared with 92.5% in Group B (95% confidence interval 0.01-0.11; P<0.02). Supplemental analgesics during handling of the posterior part of the shoulder capsule were needed in two patients in Group DT and seven patients in Group B. Three patients in Group B had an incomplete radial nerve distribution anaesthesia necessitating general anaesthesia. One patient in Group B had an incomplete posterior block extension of the supraclavicular nerve. No acute or late complications were observed. Conclusions Eliciting deltoid, triceps, or both twitches was associated with a higher success rate compared with eliciting biceps twitches during continuous interscalene bloc

Hacking for Good - Workshop Summary

At the 2019 Charleston Library Conference, five facilitators from a diversity of organizations led a pre-conference called Hacking for Good. The goal of the half-day pre-conference was to introduce participants to the “hacking mindset” beyond the traditionally understood technology-driven terminology. In this context, hacking refersred to an approach of identifying a challenge or set of challenges in their respective knowledge organizations and gathering a set of techniques or approaches to address and overcome those challenges. The pre-conference provided a highly interactive and supportive environment to consider all aspects of a workplace challenge related to workflows and personnel and determine the most effective tools to tackle that challenge

Abundances of Baade's Window Giants from Keck/HIRES Spectra: II. The Alpha- and Light Odd Elements

We report detailed chemical abundance analysis of 27 RGB stars towards the Galactic bulge in Baade's Window for elements produced by massive stars: O, Na, Mg, Al, Si, Ca and Ti. All of these elements are overabundant in the bulge relative to the disk, especially Mg, indicating that the bulge is enhanced in Type~II supernova ejecta and most likely formed more rapidly than the disk. We attribute a rapid decline of [O/Fe] to metallicity-dependent yields of oxygen in massive stars, perhaps connected to the Wolf-Reyet phenomenon. he explosive nucleosynthesis alphas, Si, Ca and Ti, possess identical trends with [Fe/H], consistent with their putative common origin. We note that different behaviors of hydrostatic and explosive alpha elements can be seen in the stellar abundances of stars in Local Group dwarf galaxies. We also attribute the decline of Si,Ca and Ti relative to Mg, to metallicity- dependent yields for the explosive alpha elements from Type~II supernovae. The starkly smaller scatter of [/Fe] with [Fe/H] in the bulge, as compared to the halo, is consistent with expected efficient mixing for the bulge. The metal-poor bulge [/Fe] ratios are higher than ~80% of the halo. If the bulge formed from halo gas, the event occured before ~80% of the present-day halo was formed. The lack of overlap between the thick and thin disk composition with the bulge does not support the idea that the bulge was built by a thickening of the disk driven by the bar. The trend of [Al/Fe] is very sensitive to the chemical evolution environment. A comparison of the bulge, disk and Sgr dSph galaxy shows a range of ~0.7 dex in [Al/Fe] at a given [Fe/H], presumably due to a range of Type~II/Type~Ia supernova ratios in these systems.Comment: 51 pages, 6 tables, 27 figures, submitte

Effects of Potassium and Manganese Promoters on Nitrogen-Doped Carbon Nanotube-Supported Iron Catalysts for CO₂ Hydrogenation

Nitrogen-doped carbon nanotubes (NCNTs) were used as a support for iron (Fe) nanoparticles applied in carbon dioxide (CO2) hydrogenation at 633 K and 25 bar (1 bar = 105 Pa). The Fe/NCNT catalyst promoted with both potassium (K) and manganese (Mn) showed high performance in CO2 hydrogenation, reaching 34.9% conversion with a gas hourly space velocity (GHSV) of 3.1 L·(g·h)−1. Product selectivities were high for olefin products and low for short-chain alkanes for the K-promoted catalysts. When Fe/NCNT catalyst was promoted with both K and Mn, the catalytic activity was stable for 60 h of reaction time. The structural effect of the Mn promoter was demonstrated by X-ray diffraction (XRD), temperature-programmed reduction (TPR) with molecular hydrogen (H2), and in situ X-ray absorption near-edge structure (XANES) analysis. The Mn promoter stabilized wüstite (FeO) as an intermediate and lowered the TPR onset temperature. Catalytic ammonia (NH3) decomposition was used as an additional probe reaction for characterizing the promoter effects. The Fe/NCNT catalyst promoted with both K and Mn had the highest catalytic activity, and the Mn-promoted Fe/NCNT catalysts had the highest thermal stability under reducing conditions

Molecular serum signature of treatment resistant depression

Rationale: A substantial number of patients suffering from major depressive disorder (MDD) do not respond to multiple trials of anti-depressants, develop a chronic course of disease and become treatment resistant. Most of the studies investigating molecular changes in treatment-resistant depression (TRD) have only examined a limited number of molecules and genes. Consequently, biomarkers associated with TRD are still lacking. Objectives: This study aimed to use recently advanced high-throughput proteomic platforms to identify peripheral biomarkers of TRD defined by two staging models, the Thase and Rush staging model (TRM) and the Maudsley Staging Model (MSM). Methods: Serum collected from an inpatient cohort of 65 individuals suffering from MDD was analysed using two different mass spectrometric-based platforms, label-free liquid chromatography mass spectrometry (LC-MSE) and selective reaction monitoring (SRM), as well as a multiplex bead based assay. Results: In the LC-MSE analysis, proteins involved in the acute phase response and complement activation and coagulation were significantly different between the staging groups in both models. In the multiplex bead-based assay analysis TNF-α levels (log(odds) = −4.95, p = 0.045) were significantly different in the TRM comparison. Using SRM, significant changes of three apolipoproteins A–I (β = 0.029, p = 0.035), M (β = −0.017, p = 0.009) and F (β = −0.031, p = 0.024) were associated with the TRM but not the MSM. Conclusion: Overall, our findings suggest that proteins, which are involved in immune and complement activation, may represent potential biomarkers that could be used by clinicians to identify high-risk patients. Nevertheless, given that the molecular changes between the staging groups were subtle, the results need to be interpreted cautiously

Mapping Tumor Spheroid Mechanics in Dependence of 3D Microenvironment Stiffness and Degradability by Brillouin Microscopy

Altered biophysical properties of cancer cells and of their microenvironment contribute to cancer progression. While the relationship between microenvironmental stiffness and cancer cell mechanical properties and responses has been previously studied using two-dimensional (2D) systems, much less is known about it in a physiologically more relevant 3D context and in particular for multicellular systems. To investigate the influence of microenvironment stiffness on tumor spheroid mechanics, we first generated MCF-7 tumor spheroids within matrix metalloproteinase (MMP)-degradable 3D polyethylene glycol (PEG)-heparin hydrogels, where spheroids showed reduced growth in stiffer hydrogels. We then quantitatively mapped the mechanical properties of tumor spheroids in situ using Brillouin microscopy. Maps acquired for tumor spheroids grown within stiff hydrogels showed elevated Brillouin frequency shifts (hence increased longitudinal elastic moduli) with increasing hydrogel stiffness. Maps furthermore revealed spatial variations of the mechanical properties across the spheroids’ cross-sections. When hydrogel degradability was blocked, comparable Brillouin frequency shifts of the MCF-7 spheroids were found in both compliant and stiff hydrogels, along with similar levels of growth-induced compressive stress. Under low compressive stress, single cells or free multicellular aggregates showed consistently lower Brillouin frequency shifts compared to spheroids growing within hydrogels. Thus, the spheroids’ mechanical properties were modulated by matrix stiffness and degradability as well as multicellularity, and also to the associated level of compressive stress felt by tumor spheroids. Spheroids generated from a panel of invasive breast, prostate and pancreatic cancer cell lines within degradable stiff hydrogels, showed higher Brillouin frequency shifts and less cell invasion compared to those in compliant hydrogels. Taken together, our findings contribute to a better understanding of the interplay between cancer cells and microenvironment mechanics and degradability, which is relevant to better understand cancer progression

Polyhedral units and network connectivity in calcium aluminosilicate glasses from high-energy x-ray diffraction

Structure factors for Cax/2AlxSi1-xO2 glasses (x=0,0.25,0.5,0.67) extended to a wave vector of magnitude Q= 40 1/A have been obtained by high-energy x-ray diffraction. For the first time, it is possible to resolve the contributions of Si-O, Al-O and Ca-O coordination polyhedra to the experimental atomic pair distribution functions (PDF). It has been found that both Si and Al are four-fold coordinated and so participate in a continuous tetrahedral network at low values of x. The number of network breaking defects in the form of non-bridging oxygens (NBO's) increases slowly with x until x=0.5 (NBO's ~ 10% at x=0.5). By x=0.67 the network breaking defects become significant as evidenced by the significant drop in the average coordination number of Si. By contrast, Al-O tetrahedra remain free of NBO's and fully integrated in the Al/Si-O network for all values of x. Calcium maintains a rather uniform coordination sphere of approximately 5 oxygen atoms for all values of x. The results suggest that not only Si/Al-O tetrahedra but Ca-O polyhedra, too, play a role in determining the glassy structure

Stellar Iron Abundances at the Galactic Center

We present measurements of [Fe/H] for six M supergiant stars and three giant stars within 0.5 pc of the Galactic Center (GC) and one M supergiant star within 30 pc of the GC. The results are based on high-resolution (lambda / Delta lambda =40,000) K-band spectra, taken with CSHELL at the NASA Infrared Telescope Facility.We determine the iron abundance by detailed abundance analysis,performed with the spectral synthesis program MOOG.The mean [Fe/H] of the GC stars is determined to be near solar,[Fe/H] = +0.12 $\pm$ 0.22. Our analysis is a differential analysis, as we have observed and applied the same analysis technique to eleven cool, luminous stars in the solar neighborhood with similar temperatures and luminosities as the GC stars. The mean [Fe/H] of the solar neighborhood comparison stars, [Fe/H] = +0.03 $\pm$ 0.16, is similar to that of the GC stars. The width of the GC [Fe/H] distribution is found to be narrower than the width of the [Fe/H] distribution of Baade's Window in the bulge but consistent with the width of the [Fe/H] distribution of giant and supergiant stars in the solar neighborhood.Comment: 41 pages, 9 figures, ApJ, in pres