Search

Background Blood pressure variability (BPV), defined as the degree of variation between discrete blood pressure readings, is associated with poor outcomes in acute care settings. Acute kidney injury (AKI) is a common and serious postoperative complication of cardiac surgery with cardiopulmonary bypass (CPB) in children. No studies have yet assessed the association between intraoperative BPV during cardiac surgery with CPB and the development of AKI in children. Methods A retrospective chart review of children undergoing cardiac surgery with CPB was performed. Intraoperative BPV was calculated using average real variability (ARV) and standard deviation (SD). Multiple regression models were used to examine the association between BPV and outcomes of AKI, hospital and intensive care unit (PICU) length of stay, and length of mechanical ventilation. Results Among 231 patients (58% males, median age 8.6 months) reviewed, 51.5% developed AKI (47.9% Stage I, 41.2% Stage II, 10.9% Stage III). In adjusted models, systolic and diastolic ARV were associated with development of any stage AKI (OR 1.40, 95% CI 1.08-1.8 and OR 1.4, 95% CI 1.05-1.8, respectively). Greater diastolic SD was associated with longer PICU length of stay ([beta] 0.94, 95% CI 0.62-1.2). When stratified by age, greater systolic ARV and SD were associated with AKI in infants [less than or equal to] 12 months, but there was no relationship in children > 12 months. Conclusions Greater BPV during cardiac surgery with CPB was associated with development of postoperative AKI in infants, suggesting that BPV is a potentially modifiable risk factor for AKI in this high-risk population. Graphical abstract, Author(s): Jennifer E. Fishbein [sup.1] , Matthew Barone [sup.2] , James B. Schneider [sup.3] , David B. Meyer [sup.4] , John Hagen [sup.5] , Adnan Bakar [sup.3] , Kalliopi Grammatikopoulos [...]

Adult degenerative scoliosis (ADS) is a coronal plane deformity often accompanied by sagittal plane malalignment. Surgical correction may involve the major and/or distally-located fractional curves (FCs). Correction of the FC has been increasingly recognized as key to ameliorating radicular pain localized to the FC levels. The present study aims to summarize the literature on the rationale for FC correction in ADS. Three databases were systematically reviewed to identify all primary studies reporting the rationale for correcting the FC in ADS. Articles were included if they were English full-text studies with primary data from ADS (≥ 18 years old) patients. Seventy-four articles were identified, of which 12 were included after full-text review. Findings suggest FC correction with long-segment fusion terminating at L5 increases the risk of distal junctional degeneration as compared to constructs instrumenting the sacrum. Additionally, circumferential fusion offers greater FC correction, lower reoperation risk, and shorter construct length. Minimally invasive surgery (MIS) techniques may offer effective radiographic correction and improve leg pain associated with foraminal stenosis on the FC concavity, though experiences are limited. Open surgery may be necessary to achieve adequate correction of severe, highly rigid deformities. Current data support major curve correction in ASD where the FC concavity and truncal shift are concordant, suggesting that the FC contributes to the patient's overall deformity. Circumferential fusion and the use of kickstand rods can improve correction and enhance the stability and durability of long constructs. Last, MIS techniques show promise for milder deformities but require further investigation. [ABSTRACT FROM AUTHOR]

Summary: Arbuscular mycorrhizal fungi (AMF) transport substantial plant carbon (C) that serves as a substrate for soil organisms, a precursor of soil organic matter (SOM), and a driver of soil microbial dynamics. Using two‐chamber microcosms where an air gap isolated AMF from roots, we 13CO2‐labeled Avena barbata for 6 wk and measured the C Rhizophagus intraradices transferred to SOM and hyphosphere microorganisms.NanoSIMS imaging revealed hyphae and roots had similar 13C enrichment. SOM density fractionation, 13C NMR, and IRMS showed AMF transferred 0.77 mg C g−1 of soil (increasing total C by 2% relative to non‐mycorrhizal controls); 33% was found in occluded or mineral‐associated pools.In the AMF hyphosphere, there was no overall change in community diversity but 36 bacterial ASVs significantly changed in relative abundance. With stable isotope probing (SIP)‐enabled shotgun sequencing, we found taxa from the Solibacterales, Sphingobacteriales, Myxococcales, and Nitrososphaerales (ammonium oxidizing archaea) were highly enriched in AMF‐imported 13C (> 20 atom%). Mapping sequences from 13C‐SIP metagenomes to total ASVs showed at least 92 bacteria and archaea were significantly 13C‐enriched.Our results illustrate the quantitative and ecological impact of hyphal C transport on the formation of potentially protective SOM pools and microbial roles in the AMF hyphosphere soil food web. [ABSTRACT FROM AUTHOR]

Background: There has been a recent focus among anesthesiologists on reducing the use of perioperative opioids in favor of multimodal analgesic regimens. Gabapentin has played an integral role in this evolution of practice. This comprehensive review assesses the current clinical evidence on the efficacy of perioperative gabapentin regarding postoperative pain and opioid requirements among the pediatric surgery population. Data Sources: Pubmed, CINAHL, Embase, Scopus, and Web of Science Review. Methods: This scoping review of the above databases includes all studies examining the use of gabapentin perioperatively in pediatric patients and its association with postoperative pain intensity and postoperative opioid consumption through July 2021. The inclusion criteria encompassed all studies evaluating gabapentin in the perioperative pediatric population through randomized controlled trials (RCTs) and retrospective studies. Relevant metadata from each study were abstracted and descriptive statistics were used to summarize the results. Results: Fifteen papers met the inclusion criteria for this review, including 11 RCTs and 4 retrospective studies. Sample sizes ranged from 20 to 144 patients. Administered doses varied widely, mainly between 5 and 20 mg/kg. The studies included primarily orthopedic (10) and neck surgery cases (3). Seven papers had gabapentin provided preoperatively only, two postoperative only, and six both pre‐ and postoperatively. Of the studies assessing postoperative pain, 6/11 studies saw a decrease in postoperative pain in at least one period for the gabapentin group. Of the studies considering opioid requirements, 6/10 reported a reduction, 1/10 an increase, and 3/10 no difference in opioid requirements for the gabapentin groups. Yet, most of these pain and opioid requirement findings were only significant at one to two time points in the study follow‐up periods, and the actual decreases had minimal clinical significance. Conclusions: The current data on perioperative gabapentin in pediatric patients are insufficient to support the routine use of gabapentin in pediatric patients. Additional high‐quality RCTs with more standardized protocols for gabapentin administration and outcome measures are necessary to provide more definitive conclusions. [ABSTRACT FROM AUTHOR]

This brief report assesses the validity of applying the adolescent-based developmental assets model to emerging adults. Developmental assets are specific constructs which predict future success, including positive individual characteristics and environmental resources. The researchers developed a self-report survey based on a subset of the assets and outcome behaviors most applicable to emerging adults. Correlational analyses revealed significant relationships of moderate strength between the perceived level of developmental assets and thriving behaviors r = 0.40, p < 0.01), risky behaviors r = -0.36, p < 0.01), and academic success r = 0.28, p < 0.01). Furthermore, a path analysis yielded significant coefficients wherein assets influenced thriving, risk, and collectively, academic success. Results suggest that the developmental assets framework applies to emerging adults and warrants further investigation.

Writing formal "journal-style" lab reports is often one of the requirements chemistry and biochemistry students encounter in the physical chemistry laboratory. Helping students improve their technical writing skills is the primary reason this type of writing is a requirement in the physical chemistry laboratory. Developing these skills is an important goal, yet sometimes students are not given enough time to review and revise their writing. Further, they seldom are taught "how" to review, and thus critical steps in the writing process are omitted. We have developed an approach with the goal of helping students improve their technical writing skills that employs the peer-review process and includes detailed guidance for writing reports in a progressive manner. We present these assignments, how student progress is assessed, and how the components fit to improve the technical writing abilities of the students. (Contains 1 table and 2 figures.)

In spring 2003, the Distance Education Network (DEN), Viterbi School of Engineering at the University of Southern California (USC), had 860 students and more than 1,000 enrollments in 70 courses toward 10 different degrees. Typically, for assignments in engineering courses, professors require students to show how their answers are derived so that they can review student analyses and progress and make notes accordingly. This results in complex formulas and drawings that cannot be written easily with desktop software. In a distance education setting, the obvious tool for this situation is the fax machine. Fax machines are widely accessible and provide a simple way for students to submit handwritten work. However, the inherent limitations of stand-alone fax machines became a problem DEN had to address. Many of the problems with stand-alone fax machines manifest themselves during unstaffed times, such as weekends: (1) Consumables run out; (2) Fax machine memory becomes full; (3) Fax receipts are automatically generated; and (4) Homework assignments can end up in disarray on the floor. In fall 2003, DEN implemented a homework processing system that included Reportee SmartForms and Biscom FAXCOM fax server software. The system, designed to cope with a growing volume of assignments, has lowered costs, reduced errors, and increased satisfaction of students and faculty. (Contains 1 figure.)

This brief report assesses the validity of applying the adolescent-based developmental assets model to emerging adults. Developmental assets are specific constructs which predict future success, including positive individual characteristics and [...]

Summary: Arbuscular mycorrhizal fungi (AMF) can help mitigate plant responses to water stress, but it is unclear whether AMF do so by indirect mechanisms, direct water transport to roots, or a combination of the two. Here, we investigated if and how the AMF Rhizophagus intraradices transported water to the host plant Avena barbata, wild oat.We used two‐compartment microcosms, isotopically labeled water, and a fluorescent dye to directly track and quantify water transport by AMF across an air gap to host plants.Plants grown with AMF that had access to a physically separated compartment containing 18O‐labeled water transpired almost twice as much as plants with AMF excluded from that compartment. Using an isotopic mixing model, we estimated that water transported by AMF across the air gap accounted for 34.6% of the water transpired by host plants. In addition, a fluorescent dye indicated that hyphae were able to transport some water via an extracytoplasmic pathway.Our study provides direct evidence that AMF can act as extensions of the root system along the soil–plant–air continuum of water movement, with plant transpiration driving water flow along hyphae outside of the hyphal cell membrane. [ABSTRACT FROM AUTHOR]

Cognitive ability of nondiabetic children and early and late onset diabetic children was compared. Diabetic children scored in the normal range in intelligence and academic performance, but showed evidence of school difficulties and memory deficiencies. Children's perceived self-competence and parents' reports of children's functioning and behavior showed no differences across groups. (BC)

Gary Anderson ('Is Purgatory Biblical?' November) gives a capable defense of the doctrine of purgatory based on subtle themes in the Old Testament and the Acts of the Apostles, but [...]

Many physical chemistry lab courses include an experiment in which students measure surface tension as a function of surfactant concentration. In the traditional experiment, the data are fit to the Gibbs isotherm to determine the molar area for the surfactant, and the critical micelle concentration is used to calculate the Gibbs energy of micelle formation. In the experiment described here, students fit their data to the Szyszkowski equation, allowing them to also calculate the Gibbs energy of surface adsorption. In addition, we use this experiment to introduce nonlinear custom curve fitting. (Contains 3 figures and 1 note.)

Despite the complexities of minimally invasive surgery (MIS), a Canadian approach to training surgeons in this field does not exist. Whereas a limited number of surgeons are fellowship-trained in the specialty, guidelines are still clearly needed to implement advanced MIS. Leaders in the field of gastrointestinal surgery and MIS attended a consensus conference where they proposed a comprehensive mentoring program that may evolve into a framework for a national mentoring and training system. Leadership and commitment from national experts to define the most appropriate template for introducing new surgical techniques into practice is required. This national framework should also provide flexibility for truly novel procedures such as natural orifice translumenal endoscopic surgery. Malgre les complexites de la chirurgie minimalement invasive (CMI), il n&apos;existe aucune approche canadienne de formation des chirurgiens dans ce domaine. Quelques chirurgiens ont ete formes dans cette specialite par le biais de stages, mais il s&apos;impose de toute evidence d&apos;implanter des cours avances en CMI. Des chefs de file en chirurgie gastro-intestinale et CMI ont participe a une conference de consensus ou ils ont propose un programme de mentorat exhaustif qui pourrait devenir le cadre d&apos;un systeme national de mentorat et de formation. Les experts nationaux doivent faire preuve de leadership et d&apos;engagement pour definir la meilleure facon d&apos;implanter dans la pratique les nouvelles techniques chirurgicales. Le cadre national doit aussi etre suffisamment souple pour permettre l&apos;integration d&apos;interventions de pointe telles que la chirurgie endoscopique transluminale par orifice naturel., Minimally invasive surgery (MIS) is one of the fastest growing areas in surgery today and is an approach that is desirable among patients and physicians because of the shorter hospital [...]

California's plans to discontinue methyl tertiary butyl ether's usage in gasoline being sold in the state are discussed. MTBE is used to oxygenate gasoline for compliance with the stipulations of the U.S. Environmental Protection Agency for regions with air quality below the national standards. Discontinuance of the usage of MTBE will increase the demand for ethanol in the state. A study analyzing the economics of using corn and other agricultural products for ethanol production and consequent development of regional economies is presented. It is observed that cost of production of ethanol exceeds the benefits and the government may have to pitch in with some subsidies.

Traditional surface tension experiment is modified to allow students to compare and contrast two distinct surfactant phenomena, micelle formation and surface adsorption. Nonlinear custom curve fitting is facilitated.