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BackgroundEarly mobilization post-total knee arthroplasty (TKA) significantly affects patient outcomes. While parecoxib is known to reduce postoperative pain and morphine use with a favorable safety profile, its impact on mobilization timing post-TKA remains uncertain. This retrospective study aims to assess parecoxib's influence on postoperative mobilization timing in TKA patients without compromising safety.MethodsThis study included unilateral TKA patients treated for primary knee osteoarthritis under general anesthesia. We divided the study period into two intervals, 2007–2012 and 2013–2018, to evaluate temporal differences. Both the control group and parecoxib group received standard postoperative oral analgesics and as-needed intramuscular morphine. The control group did not receive parecoxib, while the parecoxib group did. Primary outcomes compared postoperative complications and mobilization timing between groups, with secondary outcomes including length of hospital stay (LOS), Visual Analog Scale (VAS) scores for pain, as-needed morphine use, and postoperative nausea/vomiting.ResultsParecoxib did not increase postoperative complications. Unmatched comparison with patients in controlled group found that patients in parecoxib group had significantly shortened mobilization time (2.2 ± 1.1 vs. 2.7 ± 1.6 days, P

Abstract The passive stiffness and strength of periscapular muscles may affect scapulohumeral control, especially in overhead athletes due to sports-specific training. This study tried to assess the relationship between the passive stiffness and strength of periscapular muscles, scapulohumeral kinematics and neuromuscular control during scaption in swimmers. Ten male adolescent competitive front-crawl swimmers were recruited. The passive stiffness and strength of periscapular muscles were measured in standard postures by a hand-held myotonometer and dynamometer, respectively. Surface electromyography and electromagnetic tracking systems were synchronized to record the muscle activities and scapulohumeral kinematics during scaption. Correlations between the passive stiffness or strength of periscapular muscles and the kinematics or muscle activity were examined by Spearman's rank correlation coefficient. The maximal strength of periscapular muscles correlated positively with the ranges of upward and external rotation of the scapula and negatively with muscle activity during scaption. Passive stiffness of periscapular muscles was associated with the downward rotation of the scapula and triggered an increase in muscle activity. Increased passive stiffness or decreased strength in the periscapular muscles may affect their role in controlling the scapular rotation and contribute to compensation from adjacent muscles. Our findings suggest that when attempting to evaluate scapular behavior, it may be beneficial to examine muscle strength and passive stiffness of periscapular muscles.

The intricate relationship between alcohol consumption and intracerebral hemorrhage (ICH) presents a nuanced field of study, especially concerning the dose-dependent impact on secondary brain injury (SBI). Recognizing the established risks associated with heavy drinking, this review delves deeper into the less understood territories of low to moderate alcohol consumption. By systematically analyzing recent studies, we uncover critical insights into how varying alcohol intake levels modulate ICH risk through mechanisms such as microglial activation, oxidative stress, and the protective potential of polyphenols. This analysis extends beyond the hypertensive effects of heavy alcohol use to explore the complex molecular pathophysiology involved in alcohol-related ICH. Our findings indicate that while heavy alcohol use unequivocally exacerbates ICH risk, moderate consumption and its associated polyphenols may offer neuroprotective effects against SBI, albeit within a finely balanced threshold. This review highlights the significant gaps in current understanding and underscores the urgent need for targeted research to elucidate these complex interactions. Through this comprehensive examination, we aim to inform more nuanced public health policies and intervention strategies, taking into account the diverse effects of alcohol consumption on ICH risk.

Objectives: Insertion of a double-lumen endotracheal tube (DLT) is the most commonly used method for one-lung ventilation (OLV). This meta-analysis was aimed at investigating the performance of lung ultrasound in assessing the DLT position in OLV. Methods: Electronic databases were searched for related trials from inception to October 2022. The primary outcome was the performance of ultrasound or clinical evaluation in confirming the correctness of the DLT position, using fiberoptic bronchoscopy or intraoperative direct visualization of lung collapse as the gold standard. The secondary outcome was the time required to confirm or adjust the DTL position. Results: Five randomized controlled trials and three observational studies involving 771 patients were included in the meta-analysis. The pooled sensitivity and specificity of ultrasound were 0.93 (95% confidence interval [CI]: 0.79–0.98) and 0.61 (95% CI: 0.41–0.77), respectively, while those of clinical evaluation were 0.93 (95% CI: 0.73–0.99) and 0.35 (95% CI: 0.25–0.47), respectively. The pooled procedure duration was 122.27 s (95% CI: 20.85–223.69) with ultrasound and 112.03 s (95% CI: 95.30–128.76) with clinical evaluation. The area under the curve for discriminating the DLT position was 0.86 (95% CI: 0.82–0.88) for ultrasound and 0.52 (95% CI: 0.48–0.57) for clinical evaluation. Conclusions: Compared to clinical evaluation, ultrasound has a similar sensitivity but a better specificity for confirming the correctness of the DLT position. Ultrasound is an acceptable imaging tool for assessing DTL placement in OLV.

Background and Objectives: Ventriculoperitoneal (VP) shunt placement is the most common treatment for cerebrospinal fluid diversion. Head and neck pain occurring after a long period following VP shunt insertion is rarely reported. Here, we present a rare case of head and neck pain occurring 2 years after surgery due to irritation of the superficial cervical plexus by the VP shunt. Case Description: A 46-year-old female patient received VP shunt placement surgery. Two years after the surgery, she experienced a left temporal headache with neck pain on the left side, which extended to the left para-auricular and fascial region. Ultrasound (US) scanning revealed that the VP shunt passed within the superficial cervical fascia and through the left sternocleidomastoid muscle (SCM). Additionally, friction of the branches of the superficial cervical plexus and of the greater auricular and lesser occipital nerves caused by the VP shunt was found underneath the lateral border of the SCM. Subsequently, the blocking and hydro-release of the left superficial cervical plexus were performed. After four series of treatments, the patient’s head and neck pain vanished, and the frequency of the headaches was substantially reduced. The patient was regularly followed-up in the outpatient department of neurosurgery. Conclusions: Head and neck pain caused by the malpositioning of a VP shunt catheter with an unusually delayed onset is a rarely reported complication and could be easily neglected. Patients with head and neck pain following VP shunt insertion should be checked using US scanning to identify the potential origin of the pain and receive adequate treatments. Intraoperative US-guided tunnelling is suggested to avoid the malpositioning of the VP shunt catheter.

Objectives: The diagnosis of malignant hyperthermia (MH) is based on clinical signs or laboratory testing. The gold standard laboratory test is the in vitro contracture test, although it is invasive, expensive, and only performed at specialized centers. Genetic diagnosis is another option, although direct mutation screening is a laborious task. Therefore, we evaluated whether high-resolution melting (HRM) curve analysis could be used as a rapid screening tool to target MH-associated mutations. Materials and Methods: The feasibility of HRM analysis was evaluated using plasmids that were constructed by cloning wild-type or mutated versions of the ryanodine receptor 1 (RYR1) gene into the pCR2.1 plasmid. We obtained engineered plasmids and patient DNA extracted from blood samples with known wild-type or mutated sequences that are associated with MH. Amplicon lengths were kept relatively short (

Intracerebral hemorrhage (ICH) is a life-threatening type of stroke that disrupts the normal neurological function of the brain. Clinical studies have reported a non-linear J-shaped association between alcohol consumption levels and the occurrence of cerebral stroke. Specifically, alcohol intoxication increases stroke incidence, while moderate alcohol pre-conditioning decreases stroke frequency and improves outcomes. Although alcohol pre-consumption is likely a crucial player in ICH, the underlying mechanism remains unclear. We performed 1-h alcohol pre-conditioning followed by ICH induction in Sprague-Dawley (SD) rats to investigate the role of alcohol pre-conditioning in ICH. Interestingly, behavioral test analysis found that ethanol intoxication (3 g/kg) aggravated ICH-induced neurological deficits, but moderate ethanol pre-conditioning (0.75 g/kg) ameliorated ICH-induced neurological deficits by reducing the oxidative stress and proinflammatory cytokines release. Moreover, we found that moderate ethanol pretreatment improved the striatal endoplasmic reticulum (ER) homeostasis by increasing the chaperone protein expression and reducing oxidative stress and apoptosis caused by ICH. Our findings show that the mechanism regulated by moderate ethanol pre-conditioning might be beneficial for ICH, indicating the importance of ER homeostasis, oxidative stress, and differential cytokines release in ICH.

Deep brain stimulation (DBS) improves Parkinson’s disease (PD) symptoms by suppressing neuropathological oscillations. These oscillations are also modulated by inhalational anesthetics used during DBS surgery in some patients, influencing electrode placement accuracy. We sought to evaluate a method that could avoid these effects. We recorded subthalamic nucleus (STN) neuronal firings in 11 PD patients undergoing DBS under inhalational anesthesia. Microelectrode recording (MER) during DBS was collected under median nerve stimulation (MNS) delivered at 5, 20, and 90 Hz frequencies and without MNS. We analyzed the spike firing rate and neuronal activity with power spectral density (PSD), and assessed correlations between the neuronal oscillation parameters and clinical motor outcomes. No patient experienced adverse effects during or after DBS surgery. PSD analysis revealed that peripheral 20 Hz MNS produced significant differences in the dorsal and ventral subthalamic nucleus (STN) between the beta band oscillation (16.9 ± 7.0% versus 13.5 ± 4.8%, respectively) and gamma band oscillation (56.0 ± 13.7% versus 66.3 ± 9.4%, respectively) (p < 0.05). Moreover, 20-Hz MNS entrained neural oscillation over the dorsal STN, which correlated positively with motor disabilities. MNS allowed localization of the sensorimotor STN and identified neural characteristics under inhalational anesthesia. This paradigm may help identify an alternative method to facilitate STN identification and DBS surgery under inhalational anesthesia.

During the processing of mango, a huge amount of peel is generated, which is environmentally problematic. In the present study, a compressional-puffing process was adopted to pretreat the peels of various mango cultivars, and then the bioactive compounds of mango peels were extracted by water or ethanol. The phenolic compound compositions as well as the free radical-scavenging, anti-inflammatory, and antibacterial activities of water extract (WE) and ethanol extract (EE) from nonpuffed (NP) and compressional-puffed (CP) mango peels were further evaluated. It was found that compressional-puffing could increase the yield of extracts obtained from most mango varieties and could augment the polyphenol content of extracts from Jinhwang and Tainoung number 1 (TN1) cultivars. The WE and EE from TN1 exhibited the highest polyphenol content and the greatest free radical-scavenging activities among the mango cultivars tested. Seven phenolic compounds (gallic acid, pyrogallol, chlorogenic acid, p-hydroxybenzoic acid, p-coumaric acid, ECG, and CG) were detected in CPWE (compressional-puffed water extract) and CPEE (compressional-puffed ethanol extract) from TN1, and antioxidant stability of both CPWE and CPEE was higher than that of vitamin C. Further biological experiments revealed that CPEE from TN1 possessed the strongest anti-inflammatory and antibacterial activities, and thus it is recommended as a multibioactive agent, which may have applications in the food, cosmetic, and nutraceutical industries.

Background: Neuroinflammation is a hallmark in intracerebral hemorrhage (ICH) that induces secondary brain injury, leading to neuronal cell death. ER stress-triggered apoptosis and proteostasis disruption caused neuroinflammation to play an important role in various neurological disorders. The consequences of ER stress and proteostasis disruption have rarely been studied during the course of ICH development. Methods: ICH was induced by collagenase VII-S intrastriatal infusion. Animals were sacrificed at 0, 3, 6, 24, and 72 h post-ICH. Rats were determined for body weight changes, hematoma volume, and neurological deficits. Brain tissues were harvested for molecular signaling analysis either for ELISA, immunoblotting, immunoprecipitation, RT-qPCR, protein aggregation, or for histological examination. A non-selective proteasome inhibitor, MG132, was administered into the right striatum three hours prior to ICH induction. Results: ICH-induced acute proteasome over-activation caused the early degradation of the endoplasmic reticulum (ER) chaperone GRP78 and IκB protein. These exacerbations were accompanied by the elevation of pro-apoptotic CCAAT-enhancer-binding protein homologous protein (CHOP) and pro-inflammatory cytokines expression via nuclear factor-kappa B (NF-κB) signal activation. Pre-treatment with proteasome inhibitor MG132 significantly ameliorated the ICH-induced ER stress/proteostasis disruption, pro-inflammatory cytokines, neuronal cells apoptosis, and neurological deficits. Conclusions: ICH induced rapid proteasome over-activation, leading to an exaggeration of the ER stress/proteostasis disruption, and neuroinflammation might be a critical event in acute ICH pathology.

The purpose of this study is to understand how the customers adopting an innovation at different stage of its life cycle may have different perceptions regarding the attributes of the innovation. The innovation in question is the gogoro electric scooter and we studied actual adoption instead of purchase intention more commonly found in the literature. We show that, with minor support from the empirical evidences, later adopters perceived the gogoro offers higher level of relative advantage, compatibility, trialability, and observability while offer lower level of complexity. We also further studied the impacts of actors’ environmental consciousness and economic factor, proxied by income level, to their actual adoption of the green innovation. Results show that environmental consciousness does increase the likelihood for an actor to adopt a green innovation while the relationship is moderated by the income level. [ABSTRACT FROM AUTHOR]

The electrochemical behavior of arsenic(III) and indium(III) is investigated in the ethaline deep eutectic solvent (a mixture of 1 mol eq. of choline chloride and 2 mol eq. of ethylene glycol) using As2O3 and InCl3 as precursors. Cyclic voltammetry of ethaline solutions containing individual As(III) and In(III) reveals that the thermodynamic deposition potential of As is more negative than that of In in ethaline, in contrast to what has been observed in aqueous solutions. When In(III) is mixed with As(III), the reduction of In(III) shifts positively while the reduction of As(III) shifts negatively with respect to that of individual solutions. Co-deposition of In-As is attempted using potentiostatic electrolysis on Cu and Ni substrates, respectively. The electrodeposited films are characterized with scanning electron microscopy (SEM), energy dispersive X-ray analysis (EDS) and X-ray powder diffraction (XRD). The As/In atom ratio in the obtained deposits increases as the deposition potential gets more negative. Crystalline InAs film can be obtained from the ethaline solution contains a As(III) concentration higher than that of In(III). However, the co-deposits turn into amorphous once the As content in the deposits exceeds that of In. [ABSTRACT FROM AUTHOR]

The fabrication of micro-nanostructured (porous) PdAgZn films is attempted by electrodeposition of Zn on PdAg substrate to form PdAgZn surface alloy followed by partial electrochemical dissolution of Zn from the PdAgZn alloy. The preparation was performed in a ZnCl2-1-ethyl-3-methylimidazolium chloride ionic liquid thanks to the high thermal stability of this melt. High working temperature (170°C) and an alloying time are required for the formation of the surface alloy owing to the low atom diffusivity of Pd. Not all the Zn in the surface alloy can be anodically dissolved because of the parting limit associated with dealloying process. Therefore, the morphology and composition of the resulted PdAgZn varied with the alloying/dealloying condition. Electro-oxidation of ethanol was used as an example to test the activity of the prepared porous PdAgZn electrodes. The results showed that the catalytic activity of the PdAgZn depends on not only the surface area but also the composition of the produced PdAgZn. The PdAgZn that was prepared by repeating for three times the deposition of 3.33 C cm-2 Zn at -0.2 V and immersion for 30 min at 170°C at open circuit potential, then dealloyed at 1.0 V showed the best performance for electro-oxidation of ethanol with the oxidation current about 25 times higher than at the unmodified PdAg electrode. [ABSTRACT FROM AUTHOR]

The electrochemical behavior of arsenic(III) is investigated in the ethaline deep eutectic solvent (DES) that is obtained by mixing 1 mol eq. of choline chloride and 2 mol eq. of ethylene glycol using As2O3 as the As(III) source. Cyclic voltammetry and rotating disc voltammetry experiments indicate that the reduction of As(III) to As is a single step three electron transfer process with slow kinetics. Chronoamperometry experiments indicate that the deposition of arsenic at a glassy carbon electrode involves with an overpotential-driven three dimensional instantaneous nucleation/growth process. The calculated number density of the nuclei increases as a function of applied overpotential. Amorphous arsenic coatings are prepared using constant potential, constant current, and pulse potential electrolysis experiments. The morphology of the electrodeposits is examined by SEM. [ABSTRACT FROM AUTHOR]

Background: Chronic stress has been reported to increase basal pain sensitivity and/or exacerbate existing persistent pain. However, most surgical patients have normal physiological and psychological health status such as normal pain perception before surgery although they do experience short-term stress during pre- and post-operative periods. Whether or not this short-term stress affects persistent postsurgical pain is unclear. Results: In this study, we showed that pre- or post-surgical exposure to immobilization 6 h daily for three consecutive days did not change basal responses to mechanical, thermal, or cold stimuli or peak levels of incision-induced hypersensitivity to these stimuli; however, immobilization did prolong the duration of incision-induced hypersensitivity in both male and female rats. These phenomena were also observed in post-surgical exposure to forced swimming 25 min daily for 3 consecutive days. Short-term stress induced by immobilization was demonstrated by an elevation in the level of serum corticosterone, an increase in swim immobility, and a decrease in sucrose consumption. Blocking this short-term stress via intrathecal administration of a selective glucocorticoid receptor antagonist, RU38486, or bilateral adrenalectomy significantly attenuated the prolongation of incision-induced hypersensitivity to mechanical, thermal, and cold stimuli. Conclusion: Our results indicate that short-term stress during the pre- or post-operative period delays postoperative pain recovery although it does not affect basal pain perception. Prevention of short-term stress may facilitate patients' recovery from postoperative pain. [ABSTRACT FROM AUTHOR]