Search

Background: Patients undergoing general anesthesia are more frequently monitored for depth of anesthesia using processed electroencephalography. Opioid-free anesthesia is nowadays an accepted modality for general anesthesia, however it is unclear how to interpret data from processed electroencephalography when using a mixture of non-opioid anesthetic drugs. Our objective was to describe density spectral array patterns and compare processed encephalographic data indices between opioid-free and routine opioid based anesthesia. Methods: This prospective observational cohort study was conducted on 30 adult patients undergoing laparoscopic surgery in a non-tertiary regional hospital. The patients underwent general anesthesia with three different methods and were monitored for anesthesia depth using processed encephalography and density spectral array. Primary outcome is a group-derived mean difference in patient state index and spectral edge frequency. As a secondary outcome a descriptive comparison of the spectral power, derived from the density spectral array, was done between groups. Results: The opioid-free anesthesia group had significantly higher patient state index and spectral edge frequency compared to routine anesthesia. Density spectral array patterns were also different, most notably lacking the high power in alpha frequency spectrum seen in the other routine anesthesia methods. Conclusions: Processed electroencephalography monitoring can be used in opioid-free anesthesia, however clinicians should expect higher values in monitoring indices. The density spectral array pattern using a common protocol for opioid-free anesthesia, with mainly sevoflurane combined with low doses of dexmedetomidine and esketamine, differs from well described opioid and GABA-ergic anesthesia methods. These findings should be further validated using other protocols for opioid-free anesthesia in order to safely monitor anesthesia depth. Trial registration: Clinicaltrials.gov registration number NCT06227143, registration date; 26th of January 2024. [ABSTRACT FROM AUTHOR]

Background: Access to adequate pain treatment is a fundamental right, yet international data suggest that a considerable number of children experience acute and persistent pain. Little is known about the occurrence of both acute and persistent pain in children. The incidence of persistent postoperative pain in children is an unexplored area but international studies suggest that many children experience long-term pain after surgery, with a major impact on daily life. In 4P, Persistent Postoperative Pediatric Pain, we want to estimate the incidence of acute and persistent postoperative pediatric pain. The European Society for Paediatric Anaesthesiology has developed guidelines for perioperative pain management. We aim to examine how well these guidelines are followed and whether adherence to guidelines influences the pain experienced after surgery. Method: 4P is a prospective observational study of children aged 1–17, planned for surgery in southern Sweden 2023–2024. After agreement from all caregivers, data concerning preoperative pain, pre-emptive analgesia, perioperative management and postoperative pain will be collected. Via an electronic management software, pain will be evaluated at home (or in hospital) at 24h, 3, 6 and 12 months after surgery. We will include 1000 patients. Discussion: 4P will prospectively follow a large number of children after general pediatric surgeries and evaluate the occurrence of postoperative pain, both acute (APOP) and persistent (PPOP). The study will assess pain treatment regimens and identify risk factors associated with the development of acute and persistent pediatric postoperative pain. Trial registration: Prospectively posted at ClinicalTrials.gov, identifier NCT06035042. [ABSTRACT FROM AUTHOR]

The Swedish vowel space is relatively densely populated with 21 categories that differ in quality and quantity. Existing descriptions of the entire space rest on recordings made in the late 1990s or earlier, while recent work in general has focused on subsets of the space. The present paper reports on static and dynamic acoustic analyses of the entire vowel space using a recently released database of h-VOWEL-d words (SwehVd). The results highlight the importance of static and dynamic spectral and temporal cues for Swedish vowel category distinction. The first two formants and vowel duration are the primary acoustic cues to vowel identity, however, the third formant contributes to increased category separability for neighboring contrasts presumed to differ in lip-rounding. In addition, even though all long-short vowel pairs differ systematically in duration, they also display considerable spectral differences, suggesting that quantity distinctions are not separate from quality distinctions in Swedish. The dynamic analysis further suggests formant movements in both long and short vowels, with [e:] and [o:] displaying clearer patterns of diphthongization. [ABSTRACT FROM AUTHOR]

Land use change impacts on Sámi reindeer husbandry are well-documented, but existing maps often fail to capture socio-ecological relationships between herders, reindeer and nature. Conventional Geographic Information Systems (GIS) simplify these relationships, lacking local context and excluding valuable knowledge due to their rigid structure. This paper introduces participatory topological mapping, a low-tech, knowledge co-production method that allows communities to share geospatial insights without advanced software. Combining hand-drawn maps with a standardised topological structure facilitates the visualisation of geographical relationships and dynamic land use systems from a local perspective. Developed and assessed through a Swedish case study in collaboration with Vittangi and Malå reindeer herding communities, the method aims to reduce barriers to knowledge exchange and enhance dialogue between Indigenous knowledge-holders, researchers and decision-makers. The paper discusses the authors' experiences with participatory topological mapping, emphasising its potential and limitations for knowledge exchange. The method is advocated for broader use, recognising its value in articulating concerns about land use change beyond research settings and reindeer husbandry. Participatory topological mapping enables knowledge-holders to control the map and its narrative, deciding what is included or excluded. The maps and accompanying stories are valuable sources for documenting, sharing and analysing local perspectives on landscapes and the effects of land use change. The method treats mapping as a social process with the potential to affect how we understanding the world. When thoughtfully applied, it offers a valuable avenue for knowledge co-production, fostering deeper engagement, supporting informed decision-making and empowering communities. [ABSTRACT FROM AUTHOR]

Background: Despite advancements in surgical and anesthesia techniques, acute and persistent postoperative pain are still a common challenge. Postoperative pain has direct effects on individual patient care and outcome, as well as putting strain on limited health care resources. Several prediction methods for postoperative pain have been described. One such method is the assessment of pain during peripheral venous cannulation (VCP). It is not known if different approaches to anesthesia and analgesia, depending on the evaluation of risk for postoperative pain, can improve outcome. The aim of this study is to evaluate if individualized anesthesia and analgesia can affect postoperative pain and recovery after surgery, in patients stratified by VCP. Methods: Adult patients scheduled for laparoscopic surgery undergo pain‐sensitivity stratification using VCP on the day of surgery. Patients scoring VCP ≥2.0 on the visual analogue scale (pain‐sensitive) are randomized to multimodal anaesthesia and analgesia with opioids or standard of care. Patients scoring VCP ≤1.9 (pain‐tolerant) are randomized to opioid‐free anaesthesia or standard of care. The primary outcome is acute postoperative pain measured with numeric rating scale in the postoperative care unit. Secondary outcomes include analysis of pain after 24 h, persistent postoperative pain and quality of recovery. Discussion: Individualized perioperative pain management has the potential to improve patient care. This study will examine the impact of different anesthesia and analgesia regimes, in patients with differing pain sensitivity, on postoperative pain. Trial Registration: Prospectively posted at ClinicalTrials.gov, identifier NCT04751812. [ABSTRACT FROM AUTHOR]

Land-use change and intensification threaten bee populations worldwide, imperilling pollination services. Global models are needed to better characterise, project, and mitigate bees' responses to these human impacts. The available data are, however, geographically and taxonomically unrepresentative; most data are from North America and Western Europe, overrepresenting bumblebees and raising concerns that model results may not be generalizable to other regions and taxa. To assess whether the geographic and taxonomic biases of data could undermine effectiveness of models for conservation policy, we have collated from the published literature a global dataset of bee diversity at sites facing land-use change and intensification, and assess whether bee responses to these pressures vary across 11 regions (Western, Northern, Eastern and Southern Europe; North, Central and South America; Australia and New Zealand; South East Asia; Middle and Southern Africa) and between bumblebees and other bees. Our analyses highlight strong regionally-based responses of total abundance, species richness and Simpson's diversity to land use, caused by variation in the sensitivity of species and potentially in the nature of threats. These results suggest that global extrapolation of models based on geographically and taxonomically restricted data may underestimate the true uncertainty, increasing the risk of ecological surprises.

The usage of thermoplastic elastomers (TPEs) is increasing, and integrated hard-soft parts can be mass produced by two-component injection molding (or sequential molding). A key property of such parts, the adhesion between the two materials, is the topic of this study. The hard part (the first molded component) in this study was polyamide-12 with 0 to 50 wt% glass fibers (PA12-GF). As the second component, two TPEs were used: a vulcanized TPE and a styrenic TPE, both modified for adhesion to polyamides. The adhesion, assessed by 90[degrees] peel tests, increased with increasing melt temperatures and TPE injection rate, while it decreased with increasing glass fiber fraction in the PA12-GF. Based on characterization of cross-sections and fiber distributions near the interface, we propose some hypotheses for the effect of fiber fraction on the fusion between PA12-GF and TPE. These hypotheses involve the near-surface properties of the PA12-GF materials, microstructure, thermomechanical properties, and thermal properties. A direct effect of increasing the glass fiber fraction, that is, a reduction in adhesion as more fibers are present at the interface, does not seem to be a major effect, since few fibers are in direct contact with the TPE for any fiber fraction. KEYWORDS adhesion, elastomers, fibers, injection molding, interfaces, 1 | INTRODUCTION Two-component injection molding (2CIM) is a sequential injection molding process, combining two materials into one molded part. The two materials may be a soft-hard pair as in [...]

AbstractObjectiveDesignStudy sampleResultsConclusionTo explore strategies for detecting childhood hearing loss, aside from newborn hearing screening.A retrospective review of medical records on the modes of detection of hearing loss, risk factors for late-onset hearing loss, hearing loss degree, aetiology, additional disabilities, and timelines from referral to intervention.Children, born 2006 to 2015, enrolled for intervention whose hearing loss was detected up to age 7 years but not from newborn hearing screening (n = 326).Universal pre-school hearing screening detected 38% of the cohort at 4–5 years of age. Risk factors for late-onset hearing loss were present in 36% of children, 80% of whom had a reported family history. Sixty-nine percent had mild bilateral or unilateral hearing loss. Children with additional disabilities faced significantly longer delays from referral to intervention. Children self-referred due to parent concern had more severe degree of hearing loss than those referred from screening.Most children with hearing loss detected after the newborn period do not have any known risk factors for late-onset hearing loss. Pre-school hearing screening is needed for comprehensive detection of hearing loss in early childhood. More work is needed towards improving timely diagnosis and intervention for children with additional disabilities. [ABSTRACT FROM AUTHOR]

Environmental change is disrupting mutualisms between organisms worldwide. Reported declines in insect populations and changes in pollinator community compositions in response to land use and other environmental drivers have put the spotlight on the need to conserve pollinators. While this is often motivated by their role in supporting crop yields, the role of pollinators for reproduction and resulting taxonomic and functional assembly in wild plant communities has received less attention. Recent findings suggest that observed and experimental gradients in pollinator availability can affect plant community composition, but we know little about when such shifts are to be expected, or the impact they have on ecosystem functioning. Correlations between plant traits related to pollination and plant traits related to other important ecosystem functions, such as productivity, nitrogen uptake or palatability to herbivores, lead us to expect non‐random shifts in ecosystem functioning in response to changes in pollinator communities. At the same time, ecological and evolutionary processes may counteract these effects of pollinator declines, limiting changes in plant community composition, and in ecosystem functioning. Despite calls to investigate community‐ and ecosystem‐level impacts of reduced pollination, the study of pollinator effects on plants has largely been confined to impacts on plant individuals or single‐species populations. With this review we aim to break new ground by bringing together aspects of landscape ecology, ecological and evolutionary plant–insect interactions, and biodiversity–ecosystem functioning research, to generate new ideas and hypotheses about the ecosystem‐level consequences of pollinator declines in response to land‐use change, using grasslands as a focal system. Based on an integrated set of seven hypotheses, we call for more research investigating the putative pollinator‐mediated links between landscape‐scale land use and ecosystem functioning. In particular, future research should use combinations of experimental and observational approaches to assess the effects of changes in pollinator communities over multiple years and across species on plant communities and on trait distributions both within and among species. [ABSTRACT FROM AUTHOR]

Agricultural intensification at field and landscape scales, including increased use of agrochemicals and loss of semi‐natural habitats, is a major driver of insect declines and other community changes. Efforts to understand and mitigate these effects have traditionally focused on ecological responses. At the same time, adaptations to pesticide use and habitat fragmentation in both insects and flowering plants show the potential for rapid evolution. Yet we lack an understanding of how such evolutionary responses may propagate within and between trophic levels with ensuing consequences for conservation of species and ecological functions in agroecosystems. Here, we review the literature on the consequences of agricultural intensification on plant and animal evolutionary responses and interactions. We present a novel conceptualization of evolutionary change induced by agricultural intensification at field and landscape scales and emphasize direct and indirect effects of rapid evolution on ecosystem services. We exemplify by focusing on economically and ecologically important interactions between plants and pollinators. We showcase available eco‐evolutionary theory and plant–pollinator modelling that can improve predictions of how agricultural intensification affects interaction networks, and highlight available genetic and trait‐focused methodological approaches. Specifically, we focus on how spatial genetic structure affects the probability of propagated responses, and how the structure of interaction networks modulates effects of evolutionary change in individual species. Thereby, we highlight how combined trait‐based eco‐evolutionary modelling, functionally explicit quantitative genetics, and genomic analyses may shed light on conditions where evolutionary responses impact important ecosystem services. [ABSTRACT FROM AUTHOR]