Journal articles on the topic 'ALU BLOCK'
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Talukder, MAH, MS Rahman, Z. Haque, KK Barman, and UK Laily. "Dissemination of BARI released potato varieties in Rangpur region of Bangladesh." Progressive Agriculture 32, no. 1 (September 20, 2021): 17–21. http://dx.doi.org/10.3329/pa.v32i1.55711.
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The experiment was conducted during rabi season 2019-2020 at Rangpur and Kurigram districts under Agricultural Research Station, On Farm Research Division, Alamnagar, Rangpur to promote and disseminate newly released potato variety, BARI Alu-35, BARI Alu-36, BARI Alu-37, BARI Alu-40 and BARI Alu-41among the potato growers of Rangpur sadar Upzilla in Rangpur and Chilmari Upazilla in Kurigram. The experiment was arranged in a randomized complete block design (RCBD) with four dispersed replications. The treatments included T1: BARI Alu-35, T2: BARI Alu-36, T3: BARI Alu-37, T4: BARI Alu-40 and T5: BARI Alu-41. BARI Alu-41 showed excellent performance and higher yield followed by BARI Alu-40 and BARI Alu-36. Farmers were happy to observe the performance of the varieties and demanded quality seed for next year cultivation. The highest common scab infection was observed in (BARI Alu-35) (1.62%) where the lowest in BARI Alu-41. Maximum virus infected was found in BARI Alu-40 (2.29%), where the lowest infection was observed in BARI Alu-41 (1.22%). Progressive Agriculture 32 (1): 17-21, 2021
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Nazrul, MI. "On-Farm Evaluation of Orange Fleshed Sweet Potato Varieties Under Acidic Soil of North-East Region in Bangladesh." Bangladesh Agronomy Journal 21, no. 2 (December 18, 2019): 59–65. http://dx.doi.org/10.3329/baj.v21i2.44493.
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An on-farm trial with four orange fleshed sweet potato varieties viz. BARI Mishti Alu-4, BARI Mishti Alu-8, BARI Mishti Alu-12, BARI Mishti Alu-13 including local check (Muli Alu) were evaluated at farming system research and development (FSRD) site, Jalalpur, Sylhet, Bangladesh during rabi season for two consecutive years (2016-2017 & 2017-2018) under Surma‐Kushiyara Floodplain of Bangladesh. The experiment was laid out in a randomized complete block design (RCBD) with six dispersed replications. The results revealed that the genotypes varied considerably in tuber root yields and yield attributing characters. Considering the average tuber root yield performance orange fleshed sweet potato varieties performed better than local variety (Muli Alu). However, among the varieties under studied BARI Mishti Alu-12 produced higher roots yield (40.63 t ha-1) than the other tested varieties. Considering economic return, the highest gross margin (Tk. 5,65,110 ha-1) and benefit cost ratio (5.50:1.00) was also obtained from sweet potato var. BARI Mishti Alu-12 and the lowest returnfrom var. BARI Mishti Alu-4 with benefit cost ratio of 3.54. Though the local cultivar (Muli Alu) produced lower root yields but it provided considerable gross margin (Tk.3,76,240 )and BCR (3.99:1.00 ) which closed to BARI Mishti Alu-12. It is due to higher demand of local cultivar with high price in the local market. Therefore, the genotypes BARI Mishti Alu-12 and local cultivar (Muli Alu) were found suitable for their better growth and yield under the acidic soils
Bangladesh Agron. J. 2018, 21(2): 59-65
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Ahmed, B., M. Sultana, MAH Chowdhury, S. Akhter, and MJ Alam. "Growth and Yield Performance of Potato Varieties Under Different Planting Dates." Bangladesh Agronomy Journal 20, no. 1 (December 11, 2017): 25–29. http://dx.doi.org/10.3329/baj.v20i1.34878.
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An experiment was conducted during 20 November 2015 through March 20I6 to assess the effect of planting dates on growth and yield performance of three potential varieties of potato at Plant Physiology research field, Bangladesh Agricultural Research Institute, Gazipur. Three planting dates (November 20, December 5 and December 29) and three varieties (var. BARI Alu-35, BARI Alu-40 and BARI Alu-41) were the treatment variables. The experiment was laid out in a randomized complete block design with three replications. Maximum plant height (42.3 cm) was observed in 5 December sowing in var. BARI Alu-40. Highest number of tuber/plant (13) was recorded from December 5 sowing in var. BARI Alu-41. The highest leaf area was found in December 5 sowing of BARI Alu-40 while the lowest leaf area in November 20 sowing in var. BARI Alu-35. The highest tuber weight/plant (97.25 g) was observed in var. BARI Alu-5 at December 5 sowing and the lowest tuber weight/plant (25.58 g) in var. BARI Alu-35 at November 20 sowing. The maximum potato yield (42.12 t/ha) was obtained at December 5 sowing of BARI Alu-35 followed by same date of var. BARIAlu- 41. From the experiment it was revealed that the first decade of December is the optimum date for planting of potato due to the physiological maturity and tuber yield.Bangladesh Agron. J. 2017, 20(1): 25-29
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Zahoor, Furqan, Fawnizu Azmadi Hussin, Farooq Ahmad Khanday, Mohamad Radzi Ahmad, and Illani Mohd Nawi. "Ternary Arithmetic Logic Unit Design Utilizing Carbon Nanotube Field Effect Transistor (CNTFET) and Resistive Random Access Memory (RRAM)." Micromachines 12, no. 11 (October 21, 2021): 1288. http://dx.doi.org/10.3390/mi12111288.
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Due to the difficulties associated with scaling of silicon transistors, various technologies beyond binary logic processing are actively being investigated. Ternary logic circuit implementation with carbon nanotube field effect transistors (CNTFETs) and resistive random access memory (RRAM) integration is considered as a possible technology option. CNTFETs are currently being preferred for implementing ternary circuits due to their desirable multiple threshold voltage and geometry-dependent properties, whereas the RRAM is used due to its multilevel cell capability which enables storage of multiple resistance states within a single cell. This article presents the 2-trit arithmetic logic unit (ALU) design using CNTFETs and RRAM as the design elements. The proposed ALU incorporates a transmission gate block, a function select block, and various ternary function processing modules. The ALU design optimization is achieved by introducing a controlled ternary adder–subtractor module instead of separate adder and subtractor circuits. The simulations are analyzed and validated using Synopsis HSPICE simulation software with standard 32 nm CNTFET technology under different operating conditions (supply voltages) to test the robustness of the designs. The simulation results indicate that the proposed CNTFET-RRAM integration enables the compact circuit realization with good robustness. Moreover, due to the addition of RRAM as circuit element, the proposed ALU has the advantage of non-volatility.
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Anvesh, S. "Optimized Design of an Alu Block Using Power Gating Technique." IOSR Journal of Electronics and Communication Engineering 4, no. 2 (2012): 24–30. http://dx.doi.org/10.9790/2834-0422430.
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Shakor Moghee, Hussein. "A New Technology for Reducing Power Consumption in Synchronous Digital Design Using Tri-State Buffer." Diyala Journal of Engineering Sciences 11, no. 2 (June 1, 2018): 60–66. http://dx.doi.org/10.24237/djes.2018.11208.
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This research paper deals with design and implementation of low power 8-bit arithmetic logic units. The main part of power consumption is consumed in ALU in any processor. Therefore, reducing power dissipation in ALU should be requiring. The proposed technique disabled one of the main block of ALU using tri-state logic which is not necessary to use, except the required processes. In this work, the suggested design is realized by using ASIC methodologies. In order to implement the arithmetic and logic architectures, 130 nm standard cell libraries are used for ASIC execution. The architecture of the design has been created using Verilog HDL language. In addition, it is simulated using ModelSim-Altera 10.3c (Quartus II 14.1) tools. By using tri-state technique, dynamic power and total power are decreased
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Rebecca Florance, D., B. Prabhakar, and Manoj Kumar Mishra. "Design and Implementation of ALU Using Graphene Nanoribbon Field-Effect Transistor and Fin Field-Effect Transistor." Journal of Nanomaterials 2022 (July 1, 2022): 1–17. http://dx.doi.org/10.1155/2022/3487853.
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Arithmetic and logical unit (ALU) are the core operational programmable logic block in microprocessors, microcontrollers, and real-time-integrated circuits. The conventional ALUs were developed using complementary metal oxide semiconductor (CMOS) technology, which resulted in excessive power consumptions, path delays, and number of transistors. Therefore, this article focuses on the design and development of hybrid delay-controlled reconfigurable ALU (DCR-ALU) using field-effect transistor (FinFET) and graphene nanoribbon field-effect transistor (GnrFET) technologies. Initially, a novel carry output predictable full adder (COPFA) and carry input selectable full adders (CISFA) are developed using multiplexer selection logic; then, delay-controlled hybrid adder (DCHA) and delay-controlled hybrid subtractor (DCHS) are developed using these full adders. In addition, a unified delay-controlled hybrid adder and subtractor (DCHAS) is developed by combining these DCHA and DCHS. Further, a delay controller array multiplier (DCAM) also developed using DCHA modules. Finally, DCR-ALU is developed by adopting the DCHAS, DCAM, and logical operations. The obtained simulation results shows that the proposed nanotechnology-based models outperformed the conventional adders and subtractors in terms of area, power, and delay reduction.
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Sasamal, Trailokya Nath, Anand Mohan, and Ashutosh Kumar Singh. "Efficient Design of Reversible Logic ALU Using Coplanar Quantum-Dot Cellular Automata." Journal of Circuits, Systems and Computers 27, no. 02 (September 11, 2017): 1850021. http://dx.doi.org/10.1142/s0218126618500214.
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Quantum-dot Cellular Automata (QCA) based reversible logic is the utmost necessity to achieve an architecture at nano-scale, which promises extremely low power consumption with high device density and faster computation. This paper emphasises on the design of an efficient reversible Arithmetic Logical Unit (ALU) block in QCA technology. We have considered [Formula: see text] RUG (Reversible Universal Gate) as the basic unit, and also report a HDLQ model for RUG with 52.2% fault tolerance capability. Further, the reversible ALU has synthesized with reversible logic unit (RLU) and reversible arithmetic unit (RAU). We also demonstrate QCA implementation of RLU and RAU with lesser complexity and cell counts. The proposed ALU needs only 64 MVs (Majority Voters), which demonstrates 40% optimizations in the majority gate counts than the existing result. QCADesigner-2.0.3 is used to verify the proposed designs.
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Roy, TS, BR Das, N. Sultana, R. Chakraborty, and MS Rahman. "Enhancement the Productivity of Processing Category Potato by Biochar." Bangladesh Agronomy Journal 24, no. 2 (February 3, 2022): 63–72. http://dx.doi.org/10.3329/baj.v24i2.58013.
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The application of biochar may enhance the yield of potato for different processing categories. A field experiment was conducted at Sher-e-Bangla Agricultural University, Dhaka-1207, during the period from November, 2020 to April, 2021 to find out the response of biochar on yield of potato for different processing categories. The experiment comprised of Potato varieties (3): V1: BARI Alu-29 (Courage), V2: BARI Alu-28 (Lady Rosetta) and V3: BARI Alu-25 (Asterix) and Biochar level (5): B0: 0 t ha-1, B1: 2.50 t ha-1, B2: 5.00 t ha-1 and B3: 7.50 t ha-1 and B4: 10 t ha-1. The study was laid out in a randomized complete block design with 3 replications. The results showed that biochar amendment could enhance the yield of processing category potato. The total yield and marketable yield of potato gradually increased with increasing biochar level. The results also revealed that the processing category potato viz., canned, chips and French fry potato yield progressively increased with advancing biochar level irrespective of varieties except dehydrated category. In case of marketable yield, BARI Alu-25 and BARI Alu-29 with biochar level 5 to 10 t ha-1performed superior than other combinations and produced 19.50 to 21.30 t ha-1which are 18.54 to 36.45% higher than without biochar. The combination of V2B4 produced maximum canned (8.10 t ha-1) and dehydrated potato (10.09t ha-1) but V3B4 made significantly highest chips (9.03 t ha-1) and French fry (5.70 t ha-1) potato, whereas, BARI Alu-29 and BARI Alu-28 did not produce any French fry category potato. However, the level of biochar of 5 to 10 t ha-1 could enhance processing category potato production. It may be concluded that potato growers may apply biochar along with recommended rate of other fertilizers for producing maximum processing category potato.
Bangladesh Agron. J. 2021, 24(2): 63-72
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Alrashdi, A., and M. I. Khan. "Design and Comparative Analysis of High Speed and Low Power ALU Using RCA and Sklansky Adders for High-Performance Systems." Engineering, Technology & Applied Science Research 12, no. 2 (April 9, 2022): 8426–30. http://dx.doi.org/10.48084/etasr.4817.
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This study examines how different initial design decisions affect the area, timing, and power of technology-mapped designs. ASIC design flow, tools used during the flow, and the factors to consider to maximize the performance and power ratio are discussed. The ALU (Arithmetic Logic Unit) is a fundamental part of all processors. In this study, two ALUs were implemented using two different types of adder circuits: a Ripple Carry Adder (RCA) and a Sklansky adder. The Cadence EDA tools were used for the implementation. A comparative analysis was conducted for the two designed ALUs in terms of area, power, and timing analysis. The ALU design was also used as an example to examine the whole workflow front-end wise by constructing a block schematic and back-end wise by floorplanning, placing, and routing the physical design.
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Doshanlou, Abdollah Norouzi, Majid Haghparast, Mehdi Hosseinzadeh, and Midia Reshadi. "Design of quaternary quantum reversible half subtractor, full subtractor and n-qudit borrow ripple subtractor." International Journal of Quantum Information 17, no. 05 (August 2019): 1950048. http://dx.doi.org/10.1142/s0219749919500485.
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In this paper, we proposed novel plans of quaternary quantum reversible half and full subtractor circuits. The subtractor element is the essential part of the ALU in the digital computational devices. Thus, the improvement of subtractor block has a significant impact on the overall system performance. According to the comparison results, the proposed quaternary quantum half and full subtractor circuits show tremendous improvement in quantum cost, hardware complexity, number of constant input and garbage output as compared to their counterparts. Moreover, for the first time, the quaternary quantum borrow ripple subtractor structure is realized using the proposed quaternary quantum half and full subtractor circuits.
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Singh, Vivek, and K. B. Ramesh. "Introduction to Reversible Logic Gates and its Operations." International Journal for Research in Applied Science and Engineering Technology 10, no. 2 (February 28, 2022): 1148–56. http://dx.doi.org/10.22214/ijraset.2022.40249.
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Abstract: Reversible logic is one of the most important issues at the moment and has a wide range of applications, such as low power CMOS, quantum computing, nanotechnol- ogy, cryptography, optical computing, DNA computing, and -digital signal processing (DSP), quantum Dot automata for mobile, communication, computer graphics. It is not possible to detect quantum computing without the implementation of a postponed brain operation. The main objectives of design are logical thinking to reduce quantum costs, circuit depths and the amount of waste disposal. This paper provides basic logical retrospective gates, which in the construction of a highly sophisticated system with retractable circuits as part of the old and unable to perform the most complex operations using quantum computers. Reversible circuits form the basic building block of quantum computers as all quantum functions are reversed. This paper presents data related to older retractable gates found in books and assists research in the design of complex computer circuits using retractable gates. Keywords: Defendable Logic, Portable Gate, Dismissal, Trash, Quantum Cost, Quantum-dot Cellular Automata, Reversible Computing, Reversible ALU, Flip Flop using Reversible Gates, Reversible Adder
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SHRIVASTAVA, ANUJ KUMAR, and SHYAM AKASHE. "DESIGN OF LOW POWER 14T FULL ADDER CELL USING DOUBLE GATE MOSFET WITH MTCMOS REDUCTION TECHNIQUE AT 45 NANOMETER TECHNOLOGY." International Journal of Nanoscience 12, no. 06 (December 2013): 1350042. http://dx.doi.org/10.1142/s0219581x13500427.
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Full adder is the basic block of arithmetic circuit found in microcontroller and microprocessor inside arithmetic and logic unit (ALU). Improving the performance of the adder is essential for upgrading the performance of digital electronics circuit where adder is employed. In this paper, a single bit full adder circuit has been designed with the help of double gate (MOSFET), the used parameters value has been varied significantly for improving the performance of full adder circuit. Double gate transistor circuit considers as a promising candidate for low power application domain as well as used in radio frequency (RF) devices. Multi-threshold CMOS (MTCMOS) is the most used circuit technique to reduce the leakage current in idle circuit. In this paper, different parameters are analyzed on MTCMOS Technique. MTCMOS technique achieves 99.6% reduction of leakage current, active power is reduced by 42.64% and delay is reduced by 71.9% as compared with conventional double gate 14T full adder. Simulation results of double gate full adder have been performed on cadence virtuoso tool with 45 nm technology.
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Manchala, Venkat Subba Rao, Satyajeet Sahoo, and G. Ramana Murthy. "Design of Hybrid Full Adder using 6T-XOR-Cell for High Speed Processor Designs Applications." International Journal on Recent and Innovation Trends in Computing and Communication 10, no. 1s (December 15, 2022): 329–36. http://dx.doi.org/10.17762/ijritcc.v10i1s.5900.
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Hybrid-logic implementation is highly suitable in the design of a full adder circuit to attain high-speed low-power consumption, which helps to design n any high speed ALUs that can be used in varies processors and applicable for high speed IoT- Application. XOR/XNOR-cell, Hybrid Full Adder (HFA) are the fundamental building block to perform any arithmetic operation. In this paper, different types of high-speed, low-power 6T-XOR/XNOR-cell designs are being proposed and simulated results are presented. The proposed HFA is simulated using a cadence virtuoso environment in a 45nm technology with supply voltage as 0.8V at 1GHz. The proposed HFA consumes a power of 1.555uw, and the delay is 36.692ns. Layout designs are drawn for both 6T-XOR/XNOR-cell, and 1- bit HFA designs. XOR/XNOR-cells are designed based on the combination of normal CMOS-inverter and Pass Transistor Logic (PTL). Which is used in the design of high end device processors such as ALU that can be implemented for the IoT- design applications?
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Amin, M. N., B. C. Kundub, M. Rahman, M. M. Rahman, and M. M. Uddin. "PROMISING EARLY PLANTING AND STRESS-TOLERANT POTATO GENOTYPES FOR NORTHERN BANGLADESH." Malaysian Journal of Sustainable Agriculture 5, no. 1 (December 7, 2020): 16–20. http://dx.doi.org/10.26480/mjsa.01.2021.16.20.
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Potato is the third major food crop in the world. In Northern Bangladesh, potato production outside the regular growing season can contribute to farmers’ profit and prices can be very favorable as consumers’ demand for potatoes is greater than the decreased, off-season supply. However, potato production may be negatively affected by increased pest and disease pressure and higher soil temperature. We hypothesized that some potato varieties would have smaller tuber yield reduction when they are grown outside the normal season. The objective of this experiment was to find out promising genotypes for earlier cultivation prior to mid of November, cultivation in northern regions of Bangladesh. The trials, corresponding to very early, early, normal and late growing seasons were planted using a randomized complete block design with three replications. Germination percent, plant height, stems per hill, marketable tuber yield at 65 days, marketable tuber yield at 90 days were recorded. For yield and components of yield contributing characters Clone 13.17, BARI Alu 7(Diamant) and Arizona outperformed in all growing condition and had wider adaptability and stability of tuber yield based on Additive main effects and multiplicative interaction (AMMI).
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Chen, Jian Feng, Li Sheng Zhao, Yan Zhao, Bin Deng, Bin Gu, Yuan Fu Yi, Long Quan Shao, Zheng Wang, and Ning Wen. "Test of Relative Translucency for Four All-Ceramic Core Material after Veneering Ceramic." Key Engineering Materials 544 (March 2013): 388–91. http://dx.doi.org/10.4028/www.scientific.net/kem.544.388.
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Objective: To study the relative translucency of 4 veneered and glazed all-ceramic systems core material, including Vita In-Ceram Alumina, Vita In-Ceram Zirconium, Ivoclar Vivodent Empress and Colored Zirconia. Methods: Under standard black and write background, the surface light reflectivity of 4 veneered all-ceramic systems core material was determined with contact color difference meter, and the ratio of Yb /Yw was calculated. Results: After veneered, the relative translucency of 4 core materials all declined, and ranged from 0.8015 of Colored Zirconia to 1.00 of In-Ceram zirconia, among of that Empress II and Colored Zirconia were most transparent. Conclusion: Among the groups, there is no significant difference between Empress II and Colored Zirconia(IL1,IL2,IL3). Compared with Vita In-Ceram Alumina and Vita In-Ceram Zirconium, Vita In-Ceram Alumina(AL1) has significant difference. There is no significant difference between Vita In-Ceram Zirconium and Vita In-Ceram Alumina(AL2,AL3,AL4).
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Mollick, Md Omar Ali, Alok Kumar Paul, Ishrat Alam, and Munshi Mohammad Sumon. "Effect of Biochar on Yield and Quality of Potato (Solanum tuberosum) Tuber." International Journal of Bio-resource and Stress Management 11, no. 5 (October 31, 2020): 445–50. http://dx.doi.org/10.23910/1.2020.2140.
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A field experiment was conducted in Sher-e-Bangla Agricultural University (SAU), Dhaka, Bangladesh during the period from November, 2017 to March, 2018 in rabi season to observe the effect of biochar on the yield and quality of potato tuber and to find out the optimum dose of biochar along with inorganic fertilizer for achieving the maximum yield of potato. The experiment consist of 9 treatments as Control (no chemical fertilizer and biochar), Recommended Fertilizer Dose; Recommended Fertilizer Dose+Biochar @ 2.5 t ha-1; Recommended Fertilizer Dose+Biochar @ 5.0 t ha-1; Recommended Fertilizer Dose+Biochar @ 7.5 t ha-1; 1/2 of Recommended Fertilizer Dose+Biochar @ 2.5 t ha-1; ½ of Recommended Fertilizer Dose+Biochar @ 5.0 t ha-1; ½ of Recommended Fertilizer Dose + Biochar @ 7.5 t ha-1; Biochar @ 10 t ha-1. The experiment was laid out in a Randomized Complete Block Design with three replications. The tested variety was BARI Alu-7 (Diamant). Data were collected on different yield attributes, growth and quality of potato and postharvest soil analysis. The results indicated that biochar application significantly (p<0.05) increased plant height, weight of tubers, yield of tubers, tuber dry matter content, tuber specific gravity, soil organic carbon. Results suggested that biochar application had significant positive effect on plant and soil.
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Aaron D’costa, Mr, Dr Abdul Razak, and Dr Shazia Hasan. "Analysis and comparison of fast multiplier circuits based on different parameters." International Journal of Engineering & Technology 7, no. 3 (June 26, 2018): 1189. http://dx.doi.org/10.14419/ijet.v7i3.12945.
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Digital multiplier circuits are used in computers. A multiplier is an electronic circuit used in digital electronics to multiply two binary numbers. Multiplier circuits are used in ALU for binary multiplication of signed and unsigned numbers. The delay, area and power consumption are the 3 most important design specifications a chip designer has to consider. Delay of the circuit is directly proportional to the delay of a multiplier. Increased delay in the multiplier leads to higher delay in the circuit. Therefore research is carried out as to how to reduce the delay of the multiplier block so as to reduce the delay of whole circuit. The main purpose is to deal with high speed and lower power consumption even after decreasing the silicon area. This makes them well-suited for numerous complex and convenient VLSI circuit implementations. The fact however, remains that area and speed are two contradictory performance restrictions. Hence, increase in speed always results in the use of more and complex hardware. Different arithmetic techniques can be used to implement different multiplier circuits. The focus of this paper is to implement various multiplier circuit and compare them. The timing signals can be observed using software such as Modelsim and Xilinx.
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Melton, Natalie, Robert Talarico, Faraj Abdallah, Paul E. Beaulé, Sylvain Boet, Alan J. Forster, Shannon M. Fernando, et al. "Peripheral Nerve Blocks and Potentially Attributable Adverse Events in Older People with Hip Fracture: A Retrospective Population-based Cohort Study." Anesthesiology 135, no. 3 (June 15, 2021): 454–62. http://dx.doi.org/10.1097/aln.0000000000003863.
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Background Peripheral nerve blocks are being used with increasing frequency for management of hip fracture–related pain. Despite converging evidence that nerve blocks may be beneficial, safety data are lacking. This study hypothesized that peripheral nerve block receipt would not be associated with adverse events potentially attributable to nerve blocks, as well as overall patient safety incidents while in hospital. Methods This was a preregistered, retrospective population-based cohort study using linked administrative data. This study identified all hip fracture admissions in people 50 yr of age or older and identified all nerve blocks (although we were unable to ascertain the specific anatomic location or type of block), potentially attributable adverse events (composite of seizures, fall-related injuries, cardiac arrest, nerve injury), and any patient safety events using validated codes. The study also estimated the unadjusted and adjusted association of nerve blocks with adverse events; adjusted absolute risk differences were also calculated. Results In total, 91,563 hip fracture patients from 2009 to 2017 were identified; 15,631 (17.1%) received a nerve block, and 5,321 (5.8%; 95% CI, 5.7 to 6.0%) patients experienced a potentially nerve block–attributable adverse event: 866 (5.5%) in patients with a block and 4,455 (5.9%) without a block. Before and after adjustment, nerve blocks were not associated with potentially attributable adverse events (adjusted odds ratio, 1.05; 95% CI, 0.97 to 1.15; and adjusted risk difference, 0.3%, 95% CI, –0.1 to 0.8). Conclusions The data suggest that nerve blocks in hip fracture patients are not associated with higher rates of potentially nerve block–attributable adverse events, although these findings may be influenced by limitations in routinely collected administrative data. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New
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Khan, MAH, N. Sultana, N. Akter, S. Akhter, and MAI Khan. "Development of Potato-Boro-T. Aman Rice Cropping Pattern Against Fallow-Boro-T. Aman Rice Cropping Pattern at Mymensingh." Bangladesh Journal of Agricultural Research 45, no. 3 (December 8, 2022): 279–92. http://dx.doi.org/10.3329/bjar.v45i3.62948.
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The experiment was conducted at Multiplication Testing Site (MLT) Trishal of On-Farm Research Division, Bangladesh Agricultural Research Institute, Mymensingh during 2017-18 and 2018-19 to evaluate the agro-economic performance of improved cropping pattern for increasing cropping intensity and system productivity as compared to farmers’ existing cropping pattern. The experiment was laid out in randomized complete block design with six dispersed replications. Two cropping patterns viz. improved pattern Potato (BARI Alu- 25)-Boro (BRRI dhan28)-T. Aman rice (BRRI dhan49) and farmers existing cropping pattern Fallow-Boro (BRRI dhan29)- T. Aman rice (BRRI dhan49) were treatments variables of the experiment. Two years mean data showed that Potato-Boro-T. Aman rice cropping pattern produced higher tuber/grain yield as well as higher rice equivalent yield (30.53 t ha-1yr-1), production efficiency (149 kg ha-1 day-1), land utilization index (74 %) and labour employment (367mandays ha-1 yr-1) than Fallow-Boro-T. Aman rice cropping pattern. This pattern also increased system productivity, production efficiency, land utilization index and labour employment by 158, 166, 26 and 51% higher over exiting pattern. The mean gross return (Tk. 481800 ha-1) and gross margin (Tk.235329 ha-1) of improved cropping pattern were 139 and 237% higher, respectively compared to existing pattern with 87% extra cost. The mean marginal benefit cost ratio (2.45) indicated superiority to improved cropping pattern over existing pattern. Experimental findings revealed that there is potential for greater adoption of intensified cropping systems with increased productivity and profitability as compared to rice–rice systems in Mymensingh.
Bangladesh J. Agril. Res. 45(3): 279-292, September 2020
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McIsaac, Daniel I., Colin J. L. McCartney, and Carl van Walraven. "Peripheral Nerve Blockade for Primary Total Knee Arthroplasty." Anesthesiology 126, no. 2 (February 1, 2017): 312–20. http://dx.doi.org/10.1097/aln.0000000000001455.
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Abstract Background Although peripheral nerve blocks decrease pain after total knee arthroplasty, the population-level impact of nerve blocks on arthroplasty resource utilization is unknown. Methods We conducted a population-based cohort study using linked administrative data from Ontario, Canada. We identified all adults having their first primary knee arthroplasty between 2002 and 2013. Using propensity scores to adjust for measureable confounders, we matched nerve block patients to a patient who did not receive a block. Within the matched cohort, we estimated the independent association of blocks with outcomes (length of hospital stay [primary]; and readmissions, emergency department visits, and falls [secondary]). Results One hundred seventy-eight thousand two hundred fourteen patients were identified; 61,588 (34.6%) had a block. The mean hospital stay was 4.6 days with a block compared to 4.8 without. After matching, there was a statistically significant decrease in the length of stay in the block group (relative risk, 0.98; 95% CI, 0.97 to 0.99; P < 0.001). Blocks were associated with a significant decrease in readmissions (relative risk, 0.87; 95% CI, 0.79 to 0.88; P < 0.001) but not emergency department visits (relative risk, 1.02; 95% CI, 0.98 to 1.05) or falls (relative risk, 1.37; 95% CI, 0.90 to 2.08). The association of blocks with length of stay after 2008 was inconsistent; overall, they were associated with longer stays; however, single-shot blocks were associated with shorter stays, while continuous techniques prolonged the length of stay. Conclusions Nerve blocks in total knee arthroplasty patients were associated with statistically significant reductions in length of stay and readmissions, but not emergency department visits or falls. The significance of these findings at the patient level and in contemporary practice requires further exploration in prospective randomized studies at low risk of indication bias.
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O’Donnell, Brian D., and Gabrielle Iohom. "An Estimation of the Minimum Effective Anesthetic Volume of 2% Lidocaine in Ultrasound-guided Axillary Brachial Plexus Block." Anesthesiology 111, no. 1 (July 1, 2009): 25–29. http://dx.doi.org/10.1097/aln.0b013e3181a915c7.
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Background Ultrasound guidance facilitates precise needle and injectate placement, increasing axillary block success rates, reducing onset times, and permitting local anesthetic dose reduction. The minimum effective volume of local anesthetic in ultrasound-guided axillary brachial plexus block is unknown. The authors performed a study to estimate the minimum effective anesthetic volume of 2% lidocaine with 1:200,000 epinephrine (2% LidoEpi) in ultrasound-guided axillary brachial plexus block. Methods After ethical approval and informed consent, patients undergoing hand surgery of less than 90 min duration were recruited. A step-up/step-down study model was used with nonprobability sequential dosing based on the outcome of the previous patient. The starting dose of 2% LidoEpi was 4 ml per nerve. Block failure resulted in a dose increase of 0.5 ml; block success in a reduction of 0.5 ml.A blinded assistant assessed sensory and motor blockade at 5-min intervals up to 30 min. Block performance time and duration were measured. Two predetermined stopping points were used; a minimum of five consecutive block success/failures and five consecutive successful blocks at 1 ml per nerve. Results The study was terminated when five consecutive patients had successful blocks using 1 ml of 2% LidoEpi per nerve (overall group n = 11). All five patients had surgical anesthesia within 10 min. The mean (SD) block performance time was 445 (100) s, and block duration was 190 min (range 120-310 min). All surgical procedures were performed under regional anesthesia with anxiolytic sedation provided in 3 of 11 cases. Conclusion Successful ultrasound-guided axillary brachial plexus block may be performed with 1 ml per nerve of 2% LidoEpi.
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Hamilton, Gavin M., Reva Ramlogan, Anne Lui, Colin J. L. McCartney, Faraj Abdallah, Jason McVicar, and Daniel I. McIsaac. "Peripheral Nerve Blocks for Ambulatory Shoulder Surgery." Anesthesiology 131, no. 6 (December 1, 2019): 1254–63. http://dx.doi.org/10.1097/aln.0000000000002865.
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Abstract Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New Background Nerve blocks improve early pain after ambulatory shoulder surgery; impact on postdischarge outcomes is poorly described. Our objective was to measure the association between nerve blocks and health system outcomes after ambulatory shoulder surgery. Methods We conducted a population-based cohort study using linked administrative data from 118 hospitals in Ontario, Canada. Adults having elective ambulatory shoulder surgery (open or arthroscopic) from April 1, 2009, to December 31, 2016, were included. After validation of physician billing codes to identify nerve blocks, we used multilevel, multivariable regression to estimate the association of nerve blocks with a composite of unplanned admissions, emergency department visits, readmissions or death within 7 days of surgery (primary outcome) and healthcare costs (secondary outcome). Neurology consultations and nerve conduction studies were measured as safety indicators. Results We included 59,644 patients; blocks were placed in 31,073 (52.1%). Billing codes accurately identified blocks (positive likelihood ratio 16.83, negative likelihood ratio 0.03). The composite outcome was not significantly different in patients with a block compared with those without (2,808 [9.0%] vs. 3,424 [12.0%]; adjusted odds ratio 0.96; 95% CI 0.89 to 1.03; P = 0.243). Healthcare costs were greater with a block (adjusted ratio of means 1.06; 95% CI 1.02 to 1.10; absolute increase $325; 95% CI $316 to $333; P = 0.005). Prespecified sensitivity analyses supported these results. Safety indicators were not different between groups. Conclusions In ambulatory shoulder surgery, nerve blocks were not associated with a significant difference in adverse postoperative outcomes. Costs were statistically higher with a block, but this increase is not likely clinically relevant.
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Martin, Frédéric, Valéria Martinez, Jean Xavier Mazoit, Didier Bouhassira, Kamel Cherif, Marc Edouard Gentili, Philippe Piriou, Marcel Chauvin, and Dominique Fletcher. "Antiinflammatory Effect of Peripheral Nerve Blocks after Knee Surgery." Anesthesiology 109, no. 3 (September 1, 2008): 484–90. http://dx.doi.org/10.1097/aln.0b013e318182c2a1.
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Background Nerve blocks provide analgesia after surgery. The authors tested whether nerve blocks have antiinflammatory effects. Methods Patients had combined sciatic (single-shot) and continuous femoral block (48 h) (block group) or morphine patient-controlled analgesia after total knee arthroplasty. Pain at rest and upon movement was monitored at 1 (D1), 4 (D4), and 7 days (D7) and 1 (M1) and 3 months (M3) after surgery. Knee inflammation was evaluated (skin temperature, knee circumference) before surgery and at D1, D4, D7, M1, and M3. Plasma cytokine concentrations (interleukin [IL]-6, IL-1beta, tumor necrosis factor [TNF], IL-10, soluble receptor 1 of TNF [sTNF-R1]) were measured before surgery and at 4 h, D1, D4, and D7 after surgery. Capsule and synovial membrane cytokines were measured (IL-6, TNF, IL-1, IL-10). Knee flexion was evaluated before surgery and at D1, D4, D7, M1, and M3. Morphine use and recovery time to autonomy were monitored. Results Pain at rest and upon movement was lower in the block group than in patient-controlled analgesia patients between D1 and D7 (analysis of variance, P < 0.005). Knee flexion was improved in the block group for D1 to M1 (analysis of variance, P < 0.0001). Block group patients recovered nonassisted mobilization (t test, P = 0.04) and toilet use (t test, P = 0.03) more rapidly. Knee circumference and skin temperature were lower in the block group between D1 and D7 (analysis of variance, P < 0.05). Synovial membrane IL-1 (P < 0.05) and IL-10 (P < 0.01) increased, and plasma IL-6 and sTNF-R1 peaked at 24 h, with no difference between groups. Conclusion Nerve blocks inhibited clinical inflammation after total knee arthroplasty, with no change in tissue and plasma cytokine concentrations.
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Candido, Kenneth D., Jason Hennes, Sergio Gonzalez, Marianne Mikat-Stevens, Michael Pinzur, Vladimir Vasic, and Nebojsa Nick Knezevic. "Buprenorphine Enhances and Prolongs the Postoperative Analgesic Effect of Bupivacaine in Patients Receiving Infragluteal Sciatic Nerve Block." Anesthesiology 113, no. 6 (December 1, 2010): 1419–26. http://dx.doi.org/10.1097/aln.0b013e3181f90ce8.
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Background Results from previous studies have shown favorable effects from the addition of buprenorphine to local anesthetics used for interscalene or axillary perivascular brachial plexus blocks. The main objective of the current study was to determine whether addition of buprenorphine could enhance bupivacaine analgesia after infragluteal sciatic nerve block. Methods One hundred and three consenting adult patients for elective foot and ankle outpatient surgeries were prospectively assigned randomly, in double-blind fashion, to one of three groups. Group 1 received 0.5% bupivacaine with epinephrine 1:200,000 for infragluteal sciatic block plus 1 ml normal saline intramuscularly. Group 2 received bupivacaine sciatic block along with intramuscular buprenorphine (0.3 mg). Group 3 received bupivacaine plus buprenorphine for infragluteal sciatic block and 1 ml normal saline intramuscularly. Results Although patients receiving buprenorphine either for sciatic block or intramuscularly had less pain in the postanesthesia care unit compared with patients receiving only bupivacaine, the individual pair-wise comparison of the analysis of variance model showed no statistical difference. However, only buprenorphine added to bupivacaine for sciatic block prolonged postoperative analgesia. Patients receiving a combination of buprenorphine and bupivacaine for sciatic block had lower numeric rating pain scores and received less opioid medication at home than patients in the other two groups. Conclusions The results show that buprenorphine may enhance and prolong the analgesic effect of bupivacaine when used for sciatic nerve blocks in patients undergoing foot and ankle surgery under general anesthesia but does not do so to the extent shown in previous studies using brachial plexus models with mepivacaine and tetracaine.
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Cohen, Steven P., Tina L. Doshi, Octav C. Constantinescu, Zirong Zhao, Connie Kurihara, Thomas M. Larkin, Scott R. Griffith, et al. "Effectiveness of Lumbar Facet Joint Blocks and Predictive Value before Radiofrequency Denervation." Anesthesiology 129, no. 3 (September 1, 2018): 517–35. http://dx.doi.org/10.1097/aln.0000000000002274.
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Abstract What We Already Know about This Topic What This Article Tells Us That Is New Background With facet interventions under scrutiny, the authors’ objectives were to determine the effectiveness of different lumbar facet blocks and their ability to predict radiofrequency ablation outcomes. Methods A total of 229 participants were randomized in a 2:2:1 ratio to receive intraarticular facet injections with bupivacaine and steroid, medial branch blocks, or saline. Those with a positive 1-month outcome (a 2-point or more reduction in average pain score) and score higher than 3 (positive satisfaction) on a 5-point satisfaction scale were followed up to 6 months. Participants in the intraarticular and medial branch block groups with a positive diagnostic block (50% or more relief) who experienced a negative outcome proceeded to the second phase and underwent radiofrequency ablation, while all saline group individuals underwent ablation. Coprimary outcome measures were average reduction in numerical rating scale pain score 1 month after the facet or saline blocks, and average numerical rating scale pain score 3 months after ablation. Results Mean reduction in average numerical rating scale pain score at 1 month was 0.7 ± 1.6 in the intraarticular group, 0.7 ± 1.8 in the medial branch block group, and 0.7 ± 1.5 in the placebo group; P = 0.993. The proportions of positive blocks were higher in the intraarticular (54%) and medial branch (55%) groups than in the placebo group (30%; P = 0.01). Radiofrequency ablation was performed on 135 patients (45, 48, and 42 patients from the intraarticular, medial branch, and saline groups, respectively). The average numerical rating scale pain score at 3 months was 3.0 ± 2.0 in the intraarticular, 3.2 ± 2.5 in the medial branch, and 3.5 ± 1.9 in the control group (P = 0.493). At 3 months, the proportions of positive responders in the intraarticular, medial branch block, and placebo groups were 51%, 56%, and 24% for the intraarticular, medial branch, and placebo groups, respectively (P = 0.005). Conclusions This study establishes that facet blocks are not therapeutic. The higher responder rates in the treatment groups suggest a hypothesis that facet blocks might provide prognostic value before radiofrequency ablation.
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Pöpping, Daniel M., Nadia Elia, Emmanuel Marret, Manuel Wenk, Martin R. Tramèr, David S. Warner, and Mark A. Warner. "Clonidine as an Adjuvant to Local Anesthetics for Peripheral Nerve and Plexus Blocks." Anesthesiology 111, no. 2 (August 1, 2009): 406–15. http://dx.doi.org/10.1097/aln.0b013e3181aae897.
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The effect of adding clonidine to local anesthetics for nerve or plexus blocks remains unclear. The authors searched for randomized placebo-controlled trials testing the impact of adding clonidine to local anesthetics for peripheral single-injection nerve or plexus blocks in adults undergoing any surgery (except eye) without general anesthesia. Twenty trials (1,054 patients, 573 received clonidine) published 1992-2006 tested plexus (14 brachial, 1 cervical) and nerve blocks (2 sciatic/femoral, 1 midhumeral, 1 ilioinguinal/iliohypogastric, 1 ankle). Clonidine doses ranged from 30 to 300 microg; most patients received 150 microg. Clonidine prolonged the duration of postoperative analgesia (weighted mean difference 122 min; 95% confidence interval [CI] 74-169), sensory block (weighted mean difference 74 min; 95% CI 37-111), and motor block (weighted mean difference 141 min; 95% CI 82-199). In a subgroup of patients receiving an axillary plexus block, these effects were independent of whether clonidine was added to an intermediate or a long-acting local anesthetic. Clonidine increased the risk of arterial hypotension (odds ratio 3.61; 95% CI 1.52-8.55; number-needed-to-harm 11), orthostatic hypotension or fainting (odds ratio 5.07; 95% CI 1.20-21.4; number-needed-to-harm 10), bradycardia (odds ratio 3.09; 95% CI 1.10-8.64; number-needed-to-harm 13), and sedation (odds ratio 2.28; 95% CI 1.15-4.51; number-needed-to-harm 5). There was a lack of evidence of dose-responsiveness for beneficial or harmful effects. Clonidine added to intermediate or long-acting local anesthetics for single-shot peripheral nerve or plexus blocks prolongs duration of analgesia and motor block by about 2 h. The increased risk of hypotension, fainting, and sedation may limit its usefulness. Dose-responsiveness remains unclear.
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Marwan, Marwan, Fepy Supriani, and Yuzuar Afrizal. "PENGARUH PENGGANTIAN SEBAGIAN SEMEN DENGAN ABU TERBANG (FLY ASH) DAN ABU CANGKANG LOKAN TERHADAP KUAT TEKAN PAVING BLOCK." Inersia, Jurnal Teknik Sipil 9, no. 1 (January 28, 2019): 1–8. http://dx.doi.org/10.33369/ijts.9.1.1-8.
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Paving block is used to fill the needs of surface pavement. This research uses waste of sea shell ash and fly ash as cement substitute material in the manufacture of paving blocks. Sea shell ash and fly ash containing calcium oxide (CaO) and silica oxide (SiO) that can replace and strengthen the chemical composition of cement. Variations of replacement much as 2.5%, 5%, 7.5% and 10% compared to normal compressive strength of the paving block (0%). Test specimen numbered 75 samples of rectangular with a length of 20 cm, width 10 cm and a thickness of 6 cm. Manufacture of paving blocks using conventional construction methods. The results of compressive strength testing of the age of 7 days, 14 days and 28 days for any 2 variations on the variations increase to 7.5% and down 10%. The results of the compressive strength largest average variation occurs in the replacement of 7.5% ie at the age of 7 days of 31.19 MPa, aged 14 days amounted to 33.55 MPa and 28 days amounted to 34.74 MPa. The percentage increase was highest compressive strength at 28 days with an increase of 23.19%.
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Nader, Antoun, Mark C. Kendall, Robert Doty, Alexander DeLeon, Edward Yaghmour, Armen S. Kelikian, and Robert J. McCarthy. "Nerve Stimulator-guided Supplemental Popliteal Sciatic Nerve Block after a Failed Sciatic Block Does Not Increase the Incidence of Transient Postoperative Neurologic Sequelae." Anesthesiology 115, no. 3 (September 1, 2011): 596–603. http://dx.doi.org/10.1097/aln.0b013e318221fca8.
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Background Supplemental peripheral nerve blocks are not commonly performed in adults because of concerns of cumulative exposure of the nerve to the local anesthetic as well as increased ischemia from epinephrine. The purpose of this study was to compare the incidence of postoperative neurologic symptoms after a failed subgluteal sciatic nerve block and a supplemental popliteal sciatic nerve block. Methods Five hundred twelve adult patients undergoing ambulatory surgery were prospectively studied (1 yr). Sciatic nerve blocks were performed using levobupivacaine 0.625% with epinephrine 1:200,000 (0.5 ml/kg). Patients who failed to achieve sensory and motor anesthesia at 30-60 min were given a popliteal sciatic nerve block (lidocaine 2% 10 ml + levobupivacaine 0.5% 10 ml). Subjects were contacted at 24 h to 48 h, 2 weeks, and 1 month. Symptomatic patients were contacted biweekly and reevaluated during follow-up surgeon visits until symptom resolution. Results Four hundred thirty-nine subjects were analyzed. Fifty-six received a popliteal sciatic nerve block. Four subjects (0.9%) had self-reported neurologic symptoms in the distribution of the sciatic nerve. Investigator-initiated follow-up revealed 33 subjects (8.7%) who received a single subgluteal sciatic block and 4 subjects (7.1%) after a supplemental sciatic nerve block with neurologic symptoms (P = 0.80). The median duration of symptoms was 4 weeks (95% CI 3-5) in the subgluteal and 4 weeks (95% CI 3-5) weeks in the popliteal group (P = 0.98). All symptoms resolved by 14 weeks postprocedure. Conclusion Blocking the sciatic nerve at a more distal site after a failed subgluteal sciatic nerve block does not appear to influence the incidence or duration of neurologic sequelae.
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Hamilton, Gavin M., Manoj M. Lalu, Reva Ramlogan, Gregory L. Bryson, Faraj W. Abdallah, Colin J. L. McCartney, and Daniel I. McIsaac. "A Population-based Comparative Effectiveness Study of Peripheral Nerve Blocks for Hip Fracture Surgery." Anesthesiology 131, no. 5 (November 1, 2019): 1025–35. http://dx.doi.org/10.1097/aln.0000000000002947.
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Abstract Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New Background Adverse outcomes and resource use rates are high after hip fracture surgery. Peripheral nerve blocks could improve outcomes through enhanced analgesia and decreased opioid related adverse events. We hypothesized that these benefits would translate into decreased resource use (length of stay [primary outcome] and costs), and better clinical outcomes (pneumonia and mortality). Methods The authors conducted a retrospective cohort study of hip fracture surgery patients in Ontario, Canada (2011 to 2015) using linked health administrative data. Multilevel regression, instrumental variable, and propensity scores were used to determine the association of nerve blocks with resource use and outcomes. Results The authors identified 65,271 hip fracture surgery patients; 10,030 (15.4%) received a block. With a block, the median hospital stay was 7 (interquartile range, 4 to 13) days versus 8 (interquartile range, 5 to 14) days without. Following adjustment, nerve blocks were associated with a 0.6-day decrease in length of stay (95% CI, 0.5 to 0.8). This small difference was consistent with instrumental variable (1.1 days; 95% CI, 0.9 to 1.2) and propensity score (0.2 days; 95% CI, 0.2 to 0.3) analyses. Costs were lower with a nerve block (adjusted difference, −$1,421; 95% CI, −$1,579 to −$1,289 [Canadian dollars]), but no difference in mortality (adjusted odds ratio, 0.99; 95% CI, 0.89 to 1.11) or pneumonia (adjusted odds ratio, 1.01; 95% CI, 0.88 to 1.16) was observed. Conclusions Receipt of nerve blocks for hip fracture surgery is associated with decreased length of stay and health system costs, although small effect sizes may not reflect clinical significance for length of stay.
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Andersen, Jakob H., Ulrik Grevstad, Hanna Siegel, Jørgen B. Dahl, Ole Mathiesen, and Pia Jæger. "Does Dexmedetomidine Have a Perineural Mechanism of Action When Used as an Adjuvant to Ropivacaine?" Anesthesiology 126, no. 1 (January 1, 2017): 66–73. http://dx.doi.org/10.1097/aln.0000000000001429.
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Abstract Background Dexmedetomidine used as an adjuvant to local anesthetics may prolong the duration of peripheral nerve blocks. Whether this is mediated by a perineural or systemic mechanism remains unknown. The authors hypothesized that dexmedetomidine has a peripheral mechanism of action. Methods The authors conducted a randomized, paired, triple-blind trial in healthy volunteers. All received bilateral saphenous nerve blocks with 20 ml ropivacaine, 0.5%, plus 1 ml dexmedetomidine, 100 µg/ml, in one thigh and 20 ml ropivacaine 0.5% plus 1 ml saline in the other thigh. The primary outcome measure was the duration of block assessed by temperature sensation (alcohol swab). The secondary outcome measure was the duration of block assessed by pinprick, pain during tonic heat stimulation, warmth detection threshold, and heat pain detection threshold. Results All 21 enrolled volunteers completed the trial. The mean duration of block assessed by temperature sensation in the leg receiving ropivacaine plus dexmedetomidine was 22 h (95% CI, 21 to 24) compared to 20 h (95% CI, 19 to 21) in the leg receiving ropivacaine plus placebo with a mean difference of 2 h (95% CI, 1 to 3; P = 0.001). The duration of block was also significantly longer in the leg receiving dexmedetomidine when assessed by pinprick, pain during tonic heat stimulation, and warmth detection threshold but not heat pain detection threshold. One participant experienced numbness in an area in the leg receiving dexmedetomidine. Conclusions Dexmedetomidine prolongs the duration of a saphenous nerve block by a peripheral mechanism when controlling for systemic effects but not necessarily to a clinically relevant extent.
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Vandepitte, Catherine, Philippe Gautier, Daquan Xu, Emine A. Salviz, and Admir Hadzic. "Effective Volume of Ropivacaine 0.75% through a Catheter Required for Interscalene Brachial Plexus Blockade." Anesthesiology 118, no. 4 (April 1, 2013): 863–67. http://dx.doi.org/10.1097/aln.0b013e3182850dc7.
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Abstract Background: Ultrasound guidance during peripheral nerve blocks has allowed for reduction in dose and volume of local anesthetic required to accomplish successful blockade using multiple injections through a needle. The authors undertook this study to determine the minimal effective volume required to accomplish successful interscalene brachial plexus block (ISB) through the catheter. Methods: After obtaining institutional ethics committee approval and written informed consent, patients aged 18–75 yr and scheduled for arthroscopic shoulder surgery under ISB were enrolled. All patients using a step-up/step-down method and the starting dose of 15 ml of 0.75% ropivacaine received an ultrasound-guided ISB catheter. The injection volume was increased or decreased by 1 ml in case of block failure or block success, respectively. Results: The authors found that the proportion of patients with successful blockade increased sharply from approximately 57% at 6 ml to 100% by 7 ml, indicating that a small increase in volume of ropivacaine 0.75% markedly affects the success rate. A total of 12 ISB with injection volume less than 7 ml resulted in successful anesthesia within 30 min, yielding an ED95 of 7 ml (95% CI 6.8–7.2) ropivacaine 0.75%. For the group as a whole, the median (min–max) sensory block onset time was 5 (5–20) min, the median (min–max) motor blocks for the biceps and the deltoid muscles were 7.5 (5–15) min and 10 (5–15) min, respectively. The median (min–max) block duration was 8.9 (3–15) h. Conclusions: An injection of a minimum of 7 ml of ropivacaine 0.75% through the catheter is required for success rate and timely onset of surgical anesthesia with ISB.
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Auyong, David B., Neil A. Hanson, Raymond S. Joseph, Brian E. Schmidt, April E. Slee, and Stanley C. Yuan. "Comparison of Anterior Suprascapular, Supraclavicular, and Interscalene Nerve Block Approaches for Major Outpatient Arthroscopic Shoulder Surgery." Anesthesiology 129, no. 1 (July 1, 2018): 47–57. http://dx.doi.org/10.1097/aln.0000000000002208.
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Abstract Background The interscalene nerve block provides analgesia for shoulder surgery, but is associated with diaphragm paralysis. One solution may be performing brachial plexus blocks more distally. This noninferiority study evaluated analgesia for blocks at the supraclavicular and anterior suprascapular levels, comparing them individually to the interscalene approach. Methods One hundred-eighty-nine subjects undergoing arthroscopic shoulder surgery were recruited to this double-blind trial and randomized to interscalene, supraclavicular, or anterior suprascapular block using 15 ml, 0.5% ropivacaine. The primary outcome was numeric rating scale pain scores analyzed using noninferiority testing. The predefined noninferiority margin was one point on the 11-point pain scale. Secondary outcomes included opioid consumption and pulmonary assessments. Results All subjects completed the study through the primary outcome analysis. Mean pain after surgery was: interscalene = 1.9 (95% CI, 1.3 to 2.5), supraclavicular = 2.3 (1.7 to 2.9), suprascapular = 2.0 (1.4 to 2.6). The primary outcome, mean pain score difference of supraclavicular–interscalene was 0.4 (–0.4 to 1.2; P = 0.088 for noninferiority) and of suprascapular–interscalene was 0.1 (–0.7 to 0.9; P = 0.012 for noninferiority). Secondary outcomes showed similar opioid consumption with better preservation of vital capacity in the anterior suprascapular group (90% baseline [P < 0.001]) and the supraclavicular group (76% [P = 0.002]) when compared to the interscalene group (67%). Conclusions The anterior suprascapular block, but not the supraclavicular, provides noninferior analgesia compared to the interscalene approach for major arthroscopic shoulder surgery. Pulmonary function is best preserved with the anterior suprascapular nerve block.
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Wang, Sho-Ya, Joanna Calderon, and Ging Kuo Wang. "Block of Neuronal Na+Channels by Antidepressant Duloxetine in a State-dependent Manner." Anesthesiology 113, no. 3 (September 1, 2010): 655–65. http://dx.doi.org/10.1097/aln.0b013e3181e89a93.
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Background Duloxetine is a mixed serotonin-norepinephrine reuptake inhibitor used for major depressive disorder. Duloxetine is also beneficial for patients with diabetic peripheral neuropathy and with fibromyalgia, but how it works remains unclear. Methods We used the whole cell, patch clamp technique to test whether duloxetine interacts with the neuronal Nav1.7 Na+ channel as a potential target. Resting and inactivated Nav1.7 Na+ channel block by duloxetine were measured by conventional pulse protocols in transfected human embryonic kidney cells. The open-channel block was determined directly using inactivation-deficient mutant Nav1.7 Na+ channels. Results The 50% inhibitory concentration (IC50) of duloxetine for the resting and inactivated wild-type hNav1.7 Na+ channel were 22.1+/-0.4 and 1.79+/-0.10 microM, respectively (mean+/-SE, n=5). The IC50 for the open Na+ channel was 0.25+/-0.02 microM (n=5), as determined by the block of persistent late Nav1.7 Na+ currents. Similar open-channel block by duloxetine was found in the muscle Nav1.4 isoform (IC50=0.51+/-0.05 microM; n=5). Block by duloxetine appeared via the conserved local anesthetic receptor as determined by site-directed mutagenesis. Finally, duloxetine elicited strong use-dependent block of neuronal transient Nav1.7 Na+ currents during repetitive stimulations. Conclusions Duloxetine blocks persistent late Nav1.7 Na+ currents preferentially, which may in part account for its analgesic action.
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Abdallah, Faraj W., Duminda N. Wijeysundera, Andreas Laupacis, Richard Brull, Aaron Mocon, Nasir Hussain, Kevin E. Thorpe, and Vincent W. S. Chan. "Subomohyoid Anterior Suprascapular Block versus Interscalene Block for Arthroscopic Shoulder Surgery." Anesthesiology 132, no. 4 (April 1, 2020): 839–53. http://dx.doi.org/10.1097/aln.0000000000003132.
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Abstract Background Interscalene brachial plexus block, the pain relief standard for shoulder surgery, is an invasive technique associated with important complications. The subomohyoid anterior suprascapular block is a potential alternative, but evidence of its comparative analgesic effect is sparse. The authors tested the hypothesis that anterior suprascapular block is noninferior to interscalene block for improving pain control after shoulder surgery. As a secondary objective, the authors evaluated the success of superior trunk (C5–C6 dermatomes) block with suprascapular block. Methods In this multicenter double-blind noninferiority randomized trial, 140 patients undergoing shoulder surgery were randomized to either interscalene or anterior suprascapular block with 15 ml of ropivacaine 0.5% and epinephrine. The primary outcome was area under the curve of postoperative visual analog scale pain scores during the first 24 h postoperatively. The 90% CI for the difference (interscalene-suprascapular) was compared against a –4.4-U noninferiority margin. Secondary outcomes included presence of superior trunk blockade, pain scores at individual time points, opioid consumption, time to first analgesic request, opioid-related side-effects, and quality of recovery. Results A total of 136 patients were included in the analysis. The mean difference (90% CI) in area under the curve of pain scores for the (interscalene-suprascapular) comparison was –0.3 U (–0.8 to 0.12), exceeding the noninferiority margin of –4.4 U and demonstrating noninferiority of suprascapular block. The risk ratio (95% CI) of combined superior trunk (C5–C6 dermatomes) blockade was 0.98 (0.92 to 1.01), excluding any meaningful difference in superior trunk block success rates between the two groups. When differences in other analgesic outcomes existed, they were not clinically important. Conclusions The suprascapular block was noninferior to interscalene block with respect to improvement of postoperative pain control, and also for blockade of the superior trunk. These findings suggest that the suprascapular block consistently blocks the superior trunk and qualify it as an effective interscalene block alternative. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New
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Berg, Aaron A., James M. Flaherty, Jason M. Habeck, Alicia K. Harrison, Jonathan P. Braman, Alexander M. Kaizer, and Jacob L. Hutchins. "Evaluation of Diaphragmatic Function after Interscalene Block with Liposomal Bupivacaine: A Randomized Controlled Trial." Anesthesiology 136, no. 4 (January 21, 2022): 531–41. http://dx.doi.org/10.1097/aln.0000000000004118.
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Background Interscalene blocks provide analgesia for shoulder surgery but also cause phrenic nerve paralysis. Liposomal bupivacaine is approved for use in interscalene blocks with the potential to provide longer pain control. However, the impact of liposomal bupivacaine on the phrenic nerve has not been evaluated. It was hypothesized that patients who received an interscalene block with both bupivacaine and liposomal bupivacaine would have a decreased diaphragmatic excursion when compared to bupivacaine alone at 24 h. Methods This was a double-blinded study of adult patients who were randomized to receive an interscalene block with either 20 ml 0.5% bupivacaine (bupivacaine group) or 10 ml 0.5% bupivacaine plus 10 ml liposomal bupivacaine (liposomal bupivacaine group). Twenty-six patients were randomized with 22 included in the analysis. Diaphragmatic excursion (via ultrasound) and spirometry were assessed before the block, in the postanesthesia care unit, and at 24 h postblock. The primary outcome was diaphragm excursion with sigh. No adverse events were observed. Results At 24 h, the liposomal bupivacaine group median [25th, 75th], had a greater percent change in diaphragmatic excursion during sigh breath compared to the bupivacaine group, –24% [–30, –9] versus 9% [–8, 26], difference in location, 32 (95% CI, 12 to 52), P = 0.007. Five patients in the liposomal bupivacaine group had a greater than 25% reduction in diaphragmatic excursion at 24 h versus zero in the bupivacaine group. They also had a significantly greater percent reduction in forced expiratory volume in 1 s and forced vital capacity compared with the bupivacaine group at 24 h (median decrease of 22% vs. 2%, P = 0.006, and median decrease of 19% vs. 1%, P = 0.049, respectively). Conclusions The addition of liposomal bupivacaine to bupivacaine in an interscalene block results in statistically significant reductions in diaphragm excursion and pulmonary function testing 24 h after block placement when compared to bupivacaine alone. This reduction, however, falls within the range of normal diaphragmatic function. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New
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Behrends, Matthias, Edward N. Yap, Alan L. Zhang, Kerstin Kolodzie, Sakura Kinjo, Monica W. Harbell, and Pedram Aleshi. "Preoperative Fascia Iliaca Block Does Not Improve Analgesia after Arthroscopic Hip Surgery, but Causes Quadriceps Muscles Weakness." Anesthesiology 129, no. 3 (September 1, 2018): 536–43. http://dx.doi.org/10.1097/aln.0000000000002321.
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Abstract What We Already Know about This Topic What This Article Tells Us That Is New Background Ambulatory hip arthroscopy is associated with postoperative pain routinely requiring opioid analgesia. The potential role of peripheral nerve blocks for pain control after hip arthroscopy is controversial. This trial investigated whether a preoperative fascia iliaca block improves postoperative analgesia. Methods In a prospective, double-blinded trial, 80 patients scheduled for hip arthroscopy were randomized to receive a preoperative fascia iliaca block with 40 ml ropivacaine 0.2% or saline. Patients also received an intraarticular injection of 10-ml ropivacaine 0.2% at procedure end. Primary study endpoint was highest pain score reported in the recovery room; other study endpoints were pain scores and opioid use 24 h after surgery. Additionally, quadriceps strength was measured to identify leg weakness. Results The analysis included 78 patients. Highest pain scores in the recovery room were similar in the block group (6 ± 2) versus placebo group (7 ± 2), difference: −0.2 (95% CI, −1.1 to 0.7), as was opioid use (intravenous morphine equivalent dose: 15 ± 7mg [block] vs. 16 ± 9 mg [placebo]). Once discharged home, patients experienced similar pain and opioid use (13 ± 7 mg [block] vs. 12 ± 8 mg [placebo]) in the 24 h after surgery. The fascia iliaca block resulted in noticeable quadriceps weakness. There were four postoperative falls in the block group versus one fall in the placebo group. Conclusions Preoperative fascia iliaca blockade in addition to intraarticular local anesthetic injection did not improve pain control after hip arthroscopy but did result in quadriceps weakness, which may contribute to an increased fall risk. Routine use of this block cannot be recommended in this patient population.
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Wahyuni, Sri, and Nina Veronika. "Pembuatan Paving Block Dinding Beton Berbahan Baku Abu Boiler Limbah Sawit Sebagai Pengganti Parsial Pasir." Jurnal Sains dan Ilmu Terapan 4, no. 2 (December 1, 2021): 17–19. http://dx.doi.org/10.59061/jsit.v4i2.48.
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Indonesia as the largest palm oil producer in the world has problems with the amount of solid waste such as boiler ash that has not been utilized properly. This study aims to determine the effect of boiler ash on the resulting paving blocks and obtain the best paving block characteristics. Utilization of boiler ash from burning palm oil waste as a partial substitute for sand in the manufacture of concrete wall paving blocks is carried out in several stages of work, namely the stages of sifting samples, mixing, molding, drying and testing the resulting product. The making of concrete wall paving blocks is done by varying the boiler ash in the composition of the concrete mixture with the ratio of cement to boiler ash, namely 1:1, 1:2, 1:3, 1:4, and 1:5. Based on the results of characteristic testing that will be carried out on the concrete wall paving block products, which include compressive strength and absorption, the best results are obtained from the 1:1 treatment with the following characteristics: absorption capacity of 19.73% and compressive strength of 5.7 Mpa
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Terkawi, Abdullah Sulieman, Dimitris Mavridis, Daniel I. Sessler, Megan S. Nunemaker, Khaled S. Doais, Rayan Sulieman Terkawi, Yazzed Sulieman Terkawi, Maria Petropoulou, and Edward C. Nemergut. "Pain Management Modalities after Total Knee Arthroplasty." Anesthesiology 126, no. 5 (May 1, 2017): 923–37. http://dx.doi.org/10.1097/aln.0000000000001607.
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Abstract Background Optimal analgesia for total knee arthroplasty remains challenging. Many modalities have been used, including peripheral nerve block, periarticular infiltration, and epidural analgesia. However, the relative efficacy of various modalities remains unknown. The authors aimed to quantify and rank order the efficacy of available analgesic modalities for various clinically important outcomes. Methods The authors searched multiple databases, each from inception until July 15, 2016. The authors used random-effects network meta-analysis. For measurements repeated over time, such as pain, the authors considered all time points to enhance reliability of the overall effect estimate. Outcomes considered included pain scores, opioid consumption, rehabilitation profile, quality of recovery, and complications. The authors defined the optimal modality as the one that best balanced pain scores, opioid consumption, and range of motion in the initial 72 postoperative hours. Results The authors identified 170 trials (12,530 patients) assessing 17 treatment modalities. Overall inconsistency and heterogeneity were acceptable. Based on the surface under the cumulative ranking curve, the best five for pain at rest were femoral/obturator, femoral/sciatic/obturator, lumbar plexus/sciatic, femoral/sciatic, and fascia iliaca compartment blocks. For reducing opioid consumption, the best five were femoral/sciatic/obturator, femoral/obturator, lumbar plexus/sciatic, lumbar plexus, and femoral/sciatic blocks. The best modality for range of motion was femoral/sciatic blocks. Femoral/sciatic and femoral/obturator blocks best met our criteria for optimal performance. Considering only high-quality studies, femoral/sciatic seemed best. Conclusions Blocking multiple nerves was preferable to blocking any single nerve, periarticular infiltration, or epidural analgesia. The combination of femoral and sciatic nerve block appears to be the overall best approach. Rehabilitation parameters remain markedly understudied.
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Soler, Vicente, Emilio Defez, and José Antonio Verdoy. "On Exact Series Solution for Strongly Coupled Mixed Parabolic Boundary Value Problems." Abstract and Applied Analysis 2014 (2014): 1–9. http://dx.doi.org/10.1155/2014/759427.
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This paper continues with the construction of the exact solution for parabolic coupled systems of the typeut=Auxx,A1u(0,t)+B1ux(0,t)=0,A2u(l,t)+B2ux(l,t)=0,0<x<1,t>0, andu(x,0)=f(x), whereA1,A2,B1, andB2are arbitrary matrices for which the block matrix(A1B1A2B2)is nonsingular, andAis a positive stable matrix. Although this problem has been solved in the literature (Soler et al., 2013), in this work we are using completely new conditions.
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Waluyo, Budi, As'at Pujianto, and Bagus Soebandono. "Pengaruh Campuran Abu Sekam Padi terhadap Kuat Tekan Paving Block." Semesta Teknika 16, no. 2 (August 28, 2018): 139–44. http://dx.doi.org/10.18196/st.v16i2.4899.
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Rice husk is an abundant by-product of rice milling results, and so far only used as a fuel for combustion red stones, burning for cooking or thrown away. Rice husk ash (RHA) is a waste material of rice that has special properties. This material also contains chemical compounds that can be pozzolan, which contains silica (SiO2), a compound which, when mixed with cement and water can be used to enhance the compressive strength and tensile strength of concrete while silica is a chemical compound that is dominant in the rice husk ash. This study aimed to compare the results of the average compressive strength of the normal paving block with the added ingredient of rice husk ash, assess the effect of the addition of rice husk ash to the compressive strength and prices comparison between the paving block and normal paving block with the added ingredient of rice husk ash. In this study, rice husk ash serves as a replacement for cement additives with a variation of 0%, 30%, 35% and 40% by weight of cement in comparison 1pc: 10ps, 1pc: 13ps and 1pc: 15ps. The results showed that the paving blocks with a mixture of rice husk ash in comparison 1pc: 10ps produce optimum compressive strength with a mixture of rice husk ash 16.6% in the amount of 32.709 MPa. Furthermore in comparison 1pc: 13ps, paving block compressive strength values obtained with the optimal mix of rice husk ash rice 13.0% amounting to 23.709 MPa. Finally, in comparison 1pc: 15ps, paving block compressive strength values obtained with the optimal mix of rice husk ash 15.0% amounting to 17.260 MPa.
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Wang, Yue, Ziqiang Chen, Mingliang Wei, Zhijie Lin, Mingjun Shen, Fei Zhu, Chaofeng Jia, et al. "Liver Transcriptome Analysis of the Black Porgy (Acanthopagrus schlegelii) under Acute Low-Temperature Stress." Life 13, no. 3 (March 7, 2023): 721. http://dx.doi.org/10.3390/life13030721.
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High nutritional value and the development of efficient biotechnological methods of controlled production have made black porgy (Acanthopagrus schlegelii) an economically important fish in Chinese aquaculture in recent years. However, aquaculture production of the species faces multiple issues associated with reduced growth rate, low reproduction ability, and high mortality during production, which are associated with the species’ limited tolerance to low temperatures. To date, comprehensive information on the genetic-based mechanisms of cold tolerance and adaptation to low temperature in the species are still unavailable. In this study, the HiSeq™2500 (Illumina) sequencing platform was used to analyze the transcriptomic profile of the liver tissue in the black porgy subjected to different extents of cold shock, including a control temperature group (AS, T = 15 °C), an intermediate temperature group (AL1, T = 10 °C), and an acute low-temperature stress group (AL2, T = 5 °C). For this purpose, three standardized cDNA libraries of AS, AL1, and AL2 were established. We obtained 43,258,908, 48,239,072, and 38,983,833 clean reads from the AS group, AL1 group, and AL2 group, respectively. After pairwise comparison, 70 differentially expressed genes (DEGs) were identified in the examined fish groups. Among them, 60 genes were found to be significantly differentially expressed after trend analysis. GO annotation and enrichment results showed that they were mainly enriched into three categories: biological processes (12 subcategories), molecular functions (7 subcategories), and cellular components (7 subcategories). KEGG analysis results indicated that all significantly differentially expressed genes were annotated to 102 signaling pathways, including biological rhythm, cholesterol metabolism, glycerolipid metabolism, animal autophagy, FoxO signaling pathway, steroid biosynthesis, and regulation of adipocyte lipolysis and apoptosis. Four of them, namely: G6PC, GPX1, GCK, and HSPE1 were randomly selected for further qRT-PCR verification of data reliability obtained by RNA-Seq technology. In this study, we found that environmental acute cold stress mainly affected the black porgy’s biological processes related to metabolism, apoptosis, and signal transduction. The data that we have reported provides baseline information for further studies concerning the genetic responses of the black porgy under cold stress conditions, the improvement of its aquaculture production, and other economically important matters regarding their limited tolerance to cold shock.
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Abdallah, Faraj W., Jorge Mejia, Govindarajulu A. Prasad, Rebecca Moga, Jaskarandip Chahal, John Theodoropulos, Tim Dwyer, and Richard Brull. "Opioid- and Motor-sparing with Proximal, Mid-, and Distal Locations for Adductor Canal Block in Anterior Cruciate Ligament Reconstruction." Anesthesiology 131, no. 3 (September 1, 2019): 619–29. http://dx.doi.org/10.1097/aln.0000000000002817.
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Abstract Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New Background The ideal location for single-injection adductor canal block that maximizes analgesia while minimizing quadriceps weakness after painful knee surgery is unclear. This triple-blind trial compares ultrasound-guided adductor canal block injection locations with the femoral artery positioned medial (proximal adductor canal), inferior (mid-adductor canal), and lateral (distal adductor canal) to the sartorius muscle to determine the location that optimizes postoperative analgesia and motor function. The hypothesis was that distal adductor block has (1) a superior opioid-sparing effect and (2) preserved quadriceps strength, compared with proximal and mid-locations for anterior cruciate ligament reconstruction. Methods For the study, 108 patients were randomized to proximal, mid-, or distal adductor canal injection locations for adductor canal block. Cumulative 24-h oral morphine equivalent consumption and percentage quadriceps strength decrease (maximum voluntary isometric contraction) at 30 min postinjection were coprimary outcomes. The time to first analgesic request, pain scores, postoperative nausea/vomiting at least once within the first 24 h, and block-related complications at 2 weeks were also evaluated. Results All patients completed the study. Contrary to the hypothesis, proximal adductor canal block decreased 24-h morphine consumption to a mean ± SD of 34.3 ± 19.1 mg, (P < 0.0001) compared to 64.0 ± 33.6 and 65.7 ± 22.9 mg for the mid- and distal locations, respectively, with differences [95% CI] of 29.7 mg [17.2, 42.2] and 31.4 mg [21.5, 41.3], respectively, mostly in the postanesthesia care unit. Quadriceps strength was similar, with 16.7%:13.4%:15.3% decreases for proximal:mid:distal adductor canal blocks. The nausea/vomiting risk was also lower with proximal adductor canal block (10 of 34, 29.4%) compared to distal location (23 of 36, 63.9%; P = 0.005). The time to first analgesic request was longer, and postoperative pain was improved up to 6 h for proximal adductor canal block, compared to mid- and distal locations. Conclusions A proximal adductor canal injection location decreases opioid consumption and opioid-related side effects without compromising quadriceps strength compared to mid- and distal locations for adductor canal block in patients undergoing anterior cruciate ligament reconstruction.
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ten Hoope, Werner, Markus W. Hollmann, Kora de Bruin, Hein J. Verberne, Arie O. Verkerk, Hanno L. Tan, Camiel Verhamme, et al. "Pharmacodynamics and Pharmacokinetics of Lidocaine in a Rodent Model of Diabetic Neuropathy." Anesthesiology 128, no. 3 (March 1, 2018): 609–19. http://dx.doi.org/10.1097/aln.0000000000002035.
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Abstract Background Clinical and experimental data show that peripheral nerve blocks last longer in the presence of diabetic neuropathy. This may occur because diabetic nerve fibers are more sensitive to local anesthetics or because the local anesthetic concentration decreases more slowly in the diabetic nerve. The aim of this study was to investigate both hypotheses in a rodent model of neuropathy secondary to type 2 diabetes. Methods We performed a series of sciatic nerve block experiments in 25 Zucker Diabetic Fatty rats aged 20 weeks with a neuropathy component confirmed by neurophysiology and control rats. We determined in vivo the minimum local anesthetic dose of lidocaine for sciatic nerve block. To investigate the pharmacokinetic hypothesis, we determined concentrations of radiolabeled (14C) lidocaine up to 90 min after administration. Last, dorsal root ganglia were excised for patch clamp measurements of sodium channel activity. Results First, in vivo minimum local anesthetic dose of lidocaine for sciatic nerve motor block was significantly lower in diabetic (0.9%) as compared to control rats (1.4%). Second, at 60 min after nerve block, intraneural lidocaine was higher in the diabetic animals. Third, single cell measurements showed a lower inhibitory concentration of lidocaine for blocking sodium currents in neuropathic as compared to control neurons. Conclusions We demonstrate increased sensitivity of the diabetic neuropathic nerve toward local anesthetics, and prolonged residence time of local anesthetics in the diabetic neuropathic nerve. In this rodent model of neuropathy, both pharmacodynamic and pharmacokinetic mechanisms contribute to prolonged nerve block duration.
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Templin, Jay S., Matthew C. Wylie, Joseph D. Kim, Katherine E. Kurgansky, Grzegorz Gorski, John Kheir, David Zurakowski, Gabriel Corfas, and Charles Berde. "Neosaxitoxin in Rat Sciatic Block." Anesthesiology 123, no. 4 (October 1, 2015): 886–98. http://dx.doi.org/10.1097/aln.0000000000000832.
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Abstract Background: Neosaxitoxin (NeoSTX) is a site-1 sodium channel blocker undergoing clinical trials as a prolonged-duration local anesthetic. Rat sciatic block and intravenous infusion models were used to assess efficacy and local and systemic toxicities for NeoSTX in saline (NeoSTX-Saline), bupivacaine (Bup), and their combination (NeoSTX-Bup). Exploratory studies evaluated the effects of addition of epinephrine to NeoSTX-Bup (NeoSTX-Bup-Epi). Methods: Rats received percutaneous sciatic blocks with escalating doses of NeoSTX-Saline or NeoSTX-Bup. Sensory-nocifensive block was assessed using modified hotplate and Von Frey filaments. Motor-proprioceptive function was assessed by extensor postural thrust. Nerves were examined histologically after 7 days and scored on the Estebe–Myers scale. Median lethal dose was estimated for NeoSTX-Saline and in combinations. Accidental intravenous overdose was simulated in isoflurane-anesthetized, spontaneously breathing rats receiving NeoSTX-Saline (n = 6), Bup (n = 7), or NeoSTX-Bup (n = 13), with respiratory, hemodynamic, and electrocardiographic endpoints. Additional groups received blocks with NeoSTX-Bup-Epi (n = 80). Investigators were blinded for behavioral and histologic studies. Results: NeoSTX-Bup produced more prolonged sensory and motor block compared with NeoSTX-Saline or Bup. NeoSTX-Bup-Epi further prolonged median time to near-complete recovery for 3 μg/kg NeoSTX-Bup (hotplate: 48 vs. 6 h, P < 0.001). With sciatic injections, addition of Bup did not worsen the systemic toxicity (median lethal dose) compared with NeoSTX-Saline. Intravenous NeoSTX-Saline infusion had significantly longer times to apnea, first arrhythmia, and asystole compared with Bup (P < 0.001 for each). Histologic injury scores overall were low for all groups, with median scores of 0 (interquartile range, 0 to 0) on a 5-point scale. Conclusion: NeoSTX-Bup and NeoSTX-Bup-Epi hold promise for prolonged-duration local anesthesia.
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Aarab, Yassir, Severin Ramin, Thomas Odonnat, Océane Garnier, Audrey Boissin, Nicolas Molinari, Grégory Marin, Pierre-Francois Perrigault, Philippe Cuvillon, and Gérald Chanques. "Pectoral Nerve Blocks for Breast Augmentation Surgery: A Randomized, Double-blind, Dual-centered Controlled Trial." Anesthesiology 135, no. 3 (June 28, 2021): 442–53. http://dx.doi.org/10.1097/aln.0000000000003855.
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Background Pectoral nerve blocks have been proposed for analgesia during and after breast cancer surgery, but data are conflicted in aesthetic breast surgery. This trial tested the primary hypothesis that adding a preincisional pectoral nerve block is superior to systemic multimodal analgesic regimen alone for pain control after breast augmentation surgery. A second hypothesis is that rescue opioid consumption would be decreased with a long-lasting effect for both outcomes during the following days. Methods Seventy-three adult female patients undergoing aesthetic breast augmentation surgery under general anesthesia were randomly allocated to receive a pectoral nerve block versus no block. Both groups received standard care with protocolized multimodal analgesia alone including systematic acetaminophen and nonsteroidal anti-inflammatory drugs. The primary outcome measure was the maximal numerical rating scale in the first 6 h after extubation. Secondary outcomes included intraoperative remifentanil consumption and from extubation to day 5: maximal numerical rating scale, postoperative cumulative opioid consumption and postoperative opioid side effects, and patient satisfaction recorded at day 5. Results The maximal numerical rating scale score in the first 6 h was lower in the pectoral nerve block group compared with the control group (3.9 ± 2.5 vs. 5.2 ± 2.2; difference: –1.2 [95% CI, –2.3 to –0.1]; P = 0.036). The pectoral nerve block group had a lower maximal numerical rating scale between days 1 and 5 (2.2 ± 1.9 vs. 3.2 ± 1.7; P = 0.032). The cumulative amount of overall opioids consumption (oral morphine equivalent) was lower for the pectoral nerve block group from hour 6 to day 1 (0.0 [0.0 to 21.0] vs. 21.0 [0.0 to 31.5] mg, P = 0.006) and from days 1 to 5 (0.0 [0.0 to 21.0] vs. 21.0 [0.0 to 51] mg, P = 0.002). Conclusions Pectoral nerve block in conjunction with multimodal analgesia provides effective perioperative pain relief after aesthetic breast surgery and is associated with reduced opioid consumption over the first 5 postoperative days. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New
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Csizinszky, A. A., and D. J. Schuster. "Effect of UV-reflective Mulches on Tomato Yields and on the Silverleaf Whitefly, Bemisia argentifolii (Bellows & Perring)." HortScience 31, no. 4 (August 1996): 570a—570. http://dx.doi.org/10.21273/hortsci.31.4.570a.
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Field studies were conducted for three seasons, Fall 1994, Spring 1995, and Fall 1995 on the effect of UV-reflective films (mulches) on fruit yields and on the silverleaf whitefly [Bemisia argentifolii (Bellows and Perring)] of staked, fresh-market tomatoes (Lycopersicon esculentum Mill). The UV-reflective mulches were metallized aluminum (ALU) and painted aluminum (PAL) on either black or white plastic film. The AL and SL mulches were evaluated with and without a white (fall) or black (spring) 25-cm-wide painted band in the bed center. Controls were the conventional white (fall) or black (spring) polyethylene mulches. Highest reflected energy (μmol·m–2·s–1) to the plants at 25 cm from the mulch surface was measured on the ALU without white painted band or on PAL on white or black mulch with white painted band. Lowest energy was reflected from the white or black controls. Whitefly populations in the fall were lower on the ALU than on the PAL mulches. In the spring, when whitefly populations were low, number of whiteflies on tomato leaves were similar with all treatments. The proportion of plants with symptoms of the silverleaf whitefly transmitted tomato mottle virus (TMoV) were highest on controls. Yields in the fall were similar with UV-reflective or with white mulch. In the spring, fruit size and marketable yields were greater (P < 0.05) on plants with PAL on white plastic film without black band than on black control.
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Kant, Abhinav, Pawan Kumar Gupta, Sarah Zohar, Sylvie Chevret, and Philip M. Hopkins. "Application of the Continual Reassessment Method to Dose-finding Studies in Regional Anesthesia." Anesthesiology 119, no. 1 (July 1, 2013): 29–35. http://dx.doi.org/10.1097/aln.0b013e31829764cf.
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Abstract Background Previously reported estimates of the ED95 doses for local anesthetics used in brachial plexus blocks vary. The authors used the continual reassessment method, already established in oncology trials, to determine the ED95 dose for 0.5% bupivacaine for the ultrasound-guided supraclavicular block. Methods A double-blind, prospective trial was scheduled for 40 patients of American Society of Anesthesiologists class I–III presenting for upper limb surgery and supraclavicular block. The study dose to be administered was arbitrarily divided into six dose levels (12, 15, 18, 21, 24, and 27 ml) with a priori probabilities of success of 0.5, 0.75, 0.90, 0.95, 0.98, and 0.99 respectively. A continual reassessment method statistical program created a dose–response curve, which would shift direction depending on the success or failure of the block. Our starting dose was 21 ml and the next allocated dose was reestimated by the program to be the dose level with the updated posterior response probability closest to 0.95. Results After recruitment of eight patients, our initial dose levels and associated probabilities were deemed too low to determine the ED95. Updated a prioris were calculated from the statistical program, and the study recommenced with a new starting dose of 30 ml. On completion, the ED95 dose was estimated to be 27 ml (95% CI, 24–28 ml). Conclusions The continual reassessment method trial design provided a credible estimate for the ED95 dose for 0.5% bupivacaine for our technique of supraclavicular block and may be of value as a statistically robust method for dose-finding studies in anesthesiology.
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Liu, Jun, Hong Hong Zhou, and Bing Zhang. "Effect of Rice Straw Amount Portion on Physical Properties of Adding Admixtures Hollow Block." Advanced Materials Research 450-451 (January 2012): 727–32. http://dx.doi.org/10.4028/www.scientific.net/amr.450-451.727.
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This study presents the impact of rice straw as additive material on physical properties of hollow block as compressive, flexural strength and water absorption, Softening coefficient. Through testing the hollow block physical properties, the of rice straw additive was studied. When the rice straw amount portion was 0~15%, with rice straw amount portion increased, compressive, flexural strength and water resistance effect of adding one kind of early strength agent and mixing Al2(SO4)3, CaCl2 early strength agent hollow block decreased gradually. When the rice straw amount portion was 10%, adding early strength agent Al2(SO4)3, CaCl2 ，the 28d compressive strength of hollow block was minimum, 3.5MPa; while mixing CaCl2, Al2(SO4)3 early strength agent, the hollow block softening coefficient was 0.76, water absorption rate was 3.9%, meet the requirements of national standard of common concrete hollow block. Through the experiment, the conclusion is mixing early strength agent Al2(SO4)3, CaCl2, Obviously superior to adding one kind of —early strength agent—Al2(SO4)3 or CaCl2 on the physical properties of hollow block.
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Schulz, Kate. "Internet filters in Canadian libraries." Pathfinder: A Canadian Journal for Information Science Students and Early Career Professionals 1, no. 2 (May 8, 2020): 36–50. http://dx.doi.org/10.29173/pathfinder23.
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Internet filters can be understood as any method that “[blocks] content [from] coming into and going out to the Internet” (PC Magazine, n.d., para. 1). Instantaneously, the word ‘blocks’ causes advocates of intellectual freedom to stand at attention. The American Library Association’s (ALA) Library Bill of Rights states: “a person’s right to use a library should not be denied or abridged because of origin, age, background, or views” (as cited in Houghton-Jan, 2010, p. 40). More specific to the topic at hand: “the use of Internet filters to block constitutionally protected speech … compromises First Amendment freedoms and the core values of librarianship” (ALA, n.d., para. 1). This paper will investigate and discuss the function of and methodology behind internet filters, with specific attention to their application in Canada. Following a general overview, a discussion follows of what library professionals in public and school libraries should do to uphold and protect intellectual freedom.