Early Paleozoic basement diorite of arc-magmatism from Kutch basin, Western India

In this study,we report for thefirst time an Early Palaeozoic basement diorite from the drilled well Nirona-A in the Banni Half-Graben of the Kutch basin,western India.The 40Ar–39Ar dates provided a plateau age of 441.84±2.66 Ma and another pseudo plateau of 441.28±5.82 to 388.08±16.65 Ma for the basement diorite.These ages constrain the basement formation age to the Late Ordovician-Early Silurian period.The obtained basement ages are correlatable with the later part of Cambro-Ordovician alkaline magmatism that has been reported from the Huqf area in Central Oman,whereas their lithological and petrographic correlativity with base-ment diorites occurring in the Dinsi Body of Nagar Parkar igneous complex in Pakistan can also be envisaged.The geochemical studies characterized the diorite with enrich-ment of LILE(Rb,Ba,and K)and LREE(La,Ce,Nd),strong depletion of HFSE(Nb,Sr,P,and Ti),along with weakly negative Eu anomalies.The geochemical signatures indicate their petrogenetic affiliation with mantle-derived magmas,as well as their tectonic setting to be arc-related,having post-collisional continental-arc type affinity.The*440 Ma basement of Kutch,therefore,appears to rep-resent the later thermal event associated with the reworked Neoproterozoic subduction-related suite from Greater India’s northwest edge,which has implications for Gond-wana assembly in the northwest Indian subcontinent.

Chart Review of PACU Outcomes for Patients Who Had Ambulatory Shoulder Surgery with Peripheral Nerve Block (PNB) and General Anesthesia Compared to General Anesthesia (GA)

Introduction: Today, regional anesthetics are frequently used in combination with general anesthesia. The purpose of two different techniques is to attain distinct goals. We believed that the use of PNB with the minimization of GA in the ambulatory setting would result in a decreased opioid requirement and subsequently fewer treatment-related side effects, more awake and pain free patients and shorter PACU stays and earlier discharges when compared with general anesthesia alone. Methods: Prior to the start of this retrospective chart review, IRB approval was obtained. Patient’s charts were selected based on the following criteria: The control group had a general anesthetic (GA) and did not have a PNB, and the experimental group (PNB/GA) had a PNB and a general anesthetic. Our primary endpoints were PACU length of stay, pain scores, use of opioids and uses of anti-emetics. Results: We found that patient with blocks used less analgesic in the PACU, 3.97 mg vs. 1.39 mg (morphine equivalents). They also appeared to use less antiemetic drugs: 14/19 (patient s without PNB) vs. 7/18. Additionally, the patients that received a block had a statistically shorter PACU stay 107 min vs. 163 min. Conclusion: Patients that did not receive PNB had a significantly longer PACU stay. Additionally the data suggest that the use of PNB’s reduces the use of post-op narcotics, which may be related to the lower use of postoperative antiemetic drugs observed.

Evaluation of the Efficacy of Liposomal Bupivacaine Infiltrated into the Posterior Capsule for Postoperative Analgesia after Total Knee Arthroplasty—A Randomized Double Blind Clinical Trial

Achieving adequate control of postsurgical pain remains a challenge in patients undergoing Total Knee Arthroplasty (TKA). The objective of this study was to assess if liposomal bupivacaine injected into the posterior capsule, in combination with a femoral nerve block and multimodal pain control regimen, would result in better pain control. The two groups were similar with regards to demographics and method of intraoperative anesthesia. Infiltration into the posterior capsule with liposomal bupivacaine had significantly lower resting pain scores compared to the saline group. Patients in the liposomal bupivacaine group also used slightly less breakthrough narcotic (5.75 to 4.31 mg of morphine equivalence). We recommend the use of infiltration of liposomal bupivacaine into the posterior capsule as an adjunct in multimodal analgesia in TKA patients to reduce pain and resultant narcotic use.

银行业的未来

Fintech公司从付款到贷款再到资本市场对金融服务价值链的全面＂入侵＂正在大幅改变银行业的面貌。比尔盖茨曾说过＂人们不需要银行,但是需要银行业。＂

Cotton Databases and Web Resources

There are several web sites for whichinformation is available to the cotton researchcommunity.Most of these sites relate toresources developed or available to the researchcommunity.Few provide bioinformatic tools,which usually relate to the specific data sets andmaterials presented in the database.Just as thebioinformatics area is evolving,the

A Case Series of 12 Patients Receiving Bilateral Transverse Abdominis Plane Blocks after Cesarean Section

Transverse abdominis Plane blocks (TAP) provide effective postoperative analgesia following surgical incisions of the lower and middle abdominal wall, including those associated with cesarean section. This study investigated the efficacy of liposomal bupivacaine diluted with 0.25% bupivacaine administered in bilateral TAP blocks for post-operative analgesia after Ce-sarean section preformed under neuraxial anesthesia. The patients who received the TAP blocks with liposomal bupivacaine had noticeably low pain scores of 1.0 ± 1.4, 1.4 ± 2.1, 1.7 ± 1.9, 1.9 ± 3.3 and 1.9 ± 2.3 at 6, 12, 24, 48 and 72 hours respectively. Only 3 patients used oxycodone (5 mg)/acetaminophen (325 mg) postoperative. One patient took two tables of oxycodone (5 mg)/acetamino-phen (325 mg) after 24 hours, a second patient used oxycodone (5 mg)/aceta-minophen (325 mg) after 72 hours and the third patient was transferred to the intensive care unit (ICU) since she developed postpartum cardiac complications, and was give oxycodone (5 mg)/acetaminophen (325 mg) despite having a 0 pain score. These results suggest that patients treated bilateral TAP blocks with a mixture of liposomal and regular bupivacaine will have low pain scores, high patient satisfaction and reduce the use of postoperative narcotics.

Randomized Trial of the Use of Dexmedetomidine vs. Propofol after Regional Blockade in Shoulder Surgery Patients in Beach Chair Position

Background: Propofol is often the drug of choice for ambulatory orthopedic cases. However, propofol can be associated with apnea or other events requiring airway interventions. Dexmedetomidine (Dex) has the unique pharmacologic profile of providing sedation without respiratory depression. This is particularly relevant in patients with morbid obesity and/or challenging airways. The hypotheses were: 1) Propofol would cause more apnea or require more airway manipulations than dexmedetomidine;2) Propofol would have shorter post anesthesia unit recovery times;and 3) Dexmedetomidine would be associated with more bradycardia and hypotension. Methods: After IRB approval, 50 patients were randomized to receive either propofol or Dex for Total Intravenous anesthesia (TIVA) after interscalene brachial plexus block was performed preoperatively under ultrasound guidance. The main end points that we measured where: airway interventions, intra-operative bradycardia, hypotension, and PACU length of stay. Results: There were more airway interventions in the propofol group compared to the Dex group. Additionally, the Dex group had significantly longer PACU stays. Conclusion: We would recommend that Dex should be preferentially considered for patients predisposed to airway obstruction;however, the standard use of Dex over Propofol needed to reconsider since the use of Dex as the agent for TIVA was associated with longer PACU stays.

A Simple Technique to Improve Standard Nasotracheal Intubation

NTI is included in the ASA difficult airway algorithm. However, even with the assistance of a Magill forceps, it might be difficult to place the endotracheal (ET) tube in the trachea because of the angle at which the tube approaches the glottis opening and the inability to bend the tube secondary to the ET-tubes compliance. By placing a soft suction catheter thru the ET-tube, and placing the suction catheter into the trachea first and sliding the tube over the catheter this problem can be avoided. In addition, grabbing the suction catheter rather than the ET-tube, also prevents the rupturing of the ET-tube balloon by the Magill forceps.

Use of Liposomal Bupivacaine (Exparel) for Reduction in the Use of Postoperative Narcotics in an Obese Patient Undergoing Modified Radical Mastectomy

Background: Obesity, particularly in the setting of comorbid disease, presents a unique challenge. Clinicians are pursuing areas of multimodal analgesia in an effort to minimize narcotic dosages. Post-operatively, their pain management can be even more challenging, which includes appropriate use of narcotics in a patient that has a high probably of sleep apnea. Aim: To show that the use of liposomal bupivacaine (Exparel) can provide effective post-operative pain relief and decrease the use of post-operative narcotics. Case: We report on a 62 years old female with a history of hypertension, obesity and a greater than a 40 pack year history of smoking who presented for a modified radical mastectomy with a lymph node dissection. At the end of the case, the patient’s wound was infiltrated with both free bupivacaine and Exparel that minimized her need for post-operative narcotics. Conclusion: We believe that the use of extended release local anesthetics should be considered when there is a need to reduce the use of post-operative narcotics.

儿童口服尼美舒利的安全性随机对照试验的系统评价（节选）

对象和方法 入围标准①随机对照试验：给药组口服尼美舒利，对照组口服其他止痛、抗炎、退热药或安慰剂。剔除直肠给药方式的试验。②各受试者严格限于〈18岁的儿童。③各试验必须对1种或多种不良反应作出评价。

Effect of biochar type on infiltration,water retention and desiccation crack potential of a silty sand

Biochar is a carbon-rich material obtained after thermochemical conversion of biomass under no oxygen environment.The effect of biochar amendment on soil properties,such as water retention,infiltration and desiccation crack potential was studied in the recent years.However,the effect of biochar or feedstock type on these properties is not explicit.This study investigates the effect of two different(in terms of feedstock)types of biochar on the water retention,infiltration and desiccation crack-ing behavior of compacted silty sand.Water retention characteristics,infiltration rate and the progression of desiccation cracks were measured after compacting soil amended with 5-10%(w/w)biochar produced from water hyacinth(WHB)and mesquite.Measurements were also taken for an unpyrolyzed material coir pith(CP,sourced from coconut husk)-amended soil for comparing the results of biochar-amended soil.The results show that the amendment of 5%to 10%biochar increased the maximum water holding capacity(θs),air entry value(AEV)and water content at 1500 kPa(θ1500)of the soil,whereas decreased the infiltration rate and peak crack intensity factor(CIF)of the soil.Moreover,the application of CP increased the infiltration rate.The amendment of WHB showed the highest increment in AEV andθ1500 and the highest decrement in infiltration rate and CIF compared to the other amendments.Based on the results,it is advisable to use the WHB-amended soil in bioengineered structures that could promote the growth of vegetation by higher water retention and could reduce the potential of leachate formation by decreasing water infiltration and desiccation crack potential.