Comparison of Propofol and Fentanyl for Preventing Emergence Agitation Following Sevoflurane Anesthesia in Pediatric Patients: A Single-Center Study in Bangladesh

Background: Emergence agitation (EA) is a common phenomenon observed in pediatric patients following general anesthesia. This study aimed to assess the efficacy of propofol and fentanyl in preventing EA and to compare their associated complications or side effects. Methods: This prospective randomized observational comparative study was conducted at Dhaka Medical College Hospital from July 2013 to June 2014. The study aimed to evaluate the effects of propofol and fentanyl on EA in children aged 18 to 72 months undergoing circumcision, herniotomy, and polypectomy operations. Ninety children were included in the study, with 45 in each group. Patients with psychological or neurological disorders were excluded. Various parameters including age, sex, weight, American Society of Anesthesiologists (ASA) class, duration of anesthesia, Saturation of Peripheral Oxygen (SPO2), heart rate (HR), respiratory rate (RR), Pediatric Anesthesia Emergence Delirium (PAED) score, duration of post-anesthesia care unit (PACU) stay, incidence of laryngospasm, nausea, vomiting, and rescue drug requirement were compared between the two groups. Results: Age, sex, weight, ASA class, and duration of anesthesia were comparable between the two groups. Perioperative SpO2 and HR were similar in both groups. However, the PAED score was significantly higher in the fentanyl group during all follow-ups except at 30 minutes postoperatively. The mean duration of PACU stay was significantly longer in the fentanyl group. Although the incidence of laryngospasm was higher in the fentanyl group, it was not statistically significant. Conversely, nausea or vomiting was significantly higher in the fentanyl group. The requirement for rescue drugs was significantly higher in the fentanyl group compared to the propofol group. Conclusion: Both propofol and fentanyl were effective in preventing emergence agitation in pediatric patients undergoing various surgical procedures under sevoflurane anesthesia. However, propofol demonstrated a better safety profile with fewer incidences of nausea, vomiting, and rescue drug requirements compared to fentanyl.

Fentanyl and xylazine crisis:Crafting coherent strategies for opioid overdose prevention

The United States is in the throes of a severe opioid overdose epidemic,primarily fueled by the pervasive use of fentanyl and the emerging threat of xylazine,a veterinary sedative often mixed with fentanyl.The high potency and long duration of fentanyl is compounded by the added risks from xylazine,heightening the lethal danger faced by opioid users.Measures such as enhanced surveillance,public awareness campaigns,and the distribution of fentanylxylazine test kits,and naloxone have been undertaken to mitigate this crisis.Fentanyl-related overdose deaths persist despite these efforts,partly due to inconsistent policies across states and resistance towards adopting harm reduction strategies.A multifaceted approach is imperative in effectively combating the opioid overdose epidemic.This approach should include expansion of treatment access,broadening the availability of medications for opioid use disorder,implementation of harm reduction strategies,and enaction of legislative reforms and diminishing stigma associated with opioid use disorder.

Post-processing Free Quantum Random Number Generator Based on Avalanche Photodiode Array

Quantum random number generators adopting single negligible dead time of avalanche photodiodes （APDs） photon detection have been restricted due to the non- We propose a new approach based on an APD array to improve the generation rate of random numbers significantly. This method compares the detectors＇ responses to consecutive optical pulses and generates the random sequence. We implement a demonstration experiment to show its simplicity, compactness and scalability. The generated numbers are proved to be unbiased, post-processing free, ready to use, and their randomness is verified by using the national institute of standard technology statistical test suite. The random bit generation efficiency is as high as 32.8% and the potential generation rate adopting the 32× 32 APD array is up to tens of Gbits/s.

Pre-processing and post-processing method for geostress simulation using seismic interpretation results

In order to carry out numerical simulation using geologic structural data obtained from Landmark(seismic interpretation system), underground geological structures are abstracted into mechanical models which can reflect actual situations and facilitate their computation and analyses.Given the importance of model building, further processing methods about traditional seismic interpretation results from Landmark should be studied and the processed result can then be directly used in numerical simulation computations.Through this data conversion procedure, Landmark and FLAC(the international general stress software) are seamlessly connected.Thus, the format conversion between the two systems and the pre-and post-processing in simulation computation is realized.A practical application indicates that this method has many advantages such as simple operation, high accuracy of the element subdivision and high speed, which may definitely satisfy the actual needs of floor grid cutting.

Development of a Post-Processing Automation Procedure for the GPS-Based Travel Time Data Collection Technique

The travel time data collection method is used to assist the congestion management. The use of traditional sensors (e.g. inductive loops, AVI sensors) or more recent Bluetooth sensors installed on major roads for collecting data is not sufficient because of their limited coverage and expensive costs for installation and maintenance. Application of the Global Positioning Systems (GPS) in travel time and delay data collections is proven to be efficient in terms of accuracy, level of details for the data and required data collection of man-power. While data collection automation is improved by the GPS technique, human errors can easily find their way through the post-processing phase, and therefore data post-processing remains a challenge especially in case of big projects with high amount of data. This paper introduces a stand-alone post-processing tool called GPS Calculator, which provides an easy-to-use environment to carry out data post-processing. This is a Visual Basic application that processes the data files obtained in the field and integrates them into Geographic Information Systems (GIS) for analysis and representation. The results show that this tool obtains similar results to the currently used data post-processing method, reduces the post-processing effort, and also eliminates the need for the second person during the data collection.

A study on fast post-processing massive data of casting numerical simulation on personal computers

When castings become complicated and the demands for precision of numerical simulation become higher,the numerical data of casting numerical simulation become more massive.On a general personal computer,these massive numerical data may probably exceed the capacity of available memory,resulting in failure of rendering.Based on the out-of-core technique,this paper proposes a method to effectively utilize external storage and reduce memory usage dramatically,so as to solve the problem of insufficient memory for massive data rendering on general personal computers.Based on this method,a new postprocessor is developed.It is capable to illustrate filling and solidification processes of casting,as well as thermal stess.The new post-processor also provides fast interaction to simulation results.Theoretical analysis as well as several practical examples prove that the memory usage and loading time of the post-processor are independent of the size of the relevant files,but the proportion of the number of cells on surface.Meanwhile,the speed of rendering and fetching of value from the mouse is appreciable,and the demands of real-time and interaction are satisfied.

A method of line spectrum extraction based on target radiated spectrum feature and its post-processing

To improve the ability of detecting underwater targets under strong wideband interference environment,an efficient method of line spectrum extraction is proposed,which fully utilizes the feature of the target spectrum that the high intense and stable line spectrum is superimposed on the wide continuous spectrum.This method modifies the traditional beam forming algorithm by calculating and fusing the beam forming results at multi-frequency band and multi-azimuth interval,showing an excellent way to extract the line spectrum when the interference and the target are not in the same azimuth interval simultaneously.Statistical efficiency of the estimated azimuth variance and corresponding power of the line spectrum band depends on the line spectra ratio(LSR)of the line spectrum.The change laws of the output signal to noise ratio(SNR)with the LSR,the input SNR,the integration time and the filtering bandwidth of different algorithms bring the selection principle of the critical LSR.As the basis,the detection gain of wideband energy integration and the narrowband line spectrum algorithm are theoretically analyzed.The simulation detection gain demonstrates a good match with the theoretical model.The application conditions of all methods are verified by the receiver operating characteristic(ROC)curve and experimental data from Qiandao Lake.In fact,combining the two methods for target detection reduces the missed detection rate.The proposed post-processing method in2-dimension with the Kalman filter in the time dimension and the background equalization algorithm in the azimuth dimension makes use of the strong correlation between adjacent frames,could further remove background fluctuation and improve the display effect.

Improved Sinusoid Analysis and Post-Processing in Parametric Audio Coding

This paper proposed improvements to the low bit rate parametric audio coder with sinusoid model as its kernel. Firstly, we propose a new method to effectively order and select the perceptually most important sinusoids. The sinusoid which contributes most to the reduction of overall NMR is chosen. Combined with our improved parametric psychoacoustic model and advanced peak riddling techniques, the number of sinusoids required can be greatly reduced and the coding efficiency can be greatly enhanced. A lightweight version is also given to reduce the amount of computation with only little sacrifice of performance. Secondly, we propose two enhancement techniques for sinusoid synthesis: bandwidth enhancement and line enhancement. With little overhead, the effective bandwidth can be extended one more octave; the timbre tends to sound much brighter, thicker and more beautiful.

A Post-Processing Algorithm for Boosting Contrast of MRI Images

Low contrast of Magnetic Resonance(MR)images limits the visibility of subtle structures and adversely affects the outcome of both subjective and automated diagnosis.State-of-the-art contrast boosting techniques intolerably alter inherent features of MR images.Drastic changes in brightness features,induced by post-processing are not appreciated in medical imaging as the grey level values have certain diagnostic meanings.To overcome these issues this paper proposes an algorithm that enhance the contrast of MR images while preserving the underlying features as well.This method termed as Power-law and Logarithmic Modification-based Histogram Equalization(PLMHE)partitions the histogram of the image into two sub histograms after a power-law transformation and a log compression.After a modification intended for improving the dispersion of the sub-histograms and subsequent normalization,cumulative histograms are computed.Enhanced grey level values are computed from the resultant cumulative histograms.The performance of the PLMHE algorithm is comparedwith traditional histogram equalization based algorithms and it has been observed from the results that PLMHE can boost the image contrast without causing dynamic range compression,a significant change in mean brightness,and contrast-overshoot.

Hybrid Post-Processing Procedure for Displacement-Based Plane Elements

In the analysis of high-rise building, traditional displacement-based plane elements are often used to get the in-plane internal forces of the shear walls by stress integration. Limited by the singular problem produced by wall holes and the loss of precision induced by using differential method to derive strains, the displacement-based elements cannot always present accuracy enough for design. In this paper, the hybrid post-processing procedure based on the Hellinger-Reissner variational principle is used for improving the stress precision of two quadrilateral plane elements. In order to find the best stress field, three different forms are assumed for the displacement-based plane elements and with drilling DOF. Numerical results show that by using the proposed method, the accuracy of stress solutions of these two displacement-based plane elements can be improved.

Manner of Death and Fentanyl Related Drug Overdose Trends in Marion County, Indiana, US from 2018 to 2021

The purpose of this research was to investigate the manner of deaths in Marion County, throughout the years of 2018 to 2021 to see if there were any correlative increases in homicide, suicide, natural, accidental, or drug overdose related deaths. We surveyed the incidence of all deaths that occurred from 2018 through 2021 which came through the Marion County Coroner’s Office, Indiana. The data was then divided into two halves. According to the data, the leading manner of death in the first half and second half was accidental. This study revealed a total of 8732 cases: 3817 of them were observed to be accidental, 3092 natural, 956 homicide, 689 suicide, and 178 were undetermined. There were initially 318 drug overdose related deaths in 2018 and they increased to 2163 by 2021. In 2018, the number of deaths due to fentanyl related overdoses increased from 195 to 799 in 2021. This research will contribute to the forensic science field by providing information about the manner of death and fentanyl trends in Marion County over the last four years.

环泊酚与异丙酚在纤维支气管镜检查中的有效性和安全性对比

目的比较接受纤维支气管镜检查的患者使用环泊酚与异丙酚的有效性和安全性。方法选取2023年3—6月在山东省聊城市人民医院接受纤维支气管镜检查的92例患者,随机数字表法均分为环泊酚组和异丙酚组。主要观察指标是纤维支气管镜检查的成功率,次要结果包括人口统计学特征、时间指标、血流动力学、咳嗽严重程度、插管条件、最低氧饱和度、患者和内镜医生的满意度评分、患者重复纤维支气管镜检查意愿以及不良事件的发生率。结果与异丙酚组相比,环泊酚组患者时间指标差异无统计学意义(P>0.05);重复纤维支气管镜检查的意愿、血流动力学、最低氧饱和度以及患者和内镜医生的满意度显著提高(P<0.05)。环泊酚组纤维支气管镜检查成功完成率为91.30%(42/46,95%CI 82.80%~99.80%),异丙酚组纤维支气管镜检查成功完成率为89.13%(41/46,95%CI 79.80%~98.50%)。2组纤维支气管镜检查成功完成率的差异为2.17%(95%CI 1.30%~3.00%)。因此,在接受纤维支气管镜检查的患者中,环泊酚组被认为不劣于异丙酚组(χ^(2)=0.123,P>0.05)。结论环泊酚组患者在纤维支气管镜检查中的有效性不低于丙泊酚组,同时,患者重复纤维支气管镜检查的意愿和满意度均显著提高。

表面增强拉曼光谱技术在新精神活性物质检测中的应用

表面增强拉曼光谱技术具有高灵敏的吸附增强效应,提供更强的拉曼信号,通过观察到的特有分子指纹信息可以对分析物做出鉴别.各类新精神活性物质均有相应的特征拉曼信号,因此将表面增强拉曼光谱技术应用于合成大麻素类、合成卡西酮类、哌嗪类、色胺类、氯胺酮及苯环利定类和芬太尼类等新精神活性物质检测中.方法具有灵敏度高、样品处理简单和检测快速的优点,可为鉴定新精神活性物质的结构类别提供科学依据.本文介绍近年来表面增强拉曼光谱技术在各类新精神活性物质检测中的应用进展,旨在为新精神活性物质的筛查提供参考.

Transdermal Fentanyl for Management of Cancer Pain in Elderly Patients in China

Objective: Objective: To assess the effect and adverse effects of transdermal fentanyl for elderly patients with cancer pain in China. Methods: A total of 1664 elderly patients (aged 65-90 with mean age of 72.6) with cancer pain enrolled in the multicenter study from 136 institutes in China. Of them, 408 (28.8%) patients were 75 years old or older. All patients received transdermal fentanyl for the management of cancer pain. The patients were asked to record the attacks of pain, quality of life, and any side effects of the treatment. Results: Baseline mean of pain intensity was 7.34. On day 1, 3, 6, 9 15, and 30, the pain mean scores were decreased to 3.82, 2.80, 2.43, 2.11, 1.83, 1.64 (P=0.000). The effective rate was 97.18%. The mean doses of fentanyl was 31.34 g/h (25-150 g/h) initially, and 40.59 g/h and 47.50 g/h (25-200 g/h) at day 15 and day 30. At treatment day 15, the dose of fentanyl was ranger from 25 to 50 g/h in 91.8% of patients, 75 to 100 g/h in 7.5% patients, and 125 to 200 g/h only in 0.8% patients. The fine quality of life was in 25.4% patients before treatment, and was 71.15% and 73.04% at day 15 and day 30 respectively (P=0.0000). The common side effects were constipation (10.70%), nausea (11.96%), dizzy (6.85%), vomiting (3.85%), sedation (2.40%), Respiratory depression (0.12%). 86.2% patients preferred continue treated by transdermal fentanyl. Conclusions: Transdermal fentanyl for the elderly with cancer pain is effective, safe, convenient, and can improve the quality of life. Transdermal fentanyl can be recommended as a first-line drug for the treatment of elderly patients with moderate to severe cancer pain, and the initial doses is recommended as 25 g/h.

The Effect of Test Dose Fentanyl on Predicting Postoperative Respiratory Depression in Patients with Continuous Intravenous Morphine Analgesia

Objective: To evaluate the effect of test dose fentanyl on predictingpostoperative analgesia and respiratory depression. Methods: Preoperatively the lowest pulseoximeter saturation (SpO_2) under room air breathing was measured after 2 μg/kg of fentanyl givenintravenously in 35 patients who were scheduled with continuous intravenous morphine analgesia (12μg·kg^(-1)·h^(-1)) postoperatively. Results: The test dose fentanyl resulted in respiratorydepression in 19 of 35 cases, while 8 (42.1%) of the 19 cases developed respiratory depressionpostoperatively. However in the rest 16 patients, no patient (0) developed respiratory depression (P< 0.01). The fentanyl-induced lowest SpO_2 significantly correlated with the lowest SpO_2postoperatively (P < 0.01). The analgesia effect in terms of verbal analogue scale was correlatedneither with the fentanyl-induced lowest SpO_2 nor with the lowest SpO_2 postoperatively (P > 0.05).Conclusion: The patient who was sensitive to fentanyl-induced respiratory depression would take ahigh risk to develop postoperative respiratory depression with intravenous morphine analgesia andthe patient with respiratory depression does not always go with satisfactory analgesia.

鞘内注射舒芬太尼与芬太尼对高龄股骨粗隆骨折PFNA内固定术患者的镇痛效果及安全性对比

目的:对比鞘内注射舒芬太尼与芬太尼对高龄股骨粗隆骨折近端股骨钉抗旋(PFNA)内固定术患者的镇痛效果及安全性对比。方法:选取2019年1月—2022年12月于常熟市第五人民医院接受股骨粗隆骨折PFNA内固定术的108例高龄患者作为研究对象,根据随机数表法将患者分为研究组54例与常规组54例。研究组采用鞘内注射舒芬太尼,常规组采用鞘内注射芬太尼。比较两组手术时间、镇痛时间、术后6 h、12 h视觉模拟评分法(VAS)评分及不良反应发生情况。结果:两组手术时间比较,差异无统计学意义(P>0.05);研究组镇痛时间长于常规组,差异有统计学意义(P<0.05)。研究组术后6 h、12 h VAS评分低于常规组,且两组术后12 h VAS评分低于术后6 h,差异有统计学意义(P<0.05)。研究组不良反应发生率低于常规组,差异有统计学意义(P<0.05)。结论:相比芬太尼,舒芬太尼在高龄股骨粗隆骨折PFNA内固定术患者中的镇痛作用显著,能缓解术后疼痛,还可降低不良反应发生率。

Non-crossing Quantile Regression Neural Network as a Calibration Tool for Ensemble Weather Forecasts

Despite the maturity of ensemble numerical weather prediction(NWP),the resulting forecasts are still,more often than not,under-dispersed.As such,forecast calibration tools have become popular.Among those tools,quantile regression(QR)is highly competitive in terms of both flexibility and predictive performance.Nevertheless,a long-standing problem of QR is quantile crossing,which greatly limits the interpretability of QR-calibrated forecasts.On this point,this study proposes a non-crossing quantile regression neural network(NCQRNN),for calibrating ensemble NWP forecasts into a set of reliable quantile forecasts without crossing.The overarching design principle of NCQRNN is to add on top of the conventional QRNN structure another hidden layer,which imposes a non-decreasing mapping between the combined output from nodes of the last hidden layer to the nodes of the output layer,through a triangular weight matrix with positive entries.The empirical part of the work considers a solar irradiance case study,in which four years of ensemble irradiance forecasts at seven locations,issued by the European Centre for Medium-Range Weather Forecasts,are calibrated via NCQRNN,as well as via an eclectic mix of benchmarking models,ranging from the naïve climatology to the state-of-the-art deep-learning and other non-crossing models.Formal and stringent forecast verification suggests that the forecasts post-processed via NCQRNN attain the maximum sharpness subject to calibration,amongst all competitors.Furthermore,the proposed conception to resolve quantile crossing is remarkably simple yet general,and thus has broad applicability as it can be integrated with many shallow-and deep-learning-based neural networks.

基于Cite Space文献分析并观察不同剂量艾司氯胺酮在无痛人工流产术应用效果

目的:运用Cite Space对中国知网(CNKI)数据库主题词“无痛人工流产”和“艾司氯胺酮”的文献进行分析,寻找无痛人工流产研究热点,探讨不同剂量艾司氯胺酮在无痛人工流产术中应用效果。方法:分别以“无痛人工流产”“艾司氯胺酮”为主题词,检索CNKI数据库,将检索得到文献导入CiteSpace软件,荟聚分析2012年1月-2023年1月国内外无痛人工流产研究的前沿热点。选取2023年3-6月本院门诊行无痛人工流产者160例,采用队列分组,艾司氯胺酮(0.1mg/kg)+丙泊酚(E1组),艾司氯胺酮(0.2mg/kg)+丙泊酚(E2组),艾司氯胺酮(0.3mg/kg)+丙泊酚(E3组),芬太尼(1ug/kg)+丙泊酚(F组)。观察各组诱导前(T1)、宫口扩张时(T2)及手术结束(T3)时的心率(HR)、血压(BP)、血氧饱和度(SPO_(2))。记录受术者术后苏醒时间、丙泊酚用量、苏醒后15minVAS评分、麻醉效果以及不良反应发生率。结果:纳入分析的中文文献2210篇,热点变迁分析显示艾司氯胺酮关临床研究文献增多,为无痛人工流产研究热点。临床观察显示,E1组、E2组、E3组T2、T3时MAP和SPO_(2)均高于F组,T2时HR均高于F组(均P<0.05),T3时各组HR无差异(P>0.05)。E2和E3组VAS评分均低于E1组和F组,E1、E2、F组苏醒时间和嗜睡发生率均优于E3组,E1组、E2组、E3组麻醉效果优良率(95.0%、97.5%、97.5%)均优于F组(80.0%),呼吸抑制发生率(5.0%、7.5%、5.0%)均低于F组(27.5%)(均P<0.05)。各组头晕头痛、恶心呕吐、注射痛发生率无差异(P>0.05)。结论:基于CNKI数据库文献荟萃分析发现艾司氯胺酮是目前无痛人工流产领域研究热点,本文临床观察0.2mg/kg艾司氯胺酮复合丙泊酚用于无痛人工流产效果及安全性最佳。

芬太尼类物质的荧光适配体传感器构建及应用

近年来报道,新精神活性物质伪装成零食、饮料等形式进入并潜伏在大众日常生活中。其中芬太尼类物质是典型代表,市场监管和公安侦查均迫切需要现场快速筛查技术和产品的支撑。基于适配体的快速检测技术发展迅速,然而特异性芬太尼类物质适配体研究相对缺乏。该文以芬太尼类物质的核心结构类似物的裁剪适配体为识别元件,以Fe_(3)O_(4)作为猝灭剂和磁分离剂,利用荧光猝灭技术构建适配体传感平台,对芬太尼类物质实现广谱识别。结果表明,该荧光传感器检测芬太尼类物质为100~500μg/L,R为0.9977,检测限为19.7μg/L,相对标准偏差为5.91%~7.51%,在非居民用水和居民用水中加标回收率分别为81.14%~91.54%和106.7%~117.4%,可用于水样芬太尼类物质的快速筛查,填补芬太尼总量广谱快速检测方面研究的空白。

白噪声联合握力球干预对心房颤动射频消融术患者的影响

目的探讨白噪声联合握力球干预对心房颤动射频消融术患者的影响。方法将177例行射频消融术的心房颤动患者按照随机数字表法分为三组各59例。对照组术中给予常规护理;握力球组在对照组的基础上持握力球,术中不适时随意加压握力球;白噪声+握力球组(联合组)在握力球组的基础上进入手术室即佩戴耳机播放预先选择的白噪声音乐。结果三组分别有51、52、50例完成研究。干预后,在消融术10 min时(T2)、消融到左右肺静脉前壁(T3)和后壁(T4)时,三组疼痛评分、焦虑评分、芬太尼使用总剂量比较,差异有统计学意义,且联合组显著低于或少于握力球组和对照组(均P<0.05)。三组T2、T3、T4的生命体征比较,差异有统计学意义,联合组心率及收缩压的稳定性优于握力球组和对照组(均P<0.05)。结论白噪声联合握力球干预可有效缓解心房颤动患者在射频消融术中的疼痛感和焦虑情绪,维持患者生命体征稳定。