Low Consumption Research Articles

Perioperative non-opioid analgesia strategies after high tibial osteotomy: a systematic review of prospective studies.

Little is known about the optimal analgesia regimen after HTO. Thus, this study systematically reviewed the literature on clinical and patient-reported outcomes of pain management strategies for patients after HTO. A comprehensive search of the PubMed, Cochrane CENTRAL, and CINAHL databases was conducted from inception through September 2023. Studies were included if they evaluated pain reduction with analgesia strategies after HTO and were excluded if they did not report pain control outcomes. Five studies with 217 patients were included. Patients with a multimodal intraoperative injection cocktail to the knee, femoral nerve block (FNB), or adductor canal block (ACB) for HTO had significant improvement in visual analog scale (VAS) and numerical rating scale (NRS) scores in the first 12h postoperatively compared to controls. Patients on duloxetine had significantly lower NRS scores at 1, 7, and 14 days postoperatively and significantly lower nonsteroidal anti-inflammatory drug (NSAID) usage throughout the two-week postoperative period than the control group. Patients receiving an ACB had significantly lower opioid consumption than controls at 12h postoperative. In patients with an FNB or ACB, no significant difference in quadriceps strength or time to straight leg raise postoperatively was observed compared to controls. A multimodal periarticular injection cocktail, FNB, or an ACB effectively reduces pain on the first day after HTO, with an ACB able to reduce opioid consumption on the first postoperative day. Duloxetine combined with an ACB effectively decreases pain for two weeks postoperatively while reducing NSAID consumption in patients after HTO. IV.

The Effect of City-Level Sugar-Sweetened Beverage Taxes on Longitudinal HbA1c and Incident Diabetes in Adults With Prediabetes.

Prediabetes, which is a condition characterized by higher-than-normal blood glucose levels that are under the threshold for diabetes, impacts over one-third of U.S. adults. Excise taxes on sugar-sweetened beverages (SSBs) are a proposed policy intervention to lower population consumption of SSBs and generate revenue to support health-related programs, thus potentially delaying or preventing the development of diabetes in individuals with prediabetes. We leveraged data from Kaiser Permanente in California to examine the impact of SSB taxes in California on individual-level mean HbA1c levels and rates of incident diabetes. We compared two outcomes, mean HbA1c levels and rates of incident diabetes, among a matched cohort of adults with prediabetes who lived and did not live in SSB excise tax cities, using outcomes collected in the 6 years prior and 4 years following SSB tax implementation. We used multivariable linear mixed effects models to analyze longitudinal mean HbA1c and discrete-time survival models for incident diabetes. We included 68,658 adults in the analysis. In adjusted models, longitudinal mean HbA1c (percent) was 0.007 (95% CI 0.002, 0.011) units higher in the tax cities compared with controls; while the estimated difference was statistically significant, it was not clinically significant (HbA1c < 0.5%). There was no significant difference in the risk of incident diabetes between individuals living in tax and control cities. We found no clinically significant association between SSB taxes and either longitudinal mean HbA1c or incident diabetes among adults with prediabetes in the 4 years following SSB tax implementation.

Factors associated with the consumption of voluntarily fortified foods with micronutrients by the Portuguese population.

This study aimed to identify the sociodemographic and health-related factors associated with the consumption of voluntarily fortified foods with micronutrients (Mn-FF) by the Portuguese population, using data from the National Food, Nutrition and Physical Activity Survey (IAN-AF 2015-2016). Food consumption, sociodemographic and other health-related factors, and physical activity data were computerised using the You Eat & Move e-platform. Foods consumed by participants and labelled foods reported as consumed were included in the database. Mn-FF were considered all foods containing added micronutrients legally authorised, and MN-FF users were those who consumed at least one Mn-FF on at least one of the dietary recall days. Approximately 57% of the population consumed at least one Mn-FF. Children and adolescents consumed significantly more Mn-FF than older age groups. The primary contributors to Mn-FF consumption were breakfast cereals and fat spreads. Being a child (female OR 2.07 [95% CI: 1.52, 2.83]; male OR 4.80 [95% CI: 3.23, 7.14]) or adolescent (female OR 1.62 [95% CI: 1.78, 2.22]; male OR 4.59 [95% CI: 3.26, 6.47]), having a higher level of education (female OR 1.52 [95% CI: 1.17, 1.99]; male OR 1.85 [95% CI: 1.42, 2.42]) and engaging in regular physical activity (female OR 1.31 [95% CI: 1.09, 1.58]; male OR 1.36 [95% CI: 1.11, 1.68]) were factors positively associated with Mn-FF consumption. Conversely, obesity (female OR 0.76 [95% CI: 0.60, 0.96]), living in predominantly rural areas (male OR 0.70 [95% CI: 0.49, 0.91]) and eating fewer mid-meals per day (female OR 0.60 [95% CI: 0.48, 0.76]; male OR 0.64 [95% CI: 0.49, 0.84]) were associated with lower Mn-FF consumption. Younger age, higher education and physical activity practice were positively associated with Mn-FF consumption. These findings provide important insights on priority factors to be considered when deciding on nutrient fortification policies from both public health and food industry perspectives.

The effect of vacuum-packaging on nutrient and Salmonella growth of sautéed vegetables

Low consumption of vegetables was associated with a lack of cooking and preparation skills. In addition, in modern times, people tend to choose foods that can be served quickly. Vacuum packaging is a simple method of preserving food that can be done at home. Therefore, sautéed vegetables in vacuum packaging were developed and evaluated for their nutrients and microbiological properties. The vegetables, including spinach, carrots, and water spinach, were sautéed before being vacuum packaged. The related parameters, including carbohydrate, protein, ash, moisture, vitamin C, pH, and Salmonella sp., were evaluated. Some parameters were measured at 0, 7, and 14 days. The results showed that the samples contained carbohydrates ranging from 8.26-17.08%, 0.145-1.90% protein, 2.23 -2.49% fiber, 1.46-3.10% fat, 0.13-0.10% ash and 82.44-86.08% moisture. The Vitamin C content was similar during storage time, at day 0, 7 and 14. The pH of sautéed vegetables was relatively constant on days 0, 7 and 14. A high Salmonella sp. content was found during storage time on days 7 and 14. The vacuum-packaging of sautéed vegetables potentially maintained the nutrients during storage time until day 7. However, the results of this study indicated that there is still a possibility that vacuum packaging has not been able to reduce the growth of micro-bacteria in the package. Overall, this study implied that vacuum packaging with other treatments is needed for food safety reasons.

Energy Management of Hydrogen Hybrid Electric Vehicles—Online-Capable Control

The results shown in this paper extend our research group’s previous work, which presents the theoretically achievable hydrogen engine-out NO​xeo (H​2-NO​xeo) Pareto front of a hydrogen hybrid electric vehicle (H​2-HEV). While the Pareto front is calculated offline, which requires significant computing power and time, this work presents an online-capable algorithm to tackle the energy management of a H​2-HEV with explicit consideration of the H​2-NO​xeo trade-off. Through the inclusion of realistic predictive data on the upcoming driving mission, a model predictive control algorithm (MPC) is utilized to effectively tackle the conflicting goal of achieving low hydrogen consumption while simultaneously minimizing NO​xeo. In a case study, it is shown that MPC is able to satisfy user-defined NO​xeo limits over the course of various driving missions. Moreover, a comparison with the optimal Pareto front highlights MPC’s ability to achieve close-to-optimal fuel performance for any desired cumulated NO​xeo target on four realistic routes for passenger cars.

Feasibility and Analgesic Efficacy of Thoracolumbar Dorsal Ramus Nerve Block Using Multiorifice Pain Catheters for Scoliosis Surgery: A Prospective Cohort Study.

Approximately 38,000 scoliosis surgery correction operations are performed annually in the United States; these operations are associated with considerable postoperative pain which can be difficult to manage. This is largely attributed to an incision spanning multiple vertebral segments with paraspinal muscle dissection and retraction to facilitate the implantation of segmental hardware and rods. Frequently utilized analgesic modalities include intravenous patient-controlled analgesia and epidural analgesia, often in combination. We sought to ascertain the feasibility and analgesic efficacy of continuous thoracolumbar dorsal ramus nerve (TDRN) block using surgically placed multiorifice catheters. Forty-two patients diagnosed with idiopathic scoliosis who underwent a posterior spinal fusion (PSF) were enrolled after consent was obtained. Patients were managed utilizing a standardized Enhanced Recovery After Surgery) protocol including a perioperative opioid-sparing regimen. Data were collected at specified time intervals during the recovery period. These data points included pain scores using the Numeric Rating Scale. Parenteral or both oral and parenteral opioid consumption doses were also collected every 4 hours. Any significant postoperative adverse events were recorded as well. A total of 42 patients had surgically placed TDRN catheters, and 40 patients were included in this study. The patients all reported low to moderate pain scores with low opioid consumption postoperatively, while the TDRN catheter delivery of local anesthetic analgesics did not result in significant complications. A regional technique utilizing TDRN catheters could be a valuable component of the postoperative pain management protocols for PSF surgery, and additional studies are warranted. This study evaluated the feasibility and analgesic efficacy of TDRN catheters for postoperative pain control following multilevel PSF for idiopathic scoliosis. Continuous local anesthetic delivery through TDRN catheters is a feasible and safe technique for postoperative pain control in these patients. Selective blockade of the dorsal rami might have benefits over epidural analgesia or other regional techniques.

Assessment of nutritional status, physical fitness and physical activity of school going adolescents (12–15 years) in Delhi

BackgroundAdolescence is a distinct period that is crucial for setting the foundation for long-term health.ObjectiveTo assess the nutritional status, physical fitness, and physical activity of adolescents.MethodsThe present cross-sectional study recruited 100 adolescents purposively. Information regarding general profile and lifestyle-related factors was collected using a questionnaire. Anthropometric data such as height, weight, BMI, and body fat% were collected using appropriate equipment. Physical fitness was assessed using a battery adapted from FITNESSGRAM® and PAQ-A assessed the physical activity. Dietary intake was analysed using a 2-day 24-hour dietary recall.ResultThe study revealed, 19% of the participants were overweight and 6% were obese. The majority (74%) were physically inactive and 15% had high body fat %. There was lower consumption of energy, carbohydrates, iron, and calcium, than the recommendations. Also, physical activity scores were negatively associated with macronutrient intake and trunk lift (strength and flexibility) [p < 0.05]. Data showed lower physical fitness scores. BMI and hand-grip strength was positively correlated [p < 0.05]. Push Ups (endurance) and Standing Broad Jump (power) showed a negative correlation with body fat%. Tennis ball throw and PACER (cardiorespiratory fitness) were positively associated with protein intake. A multiple regression analysis significantly showed that a unit increase in cell phone usage increases body fat% by 11.64 units. Standing broad jump increases by 38.6 cm and decreases with 28.76 cm with a unit increase in playing outside and tuitions timings respectively.ConclusionPoor nutritional status, physical fitness, and physical activity were reported among adolescents. It is imperative to plan intervention strategies to improve the overall health of adolescents.

Discrete Dynamic System Modeling for Simulated Moving Bed Processes

Although the simulated moving bed (SMB) process boasts advantages such as high productivity and low consumption, the cost of obtaining optimized parameters through practical experiments to control the separation process can be enormous due to its complex nonlinear characteristics. Consequently, the successful transformation of the SMB separation process into a mathematical dynamic model for computer simulation would greatly reduce the research costs associated with experimental studies. In this study, the Crank–Nicolson method was employed to discretize and dynamize the SMB process, enabling the simulation of processes under both linear and Langmuir isotherms. The results of the simulation experiments demonstrated the feasibility and high efficiency of this approach, thereby establishing a solid foundation for further advancements in online control strategies.

СРАВНИТЕЛЬНЫЕ ОЦЕНКИ ПЕРСПЕКТИВНЫХ КАПЕЛЬНЫХ ПОИЛОК ДЛЯ СЕЛЬСКОХОЗЯЙСТВЕННЫХ ПТИЦ

The problem of watering poultry with water is analyzed. The aim of the study is to choose the design of a nipple drinker for poultry when they are with cage kept. In accordance with this, in order to develop a modern nipple drinker for poultry that meets the sanitary and technical requirements of the poultry housing, a comparative analysis of existing nipple drinker designs is carried out. A nipple drinker for poultry of cage keeping is developed. The tests conducted on broilers show that the nipple drinker meets the physiological needs of poultry in water and is reliable in operation while reducing the cost of its preventive maintenance. The nipple drinker has a low water consumption during batch feeding, is hygienic in use, improves the sanitary condition of the poultry room, increases the live weight of broilers by 3...5%. The developed nipple drinker for poultry in comparison with its closest analogues has a simple design, low labor intensity of manufacture, the possibility of self-purification from salt deposits on the inner surface of the device regulating the flow of water, increases reliability in operation and reduces water losses by its portion supply, improves the sanitary condition of the room for keeping poultry.

By the people, for the people: Local government's representation of voter preferences under the Affordable Care Act

AbstractDecentralized government is hypothesized to lead public service investments to better align with political preferences across geographical regions, yet there has been limited rigorous testing of this hypothesis. We examine how local public provision of hospital services varied according to political preferences between 2006 and 2016. We use state Medicaid expansion under the Affordable Care Act (ACA) as a source of exogenous variation. Consistent with the motivation for federalism, we find that areas less supportive of the ACA tended to convert the state expansion into lower property taxes with lower public hospital expenditures, whereas, in states that expanded Medicaid, local governments tended to increase public provision of healthcare.

Association of dietary and nutritional factors with cognitive decline, dementia, and depressive symptomatology in older individuals according to a neurogenesis-centred biological susceptibility to brain ageing.

Hippocampal neurogenesis (HN) occurs throughout the life course and is important for memory and mood. Declining with age, HN plays a pivotal role in cognitive decline (CD), dementia, and late-life depression, such that altered HN could represent a neurobiological susceptibility to these conditions. Pertinently, dietary patterns (e.g., Mediterranean diet) and/or individual nutrients (e.g., vitamin D, omega 3) can modify HN, but also modify risk for CD, dementia, and depression. Therefore, the interaction between diet/nutrition and HN may alter risk trajectories for these ageing-related brain conditions. Using a subsample (n= 371) of the Three-City cohort-where older adults provided information on diet and blood biobanking at baseline and were assessed for CD, dementia, and depressive symptomatology across 12years-we tested for interactions between food consumption, nutrient intake, and nutritional biomarker concentrations and neurogenesis-centred susceptibility status (defined by baseline readouts of hippocampal progenitor cell integrity, cell death, and differentiation) on CD, Alzheimer's disease (AD), vascular and other dementias (VoD), and depressive symptomatology, using multivariable-adjusted logistic regression models. Increased plasma lycopene concentrations (OR [95% CI] = 1.07 [1.01, 1.14]), higher red meat (OR [95% CI] = 1.10 [1.03, 1.19]), and lower poultry consumption (OR [95% CI] = 0.93 [0.87, 0.99]) were associated with an increased risk for AD in individuals with a neurogenesis-centred susceptibility. Increased vitamin D consumption (OR [95% CI] = 1.05 [1.01, 1.11]) and plasma γ-tocopherol concentrations (OR [95% CI] = 1.08 [1.01, 1.18]) were associated with increased risk for VoD and depressive symptomatology, respectively, but only in susceptible individuals. This research highlights an important role for diet/nutrition in modifying dementia and depression risk in individuals with a neurogenesis-centred susceptibility.

Comparison of the Analgesic Effect of Pericapsular Nerve Group Block and Lumbar Erector Spinae Plane Block in Elective Hip Surgery

Background and Objectives: The aim of this study was to compare the effectiveness of pericapsular nerve group (PENG) and lumbar erector spinae plane (L-ESP) blocks, both administered with a high volume (40 mL) of local anesthetic (LA), for multimodal postoperative analgesia in patients undergoing hip surgery. Materials and Methods: This was a prospective, double-blind, randomized study that included 75 adult patients who were divided into three equal groups: control, PENG, and L-ESP. The study compared pain intensity, morphine consumption, time to first morphine request, and postoperative satisfaction between the control group, which received standard multimodal analgesia, and the block groups, which received PENG or L-ESP block in addition to multimodal analgesia. The numerical rating scale (NRS) was used to measure pain intensity. Results: The results showed that the block groups had lower pain intensity scores and morphine consumption, a longer time to the first morphine request, and higher postoperative satisfaction compared to the control group. The median maximum NRS score during the first 12 h was four in the control group, two in the PENG group, and three in the L-ESP group. The control group (21.52 ± 9.63 mg) consumed more morphine than the two block groups (PENG, 11.20 ± 7.55 mg; L-ESP, 12.88 ± 8.87 mg) and requested morphine 6.8 h earlier and 5 h earlier than the PENG and L-ESP groups, respectively. The control group (median 3) had the lowest Likert satisfaction scores, while the PENG group (median 4) had the lowest NRS scores (L-ESP, median 4). Conclusions: The application of PENG or L-ESP blocks with high-volume LA in patients undergoing hip surgery reduces the need for postoperative analgesia and improves the quality of multimodal analgesia.

Health Expenditures After Bariatric Surgery: A Retrospective Cohort Study.

Bariatric surgery leads to substantial improvements in weight and weight-related conditions, but prior literature on post-surgical health expenditures is equivocal. In a retrospective cohort study, we compared expenditures between surgical and matched non-surgical patients. In a retrospective study, total, outpatient, inpatient and medication expenditures 3 years before and 5.5 years after surgery were compared between 22,698 bariatric surgery (n=7,127 RYGB, 15,571 sleeve gastrectomy) patients from 2012-2019 and 66,769 matched non-surgical patients, using generalized estimating equations. We also compared expenditures between patients receiving the two leading surgical procedures in weighted analyses. Surgical and non-surgical cohorts were well matched, 80-81% female, with mean body mass index (BMI) of 44, and mean age of 47 (RYGB) and 44 (SG) years. Estimated total expenditures were similar between surgical and non-surgical groups 3 years before surgery ($27 difference, 95% confidence interval (CI): -42, 102)), increased 6 months prior to surgery for surgical patients, and decreased below pre-period levels for both groups after 3-5.5 years to become similar (difference at 5.5y=-$61, 95% CI: -166, 52). Long-term outpatient expenditures were similar between groups. Surgical patients' lower long-term medication expenditures ($314 lower at 5.5y, 95% CI: -419, -208) were offset by a higher risk of hospitalization. Total expenditures were similar between RYGB and SG patients 3.5 to 5.5 years after surgery. Bariatric surgery translated into lower medication expenditures than matched controls, but not lower overall long-term expenditures. Expenditure trends appear similar for the two leading bariatric operations.

Noninvasive characterization methods for ultra-short laser pulse induced volume modifications

We present two noninvasive characterization methods to investigate laser induced modifications in bulk fused silica glasses. The methods discussed are immersion microscopy and scanning acoustic microscopy (SAM). SAM shows merits in measuring the distance from sample surface to the first detectable density change of the modification, while immersion microscopy offers a look into the modification. Both noninvasive methods are preferred over conventional polishing or etching techniques due to the facts, that multiple investigations can be done with only one sample and lower time expenditure. The type II modifications were introduced by focusing laser pulses with high repetition rates into the fused silica.

Excel as an optimization tool applied to multicomponent distillation column sizing

The unit operation of distillation is a method of significant importance for industrial separation processes, as it enables the fractionation of a mixture based on the differences in volatility among its components. Considering that a typical initial mixture generally contains three or more products of interest, studies aimed at optimizing multicomponent distillation, although scarce in the literature, are increasingly imperative to ensure efficiency and reduce operational and energy costs associated with the process. Since sizing multicomponent distillation columns using the Fenske-Underwood and Gilliland (FUG) and Kirkbride methods involves extensive and complex calculations to obtain operational parameters, the objective of this study was to develop a computational method using Microsoft Excel® software to make them more practical and enhance the accuracy of the results obtained. The functionality of the developed spreadsheet was verified through the resolution of an example of application, both manually and electronically. In both cases, the results obtained were identical, but with significantly lower time consumption and probability of error by the electronic method, demonstrating its potential for use in academic and industrial settings.

Gender dynamics of the impact of cash transfer on female educational expenditure of informal settlements in Bangladesh

Gender-biased educational investment remains a critical issue for vulnerable households. Despite increased female enrolment in the past decade, motivation to invest on female education remains low. Resource scarcity and low woman empowerment are two major reasons of low educational expenditure on female children of a vulnerable household. As the most vulnerable households in a society, informal settlers (slum households) are supposed to spend less on female children. However, whether there is any gender bias in informally settled households’ spending on education remains a question. Further, Cash Transfer (CT) programs provide resources to vulnerable households for investing on human capital elements like education. This study aims to examine three research questions: whether a informally settled household’s spending on education is gender biased, whether the households in which women receive CT spend more for female education than those in which women do not receive CT, and finally whether the impact of female receipt of CT differs from that of male receipt of CT in terms of female education expenditure. As the assignment of female access to CT is not randomized, the simple comparison between the treated and untreated suffers from selection bias. We employ propensity score matching (PSM) as an identification strategy to address selection bias. Inverse probability weighted regression adjustment (IPWRA) has been applied as a robustness check. The study's policy implications highlight the significance for policymakers in the domains of women's education, empowerment, and the achievement of Sustainable Development Goals.

Research on Low Carbon Consumption Intention Survey and Incentive Mechanism under the Dual Carbon Goal

Research on Low Carbon Consumption Intention Survey and Incentive Mechanism under the Dual Carbon Goal

The effect of intraoperative low-dose ketamine versus dexmedetomidine infusion on postoperative bowel recovery in patients undergoing gastrointestinal malignancy surgeries: Placebo-controlled, randomized trial

Abstract Background and Aims: No studies have compared the effects of ketamine and dexmedetomidine on bowel recovery. We evaluated the effects of intraoperative low-dose ketamine or dexmedetomidine infusion on postoperative bowel recovery in patients undergoing gastrointestinal (GI) malignancy surgeries. Material and Methods: This placebo-controlled, randomized study was carried out in 84 American Society of Anesthesiologists II patients, aged 18–70 years, of either gender, undergoing elective open GI malignancy surgeries. Patients received intraoperative infusion of ketamine @ 0.1 mg kg-1 h-1 (KET), dexmedetomidine @ 0.25 μg kg-1 h-1 (DEX), or normal saline (placebo). Primary outcome was the time to first flatus and/or stool. Secondary outcomes included time to extubation, total analgesic requirement, postoperative pain scores, time to feeds, duration of intensive care unit (ICU) and hospital stay, and the incidence of adverse events. Continuous data were analyzed by the one-way analysis of variance (ANOVA) or the Kruskal–Wallis test. Categorical data were analyzed by the Chi-square test or the Fisher’s exact test. Results: Median time to passage of flatus and/or stool was 3 [interquartile range (IQR) 2–3] days in the KET group, 2 [IQR 2–3] days in the DEX group, and 2 [IQR 2–3] days in the placebo group (P = 0.53 for placebo vs. KET, 0.81 for placebo vs. DEX, and 0.99 for KET vs. DEX). Pain scores and analgesic consumption were significantly less in the intervention groups versus placebo (P &lt; 0.001). No difference was seen in other secondary outcomes. Conclusion: Low-dose ketamine or dexmedetomidine did not result in early bowel recovery despite lower pain scores and opioid consumption in patients undergoing open GI malignancy surgeries. Key Message: What is known: Ketamine and dexmedetomidine may promote bowel recovery by improving analgesia and decreasing opioid usage.Main findings: This randomized controlled trial found no evidence of earlier bowel recovery with ketamine or dexmedetomidine versus placebo despite lower pain scores and analgesic consumption in the ketamine and dexmedetomidine groups.

Enhanced recovery after cesarean (ERAC) versus conventional care: An expanded systematic review and meta-analysis of 18,368 subjects

Abstract Background and Aims: Enhanced recovery after cesarean (ERAC) is an interdisciplinary approach to improve patient outcomes following cesarean section. ERAC’s execution must be constantly evaluated. Thus, we aimed to analyze parameters associated with ERAC adoption for clinical care in this expanded systematic review. Material and Methods: A systematic literature search using Epistemonikos, Google Scholar, PubMed, and Scopus was done until February 2023. The appropriate observational and experimental research comparing the effects of ERAC protocols with conventional care on postoperative adverse events, operation-related characteristics, time to first (oral intake, mobilization, bowel movement, and urinary catheter removal), and opioid use. Meta-analyses were conducted using the RevMan 5.4.1. and Comprehensive Meta-Analysis version 3.3 software. Results: In total, 23 studies were included in this systematic review. ERAC implementation was found to be associated with improvement in terms of shorter postoperative hospital stays and faster time to first liquid intake, first solid diet, urinary catheter removal, and mobilization. Furthermore, the rate of opioid-free treatment, total in-hospital morphine milligram equivalent (MME), daily in-hospital MME, and total prescribed opioid pills at discharge (all parameters, P &lt; 0.01) were significantly better in the ERAC group than in the conventional care group. However, no significant difference was observed regarding postoperative adverse events, blood loss, operation duration, and total prescribed MME at discharge parameters between the two observed groups. Conclusion: ERAC implementation is associated with better healthcare delivery, as determined by shorter time to first, lower opioid consumption, and shorter postoperative length of stay compared with conventional care. However, it is not associated with a lower dosage of opioid prescription at discharge. Key Message: ERAC has demonstrated immense advantages and appears to be the future of cesarean delivery methods worldwide. However, based on our analysis, it is not associated with a lower dosage of opioid prescription at discharge.

Recent Advances in Microfluidic-Based Extracellular Vesicle Analysis

Extracellular vesicles (EVs) serve as vital messengers, facilitating communication between cells, and exhibit tremendous potential in the diagnosis and treatment of diseases. However, conventional EV isolation methods are labor-intensive, and they harvest EVs with low purity and compromised recovery. In addition, the drawbacks, such as the limited sensitivity and specificity of traditional EV analysis methods, hinder the application of EVs in clinical use. Therefore, it is urgent to develop effective and standardized methods for isolating and detecting EVs. Microfluidics technology is a powerful and rapidly developing technology that has been introduced as a potential solution for the above bottlenecks. It holds the advantages of high integration, short analysis time, and low consumption of samples and reagents. In this review, we summarize the traditional techniques alongside microfluidic-based methodologies for the isolation and detection of EVs. We emphasize the distinct advantages of microfluidic technology in enhancing the capture efficiency and precise targeting of extracellular vesicles (EVs). We also explore its analytical role in targeted detection. Furthermore, this review highlights the transformative impact of microfluidic technology on EV analysis, with the potential to achieve automated and high-throughput EV detection in clinical samples.