Min Total Time Research Articles

17. Ultrasound-guided Supraclavicular Block (USGB) by Surgeon for ORIF of Distal Radius Fractures (DRF): A 6-year Experience with 1830 Consecutive Cases

PURPOSE: Anesthesiologist need for preoperative testing for distal radius (DRF) ORIF delays care and increases costs. Familiar with ultrasound and anatomy, surgeons are well poised to deliver ultrasound guided supraclavicular block (UGSB.) We reviewed our experience with surgeon delivered UGSB without anesthesiologists to assess its safety and efficacy. METHODS: We retrospectively reviewed all DRFsORIF performed at our ASC by 3 surgeons over a 6-year period. Operative data, complications, demographics, clinical characteristics, fracture patterns, and functional outcomes were evaluated. RESULTS: 1,830 consecutive patients underwent ORIF without anesthesiologists; 1123 females, 707 males, age 62years (27-97). Six bilateral fractures. Fracture types: 783(A), 244(B) and 704(C); with 9 Gustilo(I), 4 Gustilo(II), and 92 malunions. Thirty-two distal ulnar fractures also required ORIF. 1,410 patients were ASA2, and 420 ASA3. Average time to administer block was 5.5min, tourniquet time 24.5min, and 63min total time patient spent in facility. Patients received no IV’s, self-ambulated to and from the OR table pain free, and conversed with the sitter nurse thru the procedure. 82 patients had partial UGSB failure requiring local lidocaine supplementation. No block related complications occurred except two transient unilateral phrenic nerve palsy. There were no infections, no hematomas and postoperatively required only 15 narcotic pills on the average (50% of historical). Upon discharge, 1,551 patients achieved normal range-of-motion, and 5 developed CRPS. Patient easily tolerated surgery without anesthesiologists and were highly satisfied with the expedited care and outcome. CONCLUSION: ORIF of DRFs can be safely, expeditiously, successfully, and cost-effectively treated by surgeon delivered UGSB without anesthesiologists and extensive preoperative testing.

Mobile ear-EEG to study auditory attention in everyday life

Most research investigating auditory perception is conducted in controlled laboratory settings, potentially restricting its generalizability to the complex acoustic environment outside the lab. The present study, in contrast, investigated auditory attention with long-term recordings (> 6 h) beyond the lab using a fully mobile, smartphone-based ear-centered electroencephalography (EEG) setup with minimal restrictions for participants. Twelve participants completed iterations of two variants of an oddball task where they had to react to target tones and to ignore standard tones. A rapid variant of the task (tones every 2 s, 5 min total time) was performed seated and with full focus in the morning, around noon and in the afternoon under controlled conditions. A sporadic variant (tones every minute, 160 min total time) was performed once in the morning and once in the afternoon while participants followed their normal office day routine. EEG data, behavioral data, and movement data (with a gyroscope) were recorded and analyzed. The expected increased amplitude of the P3 component in response to the target tone was observed for both the rapid and the sporadic oddball. Miss rates were lower and reaction times were faster in the rapid oddball compared to the sporadic one. The movement data indicated that participants spent most of their office day at relative rest. Overall, this study demonstrated that it is feasible to study auditory perception in everyday life with long-term ear-EEG.

High Intensity Interval Training Does Not Improve Cardiorespiratory Parameters In Trained Young Soccer Players

Soccer performance is the result of technical, tactical, physiological and psychological attributes of the players. PURPOSE: The present study investigated the effect of high- intensity interval training (HIIT) and continuous moderate intensity training (CONT) on selected parameters of the cardiorespiratory function in young trained soccer players. METHODS: Thirty Greek amateur soccer players (mean ± sd, age 19 ± 2,21y, Body mass 71.19 ± 2.5 kg) were randomized into a high-intensity interval training group (HIIT, n = 10), a continuous moderate intensity training group (CONT, n = 10) and a control group (Control, n = 10). The intervention for HIIT and CONT groups was 16 more training sessions, 2 per week while CONTROL group continued regular soccer training routine. The HIIT group training sessions consisted either of 15s sprints interspersed by 15s of recovery at 120%VO2max with 8 min total exercise time or they played 4x4 min (16 min total time) small-sided games (4v4) followed by 2 min recovery interval. The CONT group training sessions consisted either of 40 min continuous running at 70% VO2max or 10v10 full field soccer game for 40min. RESULTS: Mean values ± sd pre and post-training for Body weight, (HIIT: 69.49 ± 8.39 v 69.0 ± 8.8; CONT: 71.2 ± 10.93 v 70.2 ± 11.01 kg), %fat, (HIIT: 13.02 ± 2.41 v 12.12 ± 2.49, CONT: 13.75 ± 2.19 v 13.82 ± 2.21), VO2max, (HIIT: 55.08 ± 4.43 v 57.75 ± 5.63, CONT: 56.46 ± 4.61 v 58.41 ± 5.24 ml.kg-1.min-1), vVO2max (velocity at VO2max, HIIT: 15.9 ± 0.70 v 16.5 ± 0.52, CONT: 16.5 ± 1.51 v 16.7 ± 1.19 km.h-1) and vVT (velocity at ventilatory threshold, HIIT: 11.8 ± 0.87 v 12.5 ± 0.69, CONT: 12.4 ± 1.03 v 12.5 ± 1.13 km.h-1). VO max, vVO2max and vVT improved 4.6, 3.6 and 5.6% only after HIIT training but the difference didn’t pass statistical significance due to large sd of the sample. CONCLUSIONS: In conclusion, the combination of the training regiments of this study did not improve cardiorespiratory parameters of endurance performance in already trained young soccer players. There was, though, a tendency for better adaptations favors the time efficient HIIT training.

Integrated Analysis of Exosomal Protein Biomarkers on Alternating Current Electrokinetic Chips Enables Rapid Detection of Pancreatic Cancer in Patient Blood.

Pancreatic ductal adenocarcinoma (PDAC) typically has nonspecific symptoms and is often found too late to treat. Because diagnosis of PDAC involves complex, invasive, and expensive procedures, screening populations at increased risk will depend on developing rapid, sensitive, specific, and cost-effective tests. Exosomes, which are nanoscale vesicles shed into blood from tumors, have come into focus as valuable entities for noninvasive liquid biopsy diagnostics. However, rapid capture and analysis of exosomes with their protein and other biomarkers have proven difficult. Here, we present a simple method integrating capture and analysis of exosomes and other extracellular vesicles directly from whole blood, plasma, or serum onto an AC electrokinetic microarray chip. In this process, no pretreatment or dilution of sample is required, nor is it necessary to use capture antibodies or other affinity techniques. Subsequent on-chip immunofluorescence analysis permits specific identification and quantification of target biomarkers within as little as 30 min total time. In this initial validation study, the biomarkers glypican-1 and CD63 were found to reflect the presence of PDAC and thus were used to develop a bivariate model for detecting PDAC. Twenty PDAC patient samples could be distinguished from 11 healthy subjects with 99% sensitivity and 82% specificity. In a smaller group of colon cancer patient samples, elevated glypican-1 was observed for metastatic but not for nonmetastatic disease. The speed and simplicity of ACE exosome capture and on-chip biomarker detection, combined with the ability to use whole blood, will enable seamless "sample-to-answer" liquid biopsy screening and improve early stage cancer diagnostics.

Sequence-specific DNA solid-phase extraction in an on-chip monolith: Towards detection of antibiotic resistance genes

Antibiotic resistance of bacteria is a growing problem and presents a challenge for prompt treatment in patients with sepsis. Currently used methods rely on culturing or amplification; however, these steps are either time consuming or suffer from interference issues. A microfluidic device was made from black polypropylene, with a monolithic column modified with a capture oligonucleotide for sequence selective solid-phase extraction of a complementary target from a lysate sample. Porous properties of the monolith allow flow and hybridization of a target complementary to the probe immobilized on the column surface. Good flow-through properties enable extraction of a 100μL sample and elution of target DNA in 12min total time. Using a fluorescently labeled target oligonucleotide related to Verona Integron-Mediated Metallo-β-lactamase it was possible to extract and detect a 1pM sample with 83% recovery. Temperature-mediated elution by heating above the duplex melting point provides a clean extract without any agents that interfere with base pairing, allowing various labeling methods or further downstream processing of the eluent. Further integration of this extraction module with a system for isolation and lysis of bacteria from blood, as well as combining with single-molecule detection should allow rapid determination of antibiotic resistance.

Microwave-accelerated method for ultra-rapid extraction of Neisseria gonorrhoeae DNA for downstream detection

Nucleic acid-based detection of gonorrhea infections typically require a two-step process involving isolation of the nucleic acid, followed by detection of the genomic target often involving polymerase chain reaction (PCR)-based approaches. In an effort to improve on current detection approaches, we have developed a unique two-step microwave-accelerated approach for rapid extraction and detection of Neisseria gonorrhoeae (gonorrhea, GC) DNA. Our approach is based on the use of highly focused microwave radiation to rapidly lyse bacterial cells, release, and subsequently fragment microbial DNA. The DNA target is then detected by a process known as microwave-accelerated metal-enhanced fluorescence (MAMEF), an ultra-sensitive direct DNA detection analytical technique. In the current study, we show that highly focused microwaves at 2.45 GHz, using 12.3-mm gold film equilateral triangles, are able to rapidly lyse both bacteria cells and fragment DNA in a time- and microwave power-dependent manner. Detection of the extracted DNA can be performed by MAMEF, without the need for DNA amplification, in less than 10 min total time or by other PCR-based approaches. Collectively, the use of a microwave-accelerated method for the release and detection of DNA represents a significant step forward toward the development of a point-of-care (POC) platform for detection of gonorrhea infections.

Synthesis, Sintering, and Oxidative Behavior of HfB2–HfSi2 Ceramics

The self-propagating high-temperature synthesis (SHS) of (1 – x)HfB2–xHfSi2 (x from 0 to 1) ceramics is successfully performed in this work starting from elemental reactants. The presence of HfSi2 in the composite system progressively reduces the exothermic character of the synthesis reaction. Bulk ceramics are then obtained after consolidation by spark plasma sintering (SPS) of the SHS crashed products. It is found that the HfB2–xHfSi2 composite powders synthesized in a single step by SHS require milder sintering conditions as compared to the mixtures consisting of the ceramic constituents obtained separately by the same route. In addition, 15 vol % is the minimum percentage of HfSi2 required to achieve the complete densification of the starting powders, under the SPS conditions investigated in the present work (I = 1350 A, P = 50 MPa, 30 min total time). Thermogravimetric analysis experiments performed in air flow up to 1450 °C clearly indicate that the introduction of HfSi2 plays a beneficial role for ...

TCH-030 PET/CT Imaging with [11C]Choline as a Radiopharmaceutical For the Detection of Recurrent Prostate Cancer: A Reliable Production Method and Quality Control

Background PET/CT Imaging with the radiopharmaceutical [11C]-choline has become a useful tool in the detection of prostate cancer, mainly used in the assessment of treated patients presenting rising PSA and...

Synthesis, densification and characterization of TaB 2–SiC composites

The TaB 2–27.9 vol% SiC composite was synthesized by self-propagating high-temperature synthesis starting from mechanically activated Ta, B 4C and Si reactants. The obtained powders were spark plasma sintered at 1800 °C and 20 MPa for 30 min total time, thus obtaining a 96% dense product. The latter one was characterized in terms of microstructure, hardness, fracture toughness, and oxidation resistance. The obtained results, particularly the fracture toughness, are promising when compared to those related to analogous materials reported in the literature and fabricated with similar and different processing routes.

Residue screening in apple, grape and wine food samples for seven new pesticides using HPLC with UV detection. An application to trifloxystrobin dissipation in grape and wine

A new analytical procedure was developed and validated, using liquid chromatography, for simultaneous determination of seven new pesticides belonging to different chemical classes (azoles, strobilurines, benzoylureas, and a new oxazolidinedione) in apple, grape and wine food samples. Solvent extraction of pesticides was performed using a cyclohexane-dichloromethane (9 + 1 v/v) mixture and the extract was cleaned-up by solid-phase extraction (SPE) using silica cartridges and elution with tetrahydrofurane. Separation of pesticides flusilazole, fenbuconazole, diniconazole, tebufenozide, famoxadone, trifloxystrobin and flufenoxuron was performed by gradient elution High-Performance Liquid Chromatography (HPLC) with a microbore Hypersil HS C18 column in 35 min total time, using mixtures of acetonitrile-water as the mobile phase. Pesticides were detected and quantified at 210 nm with a variable-wavelength UV detector. Recoveries of pesticides from spiked samples, at 0.05–2.0 mg kg−1 for apple and grape and at 0.025–0.250 mg L−1 for wine, ranged from 82 to 107% for apple and grape and from 87% to 106% for wine with RSD < 12%. The limits of quantification (LOQs) of the method, as a signal to noise ratio equalled 10, ranged from 0.02 to 0.10 mg kg−1 for apple and grape and from 0.005 to 0.02 mg L−1 for wine samples. The uncertainty associated with the analytical methodology, estimated using the ‘bottom-up’ approach, was lower than 12.8% for all pesticides and matrices tested. The proposed methodology was applied for the evaluation of trifloxystrobin residue levels in grapes exposed to field treatments and in the must and wine produced from them.

Melamine Detection in Infant Formula Powder Using Near- and Mid-Infrared Spectroscopy

Near- and mid-infrared spectroscopy methods (NIR, FTIR-ATR, FTIR-DRIFT) were evaluated for the detection and quantification of melamine in infant formula powder. Partial least-squares (PLS) models were established for correlating spectral data to melamine concentration: R(2) > 0.99, RMSECV ≤ 0.9, and RPD ≥ 12. Factorization analysis of spectra was able to differentiate unadulterated infant formula powder from samples containing 1 ppm melamine with no misclassifications, a confidence level of 99.99%, and selectivity > 2. These nondestructive methods require little or no sample preparation. The NIR method has an assay time of 1 min, and a 2 min total time to detection. The FTIR methods require up to 5 min for melamine detection. Therefore, NIR and FTIR methods enable rapid detection of 1 ppm melamine in infant formula powder.

Amplification of microsphere-based microarrays using catalyzed reporter deposition

Assay sensitivities using three fluorescent signal generation schemes were evaluated on the Luminex flow cytometer. Following microsphere capture of antigen by immobilized antibodies, bound targets were quantified by use of (1) Cy3-labeled “tracer” antibodies (30min total time), (2) biotinylated tracers followed by streptavidin-R-phycoerythrin (60min total time), or (3) biotinylated tracers followed by avidin-peroxidase conjugates and tyramide signal amplification (TSA; 90min total time). Use of TSA for signal generation in three individual toxin assays improved performance up to 100-fold over Cy3-antibody-based detection, and while streptavidin-R-phycoerythrin provided equivalent sensitivities, TSA produced dramatic increases at low concentrations simplifying positive sample identification. Detection limits for TSA-interrogated assays for ricin, cholera toxin, and staphylococcal enterotoxin B were 64pg/ml, 4pg/ml, and 0.1ng/ml, respectively, using optimized conjugates; analogous detection limits for Cy3-antibody-interrogated assays were 8ng/ml, 1ng/ml, and 1ng/ml, respectively. No improvement was observed in botulinum toxoid A assays when TSA amplification was used. As unique preferences for specific avidin-peroxidase conjugates were observed in the individual assays, improvements in multiplexed assays utilizing a single conjugate were significantly lower (3–10-fold improvements). Furthermore, increases in variability resulted in poorer performance of TSA-interrogated assays for botulinum toxoid, indicating that assay-specific optimization should be performed, especially prior to multiplexing.

Combination of SHS and SPS Techniques for fabrication of fully dense ZrB2-ZrC-SiC composites

A novel method for the fabrication of fully dense ZrB2-ZrC-SiC Ultra High Temperature Ceramic (UHTC) materials is proposed. It consists of first synthesizing ZrB2-40 vol.% ZrC-12 vol.% SiC powders by Self-propagating High-temperature Synthesis (SHS) and subsequently consolidating them by Spark Plasma Sintering (SPS). Specifically, when starting from Zr, B4C, Si, and graphite, the SHS technique leads to the complete conversion of reactants to the desired product. In addition, the use of the SPS apparatus allows for the full consolidation of the SHS powders. This result is achieved under the optimal conditions of 10 min total time and with a maximum temperature of 1800 °C. The proposed method is particularly rapid and convenient as compared to other techniques available for the preparation of analogous materials and for the consolidation of commercial ZrB2, ZrC, and SiC, using the same SPS conditions.

To perform your best: work hard not long

The overload principle, that improved performance is the result of systematic and progressive training of sufficient frequency, intensity and duration, is the one overriding truth in exercise physiology. The uncertainty that has cost many a coach their job is: what is the optimal frequency, intensity and duration? With the results in this issue of The Journal of Physiology, Gibala et al. (2006) have started to determine how short the duration of exercise can be while still increasing cycling performance. As a result of the short duration, the workload of their subjects is extreme: about 4-times as high as regular endurance training. If you can complete the high-intensity exercise, the improvement in performance, mitochondrial mass, muscle buffering capacity, and glycogen supercompensation is the same following as little as 3 min of cycling as it is in subjects who performed 90–120 min of cycling at 65% of their maximum. While these findings probably won't change the training protocols of elite athletes, they may have important implications for those wishing to maintain fitness and they also provide clues as to the complex nature of the response to endurance exercise. It is becoming increasingly clear that there are at least three molecular signals that can lead to an increase in mitochondrial mass and glucose transport capacity in skeletal muscle following endurance exercise training (Hood et al. 2006). The pulsatile decrease of ATP and concomitant increase in AMP during repeated high-intensity exercise can activate the AMP-activated protein kinase; a long-term rise in intracellular calcium can activate calcium–calmodulin kinases; and the cellular stress associated with intense endurance exercise can activate p38 MAP kinase. The reason that many different types of training have a similar net result on muscle phenotype might be explained by the fact that all three signalling molecules have a similar downstream target. In skeletal muscle, all three of these molecules participate in the phosphorylation of the transcriptional repressor HDAC5 (Al-Khalili et al. 2004; Bassel-Duby & Olson, 2006). Phosphorylation of HDAC5 results in its dissociation from Mef2 and the subsequent activation of transcription. Two of the targets of this transcriptional activation are the GLUT4 and PGC-1α genes (Bassel-Duby & Olson, 2006). GLUT4 catalyses the rate-limiting step in glucose uptake and glycogen synthesis, the transport of glucose into the muscle cell, while PGC-1α coordinates the expression of the nuclear and mitochondrial genes needed for mitochondrial biogenesis. The result is an increase in the capacity to take up and either oxidize or store glucose, the main fuel used during maximal performance, as well as an increased capacity to generate ATP from fat and spare glycogen during lower intensity exercise. In support of this hypothesis, the work of Gibala et al. (2006) draws on studies performed by Shin Terada (Terada et al. 2001, 2005). Dr Terada showed that rats swimming 6 h a day carrying a weight equal to 2% of their body weight had similar increases in GLUT4 and PGC-1α content as rats that swam for 14 intervals lasting 20 s carrying a weight equal to 14% of their body weight. While not all of the cellular signals described above were measured, they did show that the activation of AMP kinase was almost twice as high in the high-intensity group as the low-intensity group (Terada et al. 2005). There are two possible explanations for the fact that the change in GLUT4 and PGC-1α were the same after either 8 days or 6 h. The first possibility is that there is a threshold for the adaptation to endurance training over which no greater increase in PGC-1α or GLUT4 is possible. The second is that the sum total of AMPK, p38 and CamK activation is the same under the two protocols: the greater AMPK activity in high-intensity training is made up for by longer periods of elevated calcium. For those looking to do the least possible work to be fit, the work of Gibala et al. (2006) presents hope. In as little as 3 min (40 min total time including warm up and cool down) we can improve our and performance. However, there are a couple of caveats. First, high-intensity training does not utilize as many calories as long-duration exercise, meaning that it would not be as good if the goal were weight loss. Second, it is unclear whether performance in other sports (i.e. running) are effected in the same way by high-intensity training, and lastly, as a former strength and conditioning coach I can say that while many people are willing to exercise at a low intensity for a long duration, it is VERY hard to get people to exercise at a high intensity for any period of time.

Quantitative determination of clenbuterol, salbutamol and tulobuterol enantiomers by capillary electrophoresis.

Enantiomers of clenbuterol, salbutamol and tulobuterol were directly separated and quantitated from a spiked sample by capillary electrophoresis (CE) using sulfaited beta-cyclodextrin (SCD) as chiral selector and phosphate as running buffer. The SCD and buffer concentration, pH and field strength were the parameters studied to optimize the separation. Optimal separation was obtained using 50 mM of phosphate monobasic at pH = 2.24, 0.25% (w/w) of sulfated cyclodextrin and a field strength of 10 kV, with 20 min total time analysis. Comparison between two different injection modes (hydrodynamic and electrokinetic) was made. In the hydrodynamic mode, repeatability (expressed as relative standard deviation, RSD) was less than 1.2% for migration times for all the analyte peaks and less than 2% for peak area percentages. With respect to reproducibility, RSD was less than 3.8% for migration time and less than 3% for peak area percentages. Calibration curves were set up for two different sample concentration ranges (1 to 10 microg mL(-1) and 160-800 ng mL(-1), of each of the racemates studied). Although the electrokinetic injection mode for an aqueous sample appeared to suffer from some enantiodiscrimination, calibration curves were linear in the range between 1 and 10 ng mL(-1) with regression coefficients ranging from 0.9996 to 0.9952. As in the case of hydrodynamic injection, the method was tested with a spiked sample.

Gallstone extracorporeal shock-wave lithotripsy: time and treatment considerations.

We evaluated 30 gallstone lithotripsy procedures performed on 27 patients with the Dornier MPL-9000 Lithotripter to determine how time was spent in the lithotripsy suite and to evaluate the various technical reasons for interrupting the administration of shock waves during the treatment. The procedure averaged 98 +/- 32 min total time in the lithotripsy suite. This included an average of 22 +/- 6 min before the treatment, 70 +/- 28 min for administration of shock waves, and 6 +/- 2 min after the treatment. The time required to deliver the shock waves did not correlate with patient age, sex, or weight; the number of gallstones; or the number or date of the treatment. However, a trend was seen toward an association between shorter treatment times and larger stone volumes. On the average, the administration of shock waves was interrupted every 48 shock waves for various reasons. Electronically changing the imaging plane of the in-line sonographic transducer to retarget the stone in the focal zone was by far ...

Gallstone extracorporeal shock-wave lithotripsy: time and treatment considerations.

We evaluated 30 gallstone lithotripsy procedures performed on 27 patients with the Dornier MPL-9000 Lithotripter to determine how time was spent in the lithotripsy suite and to evaluate the various technical reasons for interrupting the administration of shock waves during the treatment. The procedure averaged 98 +/- 32 min total time in the lithotripsy suite. This included an average of 22 +/- 6 min before the treatment, 70 +/- 28 min for administration of shock waves, and 6 +/- 2 min after the treatment. The time required to deliver the shock waves did not correlate with patient age, sex, or weight; the number of gallstones; or the number or date of the treatment. However, a trend was seen toward an association between shorter treatment times and larger stone volumes. On the average, the administration of shock waves was interrupted every 48 shock waves for various reasons. Electronically changing the imaging plane of the in-line sonographic transducer to retarget the stone in the focal zone was by far the most frequent reason for interrupting shock-wave delivery, averaging 56 shock waves between changes. We conclude that extracorporeal shock-wave lithotripsy of gallstones is a time consuming and technically demanding procedure that requires continuous monitoring and frequent interruption in order to optimize targeting and fragmentation of the stone(s) while maintaining the patient's comfort.