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Balanced electrolyte solution with 1% glucose as intraoperative maintenance fluid in infants : a prospective study of glucose, electrolyte, and acid-base homeostasis.
No full textBACKGROUND: Optimal composition and infusion rates of intravenous maintenance fluids for children undergoing surgery are not well defined. Avoidance of hypoglycaemia, ketosis, and hyponatraemia is important, and current guidelines recommend isotonic fluids containing 1.0-2.5% glucose. However, evidence for its safe use in infants is insufficient. The aim of this study was to investigate whether normoglycaemia is maintained in infants using a balanced electrolyte maintenance infusion with 1% glucose. METHODS: Infants 1-12 months of age undergoing surgery were included in this prospective two-centre study. Intravenous maintenance fluid was given with infusion rates of 4-8 ml kg-1 h-1. Blood gas and ketone body analysis were performed at induction and at the end of anaesthesia. Plasma glucose concentration was monitored intraoperatively. RESULTS: For the 365 infants included in this study, the median infusion rate of maintenance fluid was 3.97 (interquartile range 3.21-5.35) ml kg-1 h-1. Mean plasma glucose concentration increased from 5.3 mM at induction to 6.1 mM at the end of anaesthesia (mean difference 0.8 mM; 95% confidence interval 0.6-0.9, P<0.001). No cases of hypoglycaemia (<3.0 mM) occurred. Mean sodium concentration remained stable during anaesthesia. Chloride and ketone body concentration increased and base excess decreased, but these were within the normal range. CONCLUSIONS: In infants undergoing surgery, maintenance infusion with a balanced electrolyte solution containing 1% glucose, at rates similar to those proposed by Holliday and Segar is a safe alternative with regards to homeostasis of glucose, electrolytes, and acid-base balance. CLINICAL TRIAL REGISTRATION: ACTRN12619000833167
Associations between daily composition of 24 h physical behavior with affective states and working memory
No full textThe daily association between 24-hour physical behavior compositions (moderate-to-vigorous physicalactivity (MVPA), light physical activity (LPA), standing, sedentary, and sleep) and psychologicaloutcomes—such as momentary affective state assessments and working memory—remainsunderstudied. We investigated whether the daily 24-hour compositions, particularly MVPA and SBconsidering the remaining behaviors, are associated with affective states and working memory.We conducted an ambulatory assessment study with 199 university employees. Physical behaviorswere measured continuously via thigh-worn accelerometers throughout the day. Affective states(i.e., valence, energetic arousal, and calmness) and working memory performance (i.e., numericupdating task) were captured up to six times a day via electronic diaries and tasks on a smartphone.We conducted Bayesian multilevel compositional data analysis to analyze within-person, andbetween-person associations of 24-hour physical behavior composition with affective states, andworking memory. Aggregated same-day outcomes were used for main analyses to capture concurrentassociations, and next-day outcomes were used for exploratory analyses to capture prospectiveassociations. Concurrent analyses showed that higher moderate-to-vigorous physical activity relativeto the remaining physical behaviors was associated with 2.49 [95%CI 1.00, 4.06] higher valence and3.65 [95%CI 2.11, 5.28] higher energetic arousal (but not calmness) ratings at the within-person, butnot at the between-person level. Sedentary behavior relative to the remaining physical behaviorswas not associated with any affective states. Spending more time in moderate-to-vigorous physicalactivity, followed by light physical activity, and standing, each at the expense of the other behaviorswas associated with higher affective state ratings on the same day (between-person: ≥1.29 [0.19, 2.51]higher valence, 1.23 [0.04, 2.40] higher calmness; within-person: ≥0.62 [0.04, 1.22] higher valence,≥ 1.10 [0.63, 1.58] higher energetic arousal, ≥ 0.95 [0.18, 1.74] higher calmness). The 24-hour physicalbehavior composition was not associated with working memory. Findings underline the importanceof the 24-hour composition of physical behavior for mental health, by demonstrating significantconcurrent associations with affective states. Even small reallocations of behaviors may positivelyinfluence affective states, providing valuable insights for the development of future interventions
Uniqueness and mixing properties of Doeblin measures
No full textIn this paper we solve two open problems in ergodic theory. We prove first that if a Doeblin function g (a g-function) satisfies lim sup n→∞ varn log g / n−1/2 < 2, then we have a unique Doeblin measure (g-measure). This result indicates a possible phase transition in analogy with the long-range Ising model. Secondly, we provide an example of a Doeblin function with a unique Doeblin measure that is not weakly mixing, which implies that the sequence of iterates of the transfer operator does not converge, solving a well-known folklore problem in ergodic theory. Previously it was only known that uniqueness does not imply the Bernoulli property
PCET-mediated deconstructive cross-coupling of aliphatic alcohols
No full textA practical deconstructive arylation of aliphatic alcohols has been developed using a synergistic photoredox proton-coupled electron transfer (PCET) and nickel dual catalytic system. The method efficiently generates alkyl radicals via concerted PCET-mediated beta-scission, enabling the formation of C(sp3)-C(sp2) bonds between alcohols and aryl halides. Optimization studies revealed a broad functional group tolerance and high chemoselectivity, with good yields even for challenging tertiary alcohol substrates. Mechanistic insights from transient absorption spectroscopy confirmed the dominance of a PCET pathway for radical generation. This strategy expands the utility of alcohols as alkyl radical precursors in cross-coupling reactions, offering a versatile tool for constructing complex molecular architectures
Evidence of Site-Specific Mucosal Autoantibody Secretion in Rheumatoid Arthritis
No full textObjective Anti–citrullinated protein antibodies (ACPA) have been detected in sputum and saliva, indicating that anti–modified protein antibodies (AMPA) can be produced at mucosal sites in patients with rheumatoid arthritis (RA). However, the body's largest mucosal compartment, the gut, has not yet been examined. We therefore investigated the presence of several AMPA (ACPA, anti–carbamylated protein antibodies [anti-CarP], and anti–acetylated protein antibodies [AAPA]) at different mucosal sites, including the intestinal tract. Methods Paired fecal/ileal wash, saliva, and serum samples of patients with RA and healthy volunteers were collected in two independent cohorts. Data involving feces were replicated in a third cohort. In these secretions, AMPA were analyzed using in-house enzyme-linked immunosorbent assay with unmodified peptides as control. In fecal samples, total IgA and anti–Escherichia coli IgA were measured. Results ACPA, anti-CarP, and AAPA IgA were measurable in saliva of seropositive patients with RA (prevalence 9%–40%). No AMPA could be detected in feces. IgA was present because total IgA and anti–E. coli IgA were detectable in feces of ACPA-positive patients with RA and healthy donors. Results were confirmed in another cohort using colonoscopically collected ileal wash samples. Conclusion Our study shows the presence of ACPA, anti-CarP, and AAPA IgA in saliva of ACPA-seropositive patients with RA. However, no AMPA could be detected in feces/ileal wash samples of these patients, although our assays were able to measure other antigen-specific antibodies. These data suggest that mucosal autoantibody secretion may occur in the oral mucosa of patients with RA, whereas no evidence could be found for this process in the lower gastrointestinal tract
Boswellia hesperia sp. nov. (Burseraceae) from Socotra
No full textThe new species Boswellia hesperia Thulin, M.H.Weber and Rzepecky is described, illustrated and mapped. It is a dwarf tree, restricted to westernmost Socotra (Yemen), growing on limestone rocks, in which the usually prostrate stems tend to fill out holes and crevices. It differs from B. nana Hepper, another dwarf tree endemic to Socotra but restricted to the easternmost parts of the island, by having leaves densely pubescent with whitish hairs beneath and by its smaller flowers and fruits
Computational fluid dynamics of hot and cold air flow inside short and long mixing tees
No full textIn this paper, the numerical simulation was done for a cylindrical tee by establishing a steady-state simulation to examine the mixing performance. The temperature of the fluid at the hot inlet was chosen as 36 °C and 19 °C for the cold inlet. The numerical simulation was done for a short tee of 192 mm and a long mixing tee of 262 mm at a variety of momentum ratios. The geometry was meshed in FLUENT before solving the domain. For the meshing, the faces were initially named hot inlet, cold inlet, outlet, and walls. The triangular method was chosen to generate a mesh for the flow domain. The size of the cell in meshing was taken as 0.1 m. In this work, the SST k–ω models were selected to perform the computations. The analytical values of temperature were used to validate the numerical results. Results show that the thermal mixing was done effectively using the CFD ANSYS software package. Results show that the size of the mixing area is the same hence there is not much of a difference between the long tee and the short tee in that particular sector. The thermal mixing was found better when the velocity at the vertical inlet (y-axis) becomes greater and the average temperature is lower. Also, the increase in the pipe's length causes the average temperature to drop since the fluid mixes better the farther along it travels, while also slightly increasing the velocity
Computational fluid dynamics of flow over a cylindrical tube for steady and transient flow conditions
No full textThe primary objective of this numerical study is to analyse the 2D flow across a circular cylindrical tube under various laminar as well as turbulent flow regimes. In this study, the implicit finite volume scheme was employed to compute incompressible flow with time precision using convective flux discretization schemes of the second order. The computational results were validated by comparing the simulation results with empirical data of mean surface pressure, wake characteristics in both constant and transient flow regimes, and the Strouhal frequency associated with vortex scattering. In addition, the present simulation model adequately captures the intricate 2D flow structure of the cylinder wake
Income and education affect prognosis and treatment in symptomatic myeloma
No full textDespite advancements in multiple myeloma treatment, prognostic variability persists. We investigated the impact of income and education on treatment and survival in a country with publicly funded healthcare. We analysed data from the Swedish Myeloma Registry (2008–2021) linked to national registers. Cox models assessed survival, adjusting for demographics and comorbidities. Treatment patterns were compared using cumulative incidence functions. Among 8,672 patients, higher education and income correlated with prolonged survival. Adjusted hazard ratios (HRs) for low income were 1.4 (95% CI 1.3–1.5) and for low education were 1.3 (95% CI 1.2–1.4). Higher income patients were more likely to receive lenalidomide (HR 1.5, 95% CI 1.3–1.6) and pomalidomide (HR 1.7, 95% CI 1.4-2.0), and less likely to receive melphalan tablets (HR 0.8, 95% CI 0.7–0.9). Low-income patients were less likely to undergo stem cell transplant (HR 0.8, 95% CI 0.7–0.9). Immigrant status or biological sex did not influence outcomes. Even in a tax-funded system, socioeconomic disparities impact myeloma survival and treatment. Lower socioeconomic status correlates with inferior outcome and more conservative treatment. Attitudinal biases may contribute to these disparities. Better treatment for the less privileged patients could significantly improve myeloma survival, advocating for efforts to overcome the influence of socioeconomic status
