Search Results (27)

Background and Objectives: Implantation of cardiac implantable electronic devices (CIEDs) is increasingly performed in elderly and comorbid patients, for whom minimizing perioperative complications—including pain and systemic drug use—is critical. Traditional local infiltration often provides insufficient analgesia. The ultrasound-guided PECS II block, an interfascial regional technique, offers promising analgesic benefits in thoracic wall procedures but remains underutilized in cardiac electrophysiology. Materials and Methods: We conducted a prospective, controlled, non-randomized clinical study including 106 patients undergoing de novo CIED implantation. Patients were assigned to receive either a PECS II block (n = 53) or standard lidocaine-based local anesthesia (n = 53). Pain intensity was assessed using the numeric rating scale (NRS) intraoperatively and at 1, 6, and 12 h postoperatively. Secondary outcomes included the need for rescue analgesia, procedural duration, length of hospitalization, and patient satisfaction. Results: Patients in the PECS II group reported significantly lower NRS scores at all time points (mean intraoperative score: 2.1 ± 1.2 vs. 5.7 ± 1.6, p < 0.001; at 1 h: 2.5 ± 1.5 vs. 6.1 ± 1.7, p < 0.001). Rescue analgesia (metamizole sodium) was required in only four PECS II patients (7.5%) vs. 100% in the control group within 1 h. Hospital stay and procedural time were also modestly reduced in the PECS II group. Patient satisfaction scores were significantly higher in the intervention group. Conclusions: The ultrasound-guided PECS II block significantly reduces perioperative pain and the need for additional analgesia during CIED implantation, offering an effective, safe, and opioid-sparing alternative to conventional local infiltration. Its integration into clinical protocols for device implantation may enhance procedural comfort and recovery. Full article

Regional anesthesia techniques such as the ultrasound-guided PECS II (pectoral nerve block) block are increasingly employed to optimize perioperative analgesia while minimizing systemic anesthetic exposure. Ropivacaine is commonly used for its favorable pharmacological profile; however, clinical data on its pharmacokinetics and systemic metabolite behavior following interpectoral administration remain limited. This study aimed to characterize the plasma concentration–time profile of ropivacaine and its main active metabolite, 3-OH-ropivacaine, in patients undergoing interpectoral nerve block, using a validated LC-MS/MS (liquid chromatography coupled with mass spectrometry) method. Venous blood samples were collected from 18 patients at predefined time points (0, 1, 3, 6, and 24 h) following a PECS II block performed with a ropivacaine-lidocaine mixture. Plasma concentrations were quantified via a validated LC-MS/MS protocol in accordance with FDA (Food and Drug Administration) and EMA (European Medicines Agency) guidelines. Pharmacokinetic parameters were derived using non-compartmental analysis. Ropivacaine reached a mean peak plasma concentration (Cmax—maximum concentration) of 167.5 ± 28.3 ng/mL at 1.3 ± 0.2 h (Tmax—maximum time). The metabolite 3-OH-ropivacaine peaked at 124.1 ± 21.4 ng/mL at 2.3 ± 0.3 h. The terminal elimination half-life was 19.4 ± 2.8 h for ropivacaine and 29.2 ± 3.1 h for its metabolite. Plasma levels demonstrated prolonged systemic exposure with predictable pharmacokinetics. The PECS II block using ropivacaine results in sustained systemic levels of both the parent drug and its primary metabolite, supporting its role in prolonged perioperative analgesia. These data provide a pharmacokinetic foundation for personalized regional anesthesia protocols. This strategy facilitates the adaptation of anesthetic protocols to the individual characteristics of each patient, aligning with the principles of personalized medicine, particularly in patients with altered metabolic capacity. Full article

Background: Thoracic outlet syndrome (TOS) is an uncommon condition defined by the compression of neurovascular structures within the thoracic outlet. When conservative management strategies fail to alleviate symptoms, surgical decompression becomes necessary. The purpose of this study is to evaluate and compare the efficacy and safety of regional anesthesia (RA) using spontaneous breathing in contrast to general anesthesia (GA) for patients undergoing surgical intervention for TOS. Methods: We conducted a retrospective comparative study involving 68 patients who underwent trans-axillary first rib resection for TOS. The patient cohort was divided into two groups: 29 patients in the GA group and 39 patients in the RA group. The RA technique employed consisted of supraclavicular brachial plexus (SBP) and pectoral nerve (PECS II) blocks, accompanied by deep sedation. Key outcome measures such as pain scores, opioid consumption, and various perioperative parameters were systematically analyzed. Results: Postoperative pain levels recorded in the recovery room were significantly lower in the RA group, with a median numerical rating scale (NRS) score of zero compared to two in the GA group (p = 0.0443). Additionally, both intraoperative and postoperative opioid consumption showed a marked reduction in the RA group, with p-values of less than 0.001 and 0.0418, respectively. The RA approach was associated with shorter surgical durations (p = 0.0008), a decrease in the incidence of postoperative nausea and vomiting (PONV) (p = 0.0312), and a lower occurrence of intraoperative lung injuries (p < 0.0001). Furthermore, the length of hospital stay was significantly reduced for patients in the RA group. Conclusions: Although both groups reported low postoperative pain scores, the regional anesthesia approach exhibited distinct advantages in terms of opioid consumption, surgical duration, and overall perioperative outcomes. The utilization of SBP and PECS II blocks facilitated surgical procedures and mitigated complications, thereby positively influencing the postoperative recovery trajectory. Future prospective studies are essential to validate these findings further and to investigate long-term outcomes associated with the use of regional anesthesia in TOS surgery. Full article

Background and Objectives: Breast cancer surgeries offer challenges in perioperative pain management, especially in the presence of inherent risk of postoperative nausea and vomiting (PONV) and postmastectomy pain syndrome (PMPS). Inappropriate opioid consumption was speculated as one of the reasons. Through this study, the influence of objective pain monitoring through a nociception level monitor (NOL) on perioperative course in breast surgeries was investigated. Materials and Methods: This was a prospective randomized study conducted at a regional hospital. Sixty female patients posted for breast cancer surgery were randomized equally into study and control groups. Both groups were monitored using BIS and NOL, but in the control group, the NOL monitor was blinded by a cover. Both groups received propofol and remifentanil through target-controlled infusions (TCIs) along with interpectoral, pectoserratus (PECS II), and superficial pectointercostal block. The primary outcome was intraoperative opioid consumption. Secondary outcomes were PONV, eligibility for discharge from the recovery room, and symptoms of PMPS after three months. Results: Two patients were excluded. The study group received significantly less remifentanil (0.9 mg in the study group vs. 1.35 mg in the control group, p = 0.033) and morphine (2.5 mg in study group vs. 5 mg in control group, p = 0.013). There was no difference in PMPS symptoms between the groups. The study group showed longer duration of inadequate analgesia (i.e., 7% vs. 10% of the total intraoperative period in control and study group, respectively, p = 0.008). There was no difference in time to eligibility for discharge from the recovery room between the groups. Conclusions: NOL monitor-guided analgesic delivery reduces intraoperative opioid consumption. No difference was demonstrated on PONV, eligibility for discharge from the recovery room, or PMPS symptoms. Full article

Objective: to study the effectiveness of type II pectoral nerve block (PEC II) for breast augmentation with submuscular implants by assessing opioid consumption and pain scale in the immediate postoperative period, from the post-anesthesia care unit (PACU) to 24 h postoperatively. Methods: A prospective, controlled, randomized, and double-blind study. Thirty-four patients were analyzed during the perioperative period and in the PACU, with one group receiving bilateral PEC II combined with general anesthesia and the control group receiving only general anesthesia. Results: There was no difference between the groups regarding demographic data, surgical and anesthetic times, or intraoperative opioid use. Opioid consumption in the control group was consistently higher at all the time intervals studied, with an average morphine consumption 38.7% greater. The largest variation in morphine consumption occurred at the fourth and sixth hours postoperatively. The greatest difference in postoperative pain was 36% higher in the control group compared to the intervention group. Conclusions: patients who underwent general anesthesia combined with PEC II had lower opioid consumption and a lower postoperative pain score without associated complications, confirming the effectiveness of the procedure. Full article

Petroleum-based food packaging causes environmental problems such as waste accumulation and microplastic generation. In this work, biobased films from stable polyelectrolyte complex suspensions (PECs) of xylan and chitosan (70 Xyl/30 Ch wt% mass ratio), at different concentrations of citric acid (CA) (0, 2.5, 5, 7.5 wt%), were prepared and characterized. Films were treated at two temperatures (135 °C, 155 °C) and times (30 min, 60 min) to promote covalent crosslinking. Esterification and amidation reactions were confirmed by Fourier Transform Infrared Spectroscopy and Confocal Raman Microscopy. Water resistance and dry and wet stress–strain results were markedly increased by thermal treatment, mainly at 155 °C. The presence of 5 wt% CA tended to increase dry and wet stress–strain values further, up to 88 MPa—10% (155 °C for 60 min), and 5.6 MPa—40% (155 °C for 30 min), respectively. The UV-blocking performance of the films was improved by all treatments, as was thermal stability (up to T_onset: 230 °C). Contact angle values were between 73 and 84°, indicating partly wettable surfaces. Thus, thermal treatment at low CA concentrations represents a good alternative for improving the performance of Xyl/Ch films. Full article

This study proposed a model of a porous media-assisted flat-plate solar collector (FPSC) using nanofluid flow. The heightened thermal efficiency of FPSC undergoes numerical scrutiny, incorporating various factors for analysis, including aspects like the configuration of the porous block introduced, Darcy number (Da = 10⁻⁵~10⁻²), types of nanoparticles, volume fraction (φ), and mixing ratio (φ_c). The numerical findings indicate that the dominant factor in the channel is the global Nusselt number (Nu_g). As the Darcy number rises, there is an improvement in the heat transfer performance within the channel. Simultaneously, for the case of Re = 234, φ = 3%, and φ_c = 100%, the Nu_g in the channel reaches a maximum value of 6.80, and the thermal efficiency can be increased to 70.5% with the insertion of rectangular porous blocks of Da = 10⁻². Finally, the performance evaluation criteria (PEC) are employed for a comprehensive assessment of the thermal performance of FPSC. This analysis considers both the improved heat transfer and the pressure drop in the collector channel. The FPSC registered a maximum PEC value of 1.8 when rectangular porous blocks were inserted under conditions of Da = 10⁻² and Re = 234 and the nanofluid concentrations of φ = 3% and φ_c = 100%. The findings can be provided to technically support the future commercial applications of FPSC. The findings may serve as a technical foundation for FPSC in upcoming porous media and support commercial applications. Full article

Background and Objectives: The increase in the incidence and diagnosis rate of breast cancer demands the optimization of resources. The aim of this study was to assess whether the supplementation of the interpectoral-pectoserratus plane block (PECS II) reduces surgery and post-anesthesia care unit (PACU) time in patients undergoing breast cancer surgery. Materials and methods: This was a retrospective data-analysis study. In 2016, PECS II block was introduced as a supplement to general anesthesia for all mastectomies with or without axillary resections in South Jutland regional hospital, Denmark. The perioperative data of patients operated 3 years before and 3 years after 2016 was retrieved through the Danish anesthesia database and patient journals and systematically analyzed. Female patients aged over 18 years, with no use of muscle relaxant, intubation, and inhalation agents, were included. The eligible data was organized into two groups, i.e., Block and Control, where the Block group received PECS II Block, while the Control group received only general anesthesia. Parameters such as surgery time, anesthesia time, PACU time, opioid consumption, and the incidence of postoperative nausea and vomiting (PONV) in PACU were retrieved and statistically analyzed. Results: A total of 172 patients out of 358 patients met eligibility criteria. After applying exclusion criteria, 65 patients were filtered out. A total of 107 patients, 51 from the Block and 56 from the Control group, were eligible for the final analysis. The patients were comparable in demographic parameters. The median surgery time was significantly less in the Block group (78 min (60–99)) in comparison to the Control group (98.5 min (77.5–139.5) p < 0.0045). Consequently, the median anesthesia time was also shorter in the Block group (140 min (115–166)) vs. the Control group (160 min (131.5 to 188), p < 0.0026). Patients from the Block group had significantly lower intraoperative fentanyl consumption (60 µg (30–100)) as compared with the Control group (132.5 µg (80–232.5), p < 0.0001). The total opioid consumption during the entire procedure (converted to morphine) was significantly lower in the Block group (16.37 mg (8–23.6)) as compared with the Control group (31.17 mg (16–46.5), p < 0.0001). No statistically significant difference was found in the PACU time, incidences of PONV, and postoperative pain. Conclusions: The interpectoral-pectoserratus plane (PECS II) block supplementation reduces surgery time, anesthesia time, and opioid consumption but not PACU time during breast cancer surgery. Full article

Volatile organic compounds (VOCs) are a notable group of indoor air pollutants released by household products. These substances are commonly employed as solvents in industrial operations, and some of them are recognized or suspected to be cancer-causing or mutagenic agents. Due to their high volatility, VOCs are typically present in surface waters at concentrations below a few micrograms per liter. However, in groundwater, their concentrations can reach levels up to thousands of times higher. This study analyses the applicability of the photoelectrochemical (PEC) sensing of VOCs in aqueous medium. Tungsten oxide and bismuth vanadate photoanodes were tested for PEC sensing of xylene, toluene, and methanol in sodium chloride and sodium sulfate electrolytes. The crystalline structure and morphology of coatings were analyzed using XRD and SEM analyses. Photoelectrochemical properties were evaluated using cyclic voltammetry, chronoamperometry, and electrochemical impedance spectroscopy. The results of the study show that aromatic compounds tend to block the surface of the photoelectrode and interfere with the PEC sensing of other substances. WO₃ photoanode is found to be suitable for the PEC sensing of methanol under the mild conditions in aqueous electrolytes; however, electrode engineering and assay optimization are required to achieve better detection limits. Full article

This study aimed to evaluate the efficacy of the pectoral nerves interfacial plane block (PECS II) in breast cancer surgery focusing on postoperative pain management and patient satisfaction. A prospective study was conducted, including 200 patients scheduled for breast cancer surgery. The participants were randomly assigned to the PECS II block and control groups. The PECS II block group received a preoperative interfascial plane block, while the control group received standard analgesia. Postoperative pain scores at 4 h intervals for the first 3 postoperative days, as well as opioid consumption and patient-reported satisfaction, were measured and compared between both groups. The PECS II block group demonstrated significantly lower postoperative pain scores at all measured time points (p < 0.001). Additionally, the PECS II block group showed reduced opioid consumption (p < 0.001), reported higher levels of patient satisfaction compared to the control group, and had a notably shorter stay in the postoperative care unit (p < 0.001). Integrating the PECS block with general anesthesia in breast cancer surgeries enhances pain management, reduces opioid use, and shorten postanesthesia care unit stay. The evident benefits suggest PECS as a potential standard in breast surgeries. Future research should further investigate its long-term impacts and broader applications. Full article

Porcine extraintestinal pathogenic Escherichia coli (ExPEC) is a leading cause of death in pigs and has led to considerable economic losses for the pig industry. Porcine ExPEC infections often cause systemic inflammatory responses in pigs, characterized by meningitis, arthritis, pneumonia, and septicemia. Baicalin has been reported to possess potent anti-inflammatory activity, but its function in porcine ExPEC remains unknown. The aim of this study was to explore the protective effect and mechanism of baicalin against the porcine ExPEC-induced inflammatory responses in 3D4/21 cells. After treatment with baicalin, the effects on cell damage, the level of pro-inflammatory cytokines, the expression of nuclear factor-$\kappa$B (NF-$\kappa$B)/mitogen-activated protein kinase (MAPK) signaling pathways, and the activation of NOD-like receptor protein 3 (NLRP3) inflammasomes were examined. Our results show that baicalin significantly reduced the damage to 3D4/21 cells infected with porcine ExPEC PCN033. Further study showed that baicalin significantly reduced the transcription and expression of pro-inflammatory cytokines such as interleukin-1$\beta$ (IL-1$\beta$), interleukin-6 (IL-6), and interleukin-8 (IL-8). Furthermore, baicalin inhibited the phosphorylation of proteins such as P65, nuclear factor $\kappa$B inhibitor $\alpha$ (I$\kappa$B$\alpha$), extracellular regulated kinase (ERK), c-Jun N-terminal kinase (JNK), and P38 and reduced the expression levels of proteins such as NLRP3, apoptosis-associated speck-like protein containing a CARD (ASC), and caspase-1. These results reveal that baicalin reduced the damage to 3D4/21 cells by inhibiting the expression of NF-$\kappa$B/MAPK signaling pathways and blocking NLRP3 inflammasome activation in 3D4/21 cells infected with porcine ExPEC. Taken together, these results suggest that baicalin may have potential as a medicine for the treatment of porcine ExPEC-infected pigs by regulating inflammatory responses. This study provides a novel potential pharmaco-therapeutic approach to preventing porcine ExPEC infection. Full article

Building energy requalification in Italy and Europe has been much discussed in recent years due to the high percentage of existing buildings with poor energy performance. In this context, it is useful to obtain a user-friendly and fast tool to predict the thermal energy demand (TED) for space conditioning and the related primary energy consumption (PEC) as a function of climatic stress. In this study, the SLABE methodology (simulation-based large-scale uncertainty/sensitivity analysis of building energy performance) is used to simulate representative Italian buildings, varying parameters such as geometry, envelope and HVAC (heating, ventilating and space conditioning) systems. MATLAB^® in combination with EnergyPlus is used to analyze 200 buildings belonging to two structural types (multi-family buildings and apartment blocks) built in 1961–1975. Nine scenarios (as-built scenarios and eight retrofit ones) are investigated in 63 climatic locations. A regression analysis shows that the classical HDDs (heating degree days) approach cannot give an accurate prediction of TED because solar radiation is not accounted for. Thus, new climatic indices are developed alongside solar radiation, including the heating stress index (HSI), the cooling stress index (CSI) and the yearly climatic stress index (YCSI). The purpose of our work is to obtain climatic stress curves for the prediction of TED and PEC. Testing of this novel approach is performed by comparison with another building energy simulation tool, showing a low discrepancy, i.e., the coefficient of variation of the root mean square error is between 12% and 28%, which confirms certain reliability of the approach here proposed. Full article

In recent years, significant technological advances have emerged in renewable power generation systems (RPGS), making them more economical and competitive. On the other hand, for the RPGS to achieve the highest level of performance possible, it is important to ensure the healthy operation of their main building blocks. Power electronic converters (PEC), which are one of the main building blocks of RPGS, have some vulnerable components, such as capacitors, which are responsible for more than a quarter of the failures in these converters. Therefore, it is of paramount importance that the design of fault diagnosis techniques (FDT) assess the capacitor’s state of health so that it is possible to implement predictive and preventive maintenance plans in order to reduce unexpected stoppage of these systems. One of the most commonly used capacitors in power converters is the aluminum electrolytic capacitor (AEC) whose aging manifests itself through an increase in its equivalent series resistance (ESR). Several advanced intelligent techniques have been proposed for assessing AEC health status, many of which require the use of a current sensor in the capacitor branch. However, the introduction of a current sensor in the capacitor branch imposes practical restrictions; in addition, it introduces unwanted resistive and inductive effects. This paper presents an FDT based on the random forest classifier (RFC), which triggers an alert mechanism when the DC-link AEC reaches its ESR threshold value. The great advantage of the proposed solution is that it is non-invasive; therefore, it is not necessary to introduce any sensor inside the converter. The validation of the proposed FDT will be carried out using several computer simulations carried out in Matlab/Simulink. Full article

The well-defined heterostructure of the photocathode is desirable for photoelectrochemically producing hydrogen from aqueous solutions. Herein, enhanced heterostructures were fabricated based on typical stable covalent organic framework (TpPa-1) films and TiO₂ nanotube arrays (NTAs) as a proof-of-concept model to tune the photoelectrochemical (PEC) hydrogen generation by tailoring the photoelectrode microstructure and interfacial charge transport. Ultrathin TpPa-1 films were uniformly grown on the surface of TiO₂ NTAs via a solvothermal condensation of building blocks by tuning the monomer concentration. The Pt₁@TpPa-1/TiO₂-NTAs photoelectrode with single-atom Pt₁ as a co-catalyst demonstrated improved visible-light response, enhanced photoconductance, lower onset potential, and decreased Tafel slope value for hydrogen evolution. The hydrogen evolution rate of the Pt₁@TpPa-1/TiO₂-NTAs photoelectrode was five times that of Pt₁@TpPa-1 under AM 1.5 simulated sunlight irradiation and the bias voltage of 0 V. A lower overpotential was recorded as 77 mV@10 mA cm⁻² and a higher photocurrent density as 1.63 mA cm⁻². The hydrogen evolution performance of Pt₁@TpPa-1/TiO₂-NTAs photoelectrodes may benefit from the well-matched band structures, effective charge separation, lower interfacial resistance, abundant interfacial microstructural sites, and surficial hydrophilicity. This work may raise a promising way to design an efficient PEC system for hydrogen evolution by tuning well-defined heterojunctions and interfacial microstructures. Full article

Mussels secrete protein-based byssal threads to tether to rocks, ships, and other organisms underwater. The secreted marine mussel adhesive proteins (MAPs) contain the peculiar amino acid L-3,4-dihydroxyphenylalanine (DOPA), whose catechol group content contributes greatly to their outstanding adhesive properties. Inspired by such mussel bioadhesion, we demonstrate that catechol-modified polysaccharides can be used to obtain adhesive membranes using the compaction of polyelectrolyte complexes (CoPEC) method. It is a simple and versatile approach that uses polyelectrolyte complexes as building blocks that coalesce and dry as membrane constructs simply as a result of sedimentation and mild temperature. We used two natural and biocompatible polymers: chitosan (CHI) as a polycation and hyaluronic acid (HA) as a polyanion. The CoPEC technique also allowed the entrapment of ternary bioactive glass nanoparticles to stimulate mineralization. Moreover, combinations of these polymers modified with catechol groups were made to enhance the adhesive properties of the assembled membranes. Extensive physico-chemical characterization was performed to investigate the successful production of composite CoPEC membranes in terms of surface morphology, wettability, stability, mechanical performance, in vitro bioactivity, and cellular behavior. Considering the promising properties exhibited by the obtained membranes, new adhesives suitable for the regeneration of hard tissues can be envisaged. Full article