Background
Postoperative pain and anxiety are two common factors influencing patient’s recovery. Benefits and safety in the use of sedative agents after abdominal operations to improve recovery are ...not well known. The present study is to evaluate the efficacy and safety of dexmedetomidine use in this population.
Methods
A prospective randomized controlled trial of 145 patients undergoing abdominal operations was conducted in the Surgical Intensive Care Unit of Jinling Hospital between October and December 2015. Thirty-two patients were excluded, and 113 were included and divided into the experimental group (59 patients) receiving dexmedetomidine and analgesics for 72 h after abdominal operations, and the control group (54 patients) receiving only analgesics. Postoperative pain, inflammatory response, recovery of gastrointestinal function, adverse events, and sedation level were analyzed.
Results
Pain scores, assessed by Prince Henry Pain Scale (PHPS), in the experimental group were significantly lower than in the control group on the first (1.53 vs. 2.07,
p
≤ 0.01), second (1.07 vs. 1.63,
p
≤ 0.01), and third day (1.08 vs. 1.82,
p
= 0.01). Time to defecation was 0.60 days shorter in the experimental group than the control group (2.51 vs. 3.11
, p
= 0.01). There was no significant difference between inflammatory responses in the two groups (
p
> 0.05). Both groups had similar blood pressure, heart rate, prevalence of bradycardia, and hypotension requiring interventions (
p
> 0.05).
Conclusions
The addition of dexmedetomidine to analgesia after abdominal operations is safe and could enhance gastrointestinal function recovery and pain control when monitored carefully. The capacity of dexmedetomidine to attenuate inflammatory responses requires further investigation.
Compared with organic–inorganic hybrid perovskite solar cells (PSCs), carbon-based all-inorganic PSCs have the advantages of low preparation cost, simple process, and good thermal stability. Here, ...three polar materials of 4-tert-Butylpyridine halides (tBPX: X = Cl, Br, I) are modified between the perovskite absorbent layer and the carbon electrode. On the one hand, the introduction of tBPX effectively improves the dielectric constant of perovskite nanocrystals and reduces the carrier trapping ability of defects. On the other hand, the structural–functional groups act on the perovskite interface, effectively passivate the surface defects of the perovskite nanoscale thick film, and reduce the nonradiative recombination loss of carriers. In addition, the interface modification of tBPX forms a hydrophobic protective barrier, which significantly improves the moisture resistance of the device. As a result, the carbon-based CsPbI2Br PSCs achieve a power conversion efficiency (PCE) of 14.39%, which is higher than 12.79% of the pristine device. The optimized device can maintain more than 80% of the original efficiency after 800 h of aging under a 20 ± 5% relative humidity in the atmospheric environment. Therefore, it provides an idea for the preparation of efficient and stable carbon-based all-inorganic PSCs.
Pulmonary changes in veno‐venous extracorporeal membrane oxygenation (VV‐ECMO) are rarely determined. We compared the contribution of VV‐ECMO and cannulation based on the observation of pulmonary ...inflammatory reaction and parenchymal construction in a porcine model of low tidal volume (VT) ventilation. We also evaluated the effect of adding continuous renal replacement therapy (CRRT) to the ECMO circuit, because CRRT is known to reduce systemic cytokine release induced by VV‐ECMO. A total of 18 pigs undergoing low‐VT ventilation were randomly divided into three groups (group 1, cannulation; group 2, VV‐ECMO; group 3, VV‐ECMO + CRRT) and studied for 24 h. Hemodynamic and ventilation parameters were recorded. We assessed plasma and alveolar cytokines, expression of pulmonary inflammatory genes, histopathological grading, and ultrastructural changes of the lungs. During the process, inspiratory volume increased and PaO2 decreased in group 1. Systemic tumor necrosis factor‐α (TNF‐α) and interleukin 6 (IL‐6) levels increased at 2 h in group 2 and partly decreased in group 3. At 24 h, the levels of bronchoalveolar lavage fluid, TNF‐α, and IL‐6 in group 2 were remarkably higher than those in groups 1 and 3. Pulmonary mRNA expression of cytokines did not differ between the groups. We observed an increased score of pulmonary pathological findings in pro‐inflammatory cell infiltration and interstitial thickening of the lungs in group 2. The epithelium of the blood–air barrier after VV‐ECMO was swollen. In group 3, the pulmonary parenchyma and blood–air barrier were well preserved. We concluded that in a porcine model of low‐VT ventilation, both VV‐ECMO and VV‐ECMO in combination with CRRT provided adequate oxygenation and carbon dioxide removal. Compared with VV‐ECMO alone, VV‐ECMO in combination with CRRT better preserved the lung parenchyma by eliminating systemic cytokines.
It is unclear at present whether extracorporeal membrane oxygenation (ECMO) therapy can improve intestinal mucous barrier function through increased perfusion. The present study establishes an animal ...model for post-traumatic acute respiratory distress syndrome (ARDS) and evaluates the effect of v-vECMO treatment on the intestinal mucosal barrier.
Pulmonary contusion combined with ischemia-reperfusion injury was induced in 30 piglets. The animals were randomly divided into control, model, and ECMO groups. Serum I-FABP, D-lactate, and endotoxin were measured over a 24-h period. The jejunum and colon were collected post-mortem and evaluated histopathologically. The tissue was also examined using electron microscopy, and intestinal tight junction proteins (ZO-1 and occludin) were measured after 24 h of ECMO therapy. Mortality rate and cause of death were also recorded.
The serum markers evaluating the intestinal mucosal barrier deteriorated in the model group compared to the control group (p < 0.05). At 2 h, serum I-FABP, D-lactate, and endotoxin were significantly increased in the ECMO group compared to the model group (p < 0.05). At 12 h, I-FABP and D-lactate in the ECMO group dropped to model group levels. Serum D-lactate was slightly lower in the ECMO group (p > 0.05) and serum I-FABP was significantly lower than in the model group (p < 0.05) at 24 h. Similarly, serum endotoxin was slightly lower in the ECMO group than in the model group (p > 0.05) at 24 h. After 24 h of ECMO therapy, the occludin and ZO-1 protein concentrations in jejunum and colon mucosa increased moderately compared to that in the model group (p < 0.05). Morphologic structure of the jejunum and colon did not improved significantly after ECMO therapy. Finally, we observed that ECMO therapy moderately decreased mortality (25% vs. 50%).
Intestinal mucosal barrier continued to deteriorate in the model group. Although early ECMO therapy aggravates intestinal mucosal injury, the damage gradually improves later during therapy. The results show that ECMO therapy has a protective effect on the intestinal mucosal barrier in the later treatment stage.
Extracorporeal membrane oxygenation (ECMO) has been recommended for treatment of acute, potentially reversible, life-threatening respiratory failure unresponsive to conventional therapy. Intestinal ...mucosal barrier dysfunction is one of the most critical pathophysiological disorders during ECMO. This study aimed to determine whether combination with CRRT could alleviate damage of intestinal mucosal barrier function during VV ECMO in a porcine model.
Twenty-four piglets were randomly divided into control(C), sham(S), ECMO(E) and ECMO + CRRT(EC) group. The animals were treated with ECMO or ECMO + CRRT for 24 hours. After the experiments, piglets were sacrificed. Jejunum, ileum and colon were harvested for morphologic examination of mucosal injury and ultrastructural distortion. Histological scoring was assessed according to Chiu's scoring standard. Blood samples were taken from the animals at -1, 2, 6, 12 and 24 h during experiment. Blood, liver, spleen, kidney and mesenteric lymphnode were collected for bacterial culture. Serum concentrations of diamine oxidase (DAO) and intestinal fatty acid binding protein (I-FABP) were tested as markers to assess intestinal epithelial function and permeability. DAO levels were determined by spectrophotometry and I-FABP levels by enzyme linked immunosorbent assay.
Microscopy findings showed that ECMO-induced intestinal microvillus shedding and edema, morphological distortion of tight junction between intestinal mucous epithelium and loose cell-cell junctions were significantly improved with combination of CRRT. No significance was detected on positive rate of serum bacterial culture. The elevated colonies of bacterial culture in liver and mesenteric lymphnode in E group reduced significantly in EC group (p < 0.05). Compared with E group, EC group showed significantly decreased level of serum DAO and I-FABP (p < 0.05).
CRRT can alleviate the intestinal mucosal dysfunction and bacterial translocation during VV ECMO, which may extenuate the ECMO-associated SIRS and raise the clinical effect and safety.
Individual Judgments Versus Consensus Song, Hengjie; Xu, Yonghui; Min, Huaqing ...
ACM transactions on the web,
02/2016, Letnik:
10, Številka:
1
Journal Article
Recenzirano
Query-URL relevance, measuring the relevance of each retrieved URL with respect to a given query, is one of the fundamental criteria to evaluate the performance of commercial search engines. The ...traditional way to collect reliable and accurate query-URL relevance requires multiple annotators to provide their individual judgments based on their subjective expertise (e.g., understanding of user intents). In this case, the annotators’ subjectivity reflected in each annotator individual judgment (AIJ) inevitably affects the quality of the ground truth relevance (GTR). But to the best of our knowledge, the potential impact of AIJs on estimating GTRs has not been studied and exploited quantitatively by existing work. This article first studies how multiple AIJs and GTRs are correlated. Our empirical studies find that the multiple AIJs possibly provide more cues to improve the accuracy of estimating GTRs. Inspired by this finding, we then propose a novel approach to integrating the multiple AIJs with the features characterizing query-URL pairs for estimating GTRs more accurately. Furthermore, we conduct experiments in a commercial search engine—Baidu.com—and report significant gains in terms of the normalized discounted cumulative gains.
Recipe is a set of instructions that describes how to make food. It can help people from the preparation of ingredients, food cooking process, etc. to prepare the food, and increasingly in demand on ...the Web. To help users find the vast amount of recipes on the Web, we address the task of recipe recommendation. Due to multiple data types and relationships in a recipe, we can treat it as a heterogeneous network to describe its information more accurately. To effectively utilize the heterogeneous network, metapath was proposed to describe the higher-level semantic information between two entities by defining a compound path from peer entities. Therefore, we propose a metapath-enhanced recipe recommendation framework, RecipeMeta, that combines GNN (Graph Neural Network)-based representation learning and specific metapath-based information in a recipe to predict User-Recipe pairs for recommendation. Through extensive experiments, we demonstrate that the proposed model, RecipeMeta, outperforms state-of-the-art methods for recipe recommendation.
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