Evaluation of Rhomboid Intercostal Block in Video-Assisted Thoracic Surgery: Comparing Three Concentrations of Ropivacaine

Background: Ultrasound-guided rhombic intercostal block (RIB) is a novel regional block that provides analgesia for patients who have received video-assisted thoracoscopic surgery (VATS). The anesthetic characteristics of ultrasound-guided RIB with different concentrations of ropivacaine are not known. This research primarily hypothesizes that ultrasound-guided RIB, given in combination with the same volume of different concentrations of ropivacaine, would improve the whole quality of recovery-40 (QoR-40) among patients with VATS.Approaches: This double-blinded, single-center, prospective, and controlled trial randomized 100 patients undergoing VATS to receive RIB. One hundred patients who have received elective VATS and satisfied inclusion standards were fallen into four groups randomly: control group with no RIB and R0.2%, R0.3%, and R0.4%; they underwent common anesthesia plus the RIB with ropivacaine at 0.2%, 0.3%, and 0.4% in a volume of 30 ml.Outcomes: Groups R0.2%, R0.3%, and R0.4% displayed great diversities in the overall QoR-40 scores and QoR-40 dimensions (in addition to psychological support) by comparing with the control group (Group C) (p < 0.001 for all contrasts). Groups R0.3% and R0.4% displayed great diversities in the overall QoR-40 scores and QoR-40 dimensions (in addition to psychological support) by comparing with the R0.2% group (p < 0.001 for all contrasts). The overall QoR-40 scores and QoR-40 dimensions [physical comfort (p = 0.585)] did not vary greatly between Groups R0.3% and R0.4% (p > 0.05 for all contrasts). Groups R0.2%, R0.3%, and R0.4% showed significant differences in numerical rating scales (NRS) score region under the curve (AUC) at rest and on movement in 48 h when compared with the Group C (p < 0.001 for all contrasts). Groups R0.3% and R0.4% displayed great diversities in NRS score AUC at rest and on movement in 48 h when compared with the R0.2% group (p < 0.001 for all contrasts). The NRS mark AUC at rest and, on movement in 48 h, did not vary greatly between the Group R0.3% and R0.4% (p > 0.05 for all contrasts).Conclusion: In this study it was found that a dose of 0.3% ropivacaine is the best concentration for RIB for patients undergoing VATS. Through growing ropivacaine concentration, the analgesia of the RIB was not improved greatly.Clinicaltrials.gov Registration:https://clinicaltrials.gov/, identifier ChiCTR2100046254.

Correlations between body postures and musculoskeletal pain in guitar players

Background The guitar-playing community is the largest group at risk of developing playing related musculoskeletal disorders. A thorough investigation of the relationships between the various risk factors and players’ report on musculoskeletal pain using objective and accurate means of assessment has yet to be reported. Purpose (a) to explore the correlations between demographic characteristics, anthropometric measurements, playing habits, and personal habits of guitar player and their complaints of musculoskeletal pain, (b) explore the correlations between the upper body kinematics of guitar players during playing the guitar and their complaints of musculoskeletal pain, and (c) compare the upper body kinematics of guitar players during playing the guitar while sitting versus standing. Methods Twenty-five guitar players (27.5±4.6 years old) filled out questionnaires regarding their guitar-playing habits, and the Standardized Nordic Questionnaires for the analysis of musculoskeletal symptoms. Kinematics of their torso and upper limbs were tracked while they played a tune twice, once while sitting and once while standing. Results We found moderate correlations between the number of painful joints in the last year and factors, such as physical comfort while playing, years of playing, and position during playing. During standing, lower back pain severity correlated with the rotation range of the torso, while during sitting, it moderately correlated with the average radial-ulnar deviation of the right wrist. During sitting, we found higher anterior and right tilt of the torso, combined with greater abduction of the right shoulder, higher flexion in the left shoulder and higher radial deviation in the left wrist. Conclusion Our results point to several risk factors, related both to playing habits but also to playing posture, which should be considered by the guitar players in order to prevent playing-related musculoskeletal disorders.

Sustainability in farming sector and physical comfort in work place to reduce Mental- stress of Farmers

Musculoskeletal discomforts and disorders cause serious health related problems that affect the mental well-being of farmers reducing their work efficiency and thus, hindering to achieve a sustainable agriculture. The objective of this study was to evaluate the discomfort levels of farmers in Indian agriculture leading to mental stresses, and for this, the discomfort questionnaire has been applied after carrying out a detailed literature review. With the help of discomfort questionnaire and “Depression, Anxiety and Stress Scale (DASS-21)”, the farmers discomfort levels and their mental stress levels were evaluated. Further by the application of ANFIS, an effort has been made to predict the mental stress of farmers during their work activities in hot-climatic conditions based on the associated parameters like “kcal burnt, Pulse rate, High BP, Low BP, and Temperature”, respectively.

Cycling for a Sustainable Touristic Mobility: A Preliminary Study in an Urban Area of Italy

This study wants to give a contribution for the investigation of sustainable mobility with positive consequences on public health implementing policies starting from cyclists’ perceptions. Data were collected by interviewing cyclists along three bike lanes of an urban area of southern Italy through a face-to-face survey. The survey was conducted in Autumn 2019, interviewing a sample of 129 cyclists. In order to identify the critical aspects of the bike paths, both an importance-performance analysis (IPA) and a gap-IPA were performed. The average values of the cyclists’ perceptions of each aspect have been considered as performance values. The importance values have been obtained by performing a principal component analysis (PCA), which was helpful also for better defining the service quality phenomenon. From the PCA, six latent constructs can be identified as: “Physical Nuisance”; “Non-physical Nuisance”; “Physical Comfort”; “Non-physical Comfort”; “Protection”; and “Ambience”. The results of Gap-IPA confirmed that the criticalities of the bike paths relate to the degree of protection in relation to accidents, and to the degree of nuisance caused by pollution and opposing pedestrians along the path. Based on the conducted analyses, sustainable tourism implementing policies should be oriented in solving the emerged criticalities of the existing bike paths. The results of Gap-IPA are very intuitive and can certainly be helpful for identifying the most convenient strategies.

HISTORICAL DEVELOPMENT OF PALLIATIVE ESTABLISHMENTS IN THE WORLD AND IN UKRAINE

The object of the research is centers of palliative help. The article of research is historical development of establishments of palliative medicine. Global environmental problems of today lead to increase in the incidence of population and increase in incurable cases. The problems of terminally ill patients are been dealt with by palliative medicine, which takes care of the situation of such patients and their families. The article deals with the history of development of palliative care facilities in the world - hospices. The situation of creation of such establishments in Ukraine is analyzed, which indicates the need to revise the state regulatory framework for design. The analysis conducted in the article indicates the inconsistency of the current norms and the absence of special normative bases for the design of hospices. Current situation does not allow for proper development of the construction of palliative care facilities. In addition, the main criteria and needs are discussed in the article: Physical comfort (achieved by creating a home atmosphere in the hospital) Psychological comfort (achieved using the principle of an individual approach to each patient, taking into account all their needs) Social comfort (achieved by designing places for communication with other patients, as well as with relatives and friends. It is important that such places possess and create a positive attitude and distract from negative thoughts) Visual comfort (achieved with the help of thoughtful landscaping and designing places for walks, squares, intimate areas for rest and relaxation, as well as for the hobbies of patients)

Recognizing and Mitigating Canine Stress during Animal Assisted Interventions

Animal-assisted Interventions (AAI) proliferated rapidly since clinicians and researchers first noted the positive effects animals have on people struggling with physical and mental health concerns. The intersection of AAI with the field of animal welfare evolved from considering animals’ basic needs, such as freedom from pain, to recognition that animals experience nuanced emotions. Current conceptualizations of the various roles of companion animals as an adjunct to treatments for humans emphasize not only the animals' physical comfort and autonomy, but also their mental well-being and enjoyment of AAI activities. However, numerous challenges to effective monitoring of animals involved in AAI exist. This article focuses specifically on dogs, highlighting factors that may lead handlers and therapists to miss or ignore canine stress signals during human-animal interactions and offers strategies to recognize and ameliorate dogs’ distress more consistently. The primary goals of this discussion are to summarize the current thinking on canine well-being and to highlight practical applications of animal welfare principles in real-world AAI settings. The paper highlights contextual factors (e.g., physical setting, patient demand), human influences (e.g., desire to help), and intervention characteristics (e.g., presence or absence of a dog-specific advocate) that may promote or inhibit humans’ ability to advocate for therapy dogs during AAI activities. Deidentified examples of each of these factors are discussed, and recommendations are provided to mitigate factors that interfere with timely recognition and amelioration of canine distress.

Medina’s Habitation as a Sustainable Investment Factors: Thermal Experience

The study examined significant summer heat effects on a traditional habitation cluster within a compact fabric of the Medina of Constantine, based on building materials and spatial functional architecture. As climate relates to energy effects, the study raises the importance of possible heat gains in the approach of thermal comfort through building materials without using other energy sources. The study employed both empirical and comparative methods to undertake the research work. The empirical method consisted of taking thermal and metric measurements of the habitation cluster and comparing them with current normative requirements in sustainable architecture. The comparative method consisted of comparing results of performance assessment of studied building materials with results of similar materials. The current study adds to researchers' claims about the importance of the Medina's habitation in the face of climatic aggression at times with its architecture and building materials. Medina’s habitat did not have the technological means to preserve some physical comfort and reduce greenhouse gas emissions, yet its architecture used soft means to accomplish the physical comfort. Additionally, the site's well-chosen materials, which are formed by the natural typology, match well with the site’s climate and provide better resistance to material overflow, not to mention their availability and inexpensive cost.

Evaluation of Rhomboid Intercostal Block in Video-assisted Thoracic Surgery: Comparing three Concentrations of Ropivacaine

Background: Ultrasound-guided rhombic intercostal block (RIB) is a novel regional block that provides analgesia for patients who have received video-assisted thoracoscopic surgery (VATS). The anesthetic characteristics of ultrasound-guided RIB with different concentrations of ropivacaine are not known. This research primarily hypothesizes that ultrasound-guided RIB, given in combination with the same volume of different concentrations of ropivacaine, would improve the whole quality of recovery-40 (QoR-40) among patients with VATS.Approaches: This double-blinded, single-center, prospective, and controlled trial randomized 100 patients undergoing VATS to receive RIB. One hundred patients who have received elective VATS and satisfied inclusion standards were fallen into four groups randomly: control group with no RIB and R0.2%, R0.3%, and R0.4%; they underwent common anesthesia plus the RIB with ropivacaine at 0.2%, 0.3%, and 0.4% in a volume of 30mL.Outcomes: Groups R0.2%, R0.3%, and R0.4% displayed great diversities in the overall QoR-40 scores and QoR-40 dimensions (in addition to psychological support) by comparing with the control group (Group C) (p<0.001 for all contrasts). Group R0.3% and R0.4% displayed great diversities in the overall QoR-40 scores and QoR-40 dimensions (in addition to psychological support) by comparing with the R0.2% group (p<0.001 for all contrasts). The overall QoR-40 scores and QoR-40 dimensions (physical comfort [p=0.585]) did not vary greatly between the Group R0.3% and R0.4% (p>0.05 for all contrasts). Group R0.2%, R0.3% and R0.4% showed significant differences in numerical rating scales (NRS) score region under the curve (AUC) at rest and on movement in 48 hours when compared with the Group C (p<0.001 for all contrasts). Group R0.3% and R0.4% displayed great diversities in NRS score AUC at rest and on movement in 48 hours when compared with the R0.2% group (p<0.001 for all contrasts). The NRS mark AUC at rest and on movement in 48 hours did not vary greatly between the Group R0.3% and R0.4% (p>0.05 for all contrasts).Conclusion: It was found that a dose of 0.3% ropivacaine is the best concentration for RIB for patients undergoing VATS. Through growing ropivacaine concentration, the analgesia of the RIB was not improved greatly.Trial registration number: ChiCTR2100046254

Ubiquitous conformable systems for imperceptible computing

Purpose Although conformable devices are commonly designed to couple with the human body for personalized and localized medicine, their applications are expanding rapidly. This paper aims to delineate this expansion and predict greater implications in diverse fields. Design/methodology/approach Today’s device technologies continue to face fundamental obstacles preventing their seamless integration with target objects to effectively access, evaluate and alter self-specific physical patterns, while still providing physical comfort and enabling continuous data collection. Due to their extreme mechanical compliance, conformable devices permit the query of signals occurring at interfaces so as to decode and encode biological, chemical and mechanical patterns with high resolution, precision and accuracy. These unique and versatile capabilities allow for a marked change in the approach to tackling scientific questions, with the ability to address societal challenges at large. Findings Here, this study highlights the current state of these devices in a wide range of fields, such as interactive teaching, textiles, robotics, buildings and infrastructure, agriculture, climate and space, and further forecasts essential features of these devices in the near future. Originality/value This study justifies conformable devices’ growing utility through a novel quantitative analysis methodology that indexes peer-reviewed journal articles based on specific keywords, whereby this study tracks keyword frequency over time across specific fields in conjunction with conformability-like topics. The resulting trends’ trajectories provide the foundation for this study’s future projections. This study concludes with a perspective on the possible challenges concomitant with a ubiquitous presence of these technologies, including manufacturing, wireless communication, storage, compression, privacy and sharing of data, environmental sustainability, avoidance of inequality and bias and collaboration between stakeholders at all levels of impact.

Introducing Exoskeletons into the Operating Room: A pilot study with vascular surgeons

The main goal of this pilot study was to create, implement and evaluate a strategy for introducing exoskeletons in the operating room (OR) at a quaternary care academic hospital. The strategy consisted of operating-room-specific considerations, introducing exoskeletons to surgeons, and a post-surgery survey. Three male attending vascular surgeons participated in eleven data collections to date. Low interference with surgeon’s ability to perform surgery was found for all surgical procedures, except for two open abdominal aortic procedures. The surgeons reported little to no limit on range of motion, except for one open abdominal aortic procedure. Lower than expected perceived improvement of ability to perform surgery and increase of physical comfort was self-reported. The responses indicate that the surgeons are willing to keep trying an exoskeleton intervention. In conclusion, a feasible process was created to introduce passive exoskeleton as an ergonomic intervention to vascular surgeons in their ORs.