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Background: Children receiving proton therapy require repeated sedation. In this study, we aimed to investigate the utility of the perfusion index (PI) for evaluating consciousness level during repeated propofol sedation. Methods: In this prospective observational study, children aged from birth to 19 years old scheduled for proton therapy under repeated propofol sedation were enrolled. The primary outcome was the equivalence of PI values 5 min after anesthesia induction on consecutive sedation. Total consumption of propofol during sedation, time to reach the University of Michigan sedation scale (UMSS) score 1 after end of proton therapy, and duration of post‐anesthesia care unit (PACU) stay were recorded. Results: The PI values measured 5 min after induction of anesthesia were not equivalent to each other in consecutive sedation except for the second versus third (1st vs. 2nd: 97.5% CI: −1.34, 0.91; p = 0.206, 0.034; 2nd vs. 3rd: 97.5% CI: −0.87, 0.94; p = 0.023, 0.036 3rd vs. 4th: 97.5% CI: −2.08, −0.26; p < 0.99, <0.001; 4th vs. 5th: 97.5% CI: 0.21, 2.28; p < 0.001, >0.99; respectively). In consecutive sedation, there was not a significantly different difference in the time to reach UMSS score 1 (p > 0.99, all) for total consumption of propofol, time to reach UMSS score 1 after the end of proton therapy, and duration of PACU stay. Conclusions: During repeated propofol sedation in children, PI was insufficient to be used as an indicator of consciousness level assessment. However, we suggest that the information related to repeated sedation provided by this study may be helpful in clinical practice. [ABSTRACT FROM AUTHOR]

Background: Posterior quadratus lumborum block (QLB) and intrathecal morphine are accepted analgesic strategies in laparoscopic liver resection, but their effects have not been compared after laparoscopic donor hepatectomy. This study was planned to perform this comparison.Methods: Fifty-six donors were randomized to receive bilateral posterior (QLB2, 20 mL of 0.375% ropivacaine on each side, 150 mg total) or preoperative injection of 0.4 mg morphine sulfate intrathecally. Primary outcome was resting pain score at 24 hour postsurgery. Secondary outcomes included cumulative opioid consumption and recovery parameters. Serial plasma ropivacaine concentrations were measured in QLB group. Only the outcome assessor was properly blinded.Results: Mean resting pain score at 24-hour postsurgery was 4.19±1.66 in QLB group (n=27) and 3.07±1.41 in intrathecal morphine group (n=27, p=0.04). Mean difference (QLB group-intrathecal morphine group) was 1.11 (95% CI 0.27 to 1.95), and the upper limit of CI was higher than prespecified non-inferiority margin (δ=1), indicating an inferior effect of QLB. Cumulative opioid consumption was significantly higher in QLB group at 24 hours and 48 hours postsurgery. QLB group exhibited lower incidence of postoperative pruritus at all time points, and there were no differences in other recovery outcomes. All measured ropivacaine concentrations were below the threshold for systemic toxicity (4.3 µg/mL).Conclusions: Bilateral posterior QLB elicited higher resting pain scores at 24-hour after laparoscopic donor hepatectomy than intrathecal morphine and did not meet the definition of non-inferiority.Trial Registration Number: KCT0005360. [ABSTRACT FROM AUTHOR]

Background: Ultrasound is not widely used to evaluate optimal supraglottic airway positioning even though it could potentially be used to identify and correct problem areas. Aims: We evaluated a new ultrasound scoring method to identify the position of the supraglottic airway and detect the location of air leaks during ventilation in pediatric patients. Methods: Using a prospective observational study design, we enrolled 90 pediatric patients of ASA physical status I–III scheduled for elective surgery under general anesthesia. After anesthesia induction, patients were assigned to a noncorrection group or a correction group after their first ultrasound evaluation. Noncorrection group comprised patients with tolerable I‐Gel positioning based on ultrasound evaluation and no problems with clinical parameters, while the correction group comprised patients with I‐Gel mispositioning based on ultrasound. Results: After the first ultrasound evaluation, 61 patients did not need I‐Gel correction (noncorrection group), while 29 patients needed I‐Gel correction (correction group) and underwent a second ultrasound evaluation. Airway sealing pressure and total ultrasound score showed a negative correlation (r = −.845, p <.001). The area under the receiver operating curve for total ultrasound score was 0.97 (95% confidence interval, 0.94–0.99; p <.001). In the correction group, ultrasound score and ventilation parameters improved after correction based on ultrasound evaluation. Conclusions: Ultrasound scores were negatively correlated with airway sealing pressure in pediatric patients. Ultrasound evaluation is useful for detecting misplacement of the I‐Gel and can be a useful tool for correction. [ABSTRACT FROM AUTHOR]

X-ray diffraction, atomic force microscopy and magnetic measurements were used for examining the structural, electrical and magnetic properties of the YMn(sub 2-x)(Fe,Co)xO(sub 5-delta) (0.0< or equal to x< or equal to 1.0) pseudobinary oxides. At room temperature, spontaneous polarization (ferroelectric) and magnetization (ferromagnetic) were observed in the samples with YMn1.8Fe0.2O(sub 5-delta) and YMn1.8Co0.2O(sub 5-delta) composition.

The structural, electrical, and magnetic properties of the YMn2-x(Fe,Co)xO5-δ (0.0<=x<=1.0) pseudobinary oxides have been studied utilizing x-ray diffraction, atomic force microscopy, and magnetic measurements. Our interest in these oxides begins with the hypothesis that both ferroelectric and ferromagnetic properties coexist (a condition known as “ferroism or multiferroism”) in these oxides. Pure and (Fe,Co)-doped YMn2O5-δ series have been successfully prepared by means of the sol–gel process. The samples with YMn1.8Fe0.2O5-δ and YMn1.8Co0.2O5-δ composition display a room temperature spontaneous polarization (ferroelectric) and magnetization (ferromagnetic). The ferroism responses in (Fe,Co)-doped YMn2O5-δ series present an opportunity to create and implement spintronics devices that actively couple the ferromagnetic and ferroelectric order parameters. © 2004 American Institute of Physics. [ABSTRACT FROM AUTHOR]

Introduction: The large-scale artificial intelligence (AI) language model chatbot, Chat Generative Pre-Trained Transformer (ChatGPT), is renowned for its ability to provide data quickly and efficiently. This study aimed to assess the medical responses of ChatGPT regarding anesthetic procedures., Methods: Two anesthesiologist authors selected 30 questions representing inquiries patients might have about surgery and anesthesia. These questions were inputted into two versions of ChatGPT in English. A total of 31 anesthesiologists then evaluated each response for quality, quantity, and overall assessment, using 5-point Likert scales. Descriptive statistics summarized the scores, and a paired sample t -test compared ChatGPT 3.5 and 4.0., Results: Regarding quality, "appropriate" was the most common rating for both ChatGPT 3.5 and 4.0 (40 and 48%, respectively). For quantity, responses were deemed "insufficient" in 59% of cases for 3.5, and "adequate" in 69% for 4.0. In overall assessment, 3 points were most common for 3.5 (36%), while 4 points were predominant for 4.0 (42%). Mean quality scores were 3.40 and 3.73, and mean quantity scores were - 0.31 (between insufficient and adequate) and 0.03 (between adequate and excessive), respectively. The mean overall score was 3.21 for 3.5 and 3.67 for 4.0. Responses from 4.0 showed statistically significant improvement in three areas., Conclusion: ChatGPT generated responses mostly ranging from appropriate to slightly insufficient, providing an overall average amount of information. Version 4.0 outperformed 3.5, and further research is warranted to investigate the potential utility of AI chatbots in assisting patients with medical information., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Choi, Oh, Park, Kang, Yoo, Lee and Yang.)

Background: Ultrasound is not widely used to evaluate optimal supraglottic airway positioning even though it could potentially be used to identify and correct problem areas., Aims: We evaluated a new ultrasound scoring method to identify the position of the supraglottic airway and detect the location of air leaks during ventilation in pediatric patients., Methods: Using a prospective observational study design, we enrolled 90 pediatric patients of ASA physical status I-III scheduled for elective surgery under general anesthesia. After anesthesia induction, patients were assigned to a noncorrection group or a correction group after their first ultrasound evaluation. Noncorrection group comprised patients with tolerable I-Gel positioning based on ultrasound evaluation and no problems with clinical parameters, while the correction group comprised patients with I-Gel mispositioning based on ultrasound., Results: After the first ultrasound evaluation, 61 patients did not need I-Gel correction (noncorrection group), while 29 patients needed I-Gel correction (correction group) and underwent a second ultrasound evaluation. Airway sealing pressure and total ultrasound score showed a negative correlation (r = -.845, p < .001). The area under the receiver operating curve for total ultrasound score was 0.97 (95% confidence interval, 0.94-0.99; p < .001). In the correction group, ultrasound score and ventilation parameters improved after correction based on ultrasound evaluation., Conclusions: Ultrasound scores were negatively correlated with airway sealing pressure in pediatric patients. Ultrasound evaluation is useful for detecting misplacement of the I-Gel and can be a useful tool for correction., (© 2021 John Wiley & Sons Ltd.)