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Purpose Recently, a new handheld ultrasound-based device, called Accuro, has been commercialized with a real-time automated interpretation of lumbar ultrasound images. We hypothesized that the handheld ultrasound device would improve the efficacy and safety of combined spinal-epidural anesthesia (CSEA) for cesarean delivery in obese parturients. Methods Eighty parturients with a body mass index > 30 kg*m.sup.-2 scheduled for elective cesarean delivery were randomly allocated equally (palpation group and ultrasound group). The primary outcome was the first insertion success rate. Secondary outcomes were the time taken to identify the needle puncture site, duration of CSEA procedure, the total time, the rate of parturients who require needle redirections, the number of skin punctures, changes in the intended interspace, and the incidence of complications. Results Compared to the palpation group, the first insertion success rate was significantly higher (72.5% vs. 40.0%; P = 0.003), and time taken to identify the needle puncture site was less (30 [26-36] vs. 39 [32-49] seconds; P = 0.001) in the ultrasound group. The rate of parturients who required needle redirections (40.0% vs. 72.5%; P = 0.003) and the incidence of paresthesia were both lower (7.5% vs. 45.0%; P < 0.001). The other outcomes had no significant difference between groups. The mean difference between the epidural depth measured by the handheld ultrasound and needle depth was - 0.29 cm [95% limit of agreement, - 0.52 to - 0.05]. Conclusions Our study suggests using the Accuro ultrasound device can enhance the efficacy and safety of CSEA in obese parturients when executed by experienced anesthesiologists, and its automated estimation of epidural depth is accurate., Author(s): Xiu Ni [sup.1], Meng-zhu Li [sup.1], Shuang-qiong Zhou [sup.1], Zhen-dong Xu [sup.1], Yue-qi Zhang [sup.1], Yi-bing Yu [sup.1], Jing Su [sup.1], Li-min Zhang [sup.1], Zhi-qiang Liu [sup.1] Author Affiliations: [...]

When the waste activated sludge (WAS) was acidified/oxidized, the extracellular polymer changed. The total extracellular polymer was dominated by aromatic proteins under strong acid condition; as the acidity decreased, the extract was dominated by humus-like substances. When soluble extracellular polymer was extracted under strong acid conditions, the dominated organic matter was fulvic acid; as the acidity decreased, the extract was dominated by similar humic substances. The main organic compounds detected in loosely bound extracellular polymers were fulvic acid and class of proteins. The extracts of tightly bound extracellular polymers were mainly proteins-like related to the structure of aromatic amino acids. After the oxidation treatment with 3.0 g/L potassium ferrate, the polysaccharide and protein content detected in the extracellular polymer extracts of each layer were 120 times and 1 time higher than that under the untreated condition, respectively. According to the dewatering tests results of the acidification treatment and oxidation treatment, the dewaterability of sludge was improved by more than 9%. [ABSTRACT FROM AUTHOR]

Vascular pathologies and injuries are important factors for the delayed wound healing in diabetes. Previous studies have demonstrated that hypoxic environments could induce formation of new blood vessels by regulating intercellular communication and cellular behaviors. In this study, we have enhanced the angiogenic potential of exosomes by subjecting urine-derived stem cells (USCs) to hypoxic preconditioning. To prolong the retention of exosomes at the wound site, we have also engineered a novel dECM hydrogel termed SISMA, which was modified from porcine small intestinal submucosa (SIS). For its rapid and controllable gelation kinetics, excellent biocompatibility, and exosome release capability, the SISMA hydrogel has proven to be a reliable delivery vehicle for exosomes. The hypoxia-induced exosomes-loaded hydrogel has promoted endothelial cell proliferation, migration, and tube formation. More importantly, as evidenced by significant in vivo vascular regeneration in the early stages post-injury, it has facilitated tissue repair. This may because miR-486-5p in H-exo inhibit SERPINE1 activity in endothelial cell. Additionally, miRNA sequencing analysis suggested that the underlying mechanism for enhanced angiogenesis may be associated with the activation of classical HIF-1α signaling pathway. In summary, our study has presented a novel non-invasive, cell-free therapeutic approach for accelerating diabetes wound healing and development of a practical and efficient exosomes delivery platform., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

Aim: The aim of this study was to observe the changes in the monoamine neurotransmitter levels of patients with post-traumatic stress disorder (PTSD) and explore whether the neurotransmitter level is correlated with the severity of PTSD., Material and Methods: A total of 15 PTSD patients without any physical injuries were enrolled into the study. Another 15 cases of pre-restoration patients were recruited as controls who experienced traumatic events but did not experience PTSD or had a Posttraumatic stress disorder Check List-Civilian version (PCL-C) score lower than 12 points. The levels of plasma monoamine neurotransmitters, including norepinephrine, 5-hydroxytryptamine, and dopamine, were tested using enzyme-linked immunosorbent assays., Results: No significant differences were found between the monoamine neurotransmitter levels of the PTSD and the control groups (p > 0.05). A correlation study confirmed that the monoamine neurotransmitter levels and the PCL-C scores of the PTSD group were not significantly correlated (p > 0.05)., Conclusion: No neurotransmitter changes are seen in PTSD caused by simple mental trauma, and the PCL-C scores do not associate with PTSD.