Obstetric analgesia using continuous epidural perfusion of bupivacaine, adrenaline, and fentanyl

OBJECTIVES: To determine the efficacy and complications of continuous epidural perfusion of bupivacaine, adrenaline and fentanyl in the relief of pain during first and second stage labour during vaginal birth. PATIENTS AND METHODS: Between January 1990 and March 1993 we used continuous epidural perfusion for control of pain during labor in 1307 women. The solution administered through an epidural catheter and maintained until expulsion was one 10 ml bolus of bupivacaine 0.25% with adrenaline 1:200,000 and fentanyl 25 micrograms followed by continuous perfusion of bupivacaine 0.0625% with adrenaline 1:200,000 and fentanyl 2 micrograms/ml at an infusion rate of 12 ml/h. When analgesia was insufficient, a bolus of local anesthetic was administered or a pudendal block was carried out. RESULTS: Ninety-two percent of the birthing women reported good analgesic effect during the first stage; for 7% the effect was fair and for 0.55% it was poor. During the second stage 88% reported satisfactory analgesia, and 8% fair or poor. Assessment was not possible for the remaining women, who underwent cesarean sections. Complications were few and easily controllable. CONCLUSIONS: Maintenance of epidural perfusion with 0.0625% bupivacaine with adrenaline 1:200,000 and fentanyl 2 micrograms/ml provides sufficient analgesia during all stages of childbirth.     

New species of Aeromonas isolated in Cuba

One hundred and fifty-five strains of Aeromonas isolated in the stools of children under 5 years presenting with acute diarrheal disease were studied. Using the Aerokey II system for the identification of species, 47 strains were identified as Aeromonas caviae, 58 as Aeromonas hydrophila, 23 as Aeromonas veronii biovar sobria, 14 as Aeromonas trota, 9 as Aeromonas veronii biovar veronii, 2 as Aeromonas jandaei and 2 as Aeromonas shubertii, Emphasis is placed on the advantages of this method which allowed for the classification of new species not identified previously in our country.     

Cathepsin L2, a novel human cysteine proteinase produced by breast and colorectal carcinomas

We have identified and cloned a new member of the papain family of cysteine proteinases from a human brain cDNA library. The isolated cDNA codes for a polypeptide of 334 amino acids that exhibits all of the structural features characteristic of cysteine proteinases, including the active site cysteine residue essential for peptide hydrolysis. Pairwise comparisons of this amino acid sequence with the remaining human cysteine proteinases identified to date showed a high percentage of identity (78%) with cathepsin L; the percentage of identity with all other members of the family was much lower (<40%). On the basis of these structural characteristics, we have tentatively called this novel protein cathepsin L2. The cDNA encoding the mature cathepsin L2 was expressed in Escherichia coli, and after purification, the recombinant protein was able to degrade the synthetic peptide benzyloxycarbonyl-L-phenylalanyl-L-arginine-7-amido-4-methylcoumarin, which is commonly used as a substrate for cysteine proteinases. Cathepsin L2 proteolytic activity on this substrate was abolished by trans-epoxysuccinyl-L-leucylamido-(4-guanidino)butane, an inhibitor of cysteine proteinases, thus providing additional evidence that the isolated cDNA encodes a functional cysteine proteinase. Northern blot analysis of polyadenylated RNAs isolated from a variety of human tissues demonstrated that cathepsin L2 is predominantly expressed in the thymus and testis. This finding is in marked contrast with the wide tissue distribution of most cysteine proteinases characterized to date, including cathepsin L, and suggests that cathepsin L2 may play a specialized role in the thymus and testis. Expression analysis of cathepsin L2 in human tumors revealed a widespread expression in colorectal and breast carcinomas but not in normal colon or mammary gland or in peritumoral tissues. Cathepsin L2 was also expressed by colorectal and breast cancer cell lines as well as by some tumors of diverse origin, including ovarian and renal carcinomas. These results open the possibility that this novel enzyme may be involved in tumor processes, as already reported for other cysteine proteinases, including cathepsin L.     

Phase transformation and densification during pressureless sintering of Si3N4 with MgO and Y3Al5O12 additives

The - transformation of Si₃N₄ during liquid-phase sintering appears to be controlled by the growth of the -Si₃N₄ grains in the direction perpendicular to thec-axis in the case of MgO additive. The diffusion through the liquid is the rate-controlling step in the case of the Y₄Al₅O₁₂ additive. The density of the sintered body at the solid skeleton stage was influenced by the change in the - transformation rate and/or by a change of the transformation mechanism. The indirect proportionality between the -phase content in the starting powder and the density at the solid skeleton stage was found. The microstructure of the sintered body is influenced by both the -phase content in the starting powder and the chemical composition of the additive. Fine, uniform microstructure with a high aspect ratio of -grains is obtained, when the -phase content in the starting powder is as small as possible and when the - transformation is controlled by grain growth.     

Densification of silicon nitride ceramics under sinter-HIP conditions

The influence of several sinter-HIP variables on the densification behaviour of silicon nitride-based ceramics has been investigated. The processing conditions were studied for Si₃N₄ powder mixtures containing controlled amounts of Y₂O₃+Al₂O₃ or Y₂O₃+MgO. The specimens were subjected to sinter-HIP cycles under argon or nitrogen atmospheres at various temperatures and pressures. The final density of the powder compacts exhibited a strong dependence not only on the applied pressure, the composition and the processing temperature, but also on the pressurization rate and the initial pressurization time. The microstructural changes induced by the application of high pressure were followed by transmission electron microscopy. On examination by TEM, large concentrations of dislocations, generated inside some-Si₃N₄ grains, were observed. Characterization of these dislocations showed thatb=0001 is their most frequently found Burgers vector. Also, two relaxation mechanisms, tending to release the stored energy of deformation in the-Si₃N₄ grains, namely grain penetration (a form of strain-induced boundary migration) and grain fragmentation (the formation of subgrains due to rearrangement of dislocations into low energy configurations), have been identified. The intergranular phases formed were characterized by energy dispersive X-ray spectroscopic analysis, X-ray diffraction and electron diffraction. The influence of different sinter-HIP cycles on the transformation of silicon nitride without additives was also investigated by X-ray diffractometry.     

Challenges and opportunities of multimodal data in human learning: The computer science students' perspective

Multimodal data have the potential to explore emerging learning practices that extend human cognitive capacities. A critical issue stretching in many multimodal learning analytics (MLA) systems and studies is the current focus aimed at supporting researchers to model learner behaviours, rather than directly supporting learners. Moreover, many MLA systems are designed and deployed without learners' involvement. We argue that in order to create MLA interfaces that directly support learning, we need to gain an expanded understanding of how multimodal data can support learners' authentic needs. We present a qualitative study in which 40 computer science students were tracked in an authentic learning activity using wearable and static sensors. Our findings outline learners' curated representations about multimodal data and the non-technical challenges in using these data in their learning practice. The paper discusses 10 dimensions that can serve as guidelines for researchers and designers to create effective and ethically aware student-facing MLA innovations.     

Deploying deep learning approaches to left ventricular non-compaction measurement

The Journal of Supercomputing - Left ventricular non-compaction (LVNC) is a rare cardiomyopathy characterized by abnormal trabeculations in the left ventricle cavity. Although traditional computer...     

A comparison study of wavelet transforms for the visualization of differentially methylated regions in DNA samples

The Journal of Supercomputing - DNA methylation analysis has become an important topic in the study of human health. DNA methylation analysis requires not only a specific treatment of DNA samples...