Abstract Background: Erector spinae plane block (ESPB) is a recently described block. In many reports, ESPB has been reported to provide effective postoperative analgesia in patients undergoing cesarean delivery (CD). Herein, we compared the effectiveness of ESPB and control group in postoperative analgesia in patients undergoing CD under spinal anesthesia. Method: This assessor-blinded, prospective, randomized, efficiency study was conducted in the postoperative recovery room and ward at a tertiary university hospital. Eighty-six patients ASA II–III were recruited. Following exclusion, 80 patients were randomized into two equal groups (block and control group). Standard multimodal analgesia was performed in the control group while ESPB block was performed in the intervention (ESPB) group. Opioid consumption was measured and pain intensity between groups was compared using Numeric Rating Scores (NRS). Results: NRS was lower in Group ESPB at 3rd and 6th hours. There was no difference between NRS scores at other hours. Opioid consumption was lower in Group ESPB. Conclusion: When added to multimodal analgesia, bilateral ultrasound guided low thoracic ESPB leads to improve the quality of analgesia in the first 24 hours in patients undergoing CD.

Occupation-based scholars are striving to mobilize socially responsive scholarship to address occupational injustices from local to global scales. Moving forward involves expanding beyond Western, Anglophonic, female, able-bodied, adult perspectives on occupation, with critically informed participatory methodologies providing one key means to incorporate diverse perspectives on occupation and occupational justice. Drawing upon a participatory action research project with children with disabilities from rural South India, this paper puts forward an understanding of participatory action research as an occupational process (i.e., embodying a variety of occupations) and an occupation-based process (i.e., informed by an occupational lens). We forefront how 'occupation' was centered and mobilized within the process of this participatory action research. In addition, drawing on select study findings, we illustrate and discuss how participatory action research provided a forum to partner with the child co-researchers and collaboratively identify and critically analyse occupational injustices. Through this illustration and discussion of participatory action research as an occupation-based process and occupational process, we demonstrate its potential to be used to enact contextually responsive scholarship and praxis.

Resumo Justificativa e objetivos: Neste estudo, avaliamos o valor preditivo de diferentes ferramentas de avaliação das vias aéreas, incluindo componentes do Escore Simplificado Preditivo de Intubação Difícil (ESPID), o próprio ESPID e a Medida da Altura Tireomentoniana (MATM), em intubações definidas como difícies pelo Escore de Dificuldade de Intubação (EDI) em um grupo de pacientes com patologia de cabeça e pescoço. Método: Incluímos no estudo 153 pacientes submetidos a cirurgia de cabeça e pescoço. Coletamos os resultados do Teste de Mallampati Modificado (TMM), Distância Tireomentoniana (DTM), Razão Altura/Distância Tireomentoniana (RADTM), MATM, amplitude máxima de movimentação da cabeça e pescoço e da abertura da boca. Os ESPIDs foram calculados e os EDIs, determinados. Resultados: Observamos intubação difícil em 25,4% dos pacientes. Os escores de ESPID > 10 tiveram sensibilidade de 86,27%, especificidade de 71,57% e valor preditivo negativo de 91,2% (VPN). O resultado da análise da curva de operação do receptor (curva ROC) para os testes de avaliação das vias aéreas e ESPID mostrou que o ESPID tinha a maior área sob a curva; no entanto, foi estatisticamente semelhante a outros testes, exceto para o TMM. Conclusões: O presente estudo demonstra o uso prático do ESPID na previsão da dificuldade de intubação em pacientes com patologia de cabeça e pescoço. O desempenho do ESPID na predição de via aérea difícil mostrou-se tão eficiente quanto os demais testes avaliados neste estudo. O ESPID pode ser considerado ferramenta abrangente e detalhada para prever via aérea difícil.

Abstract Background and objectives: In this study, we aimed to investigate the predictive value of different airway assessment tools, including parts of the Simplified Predictive Intubation Difficulty Score (SPIDS), the SPIDS itself and the Thyromental Height Test (TMHT), in intubations defined as difficult by the Intubation Difficulty Score (IDS) in a group of patients who have head and neck pathologies. Methods: One hundred fifty-three patients who underwent head and neck surgeries were included in the study. The Modified Mallampati Test (MMT) result, Thyromental Distance (TMD), Ratio of the Height/Thyromental Distance (RHTMD), TMHT, maximum range of head and neck motion and mouth opening were measured. The SPIDSs were calculated, and the IDSs were determined. Results: A total of 25.4% of the patients had difficult intubations. SPIDS scores >10 had 86.27% sensitivity, 71.57% specificity and 91.2% Negative Predictive Value (NPV). The results of the Receiver Operating Curve (ROC) analysis for the airway screening tests and SPIDS revealed that the SPIDS had the highest area under the curve; however, it was statistically similar to other tests, except for the MMT. Conclusions: The current study demonstrates the practical use of the SPIDS in predicting intubation difficulty in patients with head and neck pathologies. The performance of the SPIDS in predicting airway difficulty was found to be as efficient as those of the other tests evaluated in this study. The SPIDS may be considered a comprehensive, detailed tool for predicting airway difficulty.

Los plasmodesmos son canales que atraviesan la membrana y la pared celular. Estos canales especializados y no pasivos, actúan como compuertas que facilitan y regulan la comunicación y el transporte de sustancias como agua, nutrientes, metabolitos y macromoléculas entre las células vegetales. En los últimos años, una nueva visión sobre estos canales ha surgido y, estudios han demostrado que los plasmodesmos son más complejos de lo que anteriormente se pensaba. En esta nota, se pretende exponer el conocimiento actual sobre dichas estructuras, enfocándonos en su estructura y función.

Plasmodesmata are channels that transverse the cell wall and membrane. These specialized and non passive channels act like gates that facilitate and regulate both communication and transportation of molecules such as water, nutrients, metabolites and macromolecules between plant cells. In the last decade a new point of view of plasmodesmata has emerged, and studies have demonstrated that these channels are more complex. In this brief note, we pretend to expose the actual knowledge of plasmodesmata, focusing on their structure and function.

Se presenta una revisión del metabolismo ácido de las Crasuláceas, caracterizado por la ocurrencia, actividad y plasticidad del mecanismo desde un punto de vista fisiológico, bioquímico y molecular, enmarcado por la presencia de las denominadas cuatro fases de dicho metabolismo y su repercusión y expresión por diversas restricciones hídricas a nivel ecológico. Se presentan las principales enzimas y metabolitos básicos para el funcionamiento del metabolismo CAM, así como su modo de acción y control celular. Finalmente, se muestra que la plasticidad fenotípica en patrones de expresión CAM se encuentra mediada por condiciones ambientales y por señalizaciones moleculares.

A review of Crassulacean acid metabolism is presented, characterized by showing the occurrence, activity and plasticity of these complex mechanism at the physiological, biochemical and molecular level, framed by the presence of the denominated four phases in CAM and its repercussion and expression due to different stresses in an ecological context. The basic enzymes, and metabolites necessary for the optional functioning of CAM are presented as well as their mode of action and cellular control. Finally, it is shown how environmental conditions and molecular signalling mediate the phenotypic plasticity.