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Pain management is often difficult in the setting of multi-site trauma such as that caused by motor vehicle accidents (MVA), which is especially compounded in the setting of polysubstance abuse. This often results in patients with poor pain tolerance requiring escalating doses of opioid therapy, which creates a vicious cycle. The use of peripheral nerve blocks (PNB) has been shown to decrease overall opioid consumption and can be used effectively to manage postoperative pain in this patient population. Our case report aims to highlight the importance of PNBs as part of a multimodal approach to pain management in patients with polytrauma in the setting of polysubstance abuse.

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This case report presents the complex analgesia management of a 52-year-old male with a significant medical history including atrial fibrillation treated with apixaban, essential trigeminal neuralgia, non-ischemic cardiomyopathy, and chronic systolic heart failure. The patient experienced a loss of control while riding a motorized bicycle, resulting in a fall and head injury with no loss of consciousness. Upon admission, he tested positive for ethanol, cannabinoids, and oxycodone. The physical exam was significant for right cephalohematoma and right elbow hematoma. Imaging revealed multiple injuries, including right rib fractures (T3-12) with hemothorax. Right paravertebral catheters were placed in the intensive care unit (ICU).

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Background: Perfusion index (PI) has been used as a surrogate marker of sympathetic blockade. This study evaluated changes in PI of bilateral upper extremity after thoracic paravertebral block (PVB) and intertransverse process block (ITPB). Methods: This pilot study included three groups of patients undergoing elective unilateral pulmonary resection under general anesthesia with PVB (n=11) or ITPB (n=10), or urologic procedures with general anesthesia (control group, n=10). Blockades were performed using 10 mL aliquots of 0.5% ropivacaine administered at T3-4, T5-6, and T7-8 intercostal levels immediately after general anesthesia induction. The PI value of the operating side (PI-O) was divided by the contralateral side (PI-CL), and the relative change to baseline was assessed (relative PI-O/PI-CL), with a 50% increase considered meaningful. Results: In all cases within the PVB and ITPB groups, a significant increase in PI was observed following the blockades. The median (1Q, 3Q) intraoperative relative PI-O/PI-CL values were 0.9 (0.8, 1.4), 2.1 (1.4, 2.5), and 1.4 (0.9, 1.9) in the control, PVB, and ITPB groups (P=0.01), respectively. Pairwise comparison revealed a significant difference only between the control and PVB groups (adjusted P=0.01). While the relative PI-O/PI-CL value in the control group generally remained close to 1, occasional fluctuations exceeding 1.5 were noted. Conclusions: PVB induced a noticeable unilateral increase in upper extremity PI, whereas ITPB tended to result in an inconsistent and lesser degree of increase. Monitoring PI values can serve as an indicator of upper extremity sympathetic blockade, but consideration of potential confounders impacting these observations during surgery is essential. Further research is needed to validate these findings.

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Patients with severe cardiopulmonary morbidity present a unique challenge to peri- and intraoperative providers. Inducing general anesthesia in this patient population poses the risk of adverse events that could lead to poor surgical outcomes, prolonged debilitation, or death. Therefore, it is important that anesthesiologists become comfortable with preoperative evaluation as well as alternative strategies to providing surgical anesthesia. This case report details the clinical course of a patient with severe cardiopulmonary morbidity who underwent open inguinal hernia repair without oral or intravenous sedation after receiving multi-level paravertebral blocks in addition to isolated ilioinguinal and iliohypogastric nerve blocks. This medically challenging case provides educational value regarding preoperative evaluation, pertinent anatomy and innervation, and the importance of patient-centered care and communication.

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This study aimed to estimate the serological status and dynamic changes in the prevalence of Parvovirus B19 (PVB19) antibodies within the general population residing in the northern part of the Republic of Serbia (Province of Vojvodina) during a 16-year period. Serum samples were analyzed for Human PVB19-specific IgM and IgG antibodies using enzyme-linked immunosorbent assay (ELISA). Throughout the study period, the overall seroprevalence was 49.51%. Approximately 10% of patients exhibited a serologic profile positive for PVB19 IgM antibodies. Notably, seroprevalence varied significantly, ranging from 9.12% in the pediatric cohort (ages 1-4 years) to 65.50% in the adult demographic (40-59 years old). Seroprevalence was higher (51.88%) among women compared to men (42.50%). Immunologically naive pregnant women in the age groups 26-36 and 36-45 years had 45% (OR = 0.55, 95% CI: 0.31-1.00) and 52% (OR = 0.48; 95% CI: 0.24-0.94) lower odds of having negative IgM and IgG compared to those in age group 16-25 years old. Improved knowledge of the epidemiology of PVB19 may assist clinicians in the differential diagnosis of PVB19 clinical manifestations. The PVB19 detection is particularly important for monitoring individuals in risk groups such as women of reproductive age, medical staff, patients with hematological disorders, and those with immunodeficiency.

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This study focuses on the fabrication of fiber membranes containing different concentrations of AgNO3 via the electrospinning technique. The AgNO3 present in the fibers is subsequently reduced to silver nanoparticles (Ag NPs) through UV irradiation. The resulting nanofiber film is characterized using scanning electron microscopy, X-ray diffraction, and evaluations of its anti-UV and anti-electromagnetic radiation properties. Experimental results demonstrate that increasing the AgNO3 content initially decreases and then increases the fiber diameter and fiber diameter deviation. Under UV light, the nanofibers fuse and bond, leading to an increase in the fiber diameter. AgNO3 is effectively reduced to Ag NPs after UV irradiation for more than 60 min, as confirmed by the characteristic diffraction peaks of Ag NPs in the XRD spectrum of the irradiated AgNO3/PVB fibers. The nanofiber film containing AgNO3 exhibits superior anti-UV performance compared to the film containing AgNO3-derived Ag NPs. The anti-electromagnetic radiation performances of the nanofiber films containing AgNO3 and AgNO3-derived Ag NPs are similar, but the nanofiber film containing AgNO3-derived Ag NPs exhibits higher performance at approximately 2.5 GHZ frequency. Additionally, at an AgNO3 concentration of less than 0.5 wt%, the anti-electromagnetic radiation performance is poor, and the shielding effect of the nanofiber film on medium- and low-frequency electromagnetic waves surpasses that on high-frequency waves. This study provides guidance for the preparation of polyvinyl butyral nanofibers, Ag NPs, and functional materials with anti-ultraviolet and anti-electromagnetic radiation properties.

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Polyvinyl butyral (PVB) is a thermoplastic resin commonly used as an interlayer material in laminated glass. Combined with textile fibres from worn tyres, PVB can produce a composite material with unique properties. One such property is absorption. Absorption in textile fibre composite materials refers to the ability of the material to absorb or retain moisture or other fluids. The presence of moisture or liquids can affect the properties of composite materials, such as their strength, stiffness, and dimensional stability. As a result of the physical and chemical action of the environment, corrosion of plastics occurs and manifests itself in changes in appearance, surface quality, weight, dimensions, and also in changes in other properties. This paper investigates four composite materials with different fabrics content. The aim of this paper is to propose a generalized mathematical model for absorption values so that, with different ratios of textile fibre in the material, its quality indicators are at a sufficient level. Our study will proceed from the assumption that by changing the values of the individual coefficients of the selected model based on their analysis, we will achieve the required qualitative indicators.

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Plastic recycling in the automotive industry is a priority. In this study, the effect of adding recycled polyvinyl butyral (rPVB) from automotive windshields on the coefficient of friction (CoF) and specific wear rate (k) of a glass-fiber reinforced polyamide (PAGF) is investigated. It was found that, at 15 and 20 wt.% of rPVB, it acts as a solid lubricant, reducing CoF and k up to 27% and 70%, respectively. Microscopical analysis of the wear tracks showed that rPVB spreads over the worn tracks, forming a lubricant layer, which protects the fibers from damage. However, at lower rPVB content, fiber damage cannot be prevented as the protective lubricant layer is not formed.

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There are few data on current trends in pain management for thoracic surgery in Australia and New Zealand. Several new regional analgesia techniques have been introduced for these operations in the past few years. Our survey aimed to assess current practice and perceptions towards various modalities of pain management for thoracic surgery among anaesthetists in Australia and New Zealand. A 22-question electronic survey was developed and distributed in 2020 with the assistance of the Australian and New Zealand College of Anaesthetists Cardiac Thoracic Vascular and Perfusion Special Interest Group. The survey focused on four key domains-demographics, general pain management, operative technique, and postoperative approach. Of the 696 invitations, 165 complete responses were obtained, for a response rate of 24%. Most respondents reported a trend away from the historical standard of thoracic epidural analgesia, with a preference towards non-neuraxial regional analgesia techniques. If representative of anaesthetists in Australia and New Zealand more widely, this trend may result in less exposure of junior anaesthetists to the insertion and management of thoracic epidurals, potentially resulting in reduced familiarity and confidence in the technique. Furthermore, it demonstrates a notable reliance on surgically or intraoperatively placed paravertebral catheters as the primary analgesic modality, and suggests the need for future studies assessing the optimal method of catheter insertion and perioperative management. It also gives some insight into the current opinion and practice of the respondents with regard to formalised enhanced recovery after surgery pathways, acute pain services, opioid-free anaesthesia, and current medication selection.

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Waste materials from the automotive industries were re-used as aggregates into metakaolin-based geopolymer (GP), geopolymer mortar (GM), and Bauhaus B20-based concrete composite (C). Specifically, the study evaluates the ability of windshield silica glass (W), PVB-Foils (P), and rubber granulates (G) to impact the mechanical and thermal properties. The addition of the recovered materials into the experimental geopolymers outperformed the commercially available B20. The flexural strength reached values of 7.37 ± 0.51 MPa in concrete with silica glass, 4.06 ± 0.32 in geopolymer malt with PVB-Foils, and 6.99 ± 0.82 MPa in pure geopolymer with rubber granulates; whereas the highest compressive strengths (бc) were obtained by the addition of PVB-Foils in pure geopolymer, geopolymer malt, and concrete (43.16 ± 0.31 MPa, 46.22 ± 2.06 MPa, and 27.24 ± 1.28 MPa, respectively). As well PVB-Foils were able to increase the impact strength (бi) at 5.15 ± 0.28 J/cm2 in pure geopolymer, 5.48 ± 0.41 J/cm2 in geopolymer malt, and 3.19 ± 0.14 J/cm2 in concrete, furnishing a significant improvement over the reference materials. Moreover, a correlation between density and thermal conductivity (λ) was also obtained to provide the suitability of these materials in applications such as insulation or energy storage. These findings serve as a basis for further research on the use of waste materials in the creation of new, environmentally friendly composites.

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Rare-earth element-free fluorescent materials are eco-friendlier than other traditional fluorescent precursors, such as quantum dots and phosphors. In this study, we explore a simple and facile solution-based technique to prepare fluorescent films, which are highly stable under ordinary room conditions and show hydrophobic behaviour. The proposed hybrid material was designed with hybrid composites that use polyvinyl butyral (PVB) as a host doped with organic dyes. The red and green fluorescent films exhibited quantum yields of 89% and 80%, respectively, and both are very uniform in thickness and water resistant. Additionally, PVB was further compared with another polymeric host, such as polyvinylpyrrolidone (PVP), to evaluate their binding ability and encapsulation behaviour. Next, the effect of PVB on the optical and chemical properties of the fluorescent materials was studied using UV spectroscopy and Fourier transform infrared spectroscopy. The analysis revealed that no new bond was formed between the host material and fluorescent precursor during the process, with intermolecular forces being present between different molecules. Moreover, the thickness of the fluorescent film and quantum yield relation were evaluated. Finally, the hydrophobic nature, strong binding ability, and optical enhancement by PVB provide a powerful tool for fabricating a highly efficient fluorescent film with enhanced stability in an external environment based on its promising encapsulation properties. These efficient fluorescent films have a bright potential in colour conversion for next-generation display applications.

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Background: General anesthesia is used in the majority of patients undergoing percutaneous nephrolithotomy. To reduce the general anesthesia-related risks and complications, this study evaluated the efficacy and safety of the paravertebral block as a novel and alternative anesthetic method for percutaneous nephrolithotomy. Methods: This was a retrospective study. A total of 198 patients under percutaneous nephrolithotomy were included. Among them, 76 patients received paravertebral block and 122 received general anesthesia. Patients' characteristics, surgical outcomes, anesthetic outcomes, and perioperative complications and the visual analog scale (VAS) were recorded to evaluate the efficacy and safety of paravertebral block compared with general anesthesia. Intergroup differences of the parameters were analyzed using an independent t-test and χ2-tests appropriate. Results: Seventy-six patients who underwent paravertebral block completed the surgery successfully, three patients were supplemented with propofol for discomfort during ureteroscopy, and two patients were supplemented with remifentanil for incomplete nerve blockade. Patients who underwent paravertebral block had a higher American Society of Anesthesiologists grade and heart function grade, including patients with contraindications to general anesthesia. Intraoperative and postoperative adverse events and the anesthesia costs were less in patients who underwent paravertebral block. VAS pain scores during the postoperative period in patients who underwent paravertebral block were lower than those in patients who underwent general anesthesia without the use of patient-controlled intravenous analgesia. Conclusion: In this retrospective study, paravertebral block was found to be effective and safe in providing intraoperative anesthesia for percutaneous nephrolithotomy, and had less adverse events and anesthesia costs. Paravertebral block is an attractive alternative anesthesia for patients at increased risk of comorbidities following general or neuraxial anesthesia.

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In this study, a 0-3 piezoelectric composite based on lead zirconate-titanate (PZT)/polyvinyl-butyral (PVB) was fabricated and characterized for its potential application in tactile sensing. The 0-3 composite was developed to incorporate the advantages of both ceramic and polymer. The paste of 0-3 PZT-PVB composite was printed using a conventional screen-printing technique on alumina and mylar substrates. The thickness of the prepared composite was approximately 80 µm. After printing the top electrode of the silver paste, 10 kV/mm of DC field was applied at 25 °C, 120 °C, and 150 °C for 10 min to align the electric dipoles in the composite. The piezoelectric charge coefficient of d33 and the piezoelectric voltage coefficient of g33 were improved by increasing the temperature of the poling process. The maximum values of d33 and g33 were 14.3 pC/N and 44.2 mV·m/N, respectively, at 150 °C. The sensor's sensitivity to the impact force was measured by a ball drop test. The sensors showed a linear behavior in the output voltage with increasing impact force. The sensitivity of the sensor on the alumina and mylar substrates was 1.368 V/N and 0.815 V/N, respectively. The rising time of the sensor to the finger touch was 43 ms on the alumina substrate and 35 ms on the mylar substrate. Consequently, the high sensitivity and fast response time of the sensor make the 0-3 PZT-PVB composite a good candidate for tactile sensors.

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The COVID-19 pandemic has caused serious social and public health problems. In the field of personal protection, the facial masks can prevent infectious respiratory diseases, safeguard human health, and promote public safety. Herein, we focused on preparing a core filter layer for masks using electrospun polyvinyl butyral/apocynum venetum extract nanofibrous membranes (PVB/AVE NMs), with durable interception efficiency and antibacterial properties. In the spinning solution, AVE acted as a salt to improve electrical conductivity, and achieve long-lasting interception efficiency with adjustable pore size. It also played the role of an antibacterial agent in PVB/AVE NMs to achieve win-win effects. The hydrophobicity of PVB-AVE-6% was 120.9° whereas its filterability reached 98.3% when the pressure drop resistance was 142 Pa. PVB-AVE-6% exhibited intriguing properties with great antibacterial rates of 99.38% and 98.96% against S. aureus and E. coli, respectively. After a prolonged usability test of 8 h, the filtration efficiency of the PVB/AVE masks remained stable at over 97.7%. Furthermore, the antibacterial rates of the PVB/AVE masks on S. aureus and E. coli were 96.87% and 96.20% respectively, after using for 2 d. These results indicate that PVB/AVE NMs improve the protective performance of ordinary disposable masks, which has certain application in air filtration.

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The intestinal barrier, with its multiple layers, is the first line of defense between the outside world and the intestine. Its disruption, resulting in increased intestinal permeability, is a recognized pathogenic factor of intestinal and extra-intestinal diseases. The identification of a gut-vascular barrier (GVB), consisting of a structured endothelium below the epithelial layer, has led to new evidence on the etiology and management of diseases of the gut-liver axis and the gut-brain axis, with recent implications in oncology as well. The gut-brain axis is involved in several neuroinflammatory processes. In particular, the recent description of a choroid plexus vascular barrier regulating brain permeability under conditions of gut inflammation identifies the endothelium as a key regulator in maintaining tissue homeostasis and health.

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BACKGROUND: Both the anesthetic efficacy of ultrasound-guided serrate anterior plane block (SAPB) and the ultrasound-guided paravertebral block (PVB) in alleviating postoperative pain have been well concerned. This study primarily aims to evaluate whether the ultrasound-guided SAPB and ultrasound-guided PVB can provide comparable analgesia for video-assisted thoracic surgery. Secondarily, the safety and clinical satisfaction of the two blocks are evaluated. METHODS: It was a prospective, randomized, double-blinded non-inferiority clinical trial involving 99 patients with lung nodules receiving video-assisted thoracic surgery with ultrasound-guided SAPB or PVB on T4 and T7 vertebra using 0.375% ropivacaine at 3 mg/kg. The Visual Analogue Scale (VAS) scores at rest and cough at 24 h/48 h postoperatively and the incidence and severity of chronic pain at 3 and 6 months postoperatively were the primary outcome. Secondary outcomes included the complications and block application time of two kinds of blocks, and consumption of sufentanil as an analgesic rescue. RESULTS: A total of 92 eligible patients were recruited, including 46 in the SAPB group and 46 in the PVB group. No significant differences in VAS scores at rest and cough at first 48 h, 3 months, and 6 months postoperatively between the SAPB group and PVB group were detected (all P > 0.05). The SAPB group had fewer complications and higher patient satisfaction(P＜0.05). CONCLUSION: The ultrasound-guided SAPB was not inferior to PVB in alleviating postoperative pain following the VATS with fewer complications and higher patient satisfaction.

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Polyvinyl(butyral) (PVB) post-production waste collected from the windshields of end-of-life vehicles and post-consumer building laminated glass are valuable polymeric materials that can be reused. Every year, large amounts of PVB waste are still being buried in landfills owing to a lack of appropriate recycling techniques. Before reuse, PVB should be thoroughly cleaned of solid contaminants such as glass dust, fused heating wires, and other waste polymers, metals, and ceramics. This can be done by polymer dissolution and filtration. In this study, we propose the purification of PVB from contamination by dissolving the post-consumer polymeric materials into single and binary organic solvents. As part of the experimental work, measurements and optimization of the dissolution time of PVB were performed. PVB dissolves faster when a binary solvent (2-propanol + ethyl acetate) than pure 2-propanol is used. From the point of view of the practical application of PVB solutions, measurements of density and dynamic viscosity as a function of PVB concentration and temperature were performed. The PVB solutions obtained in this work can be widely used as glues for glass, ceramics, metal, impregnating, and insulating materials or as paint additives that are entirely transparent for visible light and to block UV rays.

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Fused Deposition Modelling (FDM) technology allows to choose a large variety of materials and it is widely used by companies and individuals nowadays. The cost effectiveness of rapid prototyping is achievable via FDM, that makes this technology useful for research and innovation. The application of 3D printing to aid production is the most common approach. Moreover, the use of 3D printing in prototypes result in a waste of material since no reuse is considered. In the following manuscript, this technology is applied to mould fabrication by achieving a low surface roughness at a modest cost compared to conventional manufacturing methods. Moreover, the possibility to use a combination of thermoplastic materials is analysed by examination of the CAD model optimized for Additive Manufacturing (AM) from scratch and was verified using metrology tools. Several moulds were finally built and applied to the specific case study of carbon fibre laminated components. This manuscript aims to analyse the manufacturing process by comparing the mould surface geometry before and after the smoothing process. The achieved tolerance between the produced moulds is ±0.05 mm that ensures the repeatability of the process from an industrial point of view; whilst the deviation between CAD and mould is ±0.2 mm. To combine an accurate FDM process together with chemical smoothing proved to be a powerful strategy to produce high quality components that can be inserted in the production process by means of traditional manufacturing techniques. This will aid to reduce the cost of standard manufacturing for low production batches and prototypes of carbon fibre composites.

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Most used laminated glass is composed of float glass plies bonded together with a viscoelastic Polyvinyl Butyral (PVB) interlayer. The shear stiffness of the polymeric interlayer is the key factor in the behavior of laminated glass. Structural engineers in the past were designing laminated glass regardless of the shear coupling of the plies. This approach with a high level of reliability led to expensive laminated glass structures due to insufficient knowledge of foil properties. Most of the current standards suggest methods that consider the shear coupling of the plies. This paper presents the experimental data from a static loading test performed on a laminated glass panel exposed to changing temperatures. The deformations were observed for 48 h. The measured results were compared with the known analytical design approaches and in addition with the finite element modeling (FEM) analysis in the available software for laminated glass design. A simplified design approach that simulates foil behavior in dependence on load duration and temperature change was adopted in this study. Design approaches that use effective thickness calculations are used with the Young and shear relaxation modulus provided by the foil producer. The imprecision of the Eurocode standards for glass design, and the propensity to change the approach to the calculation by introducing more precise parameters were expounded. The results when combining the time-temperature superposition (TTS) and the Wölfel-Bennison approach were found to be in very good agreement with the FEM analysis of 3D solid elements in Abaqus and measured data.