Patients' expectations, experience and acceptability of postoperative analgesia: a nested qualitative study within a randomised controlled trial comparing rectus sheath catheter and thoracic epidural analgesia.

Adequate postoperative analgesia is a key element of enhanced recovery programmes. Thoracic epidural analgesia is associated with superior postoperative analgesia but can lead to complications. Rectus sheath catheter analgesia may provide an alternative.

An immune dysfunction score for stratification of patients with acute infection based on whole-blood gene expression.

Dysregulated host responses to infection can lead to organ dysfunction and sepsis, causing millions of global deaths each year. To alleviate this burden, improved prognostication and biomarkers of response are urgently needed. We investigated the use of whole-blood transcriptomics for stratification of patients with severe infection by integrating data from 3149 samples from patients with sepsis due to community-acquired pneumonia or fecal peritonitis admitted to intensive care and healthy individuals into a gene expression reference map.

A comparison between thoracic epidural analgesia and rectus sheath catheter analgesia after open midline major abdominal surgery: randomized clinical trial.

Background: Rectus sheath catheter analgesia (RSCA) and thoracic epidural analgesia (TEA) are both used for analgesia following laparotomy. The aim was to compare the analgesic effectiveness of RSCA with TEA after laparotomy for elective colorectal and urological surgery.

Methods: Patients undergoing elective midline laparotomy were randomized in a non-blinded fashion to receive RSCA or TEA for postoperative analgesia at a single UK teaching hospital.

Advances in cathode designs and reactor configurations of microbial electrosynthesis systems to facilitate gas electro-fermentation.

In gas fermentation, a range of chemolithoautotrophs fix single-carbon (C1) gases (CO and CO) when H or other reductants are available. Microbial electrosynthesis (MES) enables CO reduction by generating H or reducing equivalents with the sole input of renewable electricity. A combined approach as gas electro-fermentation is attractive for the sustainable production of biofuels and biochemicals utilizing C1 gases.

Anaesthesia for Hepatic Resection Surgery.

This article will focus on the perioperative management of hepatic resection for colorectal cancer (CRC) liver metastases (CLRMs) (the liver is the dominant metastatic site for CRC) within the context of the Enhanced Recovery After Surgery (ERAS) paradigm. It discusses the epidemiology and outcomes along with the history of hepatic resection surgery and pertinent anatomy. The discussion of the preoperative phase includes patient selection, assessment of liver functional status, and new developments in prehabilitation.

Opioid-Sparing Perioperative Analgesia Within Enhanced Recovery Programs.

Opioid-based analgesia in the perioperative period can provide excellent pain control, but this approach exposes the patient to avoidable side effects and possible harm. Optimal analgesia, an approach that targets the fastest functional recovery with adequate pain control while minimizing side effects, can be achieved with opioid minimization. Many different options for nonopioid multimodal analgesia exist and have been shown to be efficacious, with certain modalities being more beneficial for specific surgeries.

Anaesthesia for Pancreatic Surgery.

This article provides a broad perspective on the salient perioperative issues encountered when caring for patients undergoing pancreatic surgery in the setting of pancreatic cancer. It describes the epidemiology of pancreatic cancer, the indications for and evolution of pancreatic resection surgery, the challenges faced perioperatively including patient selection, optimization, anesthetic considerations, postoperative analgesia, fluid management, and nutrition and discusses some of the common complications and their management. It finishes by outlining the future directions for research and development required to continue improving outcomes for these patients.

'A flying start': Wildlife trypanosomes in tissues of Australian tabanids (Diptera: Tabanidae).

Tabanids (syn. horse flies) are biting-flies of medical and veterinary significance because of their ability to transmit a range of pathogens including trypanosomes - some species of which carry a combined health and biosecurity risk. Invertebrate vectors responsible for transmitting species of Trypanosoma between Australian wildlife remains unknown, thus establishing the role of potential vector candidates such as tabanids is of utmost importance.

Dual cathode configuration and headspace gas recirculation for enhancing microbial electrosynthesis using Sporomusa ovata.

High-rate production of acetate and other value-added products from the reduction of CO in microbial electrosynthesis (MES) using acetogens can be achieved with high reducing power where H appears as a key electron mediator. H evolution using metal cathodes can enhance the availability of H to support high-rate microbial reduction of CO. Due to the low solubility of H, the availability of H remains limited to the bacteria.

Molecular Detection of spp. in Questing and Feeding Ticks (Ixodidae) Collected from an Endemic Region of South-West Australia.

A growing number of indigenous trypanosomes have been reported to naturally infect a variety of Australian wildlife with some species of implicated in the population decline of critically endangered marsupials. However, the mode of transmission of Australian trypanosomes is unknown since their vectors remain unidentified. Here we aimed to fill this current knowledge gap about the occurrence and identity of indigenous trypanosomes in Australian invertebrates by conducting molecular screening for the presence of spp.

Augmented renal clearance: a retrospective, cohort study of urinary creatinine clearance in critically ill patients in the United Kingdom.

Objective: Augmented renal clearance (ARC) is associated with sub-therapeutic antibiotic, anti-epileptic, and anticoagulant serum concentrations leading to adverse patient outcomes. We aimed to describe the prevalence and associated risk factors for ARC development in a large, single-centre cohort in the United Kingdom.

Methods: We conducted a retrospective observational study of critically unwell patients admitted to intensive care between 2014 and 2016.

Design and implementation of a low cost bio-printer modification, allowing for switching between plastic and gel extrusion.

Due to the high cost of bioprinters they are not feasible for proof of concept experiments or educational purposes. Furthermore, the more affordable DIY methods all disable the plastic printing capability of the original printer. Here we present an affordable bio-printing modification that is easy to install and maintains the original capabilities of the printer.

'Hook, line, and sinker': Fluorescence in situ hybridisation (FISH) uncovers Trypanosoma noyesi in Australian questing ticks.

Trypanosomes are blood-borne parasites infecting a range of mammalian hosts worldwide. In Australia, an increasing number of novel Trypanosoma species have been identified from various wildlife hosts, some of which are critically endangered. Trypanosoma noyesi is a recently described species of biosecurity concern, due to a close relationship to the South American human pathogen, Trypanosoma cruzi.

A New Approach for Evaluating Electron Transfer Dynamics by Using Resonance Raman Microscopy and Chronoamperometry in Conjunction with a Dynamic Model.

is a good candidate as a chassis organism due to its ability to form thick, conductive biofilms, enabling long-distance extracellular electron transfer (EET). Due to the complexity of EET pathways in , a dynamic approach is required to study genetically modified EET rates in the biofilm. By coupling online resonance Raman microscopy with chronoamperometry, we were able to observe the dynamic discharge response in the biofilm's cytochromes to an increase in anode voltage.

Heart rate variability: Measurement and emerging use in critical care medicine.

Variation in the time interval between consecutive R wave peaks of the QRS complex has long been recognised. Measurement of this RR interval is used to derive heart rate variability. Heart rate variability is thought to reflect modulation of automaticity of the sinus node by the sympathetic and parasympathetic components of the autonomic nervous system.

Numerical modeling and verification of a sonobioreactor and its application on two model microorganisms.

Ultrasound has many uses, such as in medical imaging, monitoring of crystallization, characterization of emulsions and suspensions, and disruption of cell membranes in the food industry. It can also affect microbial cells by promoting or slowing their growth and increasing the production of some metabolites. However, the exact mechanism explaining the effect of ultrasound has not been identified yet.

Hepatic steatosis in patients undergoing resection of colorectal liver metastases: A target for prehabilitation? A narrative review.

The prevalence of elevated intra-hepatic fat (IHF) is increasing in the Western world, either alone as hepatic steatosis (HS) or in conjunction with inflammation (steatohepatitis). These changes to the hepatic parenchyma are an independent risk factor for post-operative morbidity following liver resection for colorectal liver metastases (CRLM). As elevated IHF and colorectal malignancy share similar risk factors for development it is unsurprisingly frequent in this cohort.

'Hang on a Tick' - Are Ticks Really the Vectors for Australian Trypanosomes?

Trypanosomes are global blood parasites that infect a wide range of vertebrate hosts. Several species of Trypanosoma cause disease in humans and domesticated animals, and the majority are transmitted between hosts by haematophagous invertebrate vectors. Ticks have long been speculated as vectors for Australian trypanosomes.

Response to the Letter to the Editor by Harris.

In a letter to the Editor, Harris considers the eight new species of Apicomplexa that were recently identified and named to be invalid on the basis that only molecular characters were provided in the species descriptions. In this response, we counter that the species names are valid as the descriptions have met the requirements of the International Code of Zoological Nomenclature; molecular characters can be used to satisfy article 13.1.

On-Line Raman Spectroscopic Study of Cytochromes' Redox State of Biofilms in Microbial Fuel Cells.

Bio-electrochemical systems such as microbial fuel cells and microbial electrosynthesis cells depend on efficient electron transfer between the microorganisms and the electrodes. Understanding the mechanisms and dynamics of the electron transfer is important in order to design more efficient reactors, as well as modifying microorganisms for enhanced electricity production. are well known for their ability to form thick biofilms and transfer electrons to the surfaces of electrodes.

Endemic, exotic and novel apicomplexan parasites detected during a national study of ticks from companion animals in Australia.

Background: Apicomplexan tick-borne pathogens that cause disease in companion animals include species of Babesia Starcovici, 1893, Cytauxzoon Neitz & Thomas, 1948, Hepatozoon Miller, 1908 and Theileria Bettencourt, Franca & Borges, 1907. The only apicomplexan tick-borne disease of companion animals that is known to occur in Australia is babesiosis, caused by Babesia canis vogeli Reichenow, 1937 and Babesia gibsoni Patton, 1910. However, no molecular investigations have widely investigated members of Apicomplexa Levine, 1980 in Australian ticks that parasitise dogs, cats or horses, until this present investigation.

Fluid responsiveness prediction using Vigileo FloTrac measured cardiac output changes during passive leg raise test.

Background: Passive leg raising (PLR) is a so called self-volume challenge used to test for fluid responsiveness. Changes in cardiac output (CO) or stroke volume (SV) measured during PLR are used to predict the need for subsequent fluid loading. This requires a device that can measure CO changes rapidly.

Cardiopulmonary exercise testing in a patient with a permanent tracheostomy.

The benefits of cardiopulmonary exercise testing have been well established. Certain patient groups present challenges for conducting such a test. We were presented with a patient with a permanent tracheostomy at the preoperative assessment clinic.