Minimal local anesthetic volume for peripheral nerve block: a new ultrasound-guided, nerve dimension-based method

BACKGROUND AND OBJECTIVES: Nerve blocks using local anesthetics are widely used. High volumes are usually injected, which may predispose patients to associated adverse events. Introduction of ultrasound guidance facilitates the reduction of volume, but the minimal effective volume is unknown. In this study, we estimated the 50% effective dose (ED50) and 95% effective dose (ED95) volume of 1% mepivacaine relative to the cross-sectional area of the nerve for an adequate sensory block. METHODS: To reduce the number of healthy volunteers, we used a volume reduction protocol using the up-and-down procedure according to the Dixon average method. The ulnar nerve was scanned at the proximal forearm, and the cross-sectional area was measured by ultrasound. In the first volunteer, a volume of 0.4 mL/mm of nerve cross-sectional area was injected under ultrasound guidance in close proximity to and around the nerve using a multiple injection technique. The volume in the next volunteer was reduced by 0.04 mL/mm in case of complete blockade and augmented by the same amount in case of incomplete sensory blockade within 20 mins. After 3 up-and-down cycles, ED50 and ED95 were estimated. Volunteers and physicians performing the block were blinded to the volume used. RESULTS: A total 17 of volunteers were investigated. The ED50 volume was 0.08 mL/mm (SD, 0.01 mL/mm), and the ED95 volume was 0.11 mL/mm (SD, 0.03 mL/mm). The mean cross-sectional area of the nerves was 6.2 mm (1.0 mm). CONCLUSIONS: Based on the ultrasound measured cross-sectional area and using ultrasound guidance, a mean volume of 0.7 mL represents the ED95 dose of 1% mepivacaine to block the ulnar nerve at the proximal forearm.

Buffer capacity: capturing a dimension of resilience to climate change in African smallholder agriculture

Building resilience to climate change in agricultural production can ensure the functioning of agricultural-based livelihoods and reduce their vulnerability to climate change impacts. This paper thus explores how buffer capacity, a characteristic feature of resilience, can be conceptualised and used for assessing the resilience of smallholder agriculture to climate change. It uses the case of conservation agriculture farmers in a Kenyan region and examines how their practices contribute to buffer capacity. Surveys were used to collect data from 41 purposely selected conservation agriculture farmers in the Laikipia region of Kenya. Besides descriptive statistics, factor analysis was used to identify the key dimensions that characterise buffer capacity in the study context. The cluster of practices characterising buffer capacity in conservation agriculture include soil protection, adapted crops, intensification/irrigation, mechanisation and livelihood diversification. Various conservation practices increase buffer capacity, evaluated by farmers in economic, social, ecological and other dimensions. Through conservation agriculture, most farmers improved their productivity and incomes despite drought, improved their environment and social relations. Better-off farmers also reduced their need for labour, but this resulted in lesser income-earning opportunities for the poorer farmers, thus reducing the buffer capacity and resilience of the latter.

Lepton Flavor Violation in the Standard Model with general Dimension-Six Operators

We study lepton flavor observables in the Standard Model (SM) extended with all dimension-6 operators which are invariant under the SM gauge group. We calculate the complete one-loop predictions to the radiative lepton decays μ → eγ, τ → μγ and τ → eγ as well as to the closely related anomalous magnetic moments and electric dipole moments of charged leptons, taking into account all dimension-6 operators which can generate lepton flavor violation. Also the 3-body flavor violating charged lepton decays τ ± → μ ± μ + μ −, τ ± → e ± e + e −, τ ± → e ± μ + μ −, τ ± → μ ± e + e −, τ ± → e ∓ μ ± μ ±, τ ± → μ ∓ e ± e ± and μ ± → e ± e + e − and the Z 0 decays Z 0 → ℓ+iℓ−j are considered, taking into account all tree-level contributions.

On restricted families of projections in ℝ3

We study projections onto non-degenerate one-dimensional families of lines and planes in R 3 . Using the classical potential theoretic approach of R. Kaufman, one can show that the Hausdorff dimension of at most 12 -dimensional sets [Math Processing Error] is typically preserved under one-dimensional families of projections onto lines. We improve the result by an ε , proving that if [Math Processing Error], then the packing dimension of the projections is almost surely at least [Math Processing Error]. For projections onto planes, we obtain a similar bound, with the threshold 12 replaced by 1 . In the special case of self-similar sets [Math Processing Error] without rotations, we obtain a full Marstrand-type projection theorem for 1-parameter families of projections onto lines. The [Math Processing Error] case of the result follows from recent work of M. Hochman, but the [Math Processing Error] part is new: with this assumption, we prove that the projections have positive length almost surely.

Die Erschliessung der dritten Dimension. Entstehung und Entwicklung der zivilen Luftfahrtinfrastruktur in der Schweiz, 1919-1990

Weshalb liegt der grösste Flughafen der Schweiz heute in Zürich-Kloten? Welche Rolle spielte der Fluglärm bei der Entwicklung der Flughäfen Genf-Cointrin und Basel-Mülhausen? Wie entstanden in der Schweiz die ersten Luftstrassen und seit wann gibt es Fluglotsen? Erstmals wird die Geschichte der Flughäfen, der Flugplätze und der Flugsicherung in der Schweiz von den Anfängen bis zum Ende des 20. Jahrhunderts umfassend dargestellt. Der Autor fokussiert nicht auf einzelne Anlagen, sondern nimmt eine gesamtschweizerische Perspektive ein, die er in einen globalen Zusammenhang stellt. Aus dem umfangreichen Quellenmaterial rekonstruiert er die Entstehung und Entwicklung der Luftfahrtinfrastruktur in der Schweiz und beleuchtet die Auswirkung verschiedener Rahmenbedingungen und ­Akteure auf diese Entwicklung. Dabei berücksichtigt er ein breites Spektrum an Faktoren: beispielsweise die im Luftverkehr besonders wichtigen internationalen Einflüsse, den seit der Zwischenkriegszeit bestehenden Konkurrenzkampf zwischen den Flugplatzstandorten, die Rolle des Bundes oder die nach dem Zweiten Weltkrieg aufkommende Fluglärmthematik. Nebst den heute noch bestehenden Standorten werden auch längst aufgehobene Infrastrukturen sowie nie verwirklichte Projekte thematisiert, darunter der europäische Zentralflughafen für interkontinentale Grosswasserflugzeuge am Bodensee sowie die schweizerischen Zentralflughäfen in Bern-Utzenstorf und auf dem Neuenburgersee.