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Please confirm that an ethics committee approval has been applied for or granted: Not relevant (see information at the bottom of this page)Background and AimsA 65 year-old male, ASA III with a medical history of etilism, hepatic fibrosis, COPD and acquired haemophilia A presented for a pylorus preserving pancreatoduodenectomy via bilateral subcostal incision. Directly before the surgery, the factor VIII level was not sufficient (only 32%) and based on the recommendation of haematologists the patient could not receive any NSAID or Salycilate. After an uneventful surgery he was transported to the intensive care unit (ICU) in intubated state. During the surgery he hasn’t received any analgesics besides total amount of 150 mcg Fentanyl.MethodsIn order to ensure adequate analgesia bilateral external oblique intercostal (EOI) catheter were placed under ultrasound guidance at the ICU, under coagulation factor protection. Once loaded with 20-20 mL of bupivacain 0.2% patient was successfully extubated with 1/10 of VAS pain score. Continuous blocks were accomplished by intermittent boluses in every 12 hours. Sensory deficit (T7-T10) was detected by pinprick test over the upper quadrants of the abdomen. There was no need to apply any additional analgesics. We have prepared a morphine PCA pump, however the patient didn’t use it once. Two hours after the extubation he was sitting in the bed without any discomfort. The patient was released from the ICU on the first postoperative day. The catheters were removed on the 4th day.ResultsThe applied regional technique resulted in an effective and safe analgesia judged by low pain scores and early mobilization.ConclusionsEOI catheters provided efficient pain relieve after a pancreatic surgery via bilateral subcostal incision.

Bulky DNA adducts reflect genotoxic exposures, have been associated with lower birth weight, and may predict cancer risk. We selected factors known or hypothesized to affect in utero adduct formation and repair and examined their associations with adduct levels in neonates. Pregnant women from Greece, Spain, England, Denmark, and Norway were recruited in 2006-2010. Cord blood bulky DNA adduct levels were measured by the 32P-postlabeling technique (n = 511). Diet and maternal characteristics were assessed via questionnaires. Modeled exposures to air pollutants and drinking-water disinfection by-products, mainly trihalomethanes (THMs), were available for a large proportion of the study population. Greek and Spanish neonates had higher adduct levels than the northern European neonates [median, 12.1 (n = 179) vs. 6.8 (n = 332) adducts per 108 nucleotides, p < 0.001]. Residence in southern European countries, higher maternal body mass index, delivery by cesarean section, male infant sex, low maternal intake of fruits rich in vitamin C, high intake of dairy products, and low adherence to healthy diet score were statistically significantly associated with higher adduct levels in adjusted models. Exposure to fine particulate matter and nitrogen dioxide was associated with significantly higher adducts in the Danish subsample only. Overall, the pooled results for THMs in water show no evidence of association with adduct levels; however, there are country-specific differences in results with a suggestion of an association in England. These findings suggest that a combination of factors, including unknown country-specific factors, influence the bulky DNA adduct levels in neonates.

Tobacco-smoke, airborne, and dietary exposures to polycyclic aromatic hydrocarbons (PAHs) have been associated with reduced prenatal growth. Evidence from biomarker-based studies of low-exposed populations is limited. Bulky DNA adducts in cord blood reflect the prenatal effective dose to several genotoxic agents including PAHs. We estimated the association between bulky DNA adduct levels and birth weight in a multicenter study and examined modification of this association by maternal intake of fruits and vegetables during pregnancy. Pregnant women from Denmark, England, Greece, Norway, and Spain were recruited in 2006-2010. Adduct levels were measured by the 32P-postlabeling technique in white blood cells from 229 mothers and 612 newborns. Maternal diet was examined through questionnaires. Adduct levels in maternal and cord blood samples were similar and positively correlated (median, 12.1 vs. 11.4 adducts in 108 nucleotides; Spearman rank correlation coefficient = 0.66, p < 0.001). Cord blood adduct levels were negatively associated with birth weight, with an estimated difference in mean birth weight of -129 g (95% CI: -233, -25 g) for infants in the highest versus lowest tertile of adducts. The negative association with birth weight was limited to births in Norway, Denmark, and England, the countries with the lowest adduct levels, and was more pronounced in births to mothers with low intake of fruits and vegetables (-248 g; 95% CI: -405, -92 g) compared with those with high intake (-58 g; 95% CI: -206, 90 g). Maternal exposure to genotoxic agents that induce the formation of bulky DNA adducts may affect intrauterine growth. Maternal fruit and vegetable consumption may be protective.

Environmental filtering and limiting similarity are those locally acting processes that influence community structure. These mechanisms acting on the traits of species result in trait convergence or divergence within the communities. The role of these processes might change along environmental gradients, and it has been conceptualised in the stress-dominance hypothesis, which predicts that the relative importance of environmental filtering increases and competition decreases with increasing environmental stress. Analysing trait convergence and divergence in lake phytoplankton assemblages, we studied how the concepts of ‘limiting similarity’ versus ‘environmental filtering’ can be applied to these microscopic aquatic communities, and how they support or contradict the stress-dominance hypothesis. Using a null model approach, we investigated the divergence and convergence of phytoplankton traits along environmental gradients represented by canonical axes of an RDA. We used Rao’s quadratic entropy as a measure of functional diversity and calculated effect size (ES) values for each sample. Negative ES values refer to trait convergence, i.e., to the higher probability of the environmental filtering in community assembly, while positive values indicate trait divergence, stressing the importance of limiting similarity (niche partitioning), that is, the competition between the phytoplankters. Our results revealed that limiting similarity and environmental filtering may operate simultaneously in phytoplankton communities, but these assembly mechanisms influenced the distribution of phytoplankton traits differently, and the effects show considerable changes along with the studied scales. Studying the changes of ES values along with the various scales, our results partly supported the stress-dominance hypothesis, which predicts that the relative importance of environmental filtering increases and competition decreases with increasing environmental stress.

Aquatic macrophytes form a three dimensional complex structure in the littoral zones of lakes, with many physical, chemical and biological gradients and interactions. This special habitat harbours a unique microalgal assemblage called metaphyton, that differs both from the phytoplankton of the pelagial and from the benthic assemblages whose elements are tightly attached to the substrates. Since metaphytic assemblages significantly contribute to the diversity of lakes’ phytoplankton, it is crucial to understand and disentangle those mechanisms that ensure their development. Therefore, we focused on the question of how a single solid physical structure contribute to maintaining metaphytic assemblages. Using a laboratory experiment we studied the floristic and functional differences of microalgal assemblages in microcosms that simulated the conditions that an open water, a complex natural macrophyte stand ( Utricularia vulgaris L.), or an artificial substrate (cotton wool) provide for them. We inoculated the systems with a species rich (> 326 species) microalgal assemblage collected from a eutrophic oxbow lake, and studied the diversity, trait and functional group composition of the assemblages in a 24 day long experimental period. We found that both natural and artificial substrates ensured higher species richness than the open water environment. Functional richness in the open water environment was lower than in the aquaria containing natural macrophyte stand but higher than in which cotton wool was placed. This means that the artificial physical structure enhanced functional redundancy of the resident functional groups. Elongation measures of microalgal assemblages showed the highest variation in the microcosms that simulated the open water environment. Our results suggest that assembly of metaphytic algal communities is not a random process, instead a deterministic one driven by the niche characteristics of the complex three dimensional structure created by the stands of aquatic macrophytes.

Background: the purpose of this study was to explore the effect of 10 weeks of yoga intervention on the mental health outcomes (stress, anxiety, and depression), quality of life, emotional regulation, and quality of sleep of medical students. Method: In the current experimental study, 220 medical students, with a mean age of 21.36 ± 2.20 years, participated in a 10-week yoga intervention at the University of Pécs. Data were collected before and after the intervention using the validated questionnaires DASS-21, WHOQOL-BREF, PSQI, and DERS. The distribution of data was checked using the Kolmogorov–Smirnov test. A paired sample T-test was used to compare the mean of the continuous variable. Stepwise linear regression was used to assess the association between mental health outcomes and quality-of-life variables. Results: The present study shows a significant reduction in (p < 0.001), depression (p < 0.001), and anxiety (p < 0.001) for participants, and overall quality of life (p < 0.001), quality of sleep (p < 0.001), and emotional regulation (p < 0.001) significantly improved after the intervention. The stepwise linear regression shows a strong association between higher levels of anxiety (β = 0.608, R2 = 0.366) and depression (β = 0.608, R2 = 0.392), with higher stress levels and improvement in environmental conditions being associated with a decrease in stress levels (β = −0.392, R2 = 0.087). Conclusions: the current study shows that yoga significantly improved the mental health and well-being of medical students, improving quality of life, quality of sleep, and emotional regulation. Registered Clinical Trial: NCT06661603.

Diverse macrovegetation can provide heterogeneous habitats for benthic diatoms. The removal of macrophytes as direct plant control, however, can be considered as a threat, which can even lead to remarkable microhabitat alterations. Lake Tisza (Hungary) has a high nature conservation value, but it is also an important recreation centre, which is why very delicate water management is necessary including vegetation thinning. Here, we studied the importance of microhabitat heterogeneity (emergent, submerged and floating macrophytes) in maintaining diverse periphytic diatom assemblages. We hypothesized that the substrate type has greater influencing role on the composition and diversity of diatoms than the lake heterogeneity related to basins. We also assumed that floating vegetation hosts the most different and least diverse diatom assemblages. Our results mostly proved these hypotheses. Heterogeneous assemblages were formed on the different substrates (support hypothesis), however, the basin level differences were also detected (reject hypothesis). Our results also highlighted, that macrophyte species with lesser morphological complexity hosted the least diverse periphytic assemblages (support hypothesis). However, many unique and red list taxa were found on floating plants (reject hypothesis). These findings emphasize the key role of microhabitat complexity in maintaining diverse and healthy functioning of microbial assemblages in a multi-purpose reservoir.

Here, we studied the influence of changes of aquatic phases (standing and flowing phases) and human-induced habitat variability (natural and artificial) on the composition and diversity of benthic diatom assemblages in a small lowland stream in the Pannonian Ecoregion. Significant differences in composition were hypothesized between phases and habitats. Lower diversity was hypothesized in the flowing phase and in the artificial habitat. In addition, worser ecological status were assumed in the artificial habitat and in the standing phase than in the others. Our results only partially supported our hypotheses. While there was no significant difference in the composition of the assemblages between the natural and concreted habitats, the alteration in flow conditions resulted in a significant change. No significant differences in diversity were found between aquatic phases. In contrast, biodiversity was higher in the artificial habitat than in the natural one. While the anthropogenic impact, i.e., concreted streambed has no significant influence on diatom-based ecological status, values of diatom indices were significantly higher in the flowing phase. Our results highlight that extreme weather events play a major role in shaping diatom assemblages even during a short period, which should be taken into account in water management and nature conservation measures.