Daily Schedule Research Articles

Optimal energy management of MG for cost-effective operations and battery scheduling using BWO

The rapid growth of renewable standalone systems, with their inherent uncertainties and intermittency, poses a huge challenge to system stability. In this paper, an intelligent microgrid is proposed that fully utilizes the complementarity characteristics in PV and battery storage system (BESS), and is capable of maintaining an economic, reliable, and environmental equilibrium in daily generation scheduling. A black widow optimization (BWO) based controller is designed to determine the best possible solution under different scheduling scenarios. In addition, an exponential cost function based on the battery’s degree of discharge (DOD) is introduced to calculate the battery generation cost. It will include the battery lifetime cost in the overall power generation cost. Furthermore, the cost of the diesel generator includes the CO2 emission cost which is inversely proportional to the generator efficiency. The BWO algorithm optimized the generation cost based on these functions and increase the reliability of the grid using reliability index. The BWO algorithm finds the optimal global solution in less than 30 iterations and avoid the local optima problem. The effectiveness and convergence speed of BWO is far better than other algorithms and is validated by simulation results.

An Automated Medicine Dispenser using IOT

Abstract—An Automated Medicine Dispenser using IoT is a part of IoT technology that takes on the challenge of medication non-adherence for daily medication schedules especially for aging population. Non-adherence to medication results in negative health outcomes, higher rates of hospitalizations, and consid- erable costs to healthcare. To ensure that medicine is delivered on time and accurately, the project integrates different hardware components such as a motor-driven dispensing mechanism. The project uses both audio and visual alerts to inform users when they should take their medication. This enables patients and caregivers, as well as clinicians care providers to instantly monitor medication adherence which is supported by the devices IoT connectivity. The dispenser is also designed to be easy-to-use and user friendly and aims at elderly patients who have a hard time managing the complexities of multi-medication schedules. The Dispenser offers a reliable solution for improving medication management. Index Terms—Automated Medicine Dispenser, IoT, medication adherence, elderly care, healthcare technology, real-time moni- toring.

Inter-temporal dynamic joint learning model considering intra- and inter-day mutable correlations for blood glucose level prediction

Accurate and low clinical risk blood glucose level (BGL) prediction plays an important role in blood glucose management of type 1 diabetes (T1D). Due to the diurnal variation in physiological regulation and the influence of external life events, blood glucose patterns change over time and events within a day. The fact that humans have an inherent biological cycle of approximately one day and an individual has similar responses to the same life events leading to day-to-day similarities in blood glucose trajectories. However, the daily schedules are not entirely same under free-living conditions so that similar glycemic patterns may occur at different periods on each day. Thus, the mutable intra-day and inter-day temporal correlations in multi-day BGL data challenge the BGL prediction. To this end, we propose an inter-temporal dynamic joint learning method, named as iTDJL. Firstly, considering the variability of the association between days in the free-living, we design a discovery strategy based on discrete cross-correlation to dynamically select the highly correlated series slices from previous days. Then, based on the multi-head self-attention mechanism, the intra-day and inter-day attention layers are developed and connected in sequence to capture the correlation relationships between different time spans that varies with input. Finally, the future multi-step predictions are obtained through a multi-layer perception layer. We evaluate the iTDJL model on the real-world OhioT1DM dataset. Compared to other advanced methods, the iTDJL produces more reliable BGL predictions without requiring meal announcement and other lifestyle information from the patients under free-living conditions. Our proposed method may promote the T1D management, such as clinical decision support assisting insulin injection and abnormal glucose warning.

A Methodological Approach for Enriching Activity–Travel Schedules with In-Home Activities

In-home activities are inevitably important parts of individuals’ daily schedules, as people spend more time working and doing various other activities (e.g., online shopping or banking) at home. However, conventional activity-based travel demand models (ABMs) only consider travel and travel-related out-of-home activities, ignoring the interaction between in-home and out-of-home activities. To fill in this gap and increase the understanding of what people do at home and how in-home and out-of-home activities affect each other, a new method is proposed in this study. The approach predicts the types and durations of in-home activities of daily schedules generated by ABMs. In model building, statistical methods such as multinomial logit, log-linear regression, and activity sequential information are utilized, while in calibration, the Simultaneous Perturbation Stochastic Approximation (SPSA) method is employed. The proposed method was tested using training data and by applying the approach to the schedules of 6.3 million people in the Flemish region of Belgium generated by a representative ABM. Based on the statistical methods, the mean absolute errors were 0.36 and 0.21 for predicting the number and sum of the durations of in-home activities (over all types) per schedule, respectively. The prediction obtained a 10% and 8% improvement using sequential information. After calibration, an additional 60% and 68% were gained regarding activity participation rates and time spent per day. The experimental results demonstrate the potential and practical ability of the proposed method for the incorporation of in-home activities in activity–travel schedules, contributing towards the extension of ABMs to a wide range of applications that are associated with individuals’ in-home activities (e.g., the appropriate evaluation of energy consumption and carbon emission estimation as well as sustainable policy designs for telecommuting).

Peer-to-Peer Transactive Energy Trading of Smart Homes/Buildings Contributed by A Cloud Energy Storage System

This paper presents a model for transactive energy management within microgrids (MGs) that include smart homes and buildings. The model focuses on peer-to-peer (P2P) transactive energy management among these homes, establishing a collaborative use of a cloud energy storage system (CESS) to reduce daily energy costs for both smart homes and MGs. This research assesses how smart homes and buildings can effectively utilize CESS while implementing P2P transactive energy management. Additionally, it explores the potential of a solar rooftop parking lot facility that offers charging and discharging services for plug-in electric vehicles (PEVs) within the MG. Controllable and non-controllable appliances, along with air conditioning (AC) systems, are managed by a home energy management (HEM) system to optimize energy interactions within daily scheduling. A linear mathematical framework is developed across three scenarios and solved using General Algebraic Modeling System (GAMS 24.1.2) software for optimization. The developed model investigates the operational impacts and optimization opportunities of CESS within smart homes and MGs. It also develops a transactive energy framework in a P2P energy trading market embedded with CESS and analyzes the cost-effectiveness and arbitrage driven by CESS integration. The results of the comparative analysis reveal that integrating CESS within the P2P transactive framework not only opens up further technical opportunities but also significantly reduces MG energy costs from $55.01 to $48.64, achieving an 11.57% improvement. Results are further discussed.

A Study on 128 Slice MDCT unit in a Tertiary Care Teaching Hospital with Special Emphasis on Work Flow and Break-Even Analysis

Purpose: To study the Cost Analysis of 128 Slice MDCT unit in a tertiary care teaching hospital Materials and methods: The study followed a biphasic design, comprising both retrospective and prospective components. The retrospective phase involved a record-based analysis conducted over a 3-month period, while the prospective phase included record review, observational methods, interviews, and material evaluation relevant to the study, carried out over the course of 1 month. Results: The cost of running the 128 Slice MDCT unit, including manpower, was calculated for a 3-month period, with an average of 28 cases per day. The unit handles a total workload of 54 TR (15 TR + 35 TR + 4 TR). Power is supplied by a 120KVA UPS located in the unit's UPS room. Depreciation for the building, with a lifespan of 100 years, is set at 1% of the capital cost. For an area of 51.2 sqm, the construction cost totals Rs 19,18,208/-, with a depreciation cost of Rs 47,955/- over 3 months. According to the CPWD manual, the annual maintenance cost is Rs 5104/- per sq.m., resulting in a maintenance expense of Rs 65,331/-. Additional costs for electricity, water, and linen over the 3-month period were also factored in. The breakeven point for the unit is estimated to be 744 days (approximately 2 years and 14 days). Conclusion: Getting each patient into and out of the procedure room in a timely manner can add minutes and maybe even hours to the daily schedules, allowing for the accommodation of a greater number of cases. Increasing the number of procedures performed per day or week can add to overall income.

Earth observation satellite imaging task scheduling with metaheuristics: Multi-level clustering and priority-driven pre-scheduling

Daily planning and scheduling of Agile Earth Observation Satellite (AEOS) observation tasks are enormously challenging due to their inherent complexity. This complexity stems from the vast number of observations that need to be coordinated and the multiple constraints that must be considered. In this study, we propose a comprehensive framework consisting of three steps to effectively tackle these challenges. To begin with, we employ a Multi-Level Clustering technique (MLC) to mitigate the problem complexity. Additionally, we integrate a Fixed High Priority First (FHPF) algorithm for tasks pre-scheduling. This algorithm effectively manages conflicts in time resource allocation for observation tasks at the lowest cluster level. Finally, we conduct a comparative analysis of four metaheuristic algorithms, integrating the pre-scheduled task clusters from the MLC-FHPF module as input for the main scheduling process. Our strategy aims to overcome the limitations of existing methods by incorporating continuous time modeling and accounting for “Fixed Time Maneuver” for time-dependent transition time constraints. Real-world evaluations highlight the resilience and effectiveness of our MLC-FHPF framework when integrated with various metaheuristic algorithms. Our approach significantly outperforms standard metaheuristics in terms of efficacy and efficiency. Notably, the GA MLC-FHPF algorithm consistently surpasses BDP-ILS and ALNS, especially in large-scale scenarios. It adapts effectively to different task densities and scales, maintaining optimized scheduling performance and efficient processing times.

Cannabinoid receptor type 1 agonist disrupts methamphetamine-induced conditioned place preference in adolescent male rats

Addiction can be viewed as a state of compulsive engagement in drug use. It is believed that drug-associated memories maintain compulsive drug-seeking behavior. Therefore, disrupting drug-associated memories may reduce drug-seeking behavior. In the present study, a conditioned place preference (CPP) apparatus was conducted to evaluate the effect of cannabinoid receptor type 1 (CB1R) agonist and antagonist on the acquisition of CPP induced by methamphetamine (METH). Anxiety behaviors and memory retrieval were assessed using elevated plus maze (EPM) and step-through passive avoidance tasks. In this study using a 5-day schedule of CPP, exposure to METH increased the time spent in the drug-paired compartment, and CB1Rs agonist (WIN 55,212–2, WIN) disrupted the METH-induced CPP. In the EPM experiment, METH significantly decreased the ratio of times spent in the open arms to total times spent in any arms (OAT) and the ratio of entries into open arms to total entries (OAE), indicating that METH increases anxiety-like behaviors. However, the CB1Rs antagonist (SR141716A, SR) reversed METH-induced anxiety behaviors. The results obtained in the passive avoidance experiment showed that blockade of brain CB1Rs by SR improves METH-induced amnesia. In summary, CB1Rs appear to modulate METH-associated memories, and antagonists of CB1Rs may serve as a therapeutic target for METH-induced anxiety behaviors.

Distributed solution of the day-ahead pump and valve scheduling problem for dynamically adaptive water distribution networks with storage

This paper investigates the computation of daily schedules of pumps and boundary valves for the minimization of energy costs in water distribution networks (WDN) with dynamically adaptive configurations. The considered problem combines integer (“on”/“off”) pump control variables, non-convex energy conservation constraints and time-coupling mass conservation constraints. For operational WDNs, the resulting non-convex mixed-integer non-linear program (MINLP) is too large to be solved using available methods. We propose a tailored heuristic solution method based on the Alternating Direction Method of Multipliers which distributes and coordinates the solution of smaller problems corresponding to individual time steps of the original MINLP. The proposed method is applied to a large-scale WDN from the UK. The daily schedule of pumps and boundary valves obtained for the dynamically adaptive network configuration, computed in 12 min, is shown to be at most 6% suboptimal and nearly 5% cheaper than the globally optimal schedule corresponding to the traditional (sectorized) network configuration. The proposed algorithm outperforms alternative off-the-shelf and tailored approaches, providing a scalable method to compute good solutions to the complex day-ahead pump and valve scheduling problem in operational dynamically adaptive WDNs.

The Importance of the Teachers’ Role in Imaginative Play

This study of Norwegian kindergartens investigates how teachers may support imaginative play, drawing on Vygotsky’s approaches to play and teachers’ positioning in play in terms of different roles. For this study, the empirical investigations were organized as both observations and focus group interviews. The sample was two kindergartens with in total 12 teachers and 44 children aged 3-5 years. The study was conducted in November 2021-April 2022. The analyses point to three main findings; firstly, changes according to daily schedule and content may have effect on play, secondly, the teacher’s role may be an obstacle in play, and thirdly, the teacher’s role may be a driving force in play. In the discussion of these findings, questions are raised about traditions and a lack of competence together can lead to children not receiving sufficient support in imaginative play. However, when the teachers are a play partner who both add new fictional elements and support the fiction by »lending« their experiences, the play’s potential and opportunity space is utilized. The conclusion is that the quality of the teachers’ role and involvement will have an impact on children’s cultural expression in play.

Exploration of primary care models and timely access to care in New Brunswick (Canada)

BackgroundThis correlative study aimed to examine how the different primary care models (physicians in solo practice, physicians in collaborative practice, physicians and nurse practitioners in collaborative practice, after-hours clinics, community centers, or emergency rooms) were associated with their capability to offer timely access to their patients. The data collected from the primary care provider’s perspective was to complete the New Brunswick Health Council results on patients’ perspective.MethodsA convenience sample of 120 primary care providers (33 physicians in solo practice, 33 physicians in collaborative practice, 27 providers in collaborative practice with nurse practitioners, 2 providers working in after-hours clinics, and 10 providers in Emergency departments) responded to an online survey about their primary care models and accessibility. We used the Statistical Package for Social Sciences software to run correlations, independent t-tests and Fisher’s exact tests to compare timely access to care between variable groups.ResultsA positive correlation was observed between patient load (or the number of patients under a primary care provider’s practice), age and years of experience. However, the patient load did not translate to more timely access to care. However, a statistically significant difference (p = 0.032) was observed when primary care providers kept appointment slots available for daily urgent requests. When a primary care provider booked all available appointment slots, only 85% of them could offer timely appointments (in 5 days or less), compared to 97% who could deliver it when appointment slots were left open in their daily schedule. The primary care model (solo vs. collaboration), the use of health technologies and the type of provider did not significantly influence timely access to care. In contrast, the primary care providers who reported teleworking (or working remotely) were less likely to offer timely access to care.ConclusionTimely access to care is not always available to patients, even those with a primary care provider. Certain organizational practices may improve access to care and should be integrated into primary care in New Brunswick and elsewhere in Canada.

Changes in Trait Mindfulness after a Brief Mindfulness Training Program of Self-Breathing.

Developing and cultivating mindfulness exerts a positive effect on psychological and cognitive performance. Sharpening the skill requires continuous mindfulness-based training (MT), which can be challenging for people leading busy lives. Therefore, the current study examined whether trait mindfulness can be improved by a flexible and brief MT program of self-breathing using a pre-post intervention design. Trait mindfulness was assessed using the Japanese version of the Five Facet Mindfulness Questionnaire (FFMQ) before the intervention (pre), after 2 weeks (during), and 4 weeks after the intervention started (post). Data were analyzed using the Friedman test followed by the Dunn-Bonferroni correction. The study sample consisted of 22 healthy participants aged from 20 to 60 years with no previous experience with yoga or meditation equivalent to MT. The mean number of days of MT practice was 26.4, and 11 participants had interruptions. The median values of pre-, during-, and post-total FFMQ scores were 115.5, 123, and 129, respectively. Significant differences were observed in the total pre and post (p < 0.001) and during and post (p = 0.002) FFMQ scores, though a medium effect was found (r = 0.30) only between the pre and post scores. Of the five sub-scales of FFMQ, significant differences were observed only between pre and post Observing (p = 0.01), Nonreactivity (p < 0.001), and Describing (p = 0.01), and during and post Nonjudging (p = 0.016), and Nonreactivity (p = 0.025). Our findings suggest that the simple, brief, and flexible self-breathing method employed in this study has a substantial effect on fostering trait mindfulness and, therefore, can be adopted by people with hectic daily schedules.

Midostaurin added to 10-day decitabine, for patients unfit for intensive chemotherapy with AML and higher risk MDS, irrespective of FLT3 mutational status, does not improve outcome.

The treatment of older patients with acute myeloid leukemia (AML) considered unfit for receiving intensive chemotherapy is challenging. Based on the hypothesis that addition of the broad tyrosine kinase inhibitor (TKI) midostaurin could improve the response to hypomethylating agents, irrespective of FLT3 gene mutational status, we conducted a randomized phase II multicenter study to assess the tolerability and efficacy of the addition of midostaurin to a 10-day schedule of decitabine in unfit (i.e. Hematopoietic Cell Transplantation Comorbidity Index (HCT-CI) ≥ 3) AML and higher risk myelodysplasia (MDS) patients (HOVON155 trial). In total, 140 eligible patients were randomly (1:1) assigned to treatment with 10-days of decitabine alone (N = 70) or combined with midostaurin (50mg bid;starting the day following the last dose of decitabine), (N = 70). Addition of midostaurin was well tolerated and the number of AEs was comparable for both treatment arms. Early death rates (< 30 days) were similar as well (10%). In the decitabine plus midostaurin arm 24% reached CR/CRi, the median OS was 4.8 months and 1-yrs OS was 31% which compared with 34% CR/CRi, median OS of 7.4 months and 1-yrs OS of 37% for the decitabine alone group (NS). Thus, while the addition of midostaurin appears safe, it does not enhance therapeutic efficacy of decitabine in unfit AML patients.

The Urgency of Social Media “Diet” for Generation Z

Social media and generation Z (Gen Z) are like two sides of a coin that cannot be separated. Various positive and negative impacts have arisen as a result of internet addiction among Gen Z. Thus, this research was conducted to obtain a suitable formulation for Gen Z, both in consuming information and using social media. Hopefully, this research contributes to decreasing the negative impacts from the consumption of information and use of social media. The research was conducted through a qualitative approach. Data was collected through Focus Group Discussions (FGD) through Zoom meetings and literature studies. The research findings provide a social media diet model that includes three aspects: Self-Awareness, Action, and Evaluation (SAAE). The first chart of Self-Awareness includes action, motivation, and self-knowledge. The Action aspect contains five dimensions: choosing social media that suits your needs, limiting and selecting the type of information consumed, setting a daily schedule, consuming more offline content, and doing productive activities. The Evaluation highlights the concern on obedience and consistency. Researchers believe that this model can create awareness among social media users about the importance of social media diet information and provide real implications in the application of social media diet models. The social media diet prospectively works for Gen Z and other generations. Keywords: Generation Z, information diet, social media, social media diet models, urgency.

Examining Management and Employees' Perceptions of Occupational Heat Exposure and the Effectiveness of a Heat Stress Prevention Intervention on Safety and Well-Being among Natural Gas Construction Workers: A Qualitative Field-Based Study.

Numerous risk factors have been identified as significantly influencing outdoor workers' risk for heat stress and heat-related conditions, impacting their health, well-being, and productivity. However, the specific effects of these factors on construction workers' safety, health, and well-being remain under-researched. With climate change increasing temperatures, assessing heat stress among construction workers is imperative. To identify the barriers and facilitators influencing the safety of natural gas construction workers and evaluate an implemented heat stress intervention. In the summer of 2023, two semi-structured interviews and six focus groups were conducted with twenty-one stakeholders at a Texas natural gas construction site. Key facilitators include employee preparedness, use of employer-provided resources, hydration logs, and real-time communication tools. Contrarily, the barriers include daily work schedules, access to dehydrating beverages, and generational differences with the non-implementation of mandatory rest breaks. The heat stress program was perceived as effective, surpassing recommended guidelines. To advance construction workers' safety, health, and well-being, both employee involvement and employer management are needed, along with no-cost accessible resources. Additionally, implementing a required routine rest break and comprehensive heat stress education, particularly for older workers, will significantly promote safety and safe work practices in hot environments. Note: in this study, the terms 'worker' and 'employee' are used interchangeably.

A multicenter phase 2 clinical trial of low-dose subcutaneous decitabine in myelofibrosis

AbstractMyelofibrosis (MF) in the chronic phase is a challenging disease to treat, and conventional treatment options are geared toward symptom palliation. In this prospective, multicenter, phase 2 trial, 21 patients with MF (18 chronic phase, 2 accelerated phase, and 1 blast phase) were treated with a 10-day schedule of subcutaneous decitabine at 0.3 mg/kg per day. The overall response rate was 33% (95% confidence interval, 15-57), primarily manifested as an improvement in cytopenias. The median duration of response was 7 months (range, 3-44). A high International Prognostic Scoring System risk score, high baseline fetal hemoglobin level, and sustained decrease in circulating CD34+ cell counts were associated with response to decitabine. All patients experienced at least 1 grade 3/4 cytopenia. Nonhematologic toxicities were less frequent, with fatigue, anorexia, and hypocalcemia being the most common. Given the lack of effective therapies in MF with severe cytopenias, this study supports further investigation into the use of hypomethylating agents as single agents or in combination therapies. This trial was registered at www.ClinicalTrials.gov as #NCT00095784.

Consecutive Daily Versus Every Other Day Stereotactic Body Radiation Therapy Scheduling for Stage I Non-small Cell Lung Cancer

The optimal delivery schedule for stereotactic body radiation therapy (SBRT) in treating stage I non-small cell lung cancer (NSCLC) is unknown. This study used the National Cancer Database to examine daily versus every other day (QOD) SBRT scheduling, including trends over time and association with survival. The National Cancer Database was used to retrospectively identify patients with stage I NSCLC treated with 3-, 4-, or 5-fraction of SBRT between 2004 and 2016. Survival analysis was performed using the Kaplan-Meier method and Cox regression modeling. Of 15,269 patients, 3927 (25.7%) received SBRT daily, and 11,342 (74.3%) received treatment QOD. The use of QOD treatment increased from 63.2% in 2007 to 78.3% in 2016, and 5-fraction SBRT increased from 3.7% in 2004 to 51.4% in 2016 (both P < .0001). QOD 5-fraction became the most prevalent scheduling from 2012 to 2016 (28.5% in 2012 to 41.6% in 2016). Factors significantly associated with daily SBRT scheduling included number of fractions, race, lower income, lower comorbidities, and treatment at academic/research programs (all P ≤ .01).Median survival for daily SBRT was 37.9 months versus 38.4 months for QOD (P = .4). On multivariable analysis, no difference was found in overall survival between daily versus QOD scheduling (adjusted hazard ratio [aHR], 0.99; 95% confidence interval [CI], 0.94-1.04; P = .55). Five-fraction SBRT was associated with worse survival versus 3 fractions (aHR, 1.09; 95% CI, 1.03-1.15; P = .002). With 3-fraction SBRT, QOD treatment was associated with improved survival versus daily treatment (aHR, 0.91; 95% CI, 0.84-0.98; P = .02). With 5-fraction SBRT, QOD treatment was associated with worse survival versus daily treatment (aHR, 1.11; 95% CI, 1.02-1.22; P = .02). QOD SBRT schedules were more frequently used to treat stage I NSCLC than daily regimens by a factor of 3:1, and QOD 5-fraction SBRT became the most common dose schedule after 2012. Three-fraction QOD SBRT was associated with improved survival versus daily, whereas 5-fraction QOD SBRT was associated with worse survival versus daily.

The impact of different doses of oral iron supplementation during pregnancy: a pilot randomized trial

AbstractOral iron is first-line medication for iron deficiency anemia in pregnancy. We conducted a pilot randomized trial to investigate the impact of different doses of oral iron supplementation started early in pregnancy on women without anemia for 4 main outcomes: recruitment and protocol compliance, adherence, maintenance of maternal hemoglobin, and side effects. At antenatal clinic visits, participants were allocated to 1 of 3 trial arms in a 1:1:1 ratio: 200 mg ferrous sulfate daily, alternate days, or 3 times per week. The participants were followed to delivery. Baseline characteristics of 300 recruited participants were well matched between trial arms. The mean proportion of tablets taken as expected per participant was 82.5% overall (72.3%, 89.6%, and 84.5% for the daily, alternate days, and 3 times a week arm, respectively). There was a lower overall adherence rate in the daily arm (47%) than in the alternate days (62%) and the 3 times per week (61%) arms. A reduction in hemoglobin between randomization and 28 weeks’ gestation seemed smaller for the daily arm. A range of side effects were commonly reported at baseline before starting interventions and at later antenatal visits. Many side effects of iron overlapped with normal pregnancy symptoms. A daily iron dosing schedule might give the best opportunity for delivering an adequate iron load during pregnancy in women without anemia. Further randomized trials powered on clinical outcomes are needed to establish the clinical effectiveness of oral iron supplementation to prevent iron deficiency anemia. This study was registered (#ISRCTN12911644).

Confirming the Causal Role of Consistent Contexts in Developing a Walking Habit: A Randomized Comparison With Varied Contexts.

Physical activity interventions using habit development may help people increase and then maintain physical activity increases over time. Enacting behavior in consistent contexts is a central component of habit development, yet its causal role in habit development in health behaviors has not been confirmed. This study tests the causal role of consistent context in habit development in health behavior, using a randomized control trial of a planning intervention to develop a walking habit in 127 insufficiently active, working, midlife adults in a real-world setting. We compare participants who plan walking in consistent contexts with controls who plan walking in varied contexts and with controls not required to plan on a change in average daily steps (measured using an accelerometer) and inhabit automaticity during a 4-week intervention and at a 4-week follow-up. As expected, consistent and varied context planners increased walking during the intervention, but only consistent context planners developed (and maintained) habit automaticity. Counter to expectations, consistent context planners did not show walking maintenance. However, across conditions, participants who developed more habit automaticity during the intervention also maintained walking more (decreased less). Having a routine daily schedule moderated some effects. Notably, no-plan controls with greater routine developed more habit automaticity, mediated by walking in more consistent contexts. This study confirms the causal role of consistent contexts in developing a walking habit, in a real-world setting, with an important but challenging population for physical activity interventions and identifies a facilitating condition common for many: a routine schedule.

Lidocaine pre-treatment for Succinylcholine induced postoperative myalgia and associated factors: Longitudinal study

IntroductionPostoperative myalgia in surgical patients is mainly caused by the routinely administered depolarizing muscle relaxant, Succinylcholine. There are many proposed strategies but no one were indicated as ideal preventive mechanisms for Succinylcholine induced post-operative myalgia. Even if data were sparse, Lidocaine pretreatment can reduce postoperative myalgia which requires further supportive evidences urging the initiation of this study. MethodsProspective longitudinal cohort study was conducted from March to May 2021 at Dessie Comprehensive Specialized Hospital on 208 adult surgical patients. Patients pretreated with Lidocaine preoperatively were grouped as exposed and others as unexposed. Patients meeting the inclusion criteria during the study period were selected sequentially from the daily operation schedule list. Postoperative myalgia level was measured using post-operative myalgia survey repeatedly. The result was analyzed by Cochran's Q test and generalized estimating equation (GEE). Adjusted odds ratio with 95 % confidence interval and p value < 0.05 was used to show the difference, direction and strength of association. ResultExposure specific incidence rate showed that 22 %, 22 % and 29.8 % of patients exposed to Lidocaine and 40.6 %, 42.7 % and 34 % not exposed to Lidocaine developed myalgia at 12, 24, and 48 h respectively. There is no significant difference in the incidence of myalgia over time between the repeated measurements in Lidocaine exposed patients (p = 0.513) but in non-exposed patients (p = 0.003). Also, there is no difference in the distribution of other predictors between Lidocaine exposed and non-exposed groups (p > 0.05). Exposure to Lidocaine reduces postoperative myalgia significantly [AOR = 0.33, 95 % CI = (0.17,0.66)]. Multimodal analgesia [AOR = 0.32, 95 % CI = (0.18,0.55)], non-steroidal anti-inflammatory drugs alone [AOR = 0.47, 95 % CI = (0.29,0.76)], postoperative immobility [AOR = 0.61, 95 % CI = (0.47,0.8)], and being male [AOR = 0.48, 95 % CI = (0.26,0.87)] were other determinants in reducing Succinylcholine induced postoperative myalgia. ConclusionLidocaine pretreatment can significantly reduce the occurrence of Succinylcholine induced postoperative myalgia. Additionally, usage of multimodal analgesia with non-steroidal anti-inflammatory drugs or even only non-steroidal anti-inflammatory drugs in the intraoperative and postoperative period can reduce Succinylcholine induced postoperative myalgia.