Optimal Dose Research Articles

Dosage Optimization Using Physiologically Based Pharmacokinetic Modeling for Pediatric Patients with Renal Impairment: A Case Study of Meropenem

Dosage Optimization Using Physiologically Based Pharmacokinetic Modeling for Pediatric Patients with Renal Impairment: A Case Study of Meropenem

Replacement of fishmeal with Quinoa Husk (Chenopodium quinoa) for mitigating multiple stresses in Pangasianodon Hypophthalmus

The fishmeal is boon for aquaculture production in this recent pollution and climate change era. However, the demand of fishmeal is enhancing in many folds which needs to find alternative to fishmeal in cheap price. The present investigation addresses these issues with quinoa husk (QH). An experiment was performed to evaluate replacement of fishmeal by QH in different proportionate at 0, 15, 20, 25, 30 and 35%. The study was designed with 12 treatments as control, stressors group (concurrent exposed to ammonia, arsenic and high temperature stress, NH3+As+T), group fed with QH at 15, 20, 25, 30 and 35% without and with stressors (NH3+As+T) in Pangasianodon hypophthalmus for 105 days. The optimization of QH dose for growth performance such as food conversion ratio, growth rate, protein efficiency ratio and specific growth rate with respect to protein percentage and obtained 26%. The oxidative enzymes such as superoxide dismutase (SOD), catalase (CAT), glutathione-s-transferase (GST) and glutathione peroxidase (GPx) in gill, kidney and liver tissues were significantly lowered by replacement of fishmeal by QH at 25% in fish reared under arsenic and ammonia toxicity and high temperature stress (NH3+As+T). The neurotransmitter enzyme (AChE) in brain tissue was noticeably enhanced by QH at 25%. The aspartate amino transferase (AST) and alanine amino transferase (ALT) as well as malate dehydrogenase (MDH) and lactate dehydrogenase (LDH) in gill and liver were significantly reduced by QH at 25% in fish reread under multiple stresses (NH3+As+T). The nitro blue tetrazolium (NBT), blood glucose, albumin, globulin, total protein, A:G ratio, myeloperoxidase (MPO) and total immunoglobulin (Ig) were noticeably improved by supplementation of QH at 25–30% in fish reared under NH3+As+T. The amylase, protease and lipase were significant improved with replacement of fishmeal by QH at 25%. The histo-pathological alterations were marked in liver and gill tissues, whereas these tissues were protected by QH at 25% in fish reared under control and stress condition (NH3+As+T). The present study revealed that replacement of fishmeal at 25% by QH could be a better replacement for improvement in anti-oxidative status, acetylcholine esterase and growth performance in fish reread under NH3+As+T stress.

Efficacy of the Optimal Dosage of Lisinopril in Inhibiting Myofibroblast Differentiation for Attenuating Rheumatic Heart Disease Progression: An in Vitro Study

Background: Rheumatic heart disease (RHD) is exacerbated by chronic inflammation that stimulates the release of proinflammatory cytokines, most notably transforming growth factor-beta 1 (TGF-β1), which promotes myofibroblast differentiation. This study aims to determine the optimal dosage of Lisinopril, an angiotensin-converting enzyme inhibitor, for mitigating the fibrotic changes associated with RHD. Methods: This in vitro, posttest-only control group study involved obtaining valvular interstitial cells from the heart valves of 25 male New Zealand rabbits (Oryctolagus cuniculus). Valvular interstitial cells were divided into 5 groups: a control group exposed to TGF-β1, and 4 experimental groups exposed to various Lisinopril doses (1 µM, 10 µM, and 100 µM) in addition to TGF-β1. The effect of Lisinopril on myofibroblast differentiation was assessed by measuring alpha-smooth muscle actin (αSMA) expression through immunocytochemical methods. Statistical significance was determined using an independent T-test with a P value of less than 0.050. Results: Independent T-tests conducted on 25 male Oryctolagus cuniculus demonstrated significantly lower αSMA expression in the groups treated with various Lisinopril doses (1 µM, 10 µM, and 100 µM) compared with the TGF-β1-induced control group (P<0.050). The most significant reduction in αSMA expression was observed in the group treated with the highest Lisinopril dose of 100 µM. Conclusion: Lisinopril demonstrates a significant ability to inhibit TGF-β1-induced myofibroblast differentiation in rabbit valve interstitial cells, with the 100 µM dose proving most effective. These results suggest that Lisinopril may have the potential to curb RHD progression, warranting further investigations in vivo.

PK/PD-Guided Strategies for Appropriate Antibiotic Use in the Era of Antimicrobial Resistance

Antimicrobial resistance (AMR) poses a critical global health threat, necessitating the optimal use of existing antibiotics. Pharmacokinetic/pharmacodynamic (PK/PD) principles provide a scientific framework for optimizing antimicrobial therapy, particularly to respond to evolving resistance patterns. This review examines PK/PD strategies for antimicrobial dosing optimization, focusing on three key aspects. First, we discuss the importance of drug concentration management for enhancing efficacy while preventing toxicity, considering various patient populations, including pediatric and elderly patients with their unique physiological characteristics. Second, we analyze different PK modeling approaches: the classic top-down approach exemplified by population PK analysis, the bottom-up approach represented by physiologically based PK modeling, and hybrid models combining both approaches for enhanced predictive performance. Third, we explore clinical applications, including nomogram-based dosing strategies, Bayesian estimation, and emerging artificial intelligence applications, for real-time dose optimization. Critical challenges in implementing PK/PD simulation are addressed, particularly the selection of appropriate PK models, the optimization of PK/PD indices, and considerations concerning antimicrobial concentrations at infection sites. Understanding these principles and challenges is crucial for optimizing antimicrobial therapy and combating AMR through improved dosing strategies.

Kinetics with UVC Irradiation Using a Continuous-Flow System: Mathematical Fitting Compared to Microbiological Analysis

Fresh produce contamination poses a significant public health risk. Traditional disinfection methods using chemical solutions, while effective, raise environmental and health concerns. This study explores UVC irradiation, a promising non-chemical alternative proven to be effective against a broad spectrum of microorganisms. We investigated the optimal UVC dosage for reducing microorganisms on fresh vegetables washed in water. Our findings suggest that dosages of approximately 2 mJ/cm2 in water and 9 mJ/cm2 in vegetables achieve reductions of up to 99%. Additionally, we established a nominal radiation application rate of 2.38 mW/cm2/s, reflecting the treatment intensity. Understanding the fundamental mechanisms of UVC irradiation and its interactions with microorganisms is crucial. Elucidating these mechanisms can significantly improve optimization efforts and seamlessly integrate UVC irradiation into food safety protocols. Implementing this strategy offers immense potential to elevate food safety standards in the industry while minimizing environmental impact. This approach aligns perfectly with sustainability objectives by providing a chemical-free solution for food disinfection.

Optimization Study of a High-Efficiency Preservative for Ammonia-Free Concentrated Natural Rubber Latex

Ammonia is commonly used as a preservative in the production of concentrated natural rubber latex (CNRL) and latex products; however, it poses a serious risk to human health and the environment. In this study, we investigated a thioacetamide derivative (TD) as a preservative of ammonia-free CNRL and the optimization of a stabilization system comprising potassium hydroxide (KOH), lauric acid (LA), and sodium dodecyl sulfate (SDS) to enhance its preservation effect. The results revealed that an optimal amount of TD (0.03%) can effectively maintain the stability of CNRL, inhibit the increase in volatile fatty acid number (VFA number), maintain stable viscosity values, and improve the mechanical stability time (MST). However, increasing the TD dosage results in an increase in both the viscosity and VFA number and a decrease in MST. KOH was used to regulate the pH value of CNRL. It was also found that it can enhance considerably the mechanical properties of CNRL dry films and accelerates the vulcanization of vulcanized film; however, an excessive amount causes latex thickening. LA proved essential for improving the MST and reducing latex viscosity, thereby substantially enhancing the stability and processability of pre-vulcanized latex, but an excessive amount is detrimental to the curing speed and final mechanical strength. SDS can rapidly improve the MST and reduce the viscosity, but it negatively affects the surface molding of dry rubber films. In conclusion, KOH, LA, and SDS at appropriate dosages play a balancing and complementary role in the preparation of ammonia-free CNRL. Upon analyzing diverse performance metrics of CNRL, it has been determined that the optimal TD dosage ranges from 0.02 to 0.03% for maximum efficacy. The KOH dosage should be maintained within 0.1–0.15% to achieve the most favorable outcome, while the LA dosage is advisable to be kept between 0.06 and 0.1%.

The effect of an additional pre-extubational loading dose of caffeine citrate on mechanically ventilated preterm infants (NEOKOFF trial): Study protocol for a multicenter randomized clinical trial.

Minimizing the duration of mechanical ventilation is one of the most important therapeutic goals during the care of preterm infants at neonatal intensive care units (NICUs). The rate of extubation failure among preterm infants is between 16% and 40% worldwide. Numerous studies have been conducted on the assessment of extubation suitability, the optimal choice of respiratory support around extubation, and the effectiveness of medical interventions. Since the Caffeine Therapy for Apnea of Prematurity (CAP) trial, caffeine has become one of the essential drugs at NICUs. However, the optimal dosage and timing for adequate effectiveness still need to be more conclusive. Previous studies suggest that higher doses of caffeine treatment increase the success rate of extubation. Therefore, we aim to determine whether using a single additional loading dose of caffeine citrate one hour prior to extubation impacts the success rate of extubation. The study is an open-label, multicenter randomized clinical trial testing the effectiveness and safety of pre-extubational loading dose of caffeine citrate. Inclusion criteria will be infants born before the 32nd gestational week, before the first extubation attempt after at least 48 hours of mechanical ventilation, and a signed parental informed consent. A total of 226 patients will be randomly allocated to either the experimental or control group. The randomization will be stratified by gestational age and antenatal steroid prophylaxis. Preterm infants in the experimental group will receive an additional intravenous (IV) loading dose (20 mg/kg) of caffeine citrate one hour before the first planned extubation, in addition to the standard dosing regimen (20 mg/kg caffeine citrate IV on the first day of life and 5 to 10 mg/kg IV or orally caffeine citrate each consecutive day). Preterm infants in the control group will receive the standard dosing regimen. The primary outcome will be reintubation within 48 hours. A pre-extubational loading dose of caffeine citrate can reduce extubation failure. Obtaining evidence on this feature has the potential to contribute to finding the optimal dosing regimen. The study protocol was approved by the Hungarian Ethics Committee for Clinical Pharmacology of the Medical Research Council and National Institute of Pharmacy and Nutrition (OGYÉI/6838-11/2023). ClinicalTrials.gov identifier NCT06401083 Registered 06. May 2024.; EudraCT number: 2022-003202-77.

Mechanical Properties, Impermeability, and Microstructure of Mortar Containing Recycled Fine Aggregates Modified by Graphene Oxide After High-Temperature Exposure

Graphene oxide (GO) has been verified to ameliorate the performance attenuation of cement-based materials exposed to high temperatures; however, its efficacy on cement-based materials containing recycled fine aggregates (RFAs) remains ambiguous. Therefore, this study assesses the macro/microperformance variations in mortar containing RFAs with diverse GO dosages (0~0.08%) after high-temperature exposure. The hydration products, pore structure, and microstructure of mortar containing RFAs and GO were analyzed using an X-ray diffractometer, mercury intrusion porosimetry, and scanning electron microscopy, respectively. The study finds that GO can reduce the mass loss rate of mortar exposed to high temperatures and enhance the residual compressive strength and flexural strength. The incorporation of 0.06% GO leads to a 10.4% increase in compressive strength and a 32.3% increase in the flexural strength of mortar containing 50% RFA after high-temperature exposure at 500 °C. Furthermore, the incorporation of GO refined the pore size and improved the densification of the interfacial transition zone (ITZ) of the mortar after high-temperature exposure. Taking into account the mechanical properties, water absorption, and microstructure of the mortar containing RFAs, a GO dosage of 0.04~0.06% could be recommended as the optimum engineering dosage.

Study on the Improvement Effect of Polypropylene Fiber on the Mechanical Properties and Freeze–Thaw Degradation Performance of High Fly Ash Content Alkali-Activated Fly Ash Slag Concrete

This article systematically investigated the improvement effect of polypropylene fiber (PPF) on the mechanical and freeze–thaw properties of alkali-activated fly ash slag concrete (AAFSC) with high fly ash content and cured at room temperature. Fly ash and slag were used as precursors, with fly ash accounting for 80% of the total mass. A mixed solution of sodium hydroxide and sodium silicate was used as alkali activator, and short-cut PPF was added to improve the performance of AAFSC. Firstly, the strength characteristics of AAFSC at different curing ages were studied. Then, key indicators such as morphology, residual compressive strength, weight loss, relative dynamic modulus of elasticity (RDME), and pore characteristics of AAFSC after different freeze–thaw cycles were tested and analyzed. The strength performance analysis showed that the optimal dosage of PPF was 0.90%. When the alkali equivalent of the alkali activator was increased from 4% to 6%, the frost resistance of AAFSC could be improved. Furthermore, adding 0.90% PPF could increase the freeze–thaw cycle number of AAFSC by about 50 times (measured by RDME). With the increase in freeze–thaw cycles, the porosity of AAFSC increased, the fractal dimension decreased, and the proportion of harmless and less harmful pores decreased, while the proportion of harmful and multiple harmful pores increased. The relationship model between the porosity and compressive strength of AAFSC after freeze–thaw cycles was established.

The Effect of Dietary Sodium Alginate on the Growth and Survival of Giant Freshwater Prawn (Macrobrachium rosenbergii)

The giant freshwater prawn, Macrobrachium rosenbergii, is a valuable aquaculture species known for its rapid growth, adaptability to environmental variations, and high nutritional value. However, challenges such as high mortality rates, algal blooms, dissolved oxygen depletion, and pathogen outbreaks constrain its cultivation. The overuse of antibiotics in aquaculture raises significant environmental and health concerns, including antimicrobial resistance. This study explores the potential of sodium alginate, a natural polysaccharide derived from brown algae, as a prebiotic and immunostimulant for improving growth and feed efficiency in M. rosenbergii. Juvenile prawns (~0.2 g) were cultured for 60 days and fed experimental diets supplemented with sodium alginate at concentrations of 0 g/kg (control, T0), 1.0 g/kg (T1), 2.0 g/kg (T2), and 3.0 g/kg (T3). Growth performance, feed utilization, and survival rates were assessed bi-weekly. Results showed significant improvements (p<0.05) in growth parameters, including mean weight gain (MWG) and specific growth rate (SGR), in prawns fed a 2.0 g/kg sodium alginate diet (T2). At the end of the experiment, T2 recorded the highest mean weight, MWG, SGR, and lowest feed conversion ratio (FCR, 2.395 ± 0.068), demonstrating superior feed utilization efficiency. In contrast, prawns fed a 3.0 g/kg sodium alginate diet (T3) showed reduced growth performance and feed efficiency. This study highlights the efficacy of sodium alginate as a dietary supplement to enhance growth, feed efficiency, and sustainability in freshwater prawn aquaculture, with the optimal dosage identified as 2.0 g/kg. These findings support sodium alginate's potential as an eco-friendly alternative to antibiotics in aquaculture systems.

The Optimal Dosage and Duration of Omega-3 Polyunsaturated Fatty Acid Supplementation in Heart Failure Management: Evidence from a Network Meta-Analysis.

Heart failure is a progressive condition associated with a high mortality rate. Despite advancements in treatment, many patients continue to experience less-than-ideal outcomes. Omega-3 polyunsaturated fatty acids (n-3 PUFAs) have been studied as a potential supplementary therapy for heart failure, but the optimal dosage and duration of supplementation remain unclear. This network meta-analysis (NMA) aimed to assess the efficacy of various n-3 PUFAs supplementation regimens in heart failure patients, focusing on dose- and time-dependent effects. We conducted a systematic search for randomized controlled trials (RCTs) on n-3 PUFAs supplementation in heart failure up to September 13th, 2024. The primary outcome was the change in heart function, specifically left ventricular ejection fraction (LVEF). Secondary outcomes included changes in peak oxygen consumption (VO2), blood BNP levels, and quality of life. The safety analysis focused on dropout rates (i.e., patients leaving the study for any reason before completion) and all-cause mortality. A frequentist-based NMA was performed. This NMA, which included 14 RCTs with 9075 participants (mean age 66.0 years, 23.3% female), found that high-dose n-3 PUFAs supplementation (2000-4000 mg/day) over a duration of at least one year significantly improved LVEF and peak VO2 compared to control groups. Lower doses and shorter treatment periods did not produce the same benefits. No significant differences were found in dropout rates or all-cause mortality between the n-3 PUFAs and control groups. Long-term, high-dose n-3 PUFAs supplementation, particularly with a predominance of docosahexaenoic acid or eicosapentaenoic acid, enhances cardiac function in heart failure patients without increasing the risk of adverse events. Further well-designed RCTs with long treatment durations (i.e., more than one year) and stringent heart failure inclusion criteria are necessary to confirm these findings and reduce potential biases. TRIAL REGISTRATION: PROSPERO CRD42024590476.

Optimizing the processing conditions of ballasted flocculation of actual turbid river water

ABSTRACT Ballasted flocculation is effective for fast turbidity removal in water treatment processes. However, there is a lack of specific information for setting the conditions for ballasted flocculation. To enhance the settling velocity and removal efficiency of ballasted flocculation of actual river water, the process parameters were examined at three turbidity levels. The optimum pH and dosages for ballasted flocculation were investigated based on the relationship between the water turbidity and the floc settling velocity at the three turbidity levels. A nonionic polymer flocculant was the most suitable for floc formation and achieved the lowest turbidity and highest settling velocity. Under the optimum processing conditions at the three turbidity levels, the treated water turbidity was ˂2 turbidity units (TU) and the floc settling velocity was ˃0.7 cm/s, which was 30 times that of conventional coagulation–sedimentation, reducing the floc settling time by 97% of those used in existing water treatment plants.

Probiotics in Mitigating Adverse Effects of Intestinal Resection and Chemotherapy: A Meta-analysis

Introduction: Colorectal cancer (CRC) imposes a significant burden on global healthcare systems, particularly in Europe, where it ranks among the most diagnosed cancers and leading causes of cancer-related deaths. With an estimated 50,000 deaths attributed to CRC in 2023 alone, a pressing need for innovative approaches to prevention, early detection, and treatment is evident. While chemotherapy and surgical resection remain crucial therapeutic strategies, they often entail significant adverse effects, such as chemotherapy-induced diarrhea and post-surgical complications. Methods: Recent research underscores the role of the microbiota in modulating these side effects, with dysbiosis associated with increased risks. Probiotics, known for their ability to restore microbial balance, have emerged as a promising adjunctive therapy for mitigating treatment-related complications in CRC patients. However, the efficacy of probiotics remains debated, necessitating a metaanalysis to provide a comprehensive assessment. Hence, this study aimed to evaluate the efficacy of probiotics in reducing complications in CRC patients undergoing chemotherapy and intestinal surgery. For this purpose, thirteen randomized controlled trials (RCTs) meeting strict inclusion criteria were included in the meta-analysis. Results: Probiotic administration was associated with significant reductions in postoperative infections, including surgical site infections (SSI), pneumonia, urinary tract infections (UTI), and central line infections, showing a Risk Ratio (RR) of 0.74 with a Confidence Interval (CI) of 95%. Moreover, probiotics demonstrated efficacy in mitigating chemotherapy-induced diarrhea and postsurgical complications, such as anastomosis loosening and abdominal disorders, with an RR of 0.35 and 0.74, respectively, with a CI of 95%. While promising, further research is needed to optimize probiotic interventions and address potential interactions with concurrent therapies. Integrating probiotics into perioperative care protocols presents a convincing opportunity to enhance surgical outcomes and improve patient prognosis following CRC resection. Conclusion: Future randomized controlled trials should focus on identifying optimal probiotic strains, dosages, and administration timing to maximize therapeutic benefits.

Population Pharmacokinetic Modeling of Certepetide in Human Subjects With Metastatic Pancreatic Ductal Adenocarcinoma.

Certepetide (aka LSTA1 and CEND-1) is a novel cyclic tumor-targeting internalizing arginyl glycylaspartic acid peptide being developed to treat solid tumors. Certepetide is designed to overcome existing challenges in treating solid tumors by delivering co-administered anticancer drugs into the tumor while selectively depleting immunosuppressive T cells, enhancing cytotoxic T cells in the tumor microenvironment, and inhibiting the metastatic cascade. A population pharmacokinetic (PK) analysis was conducted to characterize the concentration-time profile of patients with metastatic exocrine pancreatic cancer receiving certepetide in combination with nab-paclitaxel and gemcitabine, and to investigate the effects of clinically relevant covariates on PK parameters. The PK of certepetide was characterized by a 2-compartment model with linear elimination and a proportional residual error structure. Body weight and baseline creatinine clearance (CrCL) were found to have statistically significant effects on central and peripheral volume (Vc and Vp) and clearance (CL) parameters, respectively, during model development and were included as covariate effects in the final PK model. Forest plots demonstrated a potentially clinically meaningful impact of high body weight (100kg) on certepetide exposure (steady-state maximum concentration [Cmax,ss] and area under the concentration-time curve [AUCss]), as well as low and high CrCL (50 and 150mL/min) on AUCss. Exposure predictions illustrated a relationship between certepetide exposure (AUCss) and renal function, with increasing exposure and decreasing CL of certepetide observed with worsening renal function. Modeling will strengthen the understanding of certepetide's PKs and will inform dose optimization in ongoing drug development activities.

Hypoparathyroidism: Similarities and differences between Western and Eastern countries.

Hypoparathyroidism (hypoPT) is characterized by acute and chronic complications due to insufficient parathyroid hormone (PTH) production or action. Several management guidelines have been developed, but mostly based on evidence from Western countries. Data from Eastern countries have not been systematically compared with those from Western countries. Literatures regarding to the epidemiology, genetics, risk factors, clinical manifestations and therapies for hypoPT in Easten and Western countries, including China, South Korea, Japan, India, and USA, Canada, Italy, and etc., were searched through PubMed and CNKI. This review was officially endorsed by European Calcified Tissue Society (ECTS) board. Postoperative hypoPT is the major form of hypoPT in both Western and Eastern countries. The genetic profiles and clinical features of hypoPT are similar in Eastern and Western countries. The most commonly used medications in Eastern countries are calcium and native vitamin D or active vitamin D analogues, similar to their Western counterparts. While PTH replacement therapy is not available and approved to use in most Eastern countries. Physicians and surgeons should follow the guidelines on the management of thyroid nodules, taking more care of protecting parathyroid glands during surgery. The cross-talk between East and West in the management of hypoPT should be continued. Direct comparisons of the management strategies in patients with hypoPT between Eastern and Wester countries regarding to the morbidity, mortality, quality of life, optimal dosage, efficacies and side-effects of conventional therapies or newer medications, as well as pharmacogenetics and pharmacoeconomics, would be valuable.

Oral Lipids/Fatty Acids Supplements and Eczema: What Is Known?

The pathogenesis of atopic dermatitis (AD) points to skin barrier dysfunction as a critical piece of the puzzle. Deficiencies in fatty acids and ceramides-key elements of the skin barrier-have been linked to AD. Fatty acids can be separated into omega-3 and omega-6, which can be found in a variety of foods such as fish, nuts, seeds, and even plants. In dogs, supplementation with oral fatty acids has shown promising benefits. This review aims to explore whether humans can similarly benefit from these supplements based on current literature. The results of our search varied by compound type. For borage oil and evening primrose oil, evidence of their effectiveness is mixed, though they may offer some preventative benefits. Fish oil supplements appear to be effective in treating AD, as they reduce clinical scores and symptom severity. Oral ceramides, blackcurrant seed oil, and hempseed oil have yet to be thoroughly studied, but preliminary results are promising. Among the studies, the supplementation doses and duration of treatment varied extensively. The literature did not provide comparative analysis between the supplements, and data on the overall safety and tolerability of these supplements are limited. While some evidence is promising, the reliability of these products, as well as their optimal dosage and frequency, remains uncertain.

Study on the effectiveness and safety of artificial intermittent infusion hemodiafiltration in MHD patients with intradialytic hypotension.

To evaluate the effectiveness and safety of artificial intermittent infusion hemodiafiltration (I-HDF) in maintenance hemodialysis (MHD) patients with intradialytic hypotension (IDH), and to determine the optimal infusion dosage. This single-center, prospective, self-controlled study included 30 MHD patients with IDH, treated from December 2022 to July 2023. Patients underwent three sessions of I-HDF as treatment group and conventional hemodialysis as control group. Comparisons were made between the two groups regarding changes in blood pressure, hypotension symptoms, changes in body water content, and achievement of infusion doses. 1. The fluctuation amplitude of SBP in the treatment group was 18.96 ± 10.400, while in the control group it was 27.4 ± 11.796. There was a significant difference between the two groups (p < 0.05). 2. During 90 sessions of dialysis, 39 interventions were needed in the treatment group, compared to 59 interventions in the control group. The treatment group required fewer interventions, with a significant difference (p < 0.05). 3. No hypotension symptoms occurred in the treatment group, whereas six cases were observed in the control group, which was significantly higher (p < 0.05). 4. One patient in the 250 ml infusion group experienced chest tightness. Among the three infusion groups, the 250 ml group had the greatest fluctuation in DBP, with a significant difference (p < 0.05). 5. Among the three infusion volumes groups, there was a significant difference between the theoretical and actual infusion volumes in the 150 and 200 ml groups (p < 0.05). The artificial I-HDF mode effectively improves the occurrence of IDH. An infusion dose of 150-200 ml is deemed appropriate.

Effect of Different Nitrogen Levels on Growth, Yield, and Nitrogen Use Efficiency (NUE) of Hardinath Hybrid Dhan-1 in Madhesh Province, Nepal

Determining the optimum dose of nitrogen fertilizer application for hybrid rice is vital for boosting production and productivity of rice. Therefore, this study examines the effect of different nitrogen levels on the growth, yield, and nitrogen use efficiency (NUE) of Hardinath Hybrid Dhan-1 in Madhesh Province, Nepal. A field experiment conducted in 2020 at the National Rice Research Program, Hardinath, Dhanusha tested six nitrogen levels (0, 75, 100, 125, 150, and 175 kg ha-1) with four replications under Randomized Complete Block Design during rainy season (June-September). The results showed that nitrogen application significantly improved plant growth and yield, with the highest grain yield (4.99 t ha-1) achieved at 150 kg N ha-1. Increasing nitrogen beyond this level did not further boost yield, indicating that excessive nitrogen does not improve productivity. Nitrogen use and agronomic efficiency were also highest at 150 kg N ha-1, marking it as the ideal rate for optimal rice performance. Soil health, in terms of organic matter and nutrient availability, improved with higher nitrogen levels, while the highest nitrogen uptake occurred at 175 kg N ha-1. In conclusion, 150 kg N ha-1 is recommended as the optimal nitrogen level to enhance hybrid rice yield and NUE, promoting sustainable rice production in the region. These findings highlight the need for optimal nitrogen management to improve crop yield and soil properties while minimizing environmental impact.

A narrative review of exercise intervention mechanisms for post-traumatic stress disorder in veterans

Post-traumatic stress disorder (PTSD) severely disrupts the daily lives of veterans and active duty personnel and may influence their suicidal behaviour. This study provides insight into existing research on PTSD in veterans through a narrative review. Exercise was found to reduce PTSD symptoms in veterans at both psychological and physiological levels, which in turn inhibits their suicidal tendencies. At the psychological level, exercise improved veterans’ Subjective Well-Being and Psychological Well-Being, and at the physiological level, it improved veterans’ brain structure, neuroendocrine system, and immune system. By combing these mechanisms in detail, we hope to provide theoretical support for the implementation of exercise interventions in the treatment of veterans with PTSD. However, it is important to note that the specifics of the exercise program, such as the optimal type, dosage, and duration to alleviate PTSD symptoms, remain unclear and require further research and exploration.

Lifetime Attributable Risk in Mammography Screenings in Dubai: The Influence of Breast Thickness and Age on Radiation Exposure.

Background/Objectives: This study investigated the lifetime attributable risk (LAR) of radiation-induced breast cancer from mammography screening in Dubai. It aimed to explore the relationship between breast thickness, patient age, and the associated radiation dose during mammographic examinations. Methods: A retrospective analysis was conducted on 2601 patients aged 40 to 69 across five screening facilities in Dubai's healthcare system. Due to a low correlation between the mean glandular dose (MGD) and breast thickness, both glandular and non-glandular doses were included in calculations as the organ dose (OD). This comprehensive approach examined the impact of whole breast tissue on risk assessments. Key exposure parameters such as the kilovoltage peak (kVp), milliampere-seconds (mAs), and source-to-skin distance were extracted from the dose survey. Results: Our findings reveal that the organ dose increases with breast thickness, emphasizing the need for dose optimization in denser tissues. The LAR decreases with age across all thickness categories, but higher initial LAR values were seen in younger patients with thicker tissue. This study emphasizes the increased sensitivity of younger women, who usually have denser breast tissue, to radiation-induced cancer risks. Conclusions: Personalized screening protocols considering age and breast thickness are crucial for balancing early cancer detection benefits with radiation risks. Future research should improve mammography protocols, explore alternative methods, and consider generic testing for young high-risk patients to mitigate risks while maintaining diagnostic efficacy.