Record Of Events Research Articles

Extubation failure in a70-year-old man after implantation of an event recorder

Extubation failure in a70-year-old man after implantation of an event recorder

Optogenetic Stimulation and Electrophysiological Recording of Synaptic Events in Rat Brain Slices

Optogenetic Stimulation and Electrophysiological Recording of Synaptic Events in Rat Brain Slices

A 3D anisotropic multifunctional composite organohydrogel for advanced fire protection and monitoring

Fires pose significant risks, leading to loss of life, property, and cultural heritage. Conventional fire protection materials encounter challenges in efficiency and intelligent monitoring, compounded by secondary hazards such as falls and impacts. Hence, there's increasing demand for innovative protective materials that combine robust mechanics, fire suppression, and advanced detection. In this study, we explore the use of reduced graphene oxide (rGO)-modified 3D spacer fabrics as a reinforcing phase within a polyvinyl alcohol (PVA)/glycerol organohydrogel (OHG) matrix, forming a novel 3D fabric-reinforced anisotropic composite OHG. This multifunctional composite OHG exhibits outstanding mechanical strength, environmental stability, enhanced flame retardancy, and smart sensing properties. The integration of fabric reinforcement significantly improves the OHG's compressive and impact resistance. The composite OHG's anisotropic structure, in conjunction with the OHG matrix, greatly enhances flame retardancy, while its dual electronic and ionic conductivities improve overall electrical performance. This synergy enables real-time compression monitoring with high sensitivity and stability, facilitated by a Bluetooth module for wireless impact event recording. Furthermore, the composite OHG's anisotropic thermal conductivity enables a thermoelectric effect, leading to self-powered fire alarm systems. This pioneering approach introduces multifunctional smart OHG composite with synergistic capabilities, offering novel prospects for advanced protection and smart firefighting applications.

Open-ended molecular recording of sequential cellular events into DNA.

Genetically encoded DNA recorders noninvasively convert transient biological events into durable mutations in a cell's genome, allowing for the later reconstruction of cellular experiences by DNA sequencing. We present a DNA recorder, peCHYRON, that achieves high-information, durable, and temporally resolved multiplexed recording of multiple cellular signals in mammalian cells. In each step of recording, prime editor, a Cas9-reverse transcriptase fusion protein, inserts a variable triplet DNA sequence alongside a constant propagator sequence that deactivates the previous and activates the next step of insertion. Insertions accumulate sequentially in a unidirectional order, editing can continue indefinitely, and high information is achieved by coexpressing a variety of prime editing guide RNAs (pegRNAs), each harboring unique triplet DNA sequences. We demonstrate that the constitutive expression of pegRNA collections generates insertion patterns for the straightforward reconstruction of cell lineage relationships and that the inducible expression of specific pegRNAs results in the accurate recording of exposures to biological stimuli.

Abstract 4136952: The Clinical Importance of Arrhythmia Notifications During Use of Wearable Cardioverter Defibrillator

Introduction: Wearable cardioverter defibrillators (WCDs) record continuous ECG data for the purpose of delivering treatment for lethal arrhythmias, but occasionally capture non-treatable arrhythmias that may be of clinical value. The purpose of this study was to evaluate the usefulness to health care providers (HCPs) of evaluating and reporting these other recorded ECGs and the impact on additional arrhythmia detection and clinical management decisions. Research Questions: Do clinicians find arrhythmias identified during routine WCD useful? What arrhythmias are observed? Can the identification of these arrhythmias, validation through ZOLL’s Independent Diagnostic Testing Facility (IDTF) and notification to the provider lead to changes in clinical management? Methods: A multi-center, observational study of 52 US HCPs enrolled 474 patients with commercial LifeVest prescriptions and followed them for up to 3 months. All routinely transmitted LifeVest ECG strips (corresponding to Baseline, Patient Initiated, or other automatic event recordings) during this period were analyzed by ECG technicians at the IDTF within ZOLL. These arrhythmias were reported to the HCP who completed a questionnaire assessing the utility (scored 1 to 5) and clinical impact (medication changes, tests, and procedures ordered) of these events. Results: At the conclusion of the study, 22% of patients (105/474) monitored had 112 reportable, unique arrhythmia events that were sent to 34 providers who completed questionnaires regarding report utility and clinical management decisions. A significant proportion of reports led to medication changes (40%), additional testing (32%) and procedural interventions (23%). The average usefulness of the reports was 3.63/5 with atrial fibrillation representing the most common arrhythmia, but many variations of ventricular ectopy were also captured which tended to be more clinically useful and impactful. Conclusions: WCD patients experience a high burden of actionable arrhythmias. Monitoring and reporting these arrhythmias over the course of normal wear provides additional clinical value to providers. Those arrhythmias that lead to changes to clinical management are the most useful.

Bi-Stable Metamaterials with Intrinsic Memory for Selective Wave Filtering Based on Frequency and Amplitude.

Analytical, numerical, and experimental methods are used to investigate the utility of metamaterials in controlling harmonic waves based on both their amplitude and frequency. By programming the metamaterials to support bi-stable configurations (i.e., two stable phases), the required conditions are elucidated for a transition wave (i.e., a topological soliton) to nucleate due to harmonic excitation, causing a phase change within ourmetamaterial. As each of these phases has its own unique transmission frequency range, such phase change is harnessed to control harmonic waves based on both their amplitude and frequency. As a demonstration of principle, a low/high-pass filter is shown by tuning the same metamaterial to change phase; from transmission to attenuation and vice versa. In addition, phase transitions taking place while preserving the metamaterial's state of attenuation or transmission are shown. Such materials can continue their functionality (i.e., either attenuation or transmission of waves) while keeping a record of extreme events that can cause their transition (i.e., have memory). These metamaterials can be useful in the next generations of advanced and functional acoustic devices.

Danning tablets for the treatment of multiple gallbladder polyps: Study protocol of multicentre, randomised, open-labelled, controlled trial

IntroductionGallbladder polyps (GPs) are protrusions of the gallbladder wall into the lumen, and are commonly detected during ultrasound examinations. Traditional management of multiple GPs (MGPs) has been conservative, including lifestyle interventions, regular monitoring, and surgical intervention in certain cases, but this approach poses risks of polyps enlargement and increase of number, as well as patients’ psychological burdens. Danning Tablets, a traditional Chinese medicine, have emerged as a potential non-surgical treatment for GPs, showing promise in reducing polyp size and alleviating symptoms, backed by their anti-inflammatory and antitumor properties demonstrated in preclinical studies. This suggests the need for further research into Danning Tablets as an alternative treatment for MGPs. Methods and analysisThe study is designed as a prospective, randomized, controlled, open-label trial. The study will be conducted across multiple centres specializing in gastroenterology and hepatology. Participants will be recruited from these centres, ensuring a diverse patient demographic. Adult patients diagnosed with MGPs, based on ultrasound findings, will be included. Exclusion criteria include patients with a history of gallbladder cancer, previous gallbladder surgery, or serious comorbid conditions. The control group will receive standard care, including dietary and lifestyle advice, while the intervention group will receive Danning Tablets and standard care. The dosage and administration of Danning Tablets will follow established clinical guidelines. The primary outcome will be the change in size of the largest gallbladder polyps on week 24 ​± ​1, measured by ultrasound. The secondary outcomes will include symptom improvement and recording of any adverse events. The study will span over a period of 6 months, with periodic assessments at baseline, 4, 8, 12, and 24 weeks.

Automating dairy farm grazing records using GPS technology

Long-term grazing records can be used to assess paddock productivity (e.g., grazings per year), yet inconsistent record-keeping among New Zealand farmers hampers accurate analysis. Recently, GPS ear tags have emerged as an automated solution for identifying and recording paddocks grazed, providing data that could be used to underpin on-farm decisions and aid sector scale tracking of pasture productivity. Two GPS-enabled ear tags (GSatSolar and Ceres Trace) powered by solar energy and reporting direct-to-satellite were evaluated on two Waikato dairy farms for recording grazing events. Five cows were fitted with GSatSolar ear tags on each farm, and a further four were fitted with Ceres Trace ear tags on the second farm. Comparing the GPS location data with manual grazing records revealed varying levels of accuracy in identifying the grazed paddock. The grazing records inferred using the GSatSolar ear tags correctly matched the manual grazing records on 58% of occasions on the first farm and 85% on the second farm, with the difference being attributed to the number of working devices between farms. By comparison, the Ceres Trace ear tags identified the grazed paddock on 91% of occasions. These findings suggest that it is feasible to automate the recording of on-farm grazing events using GPS-enabled devices. However, a greater number of devices should be deployed, and/or the location reporting frequency must be increased to identify the grazed paddock accurately. The considerations when choosing devices for these purposes are also discussed, including reporting frequency and tag attachment methods.

Ablation outcome in elderly women with atrial fibrillation undergoing pulsed-field ablation for electrical isolation of pulmonary veins and left atrial posterior wall

Abstract Background Documented evidences indicate higher prevalence of non-paroxysmal atrial fibrillation (AF) as well as in elderly women but also demonstrate the need to go beyond the pulmonary veins (PV) when treating these patients. Objective We compared the ablation outcome in elderly women (>70 years) with that in men in the same age group as well as in younger women (≤70 years) undergoing pulsed-field ablation (PFA) for persistent AF (PerAF). Methods This multicenter study included consecutive PerAF patients undergoing PFA as their first procedure. Patients were divided into 3 groups: Group 1: women >70 years, Group 2: men ≥70 years and Group 3: women ≤70 years. All received PV isolation (PVI) and isolation of left atrial posterior wall (LAPWI). Concentric overlapping lesions were placed in the LAPW. Number of applications were determined on a case-by-case basis. Isolation was confirmed by electrograms recorded on the multispline catheter. In all patients, ICE and fluoroscopy were used to optimize contact between the PFA catheter and the targeted tissue. Arrhythmia-monitoring was performed for 1-year with periodic clinic visits, event recorders and 7-day Holter monitoring. Results A total of 229 patients (group 1: 73; group 2: 47 and group 3: 109) were included in this analysis. Baseline characteristics of the study population is presented in table 1. At 1-year follow-up, 15 (20.5%), 3 (6.38%) and 10 (9.17%) from group 1, 2 and 3 respectively, experienced arrhythmia recurrence off-antiarrhythmic drugs. Recurrence rate in group 1 was significantly higher than that in group 2 (p=0.034) and group 3 (p=0.029). Conclusion In women aged ≤70 years and in elderly men (>70 years), PVI plus isolation of LAPW using ICE-guided PFA was associated with significantly lower recurrence rate compared to that in the elderly women. Given the higher recurrence rate following PVI+LAPWI in the elderly females, the operators should consider addressing all other AF-initiating extra-PV triggers for better ablation-outcome in this subset of the AF population.

Ablation outcome in patients with atrial fibrillation undergoing ICE-guided pulsed-field ablation

Abstract Background Prior experiences from preclinical studies indicate the critical need of catheter-tissue- contact for creation of consistent transmural lesions in pulsed-field ablation (PFA). Intracardiac echocardiography (ICE) not only provide real-time visualization of cardiac structures, but also ensure adequate contact with the tissue. Objective We evaluated ablation outcome and reconnection rate following ICE-guided PFA procedure in patients with atrial fibrillation (AF). Methods Consecutive patients receiving ICE-guided PFA procedure were included in this multi-center analysis. All patients received isolation of PVs (PVI). Additional ablation of left atrial posterior wall (LAPW) was decided based on operator’s discretion. Concentric overlapping lesions were placed in the LAPW. Number of applications were determined on a case-by-case basis. ICE and fluoroscopy were used to optimize contact between the PFA catheter and the targeted tissue. All procedures were performed under uninterrupted anticoagulation. Mapping was done before and after ablation to confirm electrical isolation. Arrhythmia-monitoring was done for 1-year with periodic clinic visits, event recorders and 7-day Holter monitoring. Results A total of 372 patients [age: 62.69 ± 10.41 years, male: 201 (71.3%), paroxysmal AF: 67 (18%)] were included in this analysis of which 48 (12.9%) underwent PVI-only and the remaining subjects received additional ablation of LAPW. Mean number of applications were 34.67 ± 8.88 and 73.65 ± 37.21 for PVI-only and PVI+LAPWI cohorts respectively (p<0.001). No major procedural complications such as esophageal injury, atrio-esophageal fistula, pericardial effusion requiring drainage or cerebrovascular accidents were reported. During 1-year follow-up, 38 (10.2%) patients underwent repeat procedure for recurrence. Reconnection of PV and LAPW were found in only 2 (5.2%) patients. In all 38 patients, new triggers initiating AF were detected to be originating from interatrial septum: 25 (65.8%), superior vena cava: 9 (23.7%), coronary sinus: 7 (18.4%) and left atrial appendage: 6 (15.8%). Conclusion ICE-guided PFA procedures are safe and produce durable lesions leading to very low reconnection rate. The recurrence was mostly due to new triggers initiating AF.

Imaging of seismic discontinuities using an adjoint method

SUMMARY For imaging of seismic discontinuities at depth, reverse time migration is a powerful method to apply to recordings of seismic events. It is especially powerful when an extensive receiver array, numerous seismic sources, or both, permit adequate reconstruction of incident and scattered wavefields at depth. Reconstructing either the incident or scattered wavefield at depth becomes less accurate when relatively few recordings of seismic events are available. Here, we explore an inverse scattering approach to imaging discontinuities based on an adjoint method, employing sensitivity kernels (Fréchet derivatives) that represent jumps in material properties across seismic-discontinuity surfaces. When combined with ray-based requirements on scattering geometry, it constitutes a powerful approach to determining the locations and amplitudes of the discontinuities, recovering only those properties that can be resolved by a spatially limited source and/or receiver distribution. This is illustrated by synthetic examples with local sources followed by a field example in a subduction zone setting.

Extracorporeal Photopheresis with 5-Aminolevulinic Acid in Crohn's Disease-A First-in-Human Phase I/II Study.

Background/Objectives: With the increasing prevalence of Crohn's disease (CD), treatment options for patients who fail conventional and advanced therapy are highly needed. Therefore, we explored the safety and efficacy of extracorporeal photopheresis (ECP) using 5-aminolevulinic acid (ALA) and blue light (405 nm). Methods: Patients with active CD who failed or were intolerant to biological therapy were eligible. Mononuclear cells (90 mL) were collected from each patient using a Spectra Optia® apheresis system and diluted with 100 mL of 0.9% sodium chloride in a collection bag. The cells were incubated with ALA at a concentration of 3 millimolar (mM) for 60 min ex vivo and illumination with an LED blue light (405 nm) source (BLUE-PIT®) before reinfusion to the patient. Recording of vital signs and adverse events were regularly performed. At week 13, we assessed the patients with colonoscopy, the Harvey Bradshaw Index (HBI), the Inflammatory Bowel disease Health Related Quality of Life Questionnaire, and the measurement of serum C-reactive protein and fecal calprotectin (FC) levels. Biopsies of the intestines were taken for immunohistochemistry. Results: Seven patients were included. Four patients completed the treatments, with a total of 24 treatments. Three of the four patients achieved a favorable response, including a lower HBI, lower FC levels, and/or endoscopic improvement. No significant adverse events were observed. The remaining three patients received only one, three, or five treatments due to technical difficulties, medical reasons, or the withdrawal of informed consent. Conclusions: ALA-based ECP appears safe and seems to give some clinical improvement for the patients with active CD who failed to respond to conventional and advanced therapies.

Assessing Downburst Kinematics Using Video Footage Analysis

Measurements of downburst outflows using standard meteorological instruments (e.g., anemometers) are rare due to their transient and localized nature. However, video recordings of such events are becoming more frequent. This short communication (Technical Note) study presents a new approach to estimating the kinematics of a downburst event using video footage recordings of the event. The main geometric dimensions of the event, such as downdraft diameter, cloud base height, outflow depth, and the radius of the outflow at a given moment in time, are estimated by sizing them against reference structures of known dimensions that are present in the video footage. From this analysis, and knowing the frame rate of the video recording, one can estimate the characteristic velocities in the downburst event, such as the mean downdraft velocity and the mean velocity of the radial outflow propagation. The proposed method is tested on an August 2015 downburst event that hit Tucson, Arizona, United States. The diameter of the downburst outflow increased with the time from approximately 1.10 km to 3.35 km. This range of values indicates that the event was a microburst. The mean descending velocity of downburst downdraft was 8.9 m s−1 and the horizontal velocity of outflow propagation was 17.7 m s−1. The latter velocity is similar to the measured wind gust at the nearby weather station and Doppler radar. The outflow depth is estimated at 160 m, and the cloud base height was approximately 1.24 km. Estimating the kinematics of downbursts using video footage, while subject to certain limitations, does yield a useful estimation of the main downburst kinematics that contribute to a better quantification of these localized windstorms.

Mineralogy and Geochemistry of Upper Miocene Igneous Rocks, Kos Island, Greece: Extension during Strike-Slip Faulting and Subduction Rollback

Upper Miocene volcanic and plutonic rocks on Kos island preserve a record of magmatic and tectonic events in the transition zone between the Aegean and Anatolian microplates. Their field setting, syn-intrusion deformation, mineralogy, and geochemistry were investigated. Volcanic rocks, including trachyandesite flows and trachyandesite to rhyolite domes, were extruded on a central E–W horst and directly overlie Alpine basement. Thick successions of trachytic flow tuffs are interbedded with fluvial and lacustrine basinal sediments to the south of this horst. Volcanism was synchronous with the emplacement of the Dikeos monzonite pluton, which is geochemically similar to some lithic clasts in the thick flow tuffs and is cut by mafic dykes including lamprophyres. Two main types of mafic magma were present: a K-rich lamprophyric magma that evolved to trachyandesite and more calc-alkaline magma similar to mafic enclaves in the monzonite. Syn-intrusion structures in the monzonite indicate emplacement during E–W sinistral strike-slip faulting that created local transtensional deformation, providing accommodation for a Dikeos magma reservoir. A change in the style of deformation in the Late Miocene led to NW-striking extension in the footwall, occupied by mafic dykes and mineralized veins, and extensional detachment of the hanging wall, resulting in unroofing of the monzonite.

First record of the Cenomanian-Turonian Oceanic Anoxic Event (OAE-2) in the eastern Rub’ Al Khali Basin by means of elemental chemostratigraphy

First record of the Cenomanian-Turonian Oceanic Anoxic Event (OAE-2) in the eastern Rub’ Al Khali Basin by means of elemental chemostratigraphy

Presence – Donation – Event

The Helikon Publishing House has published (2006–2018) Sándor Márai’s (1900–1989) diaries in eighteen volumes of eight thousand pages under the title The Complete Diary. After Márai left the country for good in 1948 and went into exile, the communist regime eliminated him from the history of Hungarian literature, and generations grew up without reading his books or hearing about him in their literary studies. The diary is a testament to the existential vulnerability of the writer in exile. This major piece of work has four layers: the first is made up of notes on regular readings, the second is about recent Hungarian history, the third is personal memory, and the fourth is the material for the absorption of the host country’s culture. The Complete Diary changes our view of Márai, whose vision of Hungarian history is disturbing. He sees Hungary as a failed attempt to create a modern bourgeois nation. What is unique about Márai’s diary is the way it fuses memories of the personal past with reflections on the present. The recording of daily events goes beyond the genre of the diary: on the one hand towards the essay, on the other towards the novel.

Fault detection framework in wind turbine pitch systems using machine learning: Development, validation, and results

This work develops a methodology for detecting faults in wind turbines through supervised machine-learning classification methods focusing in two modes of operation. The Normal mode will be related to the regular operation of the wind turbines and in the case of the abnormal mode, the system will be cataloged as Pitch system failure. This methodology uses real data through the supervisory control and data acquisition (SCADA) system and the recording of events and actions (LOG alarm system). Sixteen classifications artificial intelligence (AI) models were tested, such as Random Forest Classifier (RF), Gradient Boosting Classifier (GBC), Extra Trees Classifier (ET), Extreme Gradient Boosting (XGBOOST), Light Gradient Boosting Machine (LIGHTGBM), Categorical Boosting Classifier (CATBOOST), Adaptative Boosting Classifier (ADA), Decision Tree Classifier (DT), Linear Discriminant Analysis (LDA), K-Nearest Neighbors Classifier (KNN), Logistic Regression (LR), Naive Bayes (NB), Quadratic Discriminant Analysis (QDA), Dummy Classifier (DC), Super vector machine (SVM), Ridge Classifier (RC). The training process model was carried out by structuring the dataset in 75% for training and validation and 25% for the final test, considering cross-validation and optimization of the hyperparameters. The Random Forest Classifier (RF) and Extra Trees Classifier (ET) classifiers models presented the best performances, and the models with the lowest performances were K-Nearest Neighbors Classifier (KNN) and Linear Discriminant Analysis (LDA) ones. The average hit effectiveness for both Healthy and Faulty operating modes was approximately 80% across most of the models developed.

Analyzing Fusion Pore Dynamics and Counting the Number of Acetylcholine Molecules Released by Exocytosis.

Acetylcholine (ACh) is a critical neurotransmitter influencing various neurophysiological functions. Despite its significance, quantitative methods with adequate spatiotemporal resolution for recording a single exocytotic ACh efflux are lacking. In this study, we introduce an ultrafast amperometric ACh biosensor that enables 50 kHz electrochemical recording of spontaneous single exocytosis events at axon terminals of differentiated cholinergic human SH-SY5Y neuroblastoma cells with sub-millisecond temporal resolution. Characterization of the recorded amperometric traces revealed seven distinct current spike types, each displaying variations in shape, time scale, and ACh quantities released. This finding suggests that exocytotic release is governed by complex fusion pore dynamics in these cells. The absolute number of ACh molecules released during exocytosis was quantified by calibrating the sensor through the electroanalysis of liposomes preloaded with varying ACh concentrations. Notably, the largest quantal release involving approximately 8000 ACh molecules likely represents full exocytosis, while a smaller release of 5000 ACh molecules may indicate partial exocytosis. Following a local administration of bafilomycin A1, a V-ATPase inhibitor, the cholinergic cells exhibited both a larger quantity of ACh released and a higher frequency of exocytosis events. Therefore, this ACh sensor provides a means to monitor minute amounts of ACh and investigate regulatory release mechanisms at the single-cell level, which is vital for understanding healthy brain function and pathologies and optimizing drug treatment for disorders.

Anthropogenic and environmental risk factors of salmonid predation in a tidal freshwater delta

Abstract Water diversions that support agricultural and municipal use result in fish mortality through entrainment and impingement. Additionally, this infrastructure may attract both predators and prey fishes, thereby increasing predation rates and prey mortality near these anthropogenic contact points. The Sacramento–San Joaquin Delta (the Delta) in California's Central Valley is a tidal freshwater ecosystem that exports large volumes of water for municipal and agricultural use while at the same time providing valuable migratory and rearing habitat for imperilled fishes. Emigrating juvenile salmonids experience high mortality in the Delta, with predation by non‐native fishes contributing substantially. Therefore, this study had three main objectives. First, we determined if small water diversions aggregated piscivorous fishes like other similar structures in freshwater ecosystems. Second, we determined how small diversions may influence juvenile salmon predation risk in conjunction with other known predation risk factors (e.g. predator abundance, temperature and depth). Third, we assessed the predator assemblage, abundance and distribution to determine the likely predator composition in objectives one and two. Throughout the spring of 2021, we used ARIS (adaptive resolution imaging sonar; Sound Metrics) sonars to compare piscivore abundance at 30 water diversions in the north Delta to shorelines adjacent to diversions that did not contain these structures. We used predation event recorders (PERs) to assess the predation risk juvenile salmonids were exposed to, with linear distance (m) from diversions, and other predation risk factors in the north Delta. Finally, we used a boat electrofishing survey to determine the piscivore assemblage and compare spatial trends in black bass (Micropterus spp.) CPUE and relative abundance throughout these waterways. Piscivore abundance was greater near small water diversions than at adjacent shorelines and the predation risk of juvenile salmonids increased with diversion proximity. Additionally, predation risk increased with increasing piscivore abundance and decreasing water depth. The north Delta predator assemblage was dominated by black basses (Micropterus spp.), which likely drove the negative relationship of predation risk with water depth, given habitat requirements of these species. Furthermore, increasing smallmouth (Micropterus dolomieu) and spotted bass (Micropterus punctulatus) abundance in our northern study sites may have weakened temperature effects on predation, given metabolic requirements of these species. Our work demonstrated that small water diversions are likely to increase mortality of endangered salmonids, and that the north Delta predator assemblage was different than recorded by previous work in this system, changing predation risk factors. Although more work is needed to determine the population level impacts of diversions, the ubiquitous distribution of these structures warrants management solutions to reduce mortality from this source. These results indicate that in addition to entrainment and impingement, water diversions may increase mortality of small‐bodied fishes by attracting predators and elevating predation risk. Given the continual human demand for freshwater, predator–prey interactions should be considered along with entrainment and impingement when assessing intake infrastructure mitigation, especially when diversions co‐occur along migratory routes and essential habitat of imperilled fishes.

Role of Peripheral Parenteral Nutrition Composition on Clinical Outcomes in Patients Undergoing Gastrectomy or Colectomy: A Phase III Indian Clinical Trial.

Various types of parenteral nutritional products exist, each with specific formulations designed to meet the diverse nutritional needs of patient's post-abdominal surgery. Here, two different parenteral nutrition (PN) solutions BFLUID and NUTRIFLEX PERI are compared in terms of therapeutic efficacy and safety profile. A prospective, multi-center, randomized, parallel-group, non-inferiority Phase III clinical trial compared two PN solutions namely BFLUID (N = 78) and NUTRIFLEX PERI (N = 72) in 150 patients undergoing gastrectomy or colectomy. Primary endpoints included length of hospital stay while secondary endpoints included assessment and comparison of length of ICU/HDU stay, assessment of incidents of infections and mortality, change in blood levels of vitamin B1, change in nutritional parameters, thrombophlebitis, pain at the injection site, and recording of adverse events (AEs). There was no significant difference in terms of length of hospital stay, length of ICU/HDU stay as well as changes in nutritional parameters from baseline and change in blood levels of vitamin B1 from baseline. Both study groups exhibited comparability in terms of AEs, pain at the injection site, and the incidence of phlebitis. There was no significant difference in the number and severity of adverse events reported in both groups. Additionally, no signs of infection were observed in patients from either group. The trial successfully demonstrated the non-inferiority of BFLUID to NUTRIFLEX PERI. Moreover, the results indicated that PN enriched with high levels of branched-chain amino acids (BCAAs), essential amino acids (EAAs), and thiamine is both safe and efficacious for adult patients undergoing gastrectomy or colectomy. Goyal A, Pathak A, BS Madhu, Soni H, Bhatt K, Raju KVVN, et al. Role of Peripheral Parenteral Nutrition Composition on Clinical Outcomes in Patients Undergoing Gastrectomy or Colectomy: A Phase III Indian Clinical Trial. Indian J Crit Care Med 2024;28(9):871-878.