Maximum Change Research Articles

Climate change signals of extreme precipitation return levels for Germany in a transient convection‐permitting simulation ensemble

AbstractThe increase in extreme precipitation with global warming (GW) and associated uncertainties are major challenges for climate adaptation. To project future extreme precipitation on different time and intensity scales (return periods [RPs] from 1 to 100 a and durations from 1 h to 3 days), we use a novel convection‐permitting (CP), multi‐global climate model ensemble of COSMO‐CLM regional simulations with a transient projection time (1971–2100) over Germany. We find an added value of the CP scale (2.8 km) with respect to the representation of hourly extreme precipitation intensities compared to the coarser scale with parametrized deep convection (7 km). In general, the return levels (RLs) calculated from the CP simulations are in better agreement with those of the conventional observation‐based risk products for the region for short event durations than for longer durations, where an overestimation by the simulation‐based results was found. A maximum climate change signal of 6–8.5% increase per degree of GW is projected within the CP ensemble, with the largest changes expected for short durations and long RPs. Analysis of the uncertainty in the climate change signal shows a substantial residual standard deviation of a linear approximation, highlighting the need for transient data sets instead of time‐slice experiments to increase confidence in the estimates. Furthermore, the ensemble spread is found to be smallest for intensities of short duration, where changes are expected to be based mainly on thermodynamic contributions. The ensemble spread is larger for long, multi‐day durations, where a stronger dependence on the dynamical component is ascribed. In addition, an increase in spatial variance of the RLs with GW implies a more variable future climate and points to an increasing importance of accounting for uncertainties.

The Controversy of Using Insufficient Great Saphenous Veins in Coronary Artery Bypass Grafting: A Comparative Morphological Analysis of Healthy and Insufficient Veins Related to the Possibility of Using Them as a Graft.

Despite advancements in coronary artery bypass grafting (CABG), the optimal choice of graft material remains a subject of investigation. This study aimed to comprehensively analyze the morphological characteristics of varicose veins, exploring their potential utilization in CABG compared to healthy veins. The study included 178 patients, categorized into two groups based on healthy and varicose veins. Morphological parameters, including maximum venous diameter, wall thickness, and specific changes in tunica intima (TI), tunica media (TM), and tunica adventitia (TA), were analyzed through microscopic evaluation. Varicose veins exhibited a significantly larger maximum venous diameter (p = 0.0001) and increased wall thickness (p = 0.0001) compared to healthy veins. Although varicose veins showed thickening in TI and TM, the differences were not statistically significant. Notably, disorganized smooth muscle bundles were more prevalent in varicose veins (p = 0.001), suggesting potential wall weakness. The absence of vasa vasorum in TA was significantly higher in varicose veins (p = 0.050), influencing vascularization considerations. The comparative morphological microscopic analysis of the specimens of healthy and varicose veins reveals significant differences between the groups, which make the conclusion of this study to plead for avoiding the use of varicose veins as a graft.

A Single-Subject Study to Consider the Premature Infant Oral Motor Intervention Combined with Kinesio-Tape in Premature Infants with Feeding Problems.

The survival rate in premature infants (PIs) has increased, but many have medical and developmental complications. Difficulty with sucking, swallowing, and poor nourishment are common complications. This study aimed to investigate the effects of Kinesio-tape (KT) combined with premature infant oromotor intervention (PIOMI) on feeding efficiency (mean volume intake [%MV]), oromotor skills (Preterm Oral Feeding Readiness Assessment Scale [POFRAS]), and weight gain in PIs. In this single-subject study, 5 PIs with feeding problems were received the PIOMI-KT for 7 consecutive days. The main outcome measure was the POFRAS scale. The %MV and weight gain were the secondary outcome measures. Measurements were taken before treatment (T0), after the 4th session (T1), and after the 7th session (T3). The POFRAS scores, %MV, and weight gain improved in all infants after treatment. The maximum and minimum change in level between the baseline and treatment phase was +26 and+16 for POFRAS, +54 and, +34 for %MV, +180, and +100 for weight gain. The treatment trend was upward for all infants and shown by the directions of the slopes indicated by positive values. The feeding problems were resolved in all infants after the 7th treatment session. The combination therapy of PIOMI-KT improved feeding function in PIs.

Magnetic properties and cryogenic magnetocaloric effect of pyrochlore structure RE2Ti2O7 (RE = Gd, Tb, and Ho) compounds

Magnetic refrigeration technology is regarded as one of the ideal solutions for cryogenic refrigeration, while magnetocaloric materials are the crucial ones. A series of polycrystalline RE2Ti2O7 (RE = Gd, Tb, and Ho) compounds were prepared by a simple one-step solid-phase reaction method in the atmosphere. The crystal structure, magnetic properties, and magnetocaloric effect (MCE) of these compounds were systematically investigated. Crystallographic research indicates that these compounds crystallized in a pyrochlore structure. Meanwhile, magnetic measurements illustrate that this class of pyrochlore oxides is highly frustrated magnetic materials and exhibits complex magnetic behavior. In addition, under the field change of 0–1 T, the values of the maximum magnetic entropy change (−ΔSMmax) and the refrigeration capacity are calculated to be 0.9 and 5.8 J/kg for Gd2Ti2O7, 9.0 and 32.9 J/kg for Tb2Ti2O7, 9.9 and 29.9 J/kg for Ho2Ti2O7, respectively. Therefore, RE2Ti2O7 (RE = Tb and Ho) pyrochlores exhibit excellent MCEs under low magnetic fields, providing candidate materials for the application of cryogenic magnetic refrigeration technology.

Effectiveness of oral semaglutide on glucose control and body weight up to 18 months: a multicenter retrospective real-world study

AimOral semaglutide, an innovative orally administered GLP-1 receptor agonist for type 2 diabetes (T2D) management was herein evaluated for its effectiveness in a multi-center retrospective real-world study.MethodsWe included new-users of oral semaglutide from 18 specialist care centres and collected retrospective data on baseline clinical characteristics. Updated values of HbA1c and body weight were analyzed using the mixed model for repeated measures.ResultsThe study included 166 individuals with T2D, predominantly men (64.5%), with a mean age of 64.4 years and a mean diabetes duration of 10.1 years. In the majority of patients (68.3%) oral semaglutide was used as a second-line drug, mostly with metformin. At baseline, mean BMI was 28.9 kg/m2 and HbA1c was 7.5%. During the 18-month observation period, oral semaglutide demonstrated significant reductions in HbA1c, with a maximum change of − 0.9%, and 42.1% of patients achieved HbA1c values below 7.0%. Additionally, there was a substantial reduction in body weight, with an estimated change of − 3.4 kg at 18 months, and 30.3% of patients experienced a 5% or greater reduction in baseline body weight. Only 24.2% of patients reached the 14 mg dose. Subgroup analysis revealed that baseline HbA1c > 7%, persistence on drug, not being on a prior therapy with DPP-4 inhibitors, and loosing 5% or more the initial body weight were associated with greater HbA1c reductions.ConclusionThis study supports oral semaglutide as an effective option for T2D treatment, offering improved glucose control and weight management in a real-world setting.

Large magnetocaloric effect and exchange bias properties in Mn-Ni-Co-Sn full Heusler alloy

We have studied the structural, magnetic, magnetocaloric properties and exchange bias (EB) of a Mn-rich Mn-Ni-Co-Sn Heusler alloy, by means of the combined experimental and theoretical investigations. The alloy possesses tetragonal structure at room temperature (RT), and exhibits a first order martensitic transition at around 335 K. It also shows a large magnetocaloric effect in the vicinity of martensitic transition, with a maximum isothermal magnetic entropy change of around 35 J/kg.K, which is significantly larger than that reported for many other Heusler systems. Frequency dependence of spin freezing temperature obeying the dynamical scaling and Vogel-Fulcher law, along with the memory effect confirms the presence of cluster spin glass (CSG) state at low temperatures in the alloy. It shows EB effect at low temperatures, with a maximum EB field of 0.099 Tesla at 2 K, after field cooling in presence of 1 Tesla. Strong exchange coupling among the CSG clusters embedded in a strong ferrimagnetic matrix is found to be responsible for the observed EB. Ab-initio calculations using density functional theory on a representative Mn50Ni35.94Co6.25Sn7.81 alloy (very close to our experimental composition) shows the tetragonal structure with the ferrimagnetic ordering as the ground state, which is in good agreement with the experimental results. Exchange mechanism behind the observed EB in the present alloy has been discussed in the light of varying interatomic distances between different atomic pairs, and hence the magnetic coupling.

Examining surgeon stress in robotic and laparoscopic surgery.

Robotic surgery may decrease surgeon stress compared to laparoscopic. To evaluate intraoperative surgeon stress, we measured salivary alpha-amylase and cortisol. We hypothesized robotic elicited lower increases in surgeon salivary amylase and cortisol than laparoscopic. Surgical faculty (n = 7) performing laparoscopic and robotic operations participated. Demographics: age, years in practice, time using laparoscopic vs robotic, comfort level and enthusiasm for each. Operative data included operative time, WRVU (surgical "effort"), resident year. Saliva was collected using passive drool collection system at beginning, middle and end of each case; amylase and cortisol measured using ELISA. Standard values were created using 7-minute exercise (HIIT), collecting saliva pre- and post-workout. Linear regression and Student's t test used for statistical analysis; p values < 0.05 were significant. Ninety-four cases (56 robotic, 38 laparoscopic) were collected (April-October 2022). Standardized change in amylase was 8.4 ± 4.5 (p < 0.001). Among operations, raw maximum amylase change in laparoscopic and robotic was 23.4 ± 11.5 and 22.2 ± 13.4; raw maximum cortisol change was 44.21 ± 46.57 and 53.21 ± 50.36, respectively. Values normalized to individual surgeon HIIT response, WRVU, and operative time, showing 40% decrease in amylase in robotic: 0.095 ± 0.12, vs laparoscopic: 0.164 ± 0.16 (p < 0.02). Normalized change in cortisol was: laparoscopic 0.30 ± 0.44, robotic 0.22 ± 0.4 (p = NS). On linear regression (p < 0.001), surgeons comfortable with complex laparoscopic cases had lower change in normalized amylase (p < 0.01); comfort with complex robotic was not significant. Robotic may be less physiologically stressful, eliciting less increase in salivary amylase than laparoscopic. Comfort with complex laparoscopic decreased stress in robotic, suggesting laparoscopic experience is valuable prior to robotic.

OrthoCalc: The six degrees of freedom measurement workflow of rotational and displacement changes for maxilla positioning evaluation

BackgroundThis study is undertaken to establish the accuracy and reliability of OrthoCalc, a 3D application designed for the evaluation of maxillary positioning. MethodsWe registered target virtual planned models, maxillary models from pre-operative and post-operative CT scans, and post-operative intra-oral scans to a common reference system, allowing for digital evaluation. To assess rotational changes, we introduced a novel measurement method based on virtual cuboid models. Displacement errors were calculated based on proposed registration matrices. We also compared OrthoCalc to established commercial medical software as a benchmark. ResultsStatistical significance calculated showed no significant differences between OrthoCalc and commercial software. the biggest error of 0.04 degree in rotation change was found in the yaw. A maximum displacement change of 0.75 mm was found in the X direction. ConclusionsOur study validates OrthoCalc as a precise and reliable tool for assessing maxillary position changes with six degrees of freedom in orthognathic surgery, endorsing its clinical utility.

Microchannel magnetic regenerators with optimized porosity by electrodischarge drilling: Microstructure and refrigeration performance

In this study, electrodischarge drilling is proposed to prepare LaFe11Co0.8Si1.2 magnetic regenerator with circular microchannels. We find that the drilling process leads to the microstructure consisting of the dominant α-Fe phase and sporadic distributed La-rich phase near the channel surface. In contrast, the microstructure away from the channels is not influenced and shows the typical dendritic morphology. Upon annealing, the microchannel blocks show a maximum entropy change of 6.0 J kg−1 K−1 at 0–2 T around room temperature. Further, we evaluated the regeneration performance of our magnetic refrigerators by using a one-dimension active magnetic regeneration numerical model, and a considerable specific cooling power of 11.1–18.3 W kg−1 is obtained. This study suggests electrodischarge drilling as a promising method for fabricating magnetocaloric regenerators with circular microchannels.

Single Hidden Layer Intelligent Approach to Modeling Relative Cooling Power of Rare-Earth-Transition-Metal-Based Refrigerants for Sustainable Magnetic Refrigeration Application

Solid-state magnetocaloric-based magnetic refrigeration offers green and sustainable refrigeration with improved efficiency, compactness and environmental friendliness compared with commercialized gas compression refrigeration systems. Relative cooling power (RCP) plays a significant role in the candidature of any magnetic material refrigerants in this application, while the tunable physical and magnetic properties of rare-earth-transition-metal-based materials strengthen the potential of these materials to be used in a cooling system. This work develops single hidden layer (SIL) extreme learning machine intelligent models for predicting the RCP of rare-earth-transition-metal-based magnetocaloric compounds using elemental constituent ionic radii (IR) and maximum magnetic entropy change (EC) descriptors. The developed model based on the sine (SN) activation function with ionic radii (IR) descriptors (SN-SIL-IR) shows superior performance over the sigmoid (SG) activation function-based model, represented as SG-SIL-IR, with performance improvements of 71.86% and 69.55% determined using the mean absolute error (MAE) and root mean square error (RMSE), respectively, upon testing rare-earth-transition-metal-based magnetocaloric compounds. The developed SN-SIL-IR further outperforms the SN-SIL-EC and SG-SIL-EC models which employed maximum magnetic entropy change (EC) descriptors with improvements of 45.74% and 24.79%, respectively, on the basis of MAE performance assessment parameters. Estimates of the developed model agree well with the measured values. The dependence of the RCP on an applied magnetic field for various classes of rare-earth-transition-metal-based magnetocaloric compounds is established using a developed SN-SIL-IR model. The improved precision of the developed SN-SIL-IR model, coupled with ease of its descriptors, will strengthen and facilitate the comprehensive exploration of rare-earth-transition-metal-based magnetocaloric compounds for their practical implementation as magnetic refrigerants for promoting a sustainable system of refrigeration that is known to be efficient and environmentally friendly.

Effect of a Photolithography Polymer Mask's Dynamic Viscoelasticity on Microchannel Cross-Sectional Shapes of Glass Processed by Micropowder Blasting.

In this study, a micropowder blasting system with varying processing temperatures was proposed to control the cross-sectional shape of a channel processed on a glass substrate. Based on an analysis of the processing temperature-dependence of the dynamic viscoelastic properties of a commercial mask material for micropowder blasting, a processing temperature control system that can be installed in a micropowder blasting machine was designed. The erosion of the mask during micropowder blasting depended on the loss tangent in dynamic viscoelasticity, and showed a maximum value at a processing temperature of 100 °C. Moreover, we confirmed that the maximum decrease in the width of the processed microchannel was 30 µm (12%) by mask erosion, and this change was large compared with the maximum change in the thickness of the eroded mask. These results clarified that varying the processing temperature using a mask could control the cross-section of the processed line pattern profile on glass, and a small-width channel was realized at a processing temperature of 109 °C.

Magnetostructural Transformation and Magnetocaloric Properties of (Ni37.5Co12.5Mn35Ti15)100−xBx (x = 0.0 and 0.4) Melt-Spun Ribbons

The effect of B-doping on the martensitic transformation (MT), microstructure, room temperature (RT) crystal structure, and magnetocaloric properties of a typical all-d-metal Ni37.5Co12.5Mn35Ti15 quaternary alloy was studied by synthesizing melt-spun ribbon samples of nominal composition (Ni37.5Co12.5Mn35Ti15)100−xBx with x = 0.0 and 0.4. For B-free samples, SEM images show a grain-oriented microstructure formed by the columnar in shape-elongated grains with their major axis oriented along the thermal gradient during solidification. By contrast, the B-doped samples show smaller grains whose orientation tends to be perpendicular to the contact surface with the copper wheel. For all samples, austenite (AST) and martensite (MST) phases exhibited a cubic B2-type and 5M monoclinic crystal structure, respectively. The martensitic transition temperature (TM) and the Curie temperature of the austenite phase (TCA) were reduced from 295 K to 253 K and 333 K to 276 K, respectively, with the addition of B. The effect of thermal annealing for different times (from 30 min to 4 h) at 1073 K was studied. Thermal annealing increases the martensitic transformation temperature, whereas TCA remains unchanged. The maximum magnetic field-induced entropy changes |ΔST|max for B-doped samples were around 4.5 J kg−1 K−1 and 4.7 J kg−1 K−1 for as-solidified and annealed samples (1073 K–4 h), respectively, compared to that found for the undoped samples (i.e., ΔST = 16 J kg−1 K−1). However, the entropy reduction is accompanied by an increase in the full width at half-maximum of the ΔST(T) curve.

Exploring Working Memory Capacity and Efficiency Processes to Understand Working Memory Training Outcomes in Primary School Children.

Despite the abundance of research evaluating working memory training outcomes in children, few studies have examined the underlying cognitive mechanisms. This study aimed to contribute understanding by exploring whether working memory capacity (maximum span) and/or efficiency (basic and cognitive processing speeds), two proposed cognitive mechanisms, are associated with children's working memory performance immediately and 6-months post-intervention. We used data from a previous trial in primary school children (7-11 years) who completed working memory training (n = 52) or an active control (n = 36), comprising 10 sessions (each 20-minutes) in class over two weeks. Children completed five working memory measures at baseline, immediately and 6-months post-intervention: two Backwards Span and two Following Instructions measures (same paradigms as training activities), and one n-back measure (different paradigm). Maximum span, basic and cognitive processing speeds, and performance were calculated for each measure. Associations between change in maximum span, processing speeds and change in performance on the working memory measures from baseline to immediately and 6-months post-intervention did not differ between groups (all p < .05). Maximum span, processing speeds and performance on working memory measures did not differ between groups. Findings provide little evidence that the studied capacity or efficiency processes contribute to understanding working memory training outcomes in primary school children. Furthermore, working memory training did not have benefits for children's working capacity, efficiency or performance up to 6-months post-intervention. It is of interest for future studies to explore cognitive mechanisms, including strategy use, maximum span and information processing, in datasets where training effects are observed.

Three-Dimensional Hinge Axis Orientation Contributes to Simultaneous Alignment Correction in All Three Anatomical Planes in Opening-Wedge High Tibial Osteotomy

To investigate the simultaneous effect of 3-dimensional (3D) hinge axis (HA) orientation on alignment parameters in all 3 anatomical planes in high tibial osteotomy. A computed tomography-based 3D model of a human tibia/fibula was used to establish a 3D tibial coordinate system based on the tibial mechanical axis. In here, an HA was positioned and an opening-wedge high tibial osteotomy with a rotation angle of 10° over the HA was simulated. HA rotation in the axial plane ranged from 0° to 90° and HA tilt relative to the axial plane ranged from -20° to+20°. The study quantified the simultaneous effect of HA orientation on change of alignment parameters in all anatomical reference planes. HA rotation within the tibial axial plane between orientations perpendicular to the coronal and sagittal planes primarily affected both coronal and sagittal plane alignment, with an inverse relationship between these planes (range: 0°-9.7°); the effect of HA rotation on the change in axial plane alignment was maximally 0.9°. In contrast, HA tilt relative to the tibial axial plane primarily affected axial alignment (maximum change: 6.9°); the effect on change in both coronal and sagittal plane alignment was maximally 0.6°. HA rotation in the tibial axial plane primarily affects sagittal and coronal plane alignment, and HA tilt relative to the tibial axial plane primarily affects axial plane alignment. Integrating 3D HA orientation in malalignment planning and correction offers the potential to minimize unintended corrections in nontargeted planes in uniplanar correction osteotomies and to facilitate intentional multiplanar correction with a single osteotomy.

549 - Laboratory parameters in adolescent patients aged 12–17 with moderate-to-severe atopic dermatitis treated with tralokinumab up to week 52: results from the phase 3 ECZTRA 6 trial

Abstract Introduction/Background Tralokinumab, a high-affinity, monoclonal antibody that targets IL-13, is approved in the EU and Canada for adolescents (aged ≥12 years) with inadequately controlled moderate-to-severe atopic dermatitis (AD), and it does not require laboratory monitoring. The phase 3 ECZTRA 6 (NCT03526861) clinical trial demonstrated efficacy and safety up to 52 weeks in that population. Objectives To further characterize the safety profile of tralokinumab by evaluating laboratory parameters of adolescents in the ECZTRA 6 trial. Methods ECZTRA 6 subjects received tralokinumab 150mg (n=98), 300mg (n=97) or placebo (n=94) every 2 weeks (Q2W) from week 0–16 after a loading dose at week 0 (twice the subsequent dose), and then randomized to maintenance [original tralokinumab dose either Q2W or every 4 weeks (Q4W) or placebo Q2W] or open-label (tralokinumab 300mg Q2W) until week 52. Laboratory parameters included hematology, serum biochemistry, and urinalysis throughout the trial (weeks 0, 8, 16, 28, and 52). Results Overall (n= 289 subjects), laboratory baseline parameters were similar across treatment groups. Mean and median changes of most hematology parameters showed minor fluctuations within the normal ranges through week 52, except for eosinophils. At baseline, elevated mean eosinophil counts (&amp;gt;0.5 109/L) were observed for 40.8% (tralokinumab 150mg), 48.5% (tralokinumab 300mg), and 43.6% (placebo) of subjects in each respective treatment group. Some tralokinumab-treated patients had small transient increases in eosinophils (maximum mean change from baseline 0.2×109/L) before week 16. Continued treatment with tralokinumab or placebo did not correspond with further increase in eosinophil levels over time, and no adverse events of eosinophilia were reported. Mean levels of most biochemistry parameters, including electrolytes, renal and liver function parameters, and lipid panel, were within normal range at baseline, and mean and median changes showed minor fluctuations within normal ranges in all treatment arms. Mean lactate dehydrogenase levels were around or above the upper limit of normal at baseline and decreased to within the normal ranges during the trial across all groups. Overall, no clinically meaningful differences were observed in hematology, biochemistry, or urinalysis parameters between active treatment groups or placebo. Conclusions Similar to findings in adult trials, no meaningful changes in laboratory parameters were observed in adolescents through week 52 with tralokinumab treatment. No routine laboratory monitoring is needed for adult or adolescent AD patients treated with tralokinumab.

Research on the effect of the refrigerant charge in a variable capacity heat pump

Current energy efficiency regulations have led to the development of heat pumps equipped with variable speed compressors (VSC) and electronic expansion valves (EEV). To reduce the amount of refrigerant charge, heat pump manufacturers are developing units without a liquid receiver. As a result, the amount of refrigerant charge has a direct impact on the unit performance and needs to be optimized. Previous studies have shown the existence of an optimum refrigerant charge that maximizes the COP at a given operating condition. However, with VSC it is not clear if the optimum charge at a given compressor speed is the adequate one at other speed values. This paper analyzes the effects of the refrigerant charge amount on the performance of a brine-to-water heat pump equipped with a VSC and an EEV. For a given compressor speed, the variation of the COP with the charge showed similar trends and an optimum refrigerant charge could be identified. The charge for the maximum COP changes slightly with the compressor speed. The seasonal coefficient of performance (SCOP) is proposed as a better metric for evaluating the optimum charge. Results show that the SCOP is quite stable with the refrigerant charge.

Optimizing intracranial electric field distribution through temperature-driven scalp conductivity adjustments in transcranial electrical stimulation

Transcranial electrical stimulation (TES) is a promising non-invasive neuromodulation technique. How to increase the current intensity entering the skull and reduce scalp shunting has become a key factor significantly influencing regulatory efficacy. In this study, we introduce a novel approach for optimizing TES by adjusting local scalp temperature to modulate scalp conductivity. We have developed simulation models for TES-induced electric fields and for temperature-induced alterations in scalp conductivity. Two common types of stimulation montage (M1-SO and 4 × 1 montage) were adopted for the evaluation of effectiveness. We observed that the modulation of scalp temperature has a significant impact on the distribution of the electric field within the brain during TES. As local scalp temperature decreases, there is an increase in the maximum electric field intensity within the target area, with the maximum change reaching 18.3%, when compared to the electric field distribution observed under normal scalp temperature conditions. Our study provide insights into the practical implementation challenges and future directions for this innovative methodology.

Methodological Breakdown of Potato Peel’s Influence on Starch Digestibility, In Vitro Glycemic Response and Pasting Properties of Potato

A Potato (Solanum tuberosum L.) is a major staple food consumed worldwide. Potato peel is an important constituent that is generally discarded and considered agricultural waste before processing or cooking. The present investigation is an attempt to utilize different contents of potato peels (PP) with potato flesh (PF) of processing cultivar (Kufri Chipsona 3) and table cultivar (Kufri Jyoti), which affect starch nutritional profile, glycemic response, and pasting properties. The combination of PP at different concentrations of 5, 10, and 15%, respectively, to PF showed a significant reduction (P < 0.05) in starch hydrolysis index (SHI), glycemic index (GI), and glycemic load (GL). Similarly, there was also a significant increase in the resistant starch content of the PP + PF combination. The maximum change in the predicted glycemic response was observed in the PP with 15%. A higher reduction in the in vitro glycemic response was observed in the Kufri Chipsona 3 as compared to Kufri Jyoti. The pasting properties of also showed significant changes with the addition of PP to the PF flour, which might be due to the change in intrinsic properties such as amylose and amylopectin content. The current investigation will help to provide an understanding of the use of PP in the processing industries to prepare low-GI food products.

The Acute Effect of Chamomile Intake on Blood Coagulation Tests in Healthy Volunteers: A Randomized Trial.

Chamomile administration may have desirable effects in the perioperative setting. Current practice, however, discourages perioperative chamomile use due to a theoretical increase in bleeding. Therefore, we evaluated if chamomile acutely (within 4 h of ingestion) prolongs coagulation assays. Eight healthy volunteers were randomized to receive 2 interventions in a crossover design: (a) single dose of chamomile extract capsule (500 mg) and (b) single dose of chamomile tea (3 g in 150 mL water). Interventions were separated at least 3 days apart from each other. Blood was sampled pre-ingestion, 2 h post-ingestion, and 4 h post-ingestion for each intervention. The primary outcome was the maximal change in prothrombin time (PT) before vs after each intervention. Secondary outcomes included changes in international normalized ratio, activated partial thromboplastin time, thrombin time, reptilase time, and fibrinogen levels. All 8 subjects completed the study. The average pre-ingestion PT values for tea and capsules were 11.9 (1.1) s and 12.0 (0.9) s, respectively. Tea significantly increased the average maximum PT by 0.7 (0.2) s (P = 0.0078). Extract capsules increased the maximum PT by 0.3 (0.2) s (P = 0.06). Neither PT prolongation met the predefined 10% threshold for clinical significance. No significant changes in secondary outcomes were observed. Chamomile tea ingestion prolongs PT. However, the clinical significance of this is unclear at this time and warrants further investigation. ClinicalTrials.gov Registration Number: NCT05272475.

Comparison of different induction techniques on hemodynamic changes in pediatric patients undergoing infra umbilical surgeries using laryngeal mask airway

Background: Post-induction hypotension associated with various agents is well-known in adults undergoing general anesthesia for various procedures. However, this phenomenon has not been addressed well in pediatric patients. We studied the incidence of postinduction hypotension in patients 1–5 years using inhalational induction with sevoflurane, intravenous induction with propofol, and co-induction with sevoflurane plus propofol. Aims and Objectives: To compare three different induction techniques in children 1–5 years undergoing various infra-umbilical surgeries under general anesthesia with laryngeal mask airway using sevoflurane induction, propofol induction, and sevoflurane plus propofol co-induction. Materials and Methods: Out of 150 patients observed in this study, 50 patients (group S) received inhalational induction with sevoflurane, 50 (group P) patients received intravenous induction with propofol, and 50 (group SP) patients received co-induction with propofol and sevoflurane. Results: Intravenous induction with propofol resulted in maximum hemodynamic changes Inhalational induction was responsible for significant changes in heart rate whereas co-induction with propofol (1–1.5 mg/kg) and sevoflurane 5% yielded minimum hemodynamic variations with least adverse effects. Conclusion: We conclude that co-induction with propofol (1–1.5 mg/kg) plus Sevoflurane 5% provided better hemodynamic stability with the least adverse effects.