Points T1 Research Articles

Long-Term Outcomes of Dysphagia Rehabilitation With an Adjustable Resistance Training Device in LaryngectomizedIndividuals.

This study investigated long-term outcomes of dysphagia rehabilitation with an adjustable resistance training device (Swallowing Exercise Aid, SEA2.0) in laryngectomized individuals. Seventeen laryngectomized participants who participated in a Clinical Phase II Trial were reevaluated at T3 (approximately 6 months after T2), including an interview, PROMS, oral intake, and swallowing capacity. Results of T3 were compared with the earlier time points T0 (baseline), T1 (after 6 weeks of training), and T2 (after 8 weeks of rest). All outcomes at T3 remained improved compared to T0. Compared to findings at T2, participants reported some deterioration in swallowing at T3. Swallowing capacity and oral intake slightly decreased. Swallowing-related quality of life slightly improved. Benefits of swallowing rehabilitation with the SEA2.0 in laryngectomized individuals are still noticeable long term. The need for continued exercising to fully maintain improved function is likely, but the required intensity and extent should be determined in further research.

A longitudinal study on the impact of student-teacher and student-peer relationships on academic performance: the mediating effects of study effort and engagement

ABSTRACT Despite the recognised importance of student-teacher and student-peer relationships as well as study effort and engagement in predicting academic performance, the interplay between these predictors has received limited attention in higher education research. Building on Study Demands-Resources theories, this longitudinal study explores the favourable impact of student-teacher and student-peer relationships on academic performance (GPA), mediated by study effort and engagement. In total, 613 undergraduate students (68% female; mean age 20 years) from all 13 Dutch public universities completed two online surveys with a 3.5-month interval. Student-teacher and student-peer relationships, study effort, and study engagement were measured at two time points (t1 and t2), while GPA was only measured at t2. Correlation and path analyses revealed that better relationships with both teachers and peers were longitudinally associated with a higher GPA, mediated by more study effort and engagement. This study contributes to the literature by employing longitudinal data, offering stronger causal evidence for processes underlying academic performance. It underscores the importance of fostering positive relationships with both teachers and peers to improve student performance. The findings suggest that educational institutions should implement strategies to strengthen these relationships, thereby enhancing study effort and engagement, ultimately leading to improved academic performance.

Effect of needle types and diameters using in spinal anesthesia on optic nerve sheath diameter: Prospective randomized study.

This prospective randomized study aimed to investigate the impact of needle types and diameters used in spinal anesthesia (SA) on optic nerve sheath diameter (ONSD) in patients undergoing lower extremity orthopedic surgery. Patients were randomly assigned to 3 groups based on the needle type and size used for SA: Group 25w (25 gauge Whitacre needle), Group 27q (27 gauge Quincke needle), and Group 25q (25 gauge Quincke needle). Initially, 165 patients (55 in each group) were enrolled, with 146 patients ultimately included in the analysis (Group 25w, n = 49; Group 27q, n = 48; Group 25q, n = 49). ONSD measurements were conducted using ultrasound guidance at 5 time points: T0 (pre-SA), T1 (5 minutes post-SA), T2 (5 minutes post-tourniquet inflation), T3 (5 minutes post-tourniquet deflation), and T4 (24 hours post-operation). Additionally, oxygen saturation, systolic arterial pressure, mean arterial pressure, diastolic arterial pressure, and heart rate were recorded at these time points. Analysis of ONSD measurements revealed no significant differences among the groups at time points T0,T1,T2, and T4 (P = .7293, P = .4428, P = .3676, and P = .3667, respectively). However, at T3, ONSD values were significantly higher in Group 27q compared to Group 25q (P = .0325). Across all groups, the mean ONSD values measured post-tourniquet release (T3) were higher than those at T0,T2, and T4 (P < .001 for all). The incidence of nausea was similar among the groups, and no cases of headache or visual impairment were reported within the initial 24 hours post-surgery. In conclusion, our study suggests that while subarachnoid injection and tourniquet inflation do not impact intracranial pressure (ICP), tourniquet deflation leads to an increase in ICP during lower limb surgery under SA. Therefore, caution should be exercised when using a tourniquet in patients at risk of elevated ICP.

Dual-Plane Treatment With Highly Concentrated Hybrid Cooperative Complexes of Hyaluronans for Facial Atrophic Acne Scars.

Managing patients with acne scars remains an important challenge, as scarring negatively affects psychosocial wellbeing. Hyaluronic acid (HA) cross-linked fillers have demonstrated good efficacy and tolerability for the correction of acne scars but are limited by their reduced biological activity and low concentrations. This study investigated the efficacy and safety on scars of a high-concentration (4.5%) HA-based filler with hybrid cooperative complexes (HCC) of high-molecular-weight and low-molecular-weight HA. Participants received treatment twice; the first was provided at baseline (T0) and the second after 4 weeks (T1). Data were collected at T1 and after 4 months (T2) by photographs and instrumental evaluation of the skin. The study population included 28 patients. Improvements in the mean Goodman and Baron grade were significant across time points T0 and T1 (12% improvement; p = .0002) and T0 and T2 (31% improvement; p < .0001). Instrumental evaluation of the skin surface demonstrated a 20% reduction in the average deepness of acne scars after 4 months (p < .0001). No serious adverse events were reported during the study procedure. Highly concentrated (4.5%) HCC appears to be an effective option for the correction of facial acne scars.

Evaluation of ocular surface parameters before and after cryo- and laser therapy for distichiasis in dogs: A pilot study.

The aim of this pilot study was to establish a satisfactory, scientific approach to effectively compare quantitative measurements of various ocular surface parameters before and after surgical treatment in dogs suffering from distichiasis. An ophthalmic examination was conducted on 12 dogs (23 eyes) before and after surgical treatments for distichiasis, at four different time points, (t0 = before surgery, t1 = 1-2 h after surgery, t2 = 1 week after surgery, t3 = 1 month after surgery, and t4 = 6 months after surgery) between 2021 and 2022, and analyzed retrospectively. The examination included Schirmer tear test-1 (STT-1), interferometry, noninvasive tear film break-up time (NIBUT), tear meniscus size (TMS), and meibography. No statistically significant changes were found in STT-1 (t0: 22.2 ± 6.5 mm, t2: 22.5 ± 5.7 mm, t3: 20.8 ± 5.1 mm, and t4: 22.6 mm ± 4.8 mm) before and after surgery. Mean interferometry scores showed a slight, not statistically significant, decrease from t0 to t3 and t4 (t0: 2.1 ± 0.8, t1: 2.1 ± 0.7, t2: 2.1 ± 0.9, t3: 1.8 ± 0.6, and t4: 1.9 ± 1.1). Mean NIBUT did not change significantly between time points (t0: 3.9 ± 1.3 s, t1: 4.0 ± 1.3 s, t2: 4.0 ± 1.4 s, t3: 3.5 ± 0.7 s, and t4: 3.5 ± 0.9 s). TMS showed a slight, not statistically significant increase (t0: 0.5 ± 0.3 mm, t1: 0.5 ± 0.3, t2: 0.5 ± 0.3 mm, t3: 0.6 ± 0.2 mm, and t4: 0.7 ± 0.3 mm). There were no changes in the gross morphology of the meibomian glands (MG). This pilot study could not detect a negative effect of different forms of treatment of distichiasis on the precorneal tear film parameters in dogs. However, due to the study's retrospective nature and small sample size, no definitive conclusion can be drawn regarding the changes at the different time points.

Quantitative Pupillometry Predicts Return to Play and Tracks the Clinical Evolution of Mild Traumatic Brain Injury in US Military Academy Cadets: A Military Traumatic Brain Injury Initiative Study.

The objective of this study was to determine the utility of the pupillary light reflex use as a biomarker of mild traumatic brain injury (mTBI). This prospective cohort study was conducted at The US Military Academy at West Point. Cadets underwent a standard battery of tests including Balance Error Scoring System, Sports Concussion Assessment Tool Fifth Edition Symptom Survey, Standard Assessment of Concussion, and measure of pupillary responses. Cadets who sustained an mTBI during training events or sports were evaluated with the same battery of tests and pupillometry within 48 hours of the injury (T1), at the initiation of a graded return to activity protocol (T2), and at unrestricted return to activity (T3). Pupillary light reflex metrics were obtained in 1300 cadets at baseline. During the study period, 68 cadets sustained mTBIs. At T1 (<48 hours), cadets manifested significant postconcussion symptoms (Sports Concussion Assessment Tool Fifth Edition P < .001), and they had decreased cognitive performance (Standardized Assessment of Concussion P < .001) and higher balance error scores (Balance Error Scoring System P < .001) in comparison with their baseline assessment (T0). The clinical parameters showed normalization at time points T2 and T3. The pupillary responses demonstrated a pattern of significant change that returned to normal for several measures, including the difference between the constricted and initial pupillary diameter (T1 P < .001, T2 P < .05), dilation velocity (T1 P < .01, T2 P < .001), and percent of pupillary constriction (T1 P < .05). In addition, a combination of dilation velocity and maximum constriction velocity demonstrates moderate prediction ability regarding who can return to duty before or after 21 days (area under the curve = 0.71, 95% CI [0.56-0.86]). This study's findings indicate that quantitative pupillometry has the potential to assist with injury identification and prediction of symptom severity and duration.

Ensuring the protection of critical infrastructure energy facilities from explosions

Purpose. Analysis of the protection of critical energy infrastructure facilities, which are often destroyed under the influence of a shock wave, which affects the stability of Ukraine's energy systems. Determination of the state of security of critical infrastructure, which ensures the functionality, continuity of work, integrity and stability, which is reflected in the life support of the population. Methodology. To achieve this goal, a simulation of a detonation explosion and the distribution of shock waves within prismatic bodies simulating urban development using the ANSYS AUTODYN software product were carried out. In conditions of dense urban development, measures to ensure the protection of critical infrastructure facilities are selected based on the interaction of liquids, gases and solids, phase transitions, propagation of shock waves, etc. The results of the study were obtained. The calculated parameters of the shock wave distribution limit in 15 ms after detonation were determined, the pressure data corresponding to the measurement sensors T1 and T2 were recorded, it was determined that the values of the pressure of the blast wave at the manometric points T1 and T2 are the highest about 5 ms, аt the same time, the pressure on the underground structure is almost 50% less than on the ground. Protection of critical energy infrastructure facilities in the form of construction of underground transformer substations and their modernization in conditions of dense urban development is proposed. This is the optimal solution to eliminate problems, which arise with an increase in loads in city power grids and protect them from the action of a blast wave PCT. Originality. The dependencies of the pressure distribution on the shock wave in time for two variants of shading of critical energy infrastructure objects, namely underground location and ground location in the urban environment, are obtained. At the same time, the parameters of the materials of the structure and the characteristics and amount of explosives were taken into account. Practical value. The construction of underground transformer substations and their modernization in dense urban areas is the optimal solution for eliminating the problems that arise with an increase in loads in city power grids and protecting them from the effects of a blast wave.

Extracorporeal membrane oxygenation aggravates platelet glycoprotein V shedding and δ-granule deficiency in COVID-19–associated acute respiratory distress syndrome

BackgroundExtracorporeal membrane oxygenation (ECMO) is a lifesaving therapy in patients with acute respiratory distress syndrome (ARDS). Hemostatic complications are frequently observed in patients on ECMO and limit the success of this therapy. Platelets are key mediators of hemostasis enabling activation, aggregation, and thrombus formation by coming in contact with exposed matrix proteins via their surface receptors such as glycoprotein (GP) VI or GPIb/V/IX. Recent research has elucidated a regulatory role of the GPV subunit. The cleaved soluble GPV (sGPV) ectodomain was identified to spatiotemporally control fibrin formation through complex formation with thrombin. ObjectivesWe aimed to decipher the impact of ECMO on platelet phenotype and function, including the role of GPV and plasmatic sGPV. MethodsWe recruited 36 patients with ARDS in the wake of COVID-19 pneumonia and performed a longitudinal comparison of platelet phenotype and function in non-ECMO (n = 23) vs ECMO (n = 13) compared with those of healthy controls. Patients were assessed at up to 3 time points (t1 = days 1-3; t2 = days 4-6; and t3 = days 7-14 after cannulation/study inclusion). ResultsAgonist-induced platelet activation was assessed by flow cytometry and revealed decreased GPIIb/IIIa activation and α-granule release in all ARDS patients. During ECMO treatment, agonist-induced δ-granule release continuously decreased, which was independently confirmed by electron microscopy and was associated with a prolonged in vitro bleeding time. GPV expression on the platelet surface markedly decreased in ECMO patients compared with that in non-ECMO patients. Plasma sGPV levels were increased in ECMO patients and were associated with poor outcome. ConclusionOur data demonstrate an ECMO-intrinsic platelet δ-granule deficiency and hemostatic dysfunction beyond the underlying ARDS.

The use of sodium caseinate in the freezing of sheep semen.

The aim of this study was to assess the addition of 2% sodium caseinate in a commercial egg yolk-based medium in frozen ovine semen. Eight Dorper males were used for the study. The ejaculate was divided into two portions and frozen without (G1) or with the addition of 2% sodium caseinate (G2). Kinetic parameters were evaluated using CASA (computer-assisted sperm analysis), and membrane and acrosome integrity as well as oxidative stress were assessed using flow cytometry. After thawing, a thermoresistance test was conducted at time points T0 and T90. For the fertility test, 100 ewes were inseminated with semen from two rams selected based on invitro parameters, one with good post-thaw quality (+70% total motility) and the other with low post-thaw quality (-55% total motility). For the fertility test, the females were divided into 4 groups for insemination: low-quality ram without caseinate (GBS = 25) and with caseinate (GBC = 25), and high-quality ram without caseinate (GAS = 25) and with caseinate (GAC = 25). Regarding the results of sperm kinetics, there was a statistically significant difference in the parameters of average path velocity (VAP) and curvilinear velocity (VCL) between the group frozen with BotuBov and the group with added caseinate. At time point T90, straight-line velocity maintained a trend (p < .06), with BotuBov® (BB group) being superior to caseinate this time, and in the linearity parameter, caseinate was superior to BotuBov®. Flow cytometry analysis showed no difference between any of the evaluated tests. In the fertility test, there was no statistically significant difference in the pregnancy rate between the BotuBOV® group (23%, 11/48) and the sodium caseinate group (BC group) (33%, 17/52), and no differences were observed in the male versus diluent interaction (p = .70). In conclusion, sodium caseinate supplementation did not influence sperm kinetic parameters and the fertility of sheep.

Can the dietary inorganic nitrate supplementation mitigate the vascular dysfunction in elderly with Alzheimer’s disease?

Aging and Alzheimer disease (AD) are both characterized by progressive reduction in nitric oxide bioavailability and endothelial function impairment. Promising studies on young healthy individuals underly the positive effect of dietary nitrate supplementation on endothelial function. However, the pharmacokinetics of the plasma nitrate and nitrite (PN) and the accompanying endothelial responsiveness following the oral nitrate ingestion in healthy elderly (HE) and patients with AD is not clear. Our hypothesis was that due to the reduction of nitric oxide bioavailability during aging and AD, an equal dose of oral nitrate (ON) would ameliorate the endothelial responsiveness more in the HE and even more in patients with AD in comparison to healthy young subjects (HY). Therefore, with the aim of investigating the pharmacokinetics of PN and the time-course endothelial responsiveness in response to a single dose ON, 10 HY (25±4 YRS), 10 HE (72±8 YRS) and 13 AD (73±7 YRS) were recruited. PN levels and endothelial responsiveness (single-passive leg movement (ΔPLM)) were measured in the recruited individuals prior to (T0) and hourly for 4 hours (T1, T2, T3, and T4) after: a) a single dose of ON; and b) a single dose of placebo. As expected at T0 both PN and ΔPLM were significantly reduced in the HE and even more reduced in the AD in comparison to the HY (all p&lt;0.001). No changes in PN nor ΔPLM were detected in any group following placebo intake. PN increased significantly in all three groups at T1 (p&lt;0.001) and constantly increased up to T4, but no differences were detected between time points T1 to T4 in any group. ΔPLM increased significantly in all three groups at T2, reaching highest values at T4 (p&lt;0.001). However, AD exhibited significantly lower ΔPLM values at any time point compared to HY (p&lt;0.0001) and HE (p&lt;0.001). Significant correlation between PN and ΔPLM was found (p&lt;0.001, R2=0.1654). Contrary to our hypothesis, the results of this study suggest that the PN pharmacokinetics following a single dose of ON is similar in HY, HE and AD. Moreover, the expected time-course amelioration of the endothelial responsiveness was reduced in the HE and even more reduced in the AD, suggesting that other factors, rather than the nitric oxide bioavailability, are playing a role in the age- and AD-related vascular dysfunction. Ricerca di Base 2017 - RBVR17XRSA - Effectiveness of exercise and nitrate supplementation on progression of dementia in patients with Alzheimer’s disease. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Analysis of the Propagation of Temperature and Thermal Conductivity of Sawdust Pyrolysis Process with Modeling Fea and Experiment

The study uses densified sawdust with heat propagation and thermal conductivity to achieve better pyrolysis and gasification processes. Analysis of sawdust's heat propagation and thermal conductivity during pyrolysis was developed with Finite Element Analysis (FEA). The thermal conductivity values of sawdust (k) obtained from FEA are 1.49, 1.3, 1.1, and 0.7 W/m C considering the sawdust heated with a triggering temperature (T0) 535 ºC and reaches a constant temperature of T1 = 265 ºC, T2 = 165 ºC, T3 = 115, and T4 = 95 ºC respectively after 20 minutes. The temperature distribution of sawdust heated shows between the experimental and FEA results is quite the same; however, differences on graph T1 show the experimental thermal conductivity (k) value is distinct from the simulated thermal conductivity (k) value due to a significant change that occurred as sawdust transformed into charcoal at minute 70, where the distance between point T1 and the trigger point (T0) is 40mm and after 180 minutes the sawdust had turned into charcoal completely. Furthermore, 31 grams (6.46%) of sawdust underwent pyrolysis in this experiment. The findings can aid future research and development in this field and provide valuable insight into the duration of time a bio stove utilizing compacted sawdust can produce a sustainable flame and be used as a reference for future experiments.

In Pursuit of Optimal Quality: Cultivar-Specific Drying Approaches for Medicinal Cannabis.

A limited number of studies have examined how drying conditions affect the cannabinoid and terpene content in cannabis inflorescences. In the present study, we evaluated the potential of controlled atmosphere drying chambers for drying medicinal cannabis inflorescence. Controlled atmosphere drying chambers were found to reduce the drying and curing time by at least 60% compared to traditional drying methods, while preserving the volatile terpene content. On the other hand, inflorescences subjected to traditional drying were highly infested by Alternaria alternata and also revealed low infestation of Botrytis cinerea. In the high-THC chemovar ("240"), controlled N2 and atm drying conditions preserved THCA concentration as compared to the initial time point (t0). On the other hand, in the hybrid chemovar ("Gen12") all of the employed drying conditions preserved THCA and CBDA content. The optimal drying conditions for preserving monoterpenes and sesquiterpenes in both chemovars were C5O5 (5% CO2, 5% O2, and 90% N2) and pure N2, respectively. The results of this study suggest that each chemovar may require tailored drying conditions in order to preserve specific terpenes and cannabinoids. Controlled atmosphere drying chambers could offer a cost-effective, fast, and efficient drying method for preserving cannabinoids and terpenes during the drying process while reducing the risk of mold growth.

Plasmatic profiles of cytokines/chemokines, glial fibrillary acidic protein (GFAP) and MRI brain damage in neonates with hypoxic ischemic encephalopathy (HIE)

BackgroundPerinatal hypoxia triggers the release of cytokines and chemokines by neurons, astrocytes and microglia. In response to hypoxia–ischemia resting/ramified microglia proliferate and undergo activation, producing proinflammatory molecules. The brain damage extension seems to be related to both the severity of hypoxia and the balance between pro and anti-inflammatory response and can be explored with neuroimaging. AimsThe aim of this preliminary study was to explore possible relationships between plasma levels of inflammatory cytokines/chemokines and the severe brain damage detectable by Magnetic Resonance Imaging (MRI), performed during the hospitalization. MethodsIn 10 full terms neonates with hypoxic ischemic encephalopathy (HIE) undergoing therapeutic hypothermia (TH), divided into cases and controls, according to MRI results, we measured and compared the plasma levels of CCL2/MCP-1, CXCL8, GFAP, IFN y, IL-10, IL-18, IL-6, CCL3, ENOLASE2, GM-CSF, IL-1b, IL-12p70, IL-33, TNFα, collected at four different time points during TH (24, 25–48, 49–72 h of life, and 7–10 days from birth). Five of enrolled babies had pathological brain MRI (cases) and 5 had a normal MRI examination (controls). Cytokines were measured by Magnetic Luminex Assay. MRI images were classified according to Barkovich’s score. ResultsMean levels of all cytokines and molecules at time T1 were not significantly different in the two groups. Comparing samples paired by day of collection, the greatest differences between cases and controls were found at times T2 and T3, during TH. At T4, levels tended to get closer again (except for IL-6, IL10 and IL18). Infants with worse MRI showed higher plasmatic GFAP levels than those with normal MRI, while their IL-18 was lower. The mean levels of CCL3MIP1alpha, GMCSF, IL1BETA overlapped throughout the observation period in both groups. ConclusionIn a small number of infants with worse brain MRI, we found higher levels of GFAP and of IL-10 at T4 and a trend toward low IL-18 levels than in infants with normal MRI, considered early biomarker of brain damage and a predictor of adverse outcome, respectively. The greatest, although not significant, difference between the levels of molecules was found in cases and controls at time points T2 and T3, during TH.

Both coiling and clipping induce the time-dependent release of endogenous neuropeptide Y into serum.

The vaso- and psychoactive endogenous Neuropeptide Y (NPY) has repeatedly been shown to be excessively released after subarachnoid hemorrhage and in numerous psychiatric disorders. NPY is stored in sympathetic perivascular nerve fibers around the major cerebral arteries. This prospective study was designed to analyze the impact of microsurgical and endovascular manipulation of the cerebral vasculature versus cranio- and durotomy alone on the serum levels of NPY. 58 patients (drop-out n = 3; m:f = 26:29; mean age 52.0 ± 14.1 years) were prospectively enrolled. The vascular group underwent repair for unruptured intracranial aneurysms (UIA) of the anterior circulation [endovascular aneurysm occlusion (EV) n = 13; microsurgical clipping (MS) n = 17]; in the non-vascular group, 14 patients received microsurgical resection of a small-sized convexity meningioma (CM), and 11 patients with surgically treated degenerative lumbar spine disease (LD) served as control. Plasma was drawn (1) before treatment (t0), (2) periprocedurally (t1), (3) 6 h postprocedurally (t2), (4) 72 h postprocedurally (t3), and (5) at the 6-week follow-up (FU; t4) to determine the NPY levels via competitive enzyme immunoassay in duplicate serum samples. We statistically evaluated differences between groups by calculating one-way ANOVA and for changes along the time points using repeated measure ANOVA. Except for time point t0, the serum concentrations of NPY ranged significantly higher in the vascular than in the non-vascular group (p < 0.001), with a slight decrease in both vascular subgroups 6 h postprocedurally, followed by a gradual increase above baseline levels until FU. At t3, the EV subgroup showed significantly higher NPY levels (mean ± standard deviation) than the MS subgroup (0.569 ± 0.198 ng/mL vs. 0.415 ± 0.192 ng/mL, p = 0.0217). The highest NPY concentrations were measured in the EV subgroup at t1, t3, and t4, reaching a climax at FU (0.551 ± 0.304 ng/mL). Our study reveals a first insight into the short-term dynamics of the serum levels of endogenous NPY in neurosurgical and endovascular procedures, respectively: Direct manipulation within but also next to the major cerebral arteries induces an excessive release of NPY into the serum. Our findings raise the interesting question of the potential capacity of NPY in modulating the psycho-behavioral outcome of neurovascular patients.

Prospective study of complications and sequelae of glucocorticoid therapy in ANCA-associated vasculitis

ObjectiveGlucocorticoids (GC) are a cornerstone in treating antineutrophil cytoplasmic antibodies-associated vasculitides (AAV), however, they add to morbidity and mortality. To date, GC toxicity in AAV has rarely been systematically investigated.MethodsPatients...

Inventory Model for Deteriorating Pharmaceutical Items with Linear Demand Rate

Good management of goods is needed so that the inventory activities of a business can run smoothly as the part of supply chain management which aims to monitor the flow of stock of goods from the purchasing process, and storage to the point of sale. In terms of inventory or supplies of pharmaceutical goods, conditions such as shortages or stockouts must also be considered which are a matter of control, management, and security. In this study, an inventory model is formulated with deterioration or damage to pharmaceutical goods that occurs due to the length of time when the goods are stored with a linear demand level. In the optimal solution, the inventory time occurs when it reaches the zero point (t1) of 0.34 and the cycle length (T1) of 0.83 with an average minimum total cost (TC) of $445.25 per cycle which is completed by WolframAlpha software. Sensitivity analysis changes the value results in the value of (TC) which that increases for all parameters. In increasing the linear function variables (a and b), it produces t1 and T1 stable values. An increase in the cost of each item damage (DC) and constant damage rate (theta) produces a t1 stable value, but the value of T1 increases. The increase in storage costs (h) results in a decrease in the value of t1 and T1. An increase in the cost of shortages (s) results in an increase in the value of t1 and a decrease in the value of T1.

13C-Metabolic flux analysis detected a hyperoxemia-induced reduction of tricarboxylic acid cycle metabolism in granulocytes during two models of porcine acute subdural hematoma and hemorrhagic shock.

Supplementation with increased inspired oxygen fractions has been suggested to alleviate the harmful effects of tissue hypoxia during hemorrhagic shock (HS) and traumatic brain injury. However, the utility of therapeutic hyperoxia in critical care is disputed to this day as controversial evidence is available regarding its efficacy. Furthermore, in contrast to its hypoxic counterpart, the effect of hyperoxia on the metabolism of circulating immune cells remains ambiguous. Both stimulating and detrimental effects are possible; the former by providing necessary oxygen supply, the latter by generation of excessive amounts of reactive oxygen species (ROS). To uncover the potential impact of increased oxygen fractions on circulating immune cells during intensive care, we have performed a 13C-metabolic flux analysis (MFA) on PBMCs and granulocytes isolated from two long-term, resuscitated models of combined acute subdural hematoma (ASDH) and HS in pigs with and without cardiovascular comorbidity. Swine underwent resuscitation after 2 h of ASDH and HS up to a maximum of 48 h after HS. Animals received normoxemia (PaO2 = 80 - 120 mmHg) or targeted hyperoxemia (PaO2 = 200 - 250 mmHg for 24 h after treatment initiation, thereafter PaO2 as in the control group). Blood was drawn at time points T1 = after instrumentation, T2 = 24 h post ASDH and HS, and T3 = 48h post ASDH and HS. PBMCs and granulocytes were isolated from whole blood to perform electron spin resonance spectroscopy, high resolution respirometry and 13C-MFA. For the latter, we utilized a parallel tracer approach with 1,2-13C2 glucose, U-13C glucose, and U-13C glutamine, which covered essential pathways of glucose and glutamine metabolism and supplied redundant data for robust Bayesian estimation. Gas chromatography-mass spectrometry further provided multiple fragments of metabolites which yielded additional labeling information. We obtained precise estimations of the fluxes, their joint credibility intervals, and their relations, and characterized common metabolic patterns with principal component analysis (PCA). 13C-MFA indicated a hyperoxia-mediated reduction in tricarboxylic acid (TCA) cycle activity in circulating granulocytes which encompassed fluxes of glutamine uptake, TCA cycle, and oxaloacetate/aspartate supply for biosynthetic processes. We further detected elevated superoxide levels in the swine strain characterized by a hypercholesterolemic phenotype. PCA revealed cell type-specific behavioral patterns of metabolic adaptation in response to ASDH and HS that acted irrespective of swine strains or treatment group. In a model of resuscitated porcine ASDH and HS, we saw that ventilation with increased inspiratory O2 concentrations (PaO2 = 200 - 250 mmHg for 24 h after treatment initiation) did not impact mitochondrial respiration of PBMCs or granulocytes. However, Bayesian 13C-MFA results indicated a reduction in TCA cycle activity in granulocytes compared to cells exposed to normoxemia in the same time period. This change in metabolism did not seem to affect granulocytes' ability to perform phagocytosis or produce superoxide radicals.

Changes in the hematobiochemical, acid–base and blood gas elements as well as biomarkers of inflammation and bone metabolism in donkeys (Equus asinus) with acute bleeding

Background: Acute hemorrhage is fatal in equines with a complication of severe hypovolemic shock that causes a sudden death in such cases. Aim: This study was designed to report the influences of acute bleeding in conscious non-sedated donkeys (Equus asinus) on the hematobiochemical variables, acid-base, blood gas elements and markers of inflammation and bone metabolism. Methods: Eight healthy donkeys were used where a total of 900mL of whole blood was collected. Five blood samples were collected from each animal: just before collection of blood (T0); (2) 30min (T1), 60min (T2), 120min (T3) and 240min (T4) later. The blood panels including total white blood cells, lymphocytes, neutrophils, red blood cell counts (RBCs), HCT, hemoglobin (Hg) and RBCs indices were measured. Biochemical parameters and electrolytes were evaluated. The activity of aspartate aminotransferase (AST), creatine kinase (CK) and γ-glutamyl transferase (GGT) were also determined. Complete acid-base and blood gas panel were assessed. Serum amyloid A (SAA), haptoglobin (Hp), osteocalcin (OC), bone alkaline phosphatase (b-ALP) and pyridinoline cross-links (PYD) were measured. Results: The RBCs, Hg and HCT increased significantly at points T1, T2 and T3 compared to T0. The concentrations of total proteins and albumin decreased significantly at points T3 and T4. The blood urea nitrogen concentrations increased significantly at T4. Creatinine concentrations increased significantly at T2 and T3. The AST, GGT and CK decreased significantly. On the other hand, glucose increased significantly at T3 and T4. The pH decreased significantly at points T1, T2, T3 and T4. The PCO2 increased significantly at T 3 and T4. The BE, HCO3 and TCO2 values decreased significantly at T2, T3 and T4. Contrary, the AG increased significantly at points T3 and T4. The potassium increased significantly at T1-T4 and chloride decreased significantly at T3 and T4. Lactate showed significant increases at T1-T4. The SAA, Hp, OC, b-ALP and PYD did not differ significantly at T1-T4. Conclusion: In conscious non-sedated donkeys, induced bleeding resulted in significant changes in the hematobiochemical elements, the acid-base status and blood gas and electrolyte parameters. However, it did not change the markers of inflammation and bone metabolism.

Analisis Karakteristik dan Tingkat Hambatan Samping Ruas Jalan D.I. Panjaitan Kota Kendari

Progress inland transportation has not escaped the emergence of new problems from environmental aspects, accidents, and congestion. Traffic congestion occurs due to the imbalance between the growth of vehicles with improved infrastructure, rapid urbanization, low of discipline of road users, and side friction. Land use, type of road, and size of the city result in the characteristics and level of side friction. From these things, research on the analysis of characteristics and level of side friction on the D.I. Panjaitan Road section of Kendari City became interesting. The purpose of this study is to identify the characteristics of side friction and determine the level of side friction. From research and analysis, it was found that side friction that occurs at three observation points is generally caused by the type of activity of stopped vehicles, parking on street, and vehicles come into and exit from the parking area and coming into or leaving the neighborhood. Based on side friction frequency data at three observation points showed the lowest Side Friction Frequency (SFF) of 33.5 and 39.4 events at point T3, then 67.6 and 64.4 at point T2, and the highest at point T3 70.5 and 59.9 events. The data shows that the side friction class on the road is categorized is very low. The low side friction at the observation location is caused by the observation time carried out during the decline in community activities due to the implementation of health protocols due to the increase in Covid-19 cases

Application of remimazolam transversus abdominis plane block in gastrointestinal tumor surgery.

Transversus abdominis plane block (TAPB) is a block of the abdominal afferent nerve fibers between the internal oblique muscle and the transverse abdominal muscle achieved with local anesthetics. It can effectively block the conduction of the anterior nerve of the abdominal wall and exert a good analgesic effect. However, the effect of combining the block with remimazolam on anesthesia in patients undergoing gastrointestinal tumor surgery is still unclear. To examine the effects of combining TAPB with remimazolam on the stress response and postoperative recovery of gastrointestinal tumor surgery patients. A retrospective analysis was conducted on the clinical data of 102 individuals diagnosed with gastrointestinal malignancies who underwent laparoscopic surgery under general anesthesia between April 2020 and June 2023. The patients were categorized into a control group (n = 51), receiving remimazolam for general anesthesia, and an observation group (n = 51), receiving TAPB combined with remimazolam for general anesthesia. A comparison was made between both groups in terms of hemodynamic parameters, stress markers, pain levels, recovery quality, analgesic effects, and adverse reactions during the perioperative period. The observation group had significantly higher heart rates at time points 1 min after induction and upon leaving the operating room than the control group (P < 0.05). The mean arterial pressure at time point T1 in the observation group was significantly higher than that in the control group (P < 0.05). Five minutes after extubation, the levels of the hormones adrenaline and noradrenaline in the observation group were considerably lower than those in the control group (P < 0.05). At 12 h, 24 h, and 48 h following surgery, the visual analog scale scores of the observation group were considerably lower than those of the control group (P < 0.05). The observation group had shorter awakening and extubation times and lower Riker sedation-agitation scale scores than the control group (P < 0.05). The observation group exhibited considerably fewer effective pump presses, lower fentanyl dosages, and lower incidences of rescue analgesia within 24 h following surgery than the control group (P < 0.05). The application effect of TAPB combined with remimazolam general anesthesia in anesthesia of patients undergoing gastrointestinal tumor surgery is good, which is helpful to promote faster recovery after operation.