Composite Scale Research Articles

Implementation of a German Feline Glasgow Composite Measure Pain Scale

Implementation of a German Feline Glasgow Composite Measure Pain Scale

Increasing Spiritual Beliefs are Associated With Lower HIV Incidence Among Black Men Who Have Sex With Men: Results From HPTN 061 Longitudinal Study.

There is a limited understanding about the impact of spiritual beliefs and activities on HIV seroconversion among black men who have sex with men (BMSM), which we investigate in this study. United States. The HIV Prevention Trials Network Study 061 collected demographic and biomedical assessments among BMSM across 6 United States cities for longitudinal analysis. Spiritual beliefs and spiritual activities are constructed composite scales. Bivariate analyses among 894 who provided data at 12-month follow-up compared men who seroconverted to HIV between baseline and 6 months with those who remained uninfected with HIV at 12 months. Cox proportional hazard regression among 944 men tested spiritual beliefs and activities on the longitudinal risk of HIV seroconversion adjusting for age and any sexually transmitted infection (STI). Among this sample, HIV incidence between baseline and 6 months was 1.69%, (95% confidence intervals [CI]: 1.04 to 2.77). Men who seroconverted to HIV were significantly younger than those who remained uninfected at the 12-month follow-up: (mean age 27, SD = 11 vs 37, SD = 12) and a higher proportion reported any STI (46.67% vs 11.39%, P < 0.01). A one-unit increase in spiritual beliefs was associated with lower hazard rate of seroconverting to HIV at follow-up [adjusted hazard ratio (aHR) = 0.37, 95% CI: = (0.16 to 0.87)]. Religious service attendance and spiritual activities were unrelated to seroconverting. Spirituality is important in the lives of BMSM. Biomedical and behavioral HIV prevention interventions should consider assessing spiritual beliefs in HIV care among BMSM.

Anatomical substrates and connectivity for bradykinesia motor features in Parkinson's disease after subthalamic nucleus deep brain stimulation.

Parkinsonian bradykinesia is rated using a composite scale incorporating the slowed frequency of repetitive movements, decrement amplitude and arrhythmicity. Differential localization of these movement components within the basal ganglia will drive the development of more personalized network-targeted symptomatic therapies. In this study, using an optical motion sensor, we evaluated the amplitude and frequency of hand movements during a grasping task with subthalamic nucleus deep brain stimulation 'on' or 'off' in 15 patients with Parkinson's disease. The severity of bradykinesia was assessed blindly using the Unified Parkinson's Disease Rating Part III scale. The volumes of activated tissue of each subject were estimated where changes in amplitude and frequency were mapped to identify distinct anatomical substrates of each component in the subthalamic nucleus. The volumes of activated tissue were used to seed a normative functional connectome to generate connectivity maps associated with amplitude and frequency changes. Deep brain stimulation-induced change in amplitude was negatively correlated with a change in Unified Parkinson's Disease Rating Part III scale for right (r = -0.65, P < 0.05) and left hand grasping scores (r = -0.63, P < 0.05). The change in frequency was negatively correlated with amplitude for both right (r = -0.63, P < 0.05) and left hands (r = -0.57, P < 0.05). The amplitude and frequency changes were represented as a spatial gradient with overlapping and non-overlapping regions spanning the anteromedial-posterolateral axis of the subthalamic nucleus. Whole-brain correlation maps between functional connectivity and motor changes were also inverted between amplitude and frequency changes. Deep brain stimulation-associated changes in frequency and amplitude were topographically and distinctly represented both locally in the subthalamic nucleus and in whole-brain functional connectivity.

Effects of assessment method (real-time versus video-recorded) on a validated pain-altered behavior scale used in castrated piglets

We aimed to compare two assessment methodologies (real-time vs. video-recorded) using the Unesp-Botucatu Pig Composite Acute Pain Scale (UPAPS) in piglets before and after castration. Twenty-nine male piglets were castrated. Four observers scored the UPAPS over three perioperative timepoints of castration following two assessment methodologies. In real-time assessments, the observers were in-person observing the piglets in front of the pen. After two weeks, the observers did video-recorded assessments randomizing piglets and timepoints. Modeling was conducted to compare the UPAPS and each pain-altered behavior between methodologies. Intraclass correlation coefficient (ICC), Bland–Altman, and Lin’s concordance correlation coefficient (CCC) were conducted to investigate agreement between methodologies. UPAPS was statistically equivalent between methodologies (P = 0.4371). The ICC for each method was very good (0.85 to 0.91). The agreement of the UPAPS assessed between methodologies had minimal bias (− 0.04), no proportion bias, and 53% of the assessments presented a perfect agreement. However, CCC of the UPAPS was moderate (0.65), and only one pain-altered behavior (“presents difficulty in overcoming obstacles or other animals”) occurred more in real-time assessments (P = 0.0444). In conclusion, piglet pain assessment by UPAPS can be conducted in real-time based on a suitable agreement between the real-time and video-recorded assessment methods.

Concomitant malnutrition and frailty are significant risk factors for poor outcome following two-stage revision for chronic periprosthetic joint infection

BackgroundTwo-stage revision remains the gold standard for periprosthetic joint infection (PJI) treatment. Although previous studies have examined malnutrition and frailty independently, their cumulative effects are not clear. Therefore, this study aimed to assess the individual and combined influence of malnutrition and frailty on the two-stage revision surgery.MethodsPatients with chronic PJI undergoing two-stage revision were retrospectively included. The definition of PJI is completely consistent with the evidence-based definition of PJI recorded by the MSIS in 2018. Preoperative serum albumin levels and 11-item modified frailty index scores were collected. Four cohorts were created: (1) Normal (N), (2) Frail (F), (3) Malnourished (M), and (4) Malnourished and frail (MF). Demographic data, comorbidities, and postoperative complications were collected and compared between the four cohorts.ResultsA total of 117 consecutive patients were enrolled, 48% of patients were healthy (27.4% F, 16.2% M, and 9.4% MF). MF group showed lower scores on the physical composite scale of the 12-item short-form health survey (SF12-PCS), mental composite summary (SF12-MCS), Harris hip score (HHS), and knee society score (KSS) (P < 0.05). The incidence of reinfection in the MF group was higher than that in all other groups (MF vs. N; odds ratio [OR] 3.7, 95% confidence interval [CI] 1.37 − 8.82, P = 0.032). The incidence of complications in the MF group was higher than that in all other groups (MF vs. N; OR 4.81, 95% CI 1.58–9.26, P = 0.018). Postoperative transfusion events (OR 2.92, 95% CI 1.27–3.09, P = 0.021), readmission at 60 days after the operation (OR 4.91, 95% CI 1.82–13.80, P = 0.012) was higher in the MF patients. In addition, the extended length of stay after the operation was highest in the MF patients, with an OR of 5.78 (95% CI 2.16–12.04, P = 0.003).ConclusionThe concurrent presence of concomitant malnutrition and frailty in patients with PJI is related to poor prognosis and may be a predictor of the efficacy of two-stage revision. Future research will be needed to describe the benefits of improving these risk factors for patients with PJI.

Mothers' experiences of emotional abuse from an intimate partner and its associations with children's developmental outcomes at 5 years

BackgroundIntimate partner violence (IPV) is associated with an increased risk of poorer child development. Existing research has focused on physical abuse with less known about the associations with emotional IPV. ObjectiveTo describe the period prevalence of mother's experiences of emotional IPV during children's preschool years and associations with child mental, physical, social, and cognitive development. MethodsSecondary analysis of control group data (n = 194) from an Australian randomised trial (right@home), which recruited pregnant women experiencing social adversity from antenatal clinics in 2013–14. Women reported emotional abuse (Composite Abuse Scale) at child ages 3–5 years. Measures of child development at 5 years included: Strengths and Difficulties Questionnaire, Social Skills Improvement System, Pediatric Quality of Life Inventory, Clinical Evaluation of Language Fundamentals, School Entry Alphabetic and Phonological Awareness Readiness Test, NIH executive function subtests, sleep and health. The prevalence of emotional IPV from 3 to 5 years was estimated. Regression models compared developmental outcomes according to emotional IPV exposure, adjusted for child age, child gender, and maternal education. Missing data were accounted for using multiple imputation. ResultsFrom 3-5 years, emotional IPV was experienced by 57% of women. Emotional IPV exposure was consistently associated with poorer child developmental outcomes. Differences were most apparent for SDQ internalising (mean difference 1.2, 95% CI 0.2 to 2.1) and externalising difficulties (1.2, 95% CI −0.1 to 2.4). ConclusionsEmotional IPV was highly prevalent amongst families experiencing social adversity. Developing acceptable and effective identification processes and interventions that prioritise families experiencing co-occurring social adversities should be a public health priority.

Instrument shank-assisted ovariohysterectomy: a randomized clinical trial of surgical and pain alleviation efficiency of a single-person modified technique.

To evaluate a modified ovariohysterectomy (OHE) technique performed by a single person and compare it with the conventional method based on time efficiency, trauma, and postoperative pain. In a prospective, randomized, experimental study, 18 healthy, large, deep-chested, mixed-breed intact female dogs were randomly allocated to conventional (n = 9) and instrument shank-assisted (n = 9) groups. On the basis of video recordings, the various surgical step durations were analyzed: total surgery time (TST), pedicle intervention time (PIT), suspensory release time (SRT), shanking time (ShT), clamping time (ClpT), ligating time (LigT), and closure time (CT). The Glasgow composite pain scale short-form (GCMPS-SF), university of Melbourne pain scale (UMPS), and Visual Analogue Scales (VAS) were used to measure pain. C-reactive protein (CRP) fluctuation was also investigated. These evaluations were completed before and 6, 24, 48, and 72 h postoperatively. Instrument shank-assisted OHE was less time-consuming than conventional OHE (p = 0.005), improved PIT by 30.7% (6.44 min for both pedicles, p = 0.014), and correlated strongly with TST (ρ = 0.862, p = 0.003 and ρ = 0.955, p = 0.000, respectively). The two method's surgical step durations were also TST = 47.40 ± 9.9 vs. 34.70 ± 6.7 min, PIT = 20.96 ± 5.78 vs. 14.52 ± 3.73 min, SRT = 78.97 ± 69.10 vs. ShT = 20.39 ± 8.18 s (p = 0.035), ClpT = 50.66 ± 45.04 vs. 63.55 ± 37.15 s (p = 0.662), LigT = 12.82 ± 3.37 vs. 8.02 ± 3.11 min (p = 0.005), and CT = 16.40 ± 4.5 vs. 11.60 ± 2.5 min (p = 0.013), respectively. While both techniques inflicted pain on the animals, the novel approach resulted in a reduction of pain at T6 (GCMPS-SF, p = 0.015 and VAS, p = 0.002), T24 (UMPS, p = 0.003), and T48 (GCMPS-SF, p = 0.015 and UMPS, p = 0.050). Both methods exhibited a peak in CRP level after 24 h, which subsequently returned to baseline after 48 h. However, the shank-assisted method demonstrated a significantly lower reduction in CRP level at the 48-h compared to the other group (p = 0.032). Instrument shank-assisted technique permitted ovarian removal without an assistant, less damage to animals and reducing its time when compared to a conventional technique, and resulting in an alternative that causes less surgical stress and fatigue. Further research with a larger population size is required to determine the serum CRP levels as an alternative pain biomarker.

The Classification of Federally Sentenced Women in Canada: Addition of Gender-Informed Variables to the Custody Rating Scale Contributes Incremental Predictive Validity

The Correctional Service of Canada (CSC) uses the Custody Rating Scale (CRS) for initial security classification; it is gender-neutral. Gender-informed scholars contend that gender-neutral assessments are problematic for use with justice-impacted women, as they exclude factors (e.g., victimization) deemed more relevant for women. Using an archival database with 1,555 federally sentenced women in Canada, we examined the extent that gender-informed indicators could yield incremental predictive validity (predicting institutional misconduct) beyond the CRS. Specifically, gender-informed variables from these domains were tested: mental health, substance misuse, relationship dysfunction, personal/emotional difficulties, parental/family issues, and victimization. Results revealed at least one gender-informed variable from each domain significantly predicted institutional misconducts. Composite gender-informed scales were created from the set of significant gender-informed predictors. Area under the curve (AUC) and hierarchical Cox regression analyses revealed the composite gender-informed scales contributed incremental predictive validity above and beyond the CRS. Although the CRS was predictive, it can be improved by including gender-informed variables.

Addressing six standard model problems with Technically Natural Higgs models

We aim to study the potential of the recently proposed model framework, called Technically Natural Higgs (TNH), in addressing six fundamental problems in particle physics and cosmology. These questions encompass the electroweak (EW) naturalness problem, neutrino mass generation, nature of the inflaton, the matter-antimatter asymmetry problem, origin of dark matter (DM) and the strong CP problem. We investigate various solutions within the TNH framework for three inflation scenarios — Higgs, Starobinsky and scale-independent inflation. In the minimal TNH model, the Higgs is a mixture of an elementary and a composite state, with a compositeness scale far exceeding the EW scale. Traditionally, this has required an unnatural small vacuum misalignment, but in the TNH framework a novel mechanism enables a technically natural large compositeness scale, even up to the Planck scale. In this model framework, we demonstrate that a scale-invariant version of the minimal TNH model, featuring a special energy scale of around mathcal{O} (1012) GeV, loop-induced by the inflaton, simultaneously yields a technically natural 125-GeV Higgs boson, scotogenic neutrinos, a scale-invariant inflaton and a QCD axion DM candidate. These components dynamically generate the Planck scale and collectively have the potential to address all six open questions.

Optimized event stratigraphy of Cenomanian-Turonian ostracods of North Africa and the Middle East

During the Cenomanian and Turonian, high eustatic sea levels combined with subsidence of North Africa resulted in widespread marine inundation and the evolution of an indigenous benthic fauna, including many endemic ostracod taxa. This is the first study to combine all information on the ranges of Cenomanian and Turonian ostracods and associated planktonic foraminifera across North Africa and the Middle East into a single event-stratigraphic composite scale. Information includes the ranges of the taxa in measured sections and wells in published articles and in unpublished theses and dissertations. Nine events are tracked across the region and are used to subdivide sections and wells into subsections whose boundaries separate older sections below from younger sections above. Pseudosections were coded to represent the older and younger surfaces of the events that are separated by a very thin interval. The subsections provide a geologic framework of ordered packages of sections and associated biologic events. In this methodology, the sequence stratigraphy is an integral part of the biostratigraphic analysis. This study includes 121 sections and wells that were subdivided into 218 sections and subsections, including the nine pseudosections, the first and last occurrences of 189 taxa, and 18 unpaired events, which resulted in a total of 396 events. This information was coded into software that uses a heuristic algorithm to optimize the sequence of events. The resulting composite was used to correlate the sections and subsections, produce range charts, and calculate diversity of ostracods. Computer runs were made for each of the four study areas (Morocco and western Algeria, eastern Algeria and Tunisia, Egypt, and the Southern Levant) separately and unitedly. Run separately, diversity peaks reflect biases of the local available information, but the combined results show steady rates of evolution and extinction that produced a peak in diversity of 66 species in the late Cenomanian. There are no mass extinction events. The continued faunal turnover also indicates that there is no community stasis in the Cenomanian-Turonian ostracods of the region.

The European Portuguese Version of the Composite Physical Function Scale: Cross-Cultural Adaptation and Validation in Community-Dwelling Older Adults.

This study aims to perform the cross-cultural adaptation to European Portuguese of the Composite Physical Function Scale and to assess its validity and reliability in a sample of community-dwelling older adults. The scale was translated into European Portuguese, back translated, and piloted in a sample of 16 representative individuals. Its validity and reliability were tested in an independent sample of 114 community-dwelling older adults (52 were tested twice to assess test-retest reliability). The results showed that the scale had good internal consistency (α = .90), construct validity (ρ = .71) and measurement error (78.8% agreement), and excellent test-retest reliability (κ = .98). However, a ceiling effect was found as 28% of the participants achieved the highest possible score. Although the scale has good measurement properties, the presence of ceiling effects is indicative that this tool is not able to distinguish higher levels of intrinsic capacity within community-dwelling older adults.

Types and sedimentary genesis of barriers and interlayers in the composite turbidite sand bodies of a deep-water canyon: A case study of the Central Canyon in the Qiongdongnan Basin

Deep-water oil and gas is currently the hot spot and difficulty of global oil and gas exploration, and the complex flow process inside the turbidite channels of deep-water canyons makes it difficult to characterize reservoir structures, identify barriers and interlayers and clarify the spatial distribution laws of reservoirs, which restricts the development of deep-water oil and gas. Taking the Central Canyon of the Qiongdongnan Basin as an example, this paper identifies and characterizes the barriers and interlayers of composite channel scale by means of seismic sedimentology, based on three-dimensional seismic and core data. Then, based on the turbidite filling process, barriers and interlayers are classified, and their genesis and control factors are analyzed. Finally, a development model of deep-water barriers and interlayers is established based on the quantitative analysis of sediment transportation system parameters. And the following research results are obtained. First, based on sedimentary genesis, barriers and interlayers are classified into four types, namely mudstone interlayers of lateral (aggradational) turbidite channel genesis (type A), mudstone interlayers of fine-grained turbidite channel genesis (type B), barriers of hemipelagic deep-water sediment genesis (type C), and calcareous petrophysical interlayers (type D). Second, based on the filling stage, barriers and interlayers are divided into four combination sequences, i.e., the initial canyon formation stage with strong sediment supply conditions (type A + type C and type B+ type C), the initial canyon formation stage with weak sediment supply conditions (type B + type C), the stable canyon development/late reworking stage with strong sediment supply conditions (types A + type D), and the stable canyon development/late reworking stage with weak sediment supply conditions (type D). Third, the development types and combination sequences of barriers and interlayers are controlled by the change of sediment transportation volume and terrain slope in the canyon. In the initial canyon formation stage, there is sufficient space for the development of turbidite, and the development of thin barriers and interlayers is controlled by sediment dischage volume, while the development of thick barriers and interlayers is controlled by terrain slope change. In the stable canyon development/late reworking stage, turbidite undergoes superimposed development and overbank. The sediment supply is the primary control factor of barrier and interlayer thickness, and the terrain slope change is the secondary factor. In conclusion, the development model of barriers and interlayers can be used to describe and predict the reservoir structure models under the same sedimentary background and provides a technical support for the exploration and development of deep-water oil and gas.

Intraperitoneal and incisional ropivacaine did not improve postoperative analgesia after multimodal anaesthesia compared with saline in dogs undergoing ovariohysterectomy.

Intraperitoneal administration of local anaesthetics may reduce postoperative pain after ovariohysterectomy in dogs. The aim of this prospective, randomised, blinded, placebo-controlled clinical trial was to compare postoperative analgesia and opioid requirements after intraperitoneal and incisional administration of ropivacaine versus 0,9 % NaCl (saline). Forty-three client-owned dogs were enrolled in the study and anaesthetised using a standardized protocol that included premedication with acepromazine (0,03-0,05 mg/kg) and dexmedetomidine (0,01 mg/kg) intramuscularly. Anaesthesia was induced with propofol titrated to effect and ketamine (1 mg/kg) intravenously and maintained with isoflurane in oxygen. The analgesic regimen included carprofen (4 mg/kg) subcutaneously and morphine (0,2 mg/kg) intravenously. Depending on group assignment, each dog received either an intraperitoneal and incisional splash with ropivacaine (2 mg/kg and 1 mg/kg, respectively) (group R), or an equal volume of saline (group S). Buprenorphine (0,02 mg/kg) was administered intramuscularly once the uterus was removed. Sedation and pain were assessed 0,5, 1, 2, 4, 6 and 8 hours after extubation using a sedation scale, the short form of the Glasgow Composite Pain Scale (CMPS-SF) and a dynamic interactive visual analogue scale (DIVAS). Postoperatively, buprenorphine (0,01 mg/kg) was administered intravenously if dogs scored 6/24 on CMPS-SF. The ordinal mixed model showed no difference in pain scores between groups. Fisher's exact test showed no significant difference in postoperative buprenorphine requirements between group S (3/22 dogs) and group R (1/21 dogs) at the doses used. In addition, lower sedation scores were associated with higher DIVAS scores. In this multimodal analgesic protocol, ropivacaine could not improve analgesia compared to saline.

Clinical characteristics and outcomes of COVID-19 infection among myasthenia gravis patients in a national referral hospital in Indonesia

Introduction. Due to their immunocompromised state from immunosuppressive therapy and respiratory efficiency, patients with Myasthenia Gravis (MG) are more likely to get infected with COVID-19. Currently, reports on MG patients exposed with COVID-19 in Indonesia are still limited. Therefore, this study was conducted to determine the clinical characteristics and outcomes of MG patients infected with COVID-19, especially in Jakarta, Indonesia. Methods. It is a retrospective study of MG patients in a National Referral Hospital in Indonesia from September 2021 to December 2022. The data obtained includes demographics, medical history, clinical characteristics, and severity of MG assessed by MG composite scale (MGCS), Myasthenia Gravis Foundation of America (MGFA) classification, symptoms, and therapy. Results. Of the 8 patients, 7 patients were female. The range of age at COVID-19 onset was 28-62 years old. On admission to the hospital, 2 patients were mild MG, 2 patients were moderate MG, 3 patients with severe MG, and one patient could not be identified because the patient came in an unconscious state. Five patients were classified as moderate COVID-19, two patients had severe COVID-19, and one patient was classified as critical COVID-19. Most patients experience MG exacerbation or require oxygen support during hospitalization. Only one patient deceased while receiving treatment at the emergency room, while the rest improved and were discharged home. Conclusion. MG patients exposed with COVID-19 tend to experience moderate, severe, and critical COVID-19 symptoms. However, with proper management of the infection and other comorbidities, MG patients with COVID-19 may achieve favorable outcome.

Prenatal exposures to organophosphate ester metabolite mixtures and children’s neurobehavioral outcomes in the MADRES pregnancy cohort

BackgroundEvidence suggests organophosphate esters (OPEs) are neurotoxic; however, the epidemiological literature remains scarce. We investigated whether prenatal exposures to OPEs were associated with child neurobehavior in the MADRES cohort.MethodsWe measured nine OPE metabolites in 204 maternal urine samples (gestational age at collection: 31.4 ± 1.8 weeks). Neurobehavior problems were assessed among 36-month-old children using the Child Behavior Checklist’s (CBCL) three composite scales [internalizing, externalizing, and total problems]. We examined associations between tertiles of prenatal OPE metabolites (> 50% detection) and detect/non-detect categories (< 50% detection) and CBCL composite scales using linear regression and generalized additive models. We also examined mixtures for widely detected OPEs (n = 5) using Bayesian kernel machine regression.ResultsMaternal participants with detectable versus non-detectable levels of bis(2-methylphenyl) phosphate (BMPP) had children with 42% (95% CI: 4%, 96%) higher externalizing, 45% (-2%, 114%) higher internalizing, and 35% (3%, 78%) higher total problems. Participants in the second versus first tertile of bis(butoxethyl) phosphate (BBOEP) had children with 43% (-1%, 109%) higher externalizing scores. Bis(1-chloro-2-propyl) phosphate (BCIPP) and child sex had a statistically significant interaction in internalizing (p = 0.02) and total problems (p = 0.03) models, with 120% (23%, 295%) and 57% (6%, 134%) higher scores in the third versus first BCIPP tertile among males. Among females, detectable vs non-detectable levels of prenatal BMPP were associated with 69% higher externalizing scores (5%, 170%) while the third versus first tertile of prenatal BBOEP was associated with 45% lower total problems (-68%, -6%). Although the metabolite mixture and each CBCL outcome had null associations, we observed marginal associations between di-n-butyl phosphate and di-isobutyl phosphate (DNBP + DIBP) and higher internalizing scores (0.15; 95% CrI: -0.02, 0.32), holding other metabolites at their median.ConclusionsOur results generally suggest adverse and sex-specific effects of prenatal exposure to previously understudied OPEs on neurobehavioral outcomes in 36-month children, providing evidence of potential OPE neurotoxicity.

Efficacy of lumbosacral and sacrococcygeal epidural ropivacaine in dogs undergoing surgery for perineal hernia.

Epidural anesthesia is commonly administered as part of balanced anesthesia for perioperative analgesia. The main goal of this randomized clinical trial was to compare the efficacy of two epidural approaches in dogs undergoing surgery for a perineal hernia. A secondary aim was to compare motor blockade. Intact ASA 1 and 2 male dogs, weighing ≤25 kg with no previous surgery for perineal hernia were enrolled. After premedication with IM acepromazine 0.02 mg/kg and butorphanol 0.3 mg/kg, general anesthesia was induced with propofol and maintained with sevoflurane in oxygen. Dogs were randomly allocated to receive either a lumbosacral (LS, n = 30) or a sacrococcygeal (SC, n = 26) epidural injection with ropivacaine 1% (0.2 mL/kg) under computed tomography guidance. Successful analgesia was defined as no need of intraoperative rescue analgesia (fentanyl 3 μg/kg IV). Clinical failure was defined as the need of more than two boluses of fentanyl/h each dog received meloxicam 0.2 mg/kg IV at the end of the surgery. The Glasgow Composite Pain Scale short form (GCPS-SF), tactile sensitivity, pressure pain thresholds and motor blockade were assessed at 4, 6, 8, and 24 h after the epidural injection. Methadone (0.2 mg/kg, IV) was administered if the GCPS-SF was ≥6/24 points. Differences between groups were analyzed with the Mann-Whitney U test, Student's t-test or Fisher's Exact test, as appropriate. Success rate was assessed for non-inferiority between groups. The non-inferiority margin was set at -10%. Epidural analgesia was successful in 24 dogs in group LS and 17 dogs in group SC (p = 0.243), resulting in success rates of 80 and 65% in LS and SC groups, respectively. The non-inferiority of group SC versus group LS was confirmed. Clinical failure was recorded in two dogs in group LS and one dog in group SC. No significant differences between groups were detected in the GCPS-SF score, tactile sensitivity, pressure pain thresholds, need of post-operative methadone, or motor blockade. Both epidural techniques are valuable analgesic options for perineal hernia repair in dogs.

Assessment of Cardiac Autonomic Function in Women With Polycystic Ovary Syndrome Through Ewing's Battery, Heart Rate Variability Analysis, and Composite Autonomic Symptom Score-31 Scale.

Introduction Polycystic ovary syndrome (PCOS) is a frequently occurringendocrine condition prevalent in women of reproductive age characterized by chronic anovulation, hyperandrogenism, insulin resistance, and a low-grade inflammatory state. Patients with PCOS are more vulnerable to developing cardiac and metabolic co-morbidities. Sympathetic overactivity is also reported in PCOS patients. Objective This study aimed to assess cardiac autonomic function in PCOS by Heart Rate Variability Analysis, Ewing's Test, and Composite Autonomic Symptom Scale-31 (COMPASS-31). Methods Thirty female PCOS patients and 30 age-matched control females were enrolled in the study. Both cases and controls were subdivided into sub-groups based on body mass index (BMI) and waist-to-hip ratio (WHR). The cardiac autonomic functions were assessed by the COMPASS-31 questionnaire, Ewing's battery tests, and short-term heart rate variability analysis. Results There was no significant difference in age, BMI, and WHR of both groups. Additionally, cases had a significantly higher low frequency to high frequency (LF/HF) ratio and COMPASS-31 score andalsoreported more derangement in Ewing's battery test, indicating cardiac autonomic dysfunction in PCOS patients. Conclusion Patients with PCOS are more prone to developing cardiac and metabolic co-morbidities.Early assessment of cardiac autonomic function can prevent future complications with timely interventions. Altered autonomic function in PCOS patients can be due to hyperandrogenism and insulin resistance.

A step to the decentralized real-time timekeeping network

The composite time scale (CTS) provides an accurate and stable time-frequency reference for modern science and technology. Conventional CTS always features a centralized network topology, which means that the CTS is accompanied by a local master clock. This largely restricts the stability and reliability of the CTS. We simulate the restriction and analyze the influence of the master clock on the CTS. It proves that the CTS’s long-term stability is also positively related to that of the master clock, until the region dominated by the frequency drift of the H-maser (averaging time longer than ∼105 s). Aiming at this restriction, a real-time clock network is utilized. Based on the network, a real-time CTS referenced by a stable remote master clock is achieved. The experiment comparing two real-time CTSs referenced by a local and a remote master clock respectively reveals that under open-loop steering, the stability of the CTS is improved by referencing to a remote and more stable master clock instead of a local and less stable master clock. In this way, with the help of the proposed scheme, the CTS can be referenced to the most stable master clock within the network in real time, no matter whether it is local or remote, making democratic polycentric timekeeping possible.

Exploring the Nexus of Domestic Violence: Impact on Married Women's Physical Health, Psychological Distress, and Magnitude of Abuse

Domestic violence is a common problem in Pakistan but due to stigma in surrounding it is not openly discussed. Current study determined the magnitude of domestic violence, physical health and psychological distress among females. Cross-sectional study was conducted in Sialkot among married females. Magnitude of domestic violence was considered as the determinant of physical health and psychological distress. Sample was comprised of 100 females from working and non-working background, selected through purposive sampling technique by random assignment. The variables were measured using three assessment tools composite abuse scale, Kessler’s psychological distress scale and physical health questionnaire. Data was analyzed by the application of SPSS, correlation and regression was measured for the assessment of purposed assumptions. Among married females domestic violence is the determinant of physical health (r=.702**, p &lt; 0.01) and psychological distress (R= -.340*, p &lt; 0.01).increase in the magnitude of domestic violence leads to the deterioration of physical health and decreases psychological distress.

Tramadol vs. Lidocaine Administered Intraperitoneally and in Incisional Lines for the Intraoperative and Postoperative Pain Management of Romifidine-Telazol-Anesthetized Swine Undergoing Umbilical Hernia Repair.

The aim of the study was to compare the analgesic efficacy of tramadol and lidocaine for local anesthesia during umbilical hernia repair in swine. The study was performed on 66 large white crossbred swine. The swine received a mixture of tiletamine/zolazepam at 5 mg/kg and romifidine at 80 µg/kg, administered intramuscularly. Then, they were divided into three groups (n = 22) that received different treatments with lidocaine at 4 mg/kg and tramadol at 4 mg/kg. The LL group received lidocaine both by infiltration of the surgical planes and intraperitoneally. The LT group received lidocaine by infiltration of the surgical planes and tramadol intraperitoneally. The TT group received tramadol both by infiltration of the surgical planes and intraperitoneally. In all groups, the infiltration of the surgical planes into the umbilical region involved both the skin and muscle planes. Heart rate, noninvasive arterial blood pressure, and respiratory frequency were recorded during surgery. The response to the surgical stimulus was evaluated using a cumulative pain scale (the cut-off point for rescue analgesia was set to 10). Postoperative pain was assessed using the UNESP-Botucatu pig composite acute pain scale (the cut-off point was set to 4). The trend of physiological variables was adequate for patients under anesthesia. No subject required intraoperative and postoperative rescue analgesia. Tramadol could therefore be used for pain management in livestock.