Time Decrement Research Articles

사이클 국가대표 후보선수의 종목별 신체구성 및 최대근력과 무산소성 파워 비교 분석

This study compared and analyzed the body composition, maximal muscle strength and anaerobic power for discipline among cycling national prospective team athletes. The 16 cyclists consisting of sprinting athletes(6 men) and endurance athletes(10 men), who joined the winter training camp in 2020 as a member of the cycling national prospective team, were selected as a candidate for this study. Body composition, maximal muscle strength and anaerobic power of the athletes participated were measured and an independent t-test was used as the analyzing method for the data collected. The results showed that body weight, volume of the skeletal mass, body fat ratio were significantly different from each groups in the body composition(p.05, p.01). Meaningful difference for grip strength (right and left), bench press, and squat between groups in maximum muscle power was indicated(p.05, p.01, p.001). The study showed that there was a meaningful difference for absolute peck power, relative peck power, absolute average power, relative average power, absolute minimum power, relative minimum power, absolute decrement, relative decrement, time decrement, and fatigue rate between each groups(p.05, p.01). There was a prominent distinction between the groups for absolute power, relative power, and pedaling in the 1st, 2nd and 3rd stage of the anaerobic power as well. Therefore, it is expected that performances of both sprinters and endurance riders, physical strength, and power ability can be measured and compared through this study and the conclusion can be used as a reference for the improvement for the riders

Relationship between decrement time and recovery time in pediatric total intravenous anesthesia with propofol and remifentanil.

Propofol target-controlled infusion is now used in many countries for the administration of total intravenous anesthesia (TIVA) and uses population pharmacokinetic data incorporated into the target-controlled infusion pump to administer a dose which will achieve a target concentration selected by the practitioner. Modern target-controlled infusion pumps can include an estimate of how long it will take for the plasma propofol concentration to fall to a value programmed into the pump, once the propofol infusion is stopped. This is known as decrement time. Many users consider decrement time to be equivalent to recovery time for the patient, despite the several assumptions that makes. To determine if the decrement time estimated by the target-controlled infusion pumps at the end of anesthesia could be reliably used to predict recovery time for individual patients. Target-controlled infusion pumps at Birmingham Children's Hospital are programmed with a propofol decrement concentration of 1.5 μg.mL-1 . Patients for a variety of surgical procedures were anesthetised with propofol-remifentanil TIVA. Eye opening was used as a surrogate of recovery time. Data were analyzed using median absolute deviation, Mann-Whitney U test, and linear regression to see if there was any correlation with decrement time and recovery time, total dose of propofol administered, duration of anesthesia and patient age. A total of 55 patients were audited. Median age was 7.2 years (range 0.9-15.9), and median weight was 26 kg (range 8.5-77). Median decrement time was 11.8 min (IQR 8.3-21), while median recovery time was 15 min (IQR 9-20). Recovery time was the same as decrement time in 2% of patients, less than in 40% of patients and more in 58% of patients. Two thirds of patients opened eyes at an estimated plasma propofol concentration between 1.2 and 1.8 μg.mL-1 . The median absolute deviation for the difference between decrement time and recovery time was 5.7 min, from a median of 1 min. Analysis demonstrated there was no statistical correlation between decrement time to 1.5 μg.mL-1 and recovery time, age, total propofol dose administered, or duration of anesthesia, for individual patients. There was variation between decrement time to 1.5 μg.mL-1 and recovery time of over 5 min in nearly half of patients. Decrement time to 1.5 μg.mL-1 must be used with caution when trying to predict recovery time for individual patients following TIVA.

Y3+ substituting-adjusted mechanical, dielectric, and impedance properties of cobalt copper zinc nanoferrites for high frequency applications

Upgrading mechanical-dielectric features of ferrites through rare-earth yttrium (Y3+) doping provides feasibility to evolving high-frequency electronic devices. This paper reports the mechanical and dielectric properties of Co0.5Cu0.25Zn0.25YxFe2–xO4 ferrite nanoparticles labeled as CCZYF#0, CCZYF#1, CCZYF#2, CCZYF#3, CCZYF#4 and CCZYF#5 for x = 0.0, 0.02, 0.04, 0.06, 0.08, and 0.1, respectively. The frequency and temperature dependence of dielectric parameters and conductivity of all CCZYF nanoferrites are well discussed. The nanoferrite CCZYF#5 has the highest dielectric constant (enhancing ratio 170%) and the highest conductivity (enhancing ratio 7125.81%) compared with the undoped sample. Nyquist plots of all CCZYF nanoferrites manifest two arcs; the main reasons for the dielectric process are the grain boundaries and bulk grains. All impedance parameters were determined, which showed the effective role of Y3+ ions on their values. The nanoferrite CCZYF#5 has the highest grain boundaries capacitance (with enhancing ratio of 59.40%) and the highest grains capacitance (with enhancing ratio of 22.53%) with a relaxation time decrement efficiency of 62.51%. An ultrasonic flaw detector was utilized to determine the elastic moduli of all CCZYF nanoferrites. The nanoferrite CCZYF#5 has the highest longitudinal modulus (with enhancing ratio of 20.95%), the highest shear modulus (with enhancing ratio of 48.72%), highest Young's modulus (with enhancing ratio of 88.47%), the highest bulk modulus (with enhancing ratio 13.27%) and the highest micro hardness (with enhancing ratio 77.77%). Hence, Y3+ tuned Co-Cu-Zn nanoferrites possess new opportunities for high-frequency and storage applications.

Propofol context-sensitive decrement times in children.

Plasma drug concentration is the variable linking dose to effect. The decrement time required for plasma concentration of anesthetic agents to decrease by 50% (context-sensitive half-time) correlates with the time taken to regain consciousness. However, the decrement time to consciousness may not be 50%. An effect compartment concentration is associated more closely with return of consciousness than plasma concentration. An alternative decrement time, the time required for propofol to decrease to a predetermined effect compartment concentration associated with movement (eg, 2µg.ml-1 ), was used to simulate time for the concentration to decrease from steady state at a typical targeted effect compartment concentration 3.5µg.ml-1 in children. These times were short and reflected a decrement time to consciousness (CSTAWAKE ) increase that was small with longer infusion time. CSTAWAKE ranged from 7.5min in 1-year-old infant given propofol for 15min to 13.5min in a 15-year-old adolescent given a 2-hour infusion. Changes in decrement time with age reflect maturation of drug clearance. Neonates had prolonged increment times, 10min after 15min infusion and 18min after 120min infusion using a target concentration of 3.5µg.ml-1 . Decrement times to a targeted arousal concentration are context-sensitive. Use of a higher target concentration of 6µg.ml-1 doubled decrement times. Decrement times are associated with variability: delayed recovery beyond these simulated times is likely more attributable to the use of adjuvant drugs or the child's clinical status. An understanding of propofol decrement times can be used to guide recovery after anesthesia.

The effect of Ramadan fasting on the morning–evening difference in team-handball-related short-term maximal physical performances in elite female team-handball players

ABSTRACT The combined effect of Ramadan fasting and the time of theday on the physical performance of team-handball players has not yet been fully investigated. This study investigated the effects of Ramadan fasting on the morning–evening difference in team-handball-related short-term maximal physical performance. With acounterbalanced study design, 15 elite female team-handball players underwent the hand grip (HG), ball throwing velocity (BTV), modified agility T-test (MAT), and repeated shuttle-sprint and jump ability (RSSJA) tests at 07:00 h and 17:00 h, one week before Ramadan (BR), and during thesecond (SWR) and fourth week of Ramadan (4WR). The oral temperature (OT) was monitored prior to exercise and the ratings of perceived exertion (RPE) scale were obtained after RSSJA. The results showed that the time of theday had an effect on OT under all conditions. The HG, BTV, and MAT test performances were higher in the evening than in the morning BR (P< .001, P< .05, and P< .001, respectively). However, the diurnal variation noted in the HG and MAT tests was reversed during the SWR and 4WR, while the BTV variation was blunted during the SWR and reversed during the 4WR. The best RSSJA performance was observed in the evening BR. However, for the best and mean sprint times, areversal of this diurnal variation was observed, which was blunted for the mean jump height and sprint time decrement during Ramadan. Moreover, RPE were influenced by the time of theday and the month of Ramadan. These findings suggest that the diurnal variation of team-handball-related short-term maximal physical performance may be reversed and/or blunted during Ramadan fasting.

Parametric analysis of thermal behavior of the building with phase change materials for passive cooling

ABSTRACT This paper assesses the parametric analysis of thermal behavior of the building walls incorporated with phase change material (PCM). Two identical cubicles-one with PCM and another one without PCM are constructed and the thermal response of all the walls and roof of both the cubicles are studied for the climatic conditions of Chennai, India. The results indicated that the maximum temperature of all the walls and roof of the experimental cubicle with PCM is reduced to around 3°C to 4°C vis-à-vis the reference cubicle without PCM. Experimental results from the cubicle with PCM confirmed a significant reduction in an overall heat flux about 28.8%, a decrease in thermal amplitude around 46.05% to 65.63% including a drop in maximum temperature by 9.01% to 11.3% at different sides of the walls. Therefore, the transmission of heat energy from the outside ambient to the room interior in hot climatic conditions can be greatly reduced due to the great impact by incorporating the PCM. The dynamic thermal characteristics of the cubicles are evaluated by means of the parameters, namely, temperature time lag and decrement factor. The experimental cubicle showed 60 to 120 minutes of time delay in reaching the peak temperature and decrement factor of about 0.4. These results confirm the decrease in the cooling load and hence the reduction in energy consumption for achieving thermal comfort inside the building.

Probabilistic analysis of settlements under a pile foundation of a road bridge pylon

The paper addresses the reliability change of a road bridge pile foundation due to the unpredictable increase of settlements in time. The analysis is based on the Rędziński Bridge in Wrocław, Poland, its design assumptions, and monitoring results. The bridge foundation rests on a multi-layered subsoil assumed random. The Finite Element model of the subgrade is generated in ZSoil® software. To simplify the probabilistic approach, substitute soil strata stiffness parameters are adopted. Tracing their time decrement allows for a comprehensive definition of the entire foundation over-settlement produced by numerous factors. Preliminary sensitivity analysis of settlements to the stiffness variation properly simplifies the random model. The Serviceability Limit State helps to assess the foundation reliability index, further compared with the condition in the EN 1990:2002/A1:2005 standard. In addition, real-life settlements are also measured in the first year of bridge operation, they are used to calibrate the reliability index assessment. An innovative approach is proposed, where appropriate time-wise fluctuation functions represent the expected settlement increase and the related reliability reduction. These fluctuation functions help to plan the future remedial actions to maintain the initial bridge safety and to indicate the action frequency and scope. Future reliability levels may be extrapolated too. The real-life survey database of settlements makes it possible to validate the results of probabilistic calculations. A dedicated flowchart is devised to support further analysis of a wide structural domain.

Probing the role of deposition time in tuning the physico-chemical, optoelectronic performance of Cu2SnS3 thin films

Abstract Time dependent Cu2SnS3 (CTS) thin films have been synthesized by simplistic arrested precipitation technique (APT) via restricted release of ions from metal complex and used as potential photocathode for photovoltaic application. The influences of deposition time on physico-chemical, optoelectronic performance have been studied for the first time. With progress in reaction time decrement in optical band gap from 1.94 to 1.75 eV was noticed. XRD & Raman analysis verified that CTS crystallize in tetragonal crystal structure. FESEM micrographs depicted nanospherical morphology of the material. The oxidation states of the elements were confirmed from XPS and are in good agreement with CTS. A drastic improvement in the photoconversion efficiency of bare CTS photocathode with 0.34 % was noticed through cell configuration glass/FTO/Cu2SnS3/(I−/I3−)/graphite.

The Effects of Lidocaine with Epinephrine on Bupivacaine-Induced Cardiotoxicity.

Bupivacaine, a local anaesthetic substance, is used as a regional-anaesthesia agent. Lidocaine, a sodium channel blocker, is used in combination with epinephrine for regional anaesthesia. We aimed to evaluate the effects of lidocaine with epinephrine (LE) at different doses on bupivacaine-induced cardiotoxicity in rats. In our study, 24 Wistar albino rats were divided into four groups: I) Control; II) LE, 1 mg kg-1; III) LE, 3 mg kg-1 and IV) LE, 6 mg kg-1. Intravenous bupivacaine was administered at a dose of 3 mg kg-1 min-1 to the anaesthetized rats in all groups until cardiac asystole was achieved. LE was administered at the doses of 1, 3 and 6 mg kg-1 min-1 using infusion, simultaneously with bupivacaine. The asystole time and 75% decrement time in mean arterial blood pressure (MABP) were determined. P-Q, Q-T and QRS intervals were measured using electrocardiography (ECG) recordings. LE significantly increased the asystole time and 75% decrement time in MABP at the doses of 3 and 6 mg kg-1 compared to the control group (p<0.05) and significantly increased these values at the dose of 1 mg kg-1 compared to the control and other treatment groups (p<0.05). LE abolished the prolongation of P-Q, Q-T and QRS intervals in ECG recordings at the dose of 1 mg kg-1 (p<0.05). These results reveal that LE has a protective effect against bupivacaine cardiotoxicity. In clinical application, the simultaneous application of LE and bupivacaine may reduce the risk of cardiotoxicity due to bupivacaine.

Influence of External Heat Transfer by Convection on Time Lag and Decrement Factor of Building Walls

In this study, the effect of external heat transfer convection on the time lag and on the decrement factor has been numerically investigated for different scenarios. For this purpose, a two-dimensional transient heat conduction equation was solved using the element finite method and COMSOL Multiphysics under convection boundary conditions. A periodic boundary condition was applied to the external surface of the wall where the convection is kept constant during the day until a time interval where it is forced. Three night time intervals were investigated: 18h to 00h, 00h to 06h and 18h to 06h. For all these cases, the computations were repeated for different values of air velocity (from 0.5 to 10m/s) in order to evaluate the time lag and the decrement factor. It was found that forcing the convection on the external face of the wall during night has a profound effect on the decrement factor and on the time lag. The best scenario has shown a cooling energy reduction by 20% compared to the reference case.

Cluster Mapping Compression Storage of Monitoring Big Data in Distribution Network Based on Hive

Aiming at the storage problems of power monitoring data in distribution automation system, a cluster mapping compression storage method is proposed. By avoiding the Reduce task, monitoring big data can be read in parallel via multiple Map tasks and then be stored in HDFS after compression. At the end of this paper, a cluster mapping compression test is conducted. The experimental results show that the data importing time which adopts cluster mapping compression in the format of Deflate, Gzip, Bzip2, Lzo and Snappy except for Bzip2 is much shorter than those which has not been compressed. The time decrement increases along with the growth of data volume and this trend slows down when the records exceed 20 million. Particularly, data compressed in the format of Deflate obtains the best effect. Therefore, the cluster mapping compression method can effectively solve the storage problem of monitoring big data.

A influência de variáveis aeróbias e anaeróbias no teste de “sprints” repetidos

Resumo O objetivo deste estudo foi determinar o modo e o grau com que variáveis aeróbias e anaeróbias influenciam o desempenho e a fadiga em “sprints” repetidos (RS) na corrida. Para este fim, participaram do estudo 24 homens, sendo oito corredores velocistas, oito corredores fundistas e oito sujeitos ativos. Em uma pista sintética de atletismo estes sujeitos foram submetidos aos seguintes testes: 1) teste incremental para determinação do VO2max e da velocidade aeróbia máxima (VAM); 2) teste de velocidade constante realizado a 110%VAM para determinar a cinética do VO2 durante exercício e o máximo déficit acumulado de oxigênio (MAOD); 3) teste de “sprints” repetidos (10 “sprints” de 35 m, intercalados com 20 s de recuperação) para determinar o tempo total dos “sprints” (TT), tempo do melhor sprint (TM) e a queda do desempenho em percentual (Sdec). Para analisar a diferença entre os grupos e as relações entre as variáveis foram utilizadas a análise de variância ANOVA “one-way”, complementada pelo teste de Tukey, e a correlação de Pearson, respectivamente. O TT em RS foi diferente significativamente entre todos os grupos (velocistas, 49,5 ± 0,8 s; fundistas, 52,6 ± 3,1 s; ativos, 55,5 ± 2,6 s) e Sdec foi significativamente inferior em fundistas comparado aos outros grupos (velocistas, 8,9 ± 2,1%; fundistas, 4,0 ± 2,0%; ativos, 8,4 ± 4,4%). O TT foi correlacionado significativamente com o TM (r = 0,85, p &lt; 0,01) e com o MAOD (r = −0,54, p &lt; 0,01). Além disso, Sdec foi correlacionado significativamente com variáveis aeróbias (VO2max, r = −0,58, p &lt; 0,01; VAM, r = −0,59, p &lt; 0,01; constante de tempo “tau”, r = 0,45, p = 0,03). Portanto, conclui-se que apesar de índices aeróbios influenciarem na redução da fadiga em RS, o desempenho em RS é principalmente influenciado por características anaeróbias.

Control of the Indoor Climate in Summer Using the Thermophysical Properties of Wood Materials in Terms of Transient Thermal State

The paper deals with the influence of wood-based thermal insulation in building envelope constructions to the summer comfort of indoor climate thorough their thermal accumulation properties. In this study, the optimum positions of thermal insulation (wood fibre insulation, cork board) were investigated numerically from the maximum decrement factor and the maximum time lag. Thermal mass material of the wall is formed from CLT (cross-laminated timber) with different thicknesses of layers. It depends on the position of the insulation material maintaining the total thickness of wall 240 mm. Totally, there were composed six different configurations of insulation placement with a consequent shift in its position. The calculations of decrement factor and time lag were carried out by computer simulations based on the particular configurations. In terms of decrement factor the most effective location of thermal insulation in two layers more precisely - in the middle of the wall and on the outer surface or on the outer surface and inner surface of the wall.

Comparison of UV Concentration Geometries as an Element Capable for the Increment of the Photocatalytic Efficiency of Advanced Oxidation Processes, Inside the Annular Batch Systems

The present research examines the efficiency achieved by the implementation of two collectors of ultraviolet radiation in an annular batch type photochemical reactor. The first geometry corresponds to a concentric cylinder with the source of radiation, which consists in a media mercury lamp with 1000 watts of power. The second dispositive is constitute by the implementation of two compound parabolic collectors, opposed in their aperture areas, with a concentration factor equal to one and an acceptance angle of 90° . The obtained results shows the capacity of both geometries to increase the efficiency of the system during the Blue Erionyl A-R acid dye degradation, dissolved in aqueous media, by the application of Advanced Oxidation Processes, in an homogeneous phase of ultraviolet radiation and H2 O2 catalyst application. By the use of 0.05 mL per liter of hydrogen peroxide at 50% as a ●OH radicals source, and a colorant concentration of 50 ppm, the collectors allows the 98.4 and 100% of the dye photochemical degradation into a experimental time of 5 minutes, So the experiments registering a system efficiency increasing around of 3.4 and 5.5% respectively. Unlike the original system, and of the cylindrical collector application, the opposite compound parabolic concentrators showed a better capacity to degrade the intermediate products, that are been produced during the mineralization process of the textile compound and absorbs light radiation at wavelengths included between 230 and 480 nm. This promotes a water treatment process time decrement and an electrical energy savings.

Prediction of the heat gain of external walls: An innovative approach for full-featured excitations based on the simplified method of Mackey-and-Wright

Abstract Nowadays, simulation tools are available for calculating the thermal loads of multiple rooms of buildings, for given inputs. However, due to inaccuracies or uncertainties in some of the input data (e.g., thermal properties, air infiltrations flow rates, building occupancy), the evaluated thermal load may represent no more than just an estimate of the actual thermal load of the spaces. Accordingly, in certain practical situations, simplified methods may offer a more reasonable trade-off between effort and results accuracy than advanced software. Hence, despite the advances in computing power over the last decades, simplified methods for the evaluation of thermal loads are still of great interest nowadays, for both the practicing engineer and the graduating student, since these can be readily implemented or developed in common computational-tools, like a spreadsheet. The method of Mackey and Wright (M&W) is a simplified method that upon values of the decrement factor and time lag of a wall (or roof) estimates the instantaneous rate of heat transfer through its indoor surface. It assumes cyclic behaviour and shows good accuracy when the excitation and response have matching shapes, but it involves non negligible error otherwise, for example, in the case of walls of high thermal inertia. The aim of this study is to develop a simplified procedure that considerably improves the accuracy of the M&W method, particularly for excitations that noticeably depart from the sinusoidal shape, while not introducing a need for an excessive volume of data or complexity in the production of results. In the first simplified procedure discussed in the paper, a full-featured excitation is decomposed into a Fourier series and then the wall’s thermal behaviour is reconstructed from the application of the M&W method to each of the N sinusoidal components. Even though this established approach can lead to the most accurate results, given a sufficiently high N , it requires the knowledge of the decrement factor and time lag associated to each component of the Fourier series, which can represent a considerable amount of data. The chief result of the research though is a novel procedure based on a parameter, γ , that weigh-averages the approximate solution obtained by considering a single term Fourier decomposition of the excitation and the solution by considering the actual excitation. The procedure is more accurate than the original M&W method and will be of interest to researchers with the means of generating values of γ for the walls which the end users of their research are interested in. It provides promising results for walls ranging from massive to negligible mass. It has been noticed that while using the same values of γ that had been optimized for the wall facing east, acceptable results are also obtained when altered external excitations are imposed, namely due to intermittency of the direct solar radiation or due to a distinct value of the external heat transfer coefficient.

Two partitioning methods for multi-area studies in large power systems

Electrical energy is one of the most common forms of energy these days. Consequently, electric power system is an indispensable part of any society. However, due to the deregulation of electricity markets and the growth in the share of power generation by uncontrollable renewable energies such as wind and solar, power system simulations are more challenging than earlier. Thus, new techniques for simplifying these simulations are needed. One important example of such simplification techniques is the power system reduction.Power system reduction can be used at least for four different purposes: a) Simplifying the power system simulations, b) Reducing the computational complexity, c) Compensating the data unavailability, and d) Reducing the existing uncertainty. Due to such reasons, power system reduction is an important and necessary subject, but a challenging task to do. Power system reduction is even more essential when system operators are facing very large-scale power systems and when the renewable energy resources like hydro, wind, and solar have a high share in power generation.This thesis focuses on the topic of large-scale power system reduction with high penetration of renewable energy resources and tries to pursue the following goals:• The thesis first reviews the different methods which can be used for simplifying the power system studies, including the power system reduction. A comparison among three important simplification techniques is also performed to reveal which simplification results in less error and more simulation time decrement.• Secondly, different steps and methods for power system reduction, including network aggregation and generation aggregation, are introduced, described and discussed.• Some improvements regarding the subject of power system reduction, i.e. on both network aggregation and generation aggregation, are developed.• Finally, power system reduction is applied to some power system problems and the results of these applications are evaluated.A general conclusion is that using power system simplification techniques and specially the system reduction can provides many important advantages in studying large-scale power systems with high share of renewable energy generations. In most of applications, not only the power system reduction highly reduces the complexity of the power system study under consideration, but it also results in small errors. Therefore, it can be used as an efficient method for dealing with current bulk power systems with huge amounts of renewable and distributed generations.

Lack of visual evoked potentials amplitude decrement during prolonged reversal and motion stimulation in migraineurs

ObjectiveWe evaluated response decrement during a short time repetitive low and high contrast reversal and low contrast motion stimulation in controls and migraineurs. MethodsA total of 39 migraine patients (out of which 19 were in the interictal period and without prophylactic treatment) and 36 healthy volunteers were examined using pattern-reversal (PR-VEP) and motion-onset (M-VEP) visual evoked potentials. Binocular stimulation lasted 2.5min and the decrement assessment was blinded. ResultsEvidence of significant decrement was observed in healthy volunteers for high contrast PR-VEP amplitude of P100-N75 ratios between the fifth and first blocks (0.9; p=0.001) with a linear decline (−0.7μV/min, p=0.001) and in the P100-N145 amplitude with linear decline (−0.5μV/min, p=0.004). Significant decrement was also observed for the ratio between the fifth and first block P1-N2 amplitudes in M-VEP (0.9, p=0.006). No significant decrement was noted in the low contrast PR-VEP or among migraineurs. ConclusionsWe confirm differences in decrease of VEPs amplitude during short term examination between controls and migraineurs. We showed the decrement deficit also in the extrastriatal regions of the migraineurs’ visual cortex. SignificanceLow contrast and motion-onset stimuli in short time decrement assessment did not increase the test sensitivity.

Context Sensitive Decrement Times of Remimazolam

To the Editor Two recently published papers describe the context sensitive half-time (CSHT) as a predictor of recovery for the novel benzodiazepine remimazolam (CNS 7056).1,2 The term CSHT was first proposed in 1992 by Hughes et al.3 and consists of curves constructed by computer simulations designed to determine how long it takes for the plasma concentration to decrease by 50% for different durations of infusion. Although Wiltshire et al.2 reported the “context sensitive half-time” of remimazolam, they used constant rate infusions for their simulations rather than a varying rate infusion designed to produce a constant concentration target-controlled infusion (TCI). Thus, we believe that the simulated remimazolam CSHT when calculated using TCI (rather than constant rate infusion) might be longer than those shown in Figure 10.2 We note that Wiltshire et al.2 present a recirculatory model as the optimal model in terms of the lowest objective function with meaningful model parameters. However, from a practical perspective (i.e., implementation in a TCI pump), a 3-compartment mammillary model would certainly be more appealing. Although the more complex model is supported from a statistical perspective, it could be that it represents only a marginal improvement from a clinical perspective. Therefore, it would be of interest to the pharmacokinetically inclined reader to see a plot showing the residuals over time, depicting the difference between the simple and the complex models. Importantly, we would not discount the potential use of the 3-compartment mammillary model with future remimazolam data sets, because it is possible that the “much poorer fits” obtained in this investigation could be avoided by the use of arterial sampling throughout the study. The family of recovery curves published by Shafer and Varvel4 provide the foundation to understanding the “relevant decrement time” published by Bailey.5 We believe that this is a clinically relevant concept because 2 drugs with different concentration response curves will require different decrements in their concentrations for the same decrement in drug effect. For example, based on the pharmacodynamic parameters given in Table 2,2 the required decrement in the effect site concentration to recover from a bispectral index (BIS) value of 80 to 92 for remimazolam is 72%, whereas for midazolam it is only 29% (this is due to the larger Hill coefficient estimated for midazolam than for remimazolam). Thus, relevant decrement time curves (based on effect site TCI simulations for different durations of infusion) for the same specified BIS end point would be a more clinically meaningful comparison than the simulations shown in Figure 11.2 However, we also note that the estimated lowest BIS value of 55.7 for remimazolam and 75.1 for midazolam are probably poor estimates of the “true” maximum effect because the electroencephalogram data are censored. Finally, we would encourage researchers to continue to use the existing phrase “relevant decrement time” introduced by Bailey5 rather than the new phrase “pharmacodynamic CSHT” introduced in the accompanying editorial by Johnson.6 Thomas Schnider, Prof. Dr. Med. Institut für Anästhesiologie, Kantonsspital St. Gallen, Switzerland University of Berne Berne, Switzerland [email protected] Charles Minto, FANZCA, PhD Anaesthetist Sydney, New South Wales, Australia

Clinical doses of citalopram or reboxetine differentially modulate passive and active behaviors of female Wistar rats with high or low immobility time in the forced swimming test

The sensitivity of immobility time (IT) to antidepressant-drugs differs in rats expressing high or low motor activity during the forced swimming test (FST). However, whether this heterogeneity is expressed after the administration of the most selective serotonin and norepinephrine reuptake inhibitors (SSRIs and SNRIs, respectively) is unknown. We compared the influence of either the SSRI citalopram or the SNRI reboxetine with the tricyclic antidepressant amitriptyline on two subgroups of female Wistar rats expressing high IT (HI; at or above the mean value) or low IT (LI; below the mean) during the initial 5min of the first session of the FST. None of the tested drugs increased motor activity in the open field test. When vehicle was applied to either HI or LI rats, IT increased in the second session of the FST. This increment concurred with a simultaneous climbing time (CT) decrement. When amitriptyline (15mg/kg) was tested the CT increased for both HI and LI rats. This increment was accompanied by an IT decrement in HI and LI rats. Reboxetine (0.16 or 1mg/kg) precluded IT and CT changes in both HI and LI rats and produced a swimming time reduction. Citalopram (0.4, 1, and 3mg/kg) essentially mimicked the influence of reboxetine on the IT and CT in LI rats, as well as in HI rats, but in the latter case only at 3mg/kg. Yet, at the dose of 10mg/kg citalopram lacked this effect in both subgroups. No differences were detected when the IT of LI rats was evaluated with citalopram (3mg/kg) during estrus or diestrus stage. These results show that clinical doses of citalopram produced an antidepressant-like effect selectively in LI rats, while amitriptyline or reboxetine produced this effect in both LI and HI animals.

Efficacy of Coupling Inhibitory and Facilitatory Repetitive Transcranial Magnetic Stimulation to Enhance Motor Recovery in Hemiplegic Stroke Patients

Although there has been extensive research on the effectiveness of repetitive transcranial magnetic stimulation (rTMS) to improve patients' motor performance after experiencing chronic stroke, explicit findings on the coupling of different rTMS protocols are meager. We designed this sham-controlled randomized study to investigate the potential for a consecutive suppressive-facilitatory TMS protocol to improve motor outcomes after chronic stroke. Fifty-four chronic hemiplegic stroke patients were allocated across 4 groups to undergo 20 daily sessions of (1) 1 Hz rTMS over the contralesional primary motor cortex (M1) and then intermittent theta burst stimulation over the ipsilesional M1 (group A); (2) contralesional sham stimulation and then ipsilesional real intermittent theta burst stimulation (group B); (3) contralesional real 1 Hz rTMS and then ipsilesional sham stimulation (group C); or (4) bilateral sham-control procedures (group D). We tested cortical excitability and motor activity assessments at the baseline, postpriming rTMS, and postconsequent rTMS periods. At post, group A showed greater muscle strength, Fugl-Meyer Assessment (FMA), Wolf Motor Function test, and reaction time improvement in comparison with group B (P<0.001≈0.003) and group C (P=0.001≈0.003). Correlation analyses in group A revealed a close relation between contralesional map area decrement and Wolf Motor Function test gain (P=0.005; r=-0.75), and also revealed ipsilesional map area increment and reaction time decrement (P=0.02; r=-0.87). We detected no such relations in the other 3 groups. Our clinical trials established an extended timeframe during which conditioning could be safely continued and produced more favorable outcomes in facilitating motor performance and ameliorating interhemispheric imbalance than those obtained from single-course rTMS modulation alone.