Total Duration Research Articles

Schedule Acceleration Planning in Construction Project (Case Study: Japek II Selatan Tollroad)

This study focuses on the remaining work at stations (STA) 53+950 to 54+550 in Jakarta – CikampekII Selatan Toll Road Package III project to find the critical path, completion durations, and projectcosts before and after acceleration. The CPM Technique was used to compile network planningdiagrams, determine the critical path and project duration. Crashing Project was applied to crashschedule through the total project duration and cost whose changes due to the implementation of thecrashing method. The critical path was found in mobilization, tree felling, clearing, dig and haul,borrow material, subgrade preparation, base course (A grade), subbase course (B grade), drainagelayer, lean concrete (t=10 cm), concrete pavement, concrete barrier type B, and signage. In the CPM,the duration of project completion is 214 days. The total project budget under normal circumstancesis Rp22.073.412.654. After accelerating with the Crashing Project by proposed overtime was obtainedthe reduced total cost of Rp32.004.882 from the total normal cost of Rp22.073.412.654 toRp22.041.407.771 with an optimum duration of 183 days

MRI economics: Balancing sample size and scan duration in brain wide association studies.

A pervasive dilemma in neuroimaging is whether to prioritize sample size or scan time given fixed resources. Here, we systematically investigate this trade-off in the context of brain-wide association studies (BWAS) using functional magnetic resonance imaging (fMRI). We find that total scan duration (sample size × scan time per participant) robustly explains individual-level phenotypic prediction accuracy via a logarithmic model, suggesting that sample size and scan time are broadly interchangeable up to 20-30 min of data. However, the returns of scan time diminish relative to sample size, which we explain with principled theoretical derivations. When accounting for fixed overhead costs associated with each participant (e.g., recruitment, non-imaging measures), prediction accuracy in many small-scale and some large-scale BWAS might benefit from longer scan time than typically assumed. These results generalize across phenotypic domains, scanners, acquisition protocols, racial groups, mental disorders, age groups, as well as resting-state and task-state functional connectivity. Overall, our study emphasizes the importance of scan time, which is ignored in standard power calculations. Standard power calculations maximize sample size, at the expense of scan time, which can result in sub-optimal prediction accuracies and inefficient use of resources. Our empirically informed reference is available for future study design: WEB_APPLICATION_LINK.

Stabilization of Networked Switched Systems Under DoS Attacks.

This article studies the stability issue of networked switched systems (NSSs) under denial-of-service (DoS) attacks. To address this issue, the derived limitations imposed on both the frequency of DoS attacks on each subsystem and the upper limit of attack duration that each subsystem can tolerate are mode-dependent, which is more efficient and flexible than the current results for NSSs. Moreover, we reveal the relationship between the upper bound of the average maximum tolerable attack duration associated with the corresponding subsystem and the actual mode-dependent average dwell time. Furthermore, we identify that the total tolerable DoS attack duration as a percentage of the system runtime in this article can be higher than existing results. Finally, an example is given to demonstrate the effectiveness of our work.

Early Proterozoic Polymigmatites in a Zone of Granulite Metamorphism: P–T–X Conditions, Age, and Duration of Migmatization (Northern Ladoga Area, Russia)

Abstract —Polymigmatites in the Early Proterozoic metamorphic complex of the Northern Ladoga area trace the evolution of thermodynamic conditions during anatexis. The P–T conditions inferred for anatectic leucosome correspond to the onset of partial melting under granulite facies conditions of 5.5–6.2 kbar and 720–810 °C. After the peak of metamorphism, pressure and temperature show a coupled decrease to 4 kbar and ~550 °C, respectively. The latest granitic veins were intruded into metamorphic rocks during an event of brittle deformation. The P–T trend correlates with changes in migmatitic mineral assemblages and in chemistry of minerals. Newly formed leucocratic material changed from plagiogranitic to granitic composition when melting involved plagiogneiss but melt derived from Al-rich metapelite remained granitic. The analyzed leucosomes and granitic veins originated by multistage melting, under P–T conditions changing from granulite to amphibolite facies, between 1875 and 1865 Ma. Judging by their ages, the leucosome and granitic vein bodies from the Lakhdenpokhia and Priozersky zones of the area differed in the total duration of crystallization. Therefore, a single thermal event involving different lithologies can produce intrusions of different ages.

Comparison of the Efficacy of Postoperative Pain Relief in Ultrasound Guided Fascia Illiaca Compartment Block versus Epidural Block on Quality of Recovery (QOR-15) in Patients Undergoing Femoral Surgery

Background: The occurrence of femoral fractures is quite high. The quality of life gets affected to a large extent due to pain and post-operative delirium. Various regional block techniques like Fascia illiaca compartment block, lumbar epidural analgesia, femoral nerve block, etc. have been described for femoral fractures. In this study, we compared the efficacy of post-operative pain relief FICB and Epidural block on quality of recovery (QOR-15) in patients undergoing femoral surgery. Methods: This study included 40 patients wherein 20 patients were given FICB and 20 patients were given Epidural block. The patients were followed up for post-operative pain relief, Quality of Recovery, occurrence of delirium, disability and fraility. Results: Quality of recovery QOR-15 was similar for both the groups preoperatively as well as at 24 hour and 48 hours post-operatively. Additionally, there was no difference in the time taken to administer the block, postoperative VAS score on movement and rest, requirement of additional analgesia and opioid consumption. Moreover, there were no significant differences in WHO disability assessment, modified frailty score, prevalence of delirium, mortality, morbidity and side effects of techniques. However, the total duration of hospital stay (in days) was found to be significantly more in the epidural group as compared with the FICB group (5.75±1.61 vs 4.75±1.16; P=0.38). Conclusion: Ultrasound guided fascia iliaca compartment block is a tangible alternative to epidural block in patients undergoing femoral fracture repair.

Ecological influences and visual attention to infant phenotypes.

In humans, the allocation of resources, such as parental care and attention, is vital to offspring survival. Life history strategies are influenced by cues in the environment, particularly those that signal the availability of resources. What has yet to be determined is how individuals allocate resources to infants as a function of perceived ecological harshness and life history strategy. In the current research we hypothesized that perceived ecology would influence infant ratings (Study 1), and that visual attention to infant phenotypes would be associated with life history strategies (Study 2). Study 1 investigated the effect of ecological conditions (control vs. harsh) on preferences to infant phenotypes (i.e., underweight, average weight, overweight). Participants (N = 246) were less likely to rate infants favorably under a harsh ecological condition. Study 2 investigated visual perception in processing infant images. Using an eye-tracking task, participants (N = 239) viewed images of infants while their eye movements were recorded. Participants displayed an early attentional bias (i.e., first fixation duration) to the head of the infant and focused most of their visual attention to the torso of infants (i.e., total visit duration). The results of the both studies indicate that ecological factors play an important role in rating infants, and data from eye-tracking demonstrates that phenotypes influence the amount of attention given to infants.

Modeling daily veterinary anesthetist patient care hours and probabilities of exceeding critical thresholds.

Use a referral dental clinic model to study how to calculate accurate 95% upper confidence limits for probabilities of workloads (total case duration, including turnover time) exceeding allocated times. Dogs and cats undergoing dental treatments. Managerial data (procedure date and duration) collected over 44 consecutive operative workdays were used to calculate the daily anesthetist workload. Workloads were compared with a normal distribution using the Shapiro-Wilk test, serial correlation was examined by runs test, and comparisons among weekdays were made using the Kruskal-Wallis test. The 95% confidence limits for normally distributed workloads exceeding allocated times were estimated with a generalized pivotal quantity. The impact of a number of procedures was assessed with scatterplots, Pearson linear correlation coefficients, and multivariable linear regression. Mean anesthetist's workload was normally distributed (Shapiro-Wilk P = .25), without serial correlation (P = .45), and without significant differences among weekdays (P = .52). Daily workload, mean 9.39 hours and SD 3.06 hours, had 95% upper confidence limit of 4.47% for the probability that exceeding 16 hours (ie, 8 hours per each of 2 tables). There was a strong positive correlation between daily workload and the end of the workday (r = .85), significantly larger than the correlation between the end of the workday and the number of procedures (r = .64, P < .0001). There are multiple managerial applications in veterinary anesthesia wherein the problem is to estimate risks of exceeding thresholds of workload, including the costs of hiring a locum, scheduling unplanned add-on cases, planning for late discharge of surgical patients to owners, and coordinating anesthetist breaks.

Physiological and Metabolic Responses to Low-Volume Sprint Interval Exercises: Influence of Sprint Duration and Repetitions.

This study aimed to determine physiological and metabolic responses to two different sprint interval exercises (SIE) matched for total sprint duration and sprint-rest ratio. After having measured peak oxygen uptake (V̇O 2peak ), 14 healthy males (27.1 ± 4.8 yr, 169.6 ± 6.0 cm, 64.5 ± 8.4 kg, V̇O 2peak : 47.2 ± 7.7 mL·kg -1 ·min -1 ) performed four 10-s sprints with 80-s recovery (SIE10) and two 20-s sprints with 160-s recovery (SIE20) on different occasions in a counterbalanced crossover manner. Pulmonary V̇O 2 and changes in tissue oxygenation index (∆TOI) at vastus lateralis (VL) and rectus femoris (RF) were measured during the SIE. Furthermore, T2-weighted magnetic resonance imaging was taken immediately before and after the SIE to determine the activation levels of VL, RF, vastus medialis, vastus intermedius, adductor magnus, biceps femoris long head, semitendinosus, and semimembranosus at 50% of right thigh length. In SIE10, increases in V̇O 2 and ∆TOI at VL and RF plateaued after the second sprint, whereas session-averaged ∆TOI was greater in SIE20 than SIE10 in both muscles (VL: 20.9 ± 7.4 vs 14.2% ± 5.9%, RF: 22.8 ± 9.3 vs 12.9% ± 6.6%, P = 0.00). Although both SIE significantly increased T2 values in all eight muscles, those magnitudes were similar between the conditions (SIE10 vs SIE20: 5%-16% vs 8%-16%). This study showed blunted responses of whole-body (V̇O 2 ) and peripheral (∆TOI) oxidative responses with successive sprints (sprint 1 < sprints 2-4) in SIE10, suggesting that increasing sprint repetitions does not necessarily induce greater oxidative metabolism or stimulus. Moreover, greater peripheral oxygen extraction (∆TOI) was achieved with SIE20, whereas %changes of T2 indicates that the thigh muscles were similarly activated between the SIE conditions.

Analysis of Sleep, Nocturnal Physiology, and Physical Demands of NCAA Women's Ice Hockey Across a Championship Season.

Merrigan, JJ, Stone, JD, Kraemer, WJ, Friend, C, Lennon, K, Vatne, EA, and Hagen, JA. Analysis of sleep, nocturnal physiology, and physical demands of NCAA women's ice hockey across a championship season. J Strength Cond Res 38(4): 694-703, 2024-The aims of this study were to evaluate the (a) relationships between daily physical demands and nighttime sleep, heart rate (HR), and heart rate variability (HRV); (b) weekly changes in physical demands and sleep; and (c) differences among positions and between training and competition during a competitive season in National Collegiate Athletic Association (NCAA) women's ice hockey. Twenty-five NCAA Division I women's ice hockey athletes wore a sensor at night to monitor sleep quantity or quality (e.g., time asleep and sleep efficiency) and physiology (e.g., HR and HRV). During training and competitions (31 regular season and 7 postseason), athletes wore performance monitoring systems to assess workload demands (e.g., training impulse and TRIMP). As internal workload (TRIMP, Time >80% of HRmax, Average HR) during training or competition increased, nocturnal HRV decreased, HR increased, and Sleep Duration, Sleep Score, and Readiness Score decreased that night. Across the season, athletes experienced lower HRV, but exhibited longer sleep durations. Training Distance, Duration, Time >80% HRmax, Average HR, and TRIMP decreased, whereas competition Total Distance, Duration, and TRIMP increased across weeks throughout the season. There were differences across positions and season blocks when evaluating these data at the mesocycle level. Athletes slept longer before competition compared with training, but physiological data did not differ. Competitions had greater physiological demands than training. We speculate that the increased focus on sleep hygiene, as evidenced by the increase in sleep over the season, may have served as a recovery aid to combat physiological stress of accumulated demands of competitions that increased over time into postseason tournaments.

Effects of High-Intensity Inspiratory Muscle Warm-Up on High-Intensity Exercise Performance and Muscle Oxygenation.

An inspiratory muscle warm-up (IMW) improves inspiratory muscle function, but the effects of high-intensity exercise are inconsistent. We aimed to determine the effects of high-intensity IMW on high-intensity exercise performance and muscle oxygenation. Ten healthy men (maximal oxygen uptake [V˙O2max] 52.2 [5.0]mL·kg-1·min-1) performed constant-load exercise to exhaustion on a cycle ergometer at V˙O2max under 2 IMW conditions: a placebo condition (PLA) and a high-intensity IMW condition (HIGH). The inspiratory loads were set at 15% and 80% of maximal inspiratory pressure, respectively. Maximal inspiratory pressure was measured before and after IMW. Oxyhemoglobin was measured in the vastus lateralis by near-infrared spectroscopy during exercise. Rating of perceived exertion (RPE)for a leg was measured after 1 and 2minutes of exercise. Exercise tolerance was significantly higher under HIGH than PLA (228 [49]s vs 218 [49]s, P = .003). Maximal inspiratory pressure was significantly increased by IMW under HIGH (from 125 [20] to 136 [25] cm H2O, P = .031). Oxyhemoglobin was significantly higher under HIGH than PLA at 80% of the total duration of exercise (P = .048). RPE for the leg was significantly lower under HIGH than PLA after 2minutes of exercise (P = .019). Given that oxyhemoglobin is an index of local oxygen supply, the results of this study suggest that high-intensity IMW increases the oxygen supply to active limbs. It may also reflect a reduction in RPE in the leg. In addition, high-intensity IMW may improve exercise performance.

HRCT chest: A valuable tool to differentiate other pneumonias from covid-19 pneumonia

To assess how COVID-19 pneumonia differs from other pneumonias in terms of the chest computed tomography features.In this study we included 170 clinically diagnosed cases pneumonia referred to department of radio diagnosis subjected to HRCT thorax which include out patients and in patients out of which 127 patients tested RT-PCR positive for Covid 19 pneumonia for a total duration of 1 year. (March 2020 to March 2021). The parenchymal abnormalities including Ground glass opacities (GGO), ground glass opacities with interlobular septal thickening (crazy paving), GGO with consolidation, consolidation, pulmonary nodules, tree in bud appearances, bronchiolar wall thickening, interlobular septal thickening , halo sign, reverse halo sign, cavitation and pleural effusion and were observed and categorized along with determination of pattern of distribution on chest CT.127 patients who tested positive for COVID 19 and 43 patients with other pneumonia (such as community-acquired pneumonia) were visited, and CT scans were analysed to determine the presence and distribution of the disease pattern.Patients with COVID 19 pneumonia primarily have peripheral-based lesions (90%), whereas patients with other pneumonias primarily have mixed patterns (70%)—a difference that is statistically different (p 0.05).Statistics show that COVID 19 had higher bilateral involvement than other pneumonia (p&amp;#60;0.05). In COVID-19 pneumonia, GGOs, GGOs with interlobular septal thickening (crazy paving), and GGOs with consolidation with peripheral and basal predominance in bilateral lung parenchyma are the most common imaging patterns and findings. These findings will help us distinguish COVID-19 pneumonia from other causes of pneumonia. There is less evidence of tree in bud, pure consolidation, cavitation, and bronchiolar wall thickening.

Efficacy of brain-computer interfaces on upper extremity motor function rehabilitation after stroke: A systematic review and meta-analysis.

The recovery of upper limb function is crucial to the daily life activities of stroke patients. Brain-computer interface technology may have potential benefits in treating upper limb dysfunction. To systematically evaluate the efficacy of brain-computer interfaces (BCI) in the rehabilitation of upper limb motor function in stroke patients. Six databases up to July 2023 were reviewed according to the PRSIMA guidelines. Randomized controlled trials of BCI-based upper limb functional rehabilitation for stroke patients were selected for meta-analysis by pooling standardized mean difference (SMD) to summarize the evidence. The Cochrane risk of bias tool was used to assess the methodological quality of the included studies. Twenty-five studies were included. The studies showed that BCI had a small effect on the improvement of upper limb function after the intervention. In terms of total duration of training, < 12 hours of training may result in better rehabilitation, but training duration greater than 12 hours suggests a non significant therapeutic effect of BCI training. This meta-analysis suggests that BCI has a slight efficacy in improving upper limb function and has favorable long-term outcomes. In terms of total duration of training, < 12 hours of training may lead to better rehabilitation.

Comparison of Two Different Volumes of Epidural Normal Saline for Enhancing the Effects of Spinal Anesthesia in Adult Patients Undergoing Elective Lower Limb Surgeries: A Prospective Randomized Study

Background: The combined spinal-epidural (CSE) anesthesia technique gives a reliable subarachnoid block as well as the flexible epidural block. One of the modified technique of CSE is epidural volume expansion (EVE) in which normal saline or local anesthetic (LA) is instilled though epidural catheter leading to increase in level of sensory blockade. Aim of the study was to compare two different volumes of normal saline for enhancing the effects of spinal anaesthesia in adult patients undergoing elective lower limb surgeries.&#x0D; Methods: 90 patients were randomly divided into two group. Group A - 45 patients who were received intrathecal 2.0ml of 0.5% hyperbaric bupivacaine and epidural 10ml of 0.9% normal saline for EVE using CSE technique. Group B - 45 patients who were received intrathecal 2.0ml of 0.5% hyperbaric bupivacaine and epidural 15ml of 0.9% normal saline for EVE using CSE technique.&#x0D; Results: The demographic data were comparable in both groups. Significant difference was seen in total duration of sensory blockade between group A (192.11±9.80) and group B (Mean ± SD 215.33±17.57minutes) (p&lt;0.0001). Total duration of motor blockade was longer in group B (Mean± SD: 181.91± 16.42) as compared to group A (Mean ± SD: 162.48 ± 9.35 minutes) (p&lt;0.0001).&#x0D; Conclusion: We conclude that epidural volume expansion (EVE) with 15 ml epidural normal saline was associated with faster onset, higher level and early achieve maximum level of sensory blockade, longer two segment regression time, early onset and longer duration of motor blockade as compared to EVE with 10 ml epidural normal saline.

Therapy of netakimab in nail psoriasis

Introduction. The nail psoriasis severity does not always correspond to the skin process intensity, but often correlates with a more severe, prolonged and aggressive course of the disease.Materials and methods. 48 adult patients (n = 48) with nail psoriasis were under observation. The severity of the psoriatic lesion of the nails was determined using the NAPSI index (Nail Psoriasis Severity Index). The assessment was carried out before the start of treatment, in the first week, and then every 4 weeks up to and including 52 weeks. The Dermatological Quality of Life Index (DLQI) were determined by questionnaires before the start of treatment, at the 12th and 52nd weeks. All patients on an outpatient basis received netakimab monotherapy at a dose of 120 mg in the form of two subcutaneous injections of 1 ml (60 mg) of the drug, each administered once a week at weeks 0, 1 and 2, then 1 time every 4 weeks. The total duration of treatment for each patient was 52 weeks. The safety of netakimab was evaluated based on the development of adverse events and local reactions to the administration of the drug.Results. The results of the study for 52 weeks showed high efficacy of netakimab. Average NAPSI score improved – 33.1% by the week 12 of treatment and – 72.3% by the week 52 compared to baseline, the quality of their life improved. During the 52 weeks of the study, there were no cases of early withdrawal due to adverse events and cases of serious adverse events.Conclusion. Based on the study results we recommend netakimab for medical use among patients with moderate and severe nail psoriasis.

The Efficiency of Segmental Le Fort I Surgery in Clear Aligner Therapy of Skeletal Class III Deformity: A Pilot Study.

The purpose of this study was to investigate the efficiency of segmental Le Fort I osteotomy in clear aligner therapy of skeletal Class III deformities and to explore whether Le Fort I segmental osteotomy was effective for maxillary incisor axis correction and reduced the duration of perioperative orthodontics. Patients who had skeletal Class III deformities (ANB<0) treated with extraction of the maxillary first premolars, segmental Le Fort I osteotomy, and clear aligners therapy were included in this retrospective study. We measured the amount of tooth extraction space that was closed by surgery and recorded the preoperative orthodontic and total treatment duration. Lateral cephalograms were analyzed to measure changes of maxillary incisor inclination before treatment (T0), 1 week before surgery (T1), 1 week after surgery (T2), and after total orthodontic treatment (T3). Statistical analyses were performed, and the P value was set at 0.05. The sample was composed of 15 patients aged 19 to 30 (M=22.9) years. The average preoperative orthodontic treatment duration was 16.2±5.22mo, with 33.5 pairs of clear aligners. The gap at the extraction site decreased from 5.42±1.57mm to 0.80±0.62mm on average after surgery. U1-SN and U1-NA(deg) increased sparingly with preoperative decompensation, decreased in quantity after surgery, and then slightly increased with postoperative compensation (T2<T3<T0<T1; △ U1-SN, △ U1-NA: T1-T2, P <0.05; T0 - T1 and T2-T3, P >0.05). Le Fort I segmental osteotomy assisted decompensation of the upper anterior teeth and reduced the duration of preoperative orthodontics with clear aligners.

Ameliorative effects of topical ramelteon on imiquimod-induced psoriasiform inflammation in mice.

Psoriasis is a long-lasting, immune-related inflammatory skin disease that affects 2-3% of the global population. It is distinguished by erythematous, silvery, and scaly patches. Ramelteon is a type of melatonin agonist that is used to treat insomnia. It has enhanced non-classical immunomodulatory and anti-inflammatory activities. The aim of the study is to assess the ameliorative effects of topical ramelteon on imiquimod (IMQ)-aggravated psoriasiform-like dermatosis in mice. The 32 albino mouse males were placed into six groups of eight animals, all of them. With the exception of the control group, all groups gained a once-a-day regimen of topical imiquimod 5% cream at a dose of 62.5mg for eight uninterrupted days, while mice in the control group gained vaseline-based ointment alternately. Immediately after an 8-day induction period in the imiquimod group, mice in the clobetasol and ramelteon treatment groups obtained a twice-daily regimen of topical clobetasol propionate 0.05% ointment and 0.1% ointment, respectively, for a further 8days. This extends the total duration of the experimental study to 16 continuous days. The findings of our study found that ramelteon significantly mitigated the concentrations of inflammatory cytokines in the skin tissue, including interleukin (IL)-6, IL-17A, IL-23, tumor necrosis factor-α (TNF-α), and vascular endothelial growth factor (VEGF), as well as the scores associated with psoriatic lesions, including erythema, scaling, skin thickening, ear thickness, and overall cumulative PASI scores. Additionally, the anti-inflammatory impact of ramelteon was achieved by markedly increasing IL-10 levels in the skin tissue and correcting cutaneous histopathological alterations. Ramelteon ointment (0.1%) was comparable to that of clobetasol (0.05%) ointment in alleviating a mouse model of imiquimod-induced psoriasiform inflammation; this is probably due to its potential anti-inflammatory and immunomodulatory activities. Therefore, ramelteon could be a good additive option for therapeutic management of immune-triggered inflammatory conditions such as psoriasis.

Clinical and laboratory evaluation of the effectiveness of the nootropic drug Actitropil (fonturacetam) in the treatment of asthenic syndrome

Background. Asthenia is one of the most common symptoms in the clinical practice of a doctor of any specialty. This is due to the high incidence of this pathology: in patients with chronic somatic diseases from 45% to 90%, with an acute pathological process – about 55%. There are no uniform standards for the treatment of asthenic disorder; however, the basis for the medical correction of this pathology is nootropic drugs.&#x0D; Aim. To study the clinical efficacy and safety of the nootropic drug Actitropil (fonturacetam) in patients with various types of asthenic disorder.&#x0D; Materials and methods. The observational clinical program included 50 patients (average age 43.22±14.60) with asthenic symptoms. Patients received Actitropil (fonturacetam) at a dose of 200 mg per day, divided into two doses. The duration of therapy was 30 days, the total duration of follow-up was 60 days. The effectiveness of treatment was evaluated before and after the course of therapy, as well as in the delayed period according to the scales of asthenia MFI-20, well-being, activity, mood SAN, anxiety and depression HADS (part 1), sleep quality Spiegel, quality of life EQoL-5D-3L. Patients' satisfaction with the treatment and tolerability of therapy were also assessed on 5-point scales; adverse events were recorded and the number of patients with good, satisfactory and unsatisfactory treatment results was calculated based on the subjective assessment of the subjects. Blood parameters analysis was used as laboratory assessment methods: erythrocytes, leukocytes, reticulocytes, platelets, hemoglobin, hematocrit, blood sedimentation rate, total protein, glucose, alanine aminotransferase, aspartate aminotransferase, prothrombin and thrombin time, prothrombin, international normalised ratio, activated partial thromboplastin time, fibrinogen.&#x0D; Results and conclusion. The results of the study showed high efficacy (98%) and safety of the use of Actitropil (absence of adverse events, low adverse events level during the course of treatment, no negative effect on liver function, blood coagulation and carbohydrate metabolism) in the treatment of various types of asthenic syndrome, including those associated with comorbid diseases. There is a significant therapeutic effect of Actitropil on concomitant symptoms of asthenia: anxiety, sleep status and quality of life. The antiasthenic effect of the drug does not differ depending on age and increases in the delayed period.

Objective sleep characteristics and hypertension: a community-based cohort study.

The link between sleep quality and hypertension risk is well-established. However, research on the specific dose-relationship between objective sleep characteristics and hypertension incidence remains limited. This study aims to explore the dose-relationship association between objective sleep characteristics and hypertension incidence. A community-based prospective cohort study design was employed using data from the Sleep Heart Health Study (SHHS). A total of 2,460 individuals were included in the study, of which 780 had hypertension. Baseline personal characteristics and medical history were collected. Objective sleep characteristics were obtained through polysomnography (PSG). Multivariate logistic regression models were utilized for analysis. Restricted cubic splines (RCS) were used to examine dose-relationship associations. After adjusting for covariates, the percentage of total sleep duration in stage 2 (N2%) was positively associated with hypertension incidence, while the N3% was negatively associated with hypertension incidence Odds ratio (OR) = 1.009, 95% confidence interval (CI) [1.001, 1.018], P = 0.037; OR = 0.987, 95% CI: [0.979, 0.995], P = 0.028, respectively. For every 10% increase in N2 sleep, the risk of developing hypertension increases by 9%, while a 3% decrease in N3 sleep corresponds to a 0.1% increase in the incidence of hypertension. In the subgroup of non-depression, a positive association between N2% and hypertension was significant statistically (OR = 1.012, 95%CI, 1.002, 1.021, P = 0.013, Pinteraction = 0.013). RCS demonstrated that the risk of developing hypertension was lower when N2% ranged from 38% to 58% and rapidly increased thereafter (P = 0.002, non-linear P = 0.040). The lowest risk for hypertension incidence risk of N3% occurring at 25%, and a significant increase below 15% or above 40% (P = 0.001, non-linear P = 0.008). There's a negative association between N3% and the incidence of hypertension, and a positive association between N2% and the incidence of hypertension, particularly among non-depression individuals. These associations exhibit strong non-linear dose-response relationships.

New Benchmarks on Protocol Amendment Practices, Trends and their Impact on Clinical Trial Performance.

The Tufts Center for the Study of Drug Development (Tufts CSDD) conducted a follow-up study in 2022 to assess trends in protocol amendment experiences and the impact amendments have had on clinical trial performance, particularly during the COVID-19 pandemic. Sixteen pharmaceutical companies and contract research organizations provided data on 950 protocols and 2188 amendments. The results show that, since 2015, the prevalence of protocols with at least one amendment in phases I-IV has increased substantially (from 57 to 76%) and the mean number of amendments per protocol has increased 60% to 3.3, up from 2.1. Phase I and III protocols saw the highest increases in the mean number of amendments implemented per protocol. A much higher percentage of amendments-77%-were deemed unavoidable with regulatory agency requests and changes to the study strategy as the top reasons cited for amending a protocol. The total average duration to implement an amendment has nearly tripled during the past decade. The time from identifying the need-to-amend to last oversight approval now takes an average of 260days and the mean duration during which investigative sites operate with different versions of the clinical trial protocol spans 215days. Protocols that implemented at least one amendment were more effective at increasing patient screening volume and reducing the actual number of patients enrolled relative to plan. Lastly, the prevalence of protocols with at least one amendment and mean number of amendments was significantly higher for protocols conducted during the pandemic.

(021) Eight-Dot Extended Corporotomy versus Conventional Corporotomy for Malleable Penile Prosthesis Implantation

Abstract Introduction To date, malleable type penile prosthesis implantation (MPPI) remains the more popular in developing countries, owing to its relative economic cost. Despite the simplicity of the procedure, there still may be areas of improvement and refinement to optimize procedure efficiency and accuracy subsequently improving postoperative outcomes while reducing complication risk. Objective We aimed to compare the eight-dot extended corporotomy and the conventional corporotomy techniques for MPPI with regard to operative time and postoperative complications. Methods We conducted a prospective randomized interventional clinical study on 51 subjects. Patients were randomized into 2 groups: the eight-dot group (n=27) and the conventional group (n=24). The eight-dot group underwent MPPI using the eight-dot extended corporotomy as previously described (VJPU - Eight-dot Extended Corporotomy: A More Secure, Aesthetic and Time Efficient Technique for Semirigid Penile Prosthesis Implantation, n.d.). The conventional group underwent MPPI using conventional limited corporotomies that were closed via continuous running sutures. We compared both groups in terms of corporotomy opening to closure time, overall procedure time, and perioperative complications. The follow-up period was 3 months. Results Upon timing in seconds (s), a significant time difference between the 2 groups was demonstrated for suture placement, corporotomy incision and implant placement, corporotomy closure, and total procedure duration. Although patients in the eight-dot group required a longer time for suture placement vs the conventional group (486 vs 201 s, respectively, p &amp;lt; 0.001), the durations for the remaining implantation steps, as well as the whole procedure, were significantly shorter for the former group. Corporotomy opening followed by implant placement took significantly less time for the eight-dot group (1090 s) vs the conventional group (1313 s), p &amp;lt;0.001. Moreover, insertion of implant rods was subjectively easier with no need for aggressive bending owing to the extended corporotomy length. Similarly, corporotomy closure using the 8-dot technique was 10.13 minutes swifter than the conventional group (220 s vs. 828 s, respectively, p &amp;lt; 0.001). The total procedure length was over 8 minutes shorter for the eight-dot group as opposed to the conventional group (2527 vs 3027 s, respectively, p &amp;lt; 0.001). In terms of postoperative complications in the form of pain, swelling, hematoma, and infection, there were no significant differences between both groups. Conclusions The eight-dot extended corporotomy technique is a safe and time-saving approach compared to the conventional limited corporotomy technique, making the MPPI procedure more efficient. A swifter procedure decreases both patient exposure to anesthesia and device exposure to air which in turn lowers the risk for potential postoperative complications. Disclosure No.