Total Duration Research Articles

(044) Does Time of Intraoperative Exposure to the Aerobiome Increase Microbial Growth on Inflatable Penile Prostheses?

Abstract Introduction The use of inflatable penile prostheses (IPP) is a fundamental approach in managing erectile dysfunction that does not respond to medical management. Approximately 28,000 IPPs are implanted annually in the United States. Device infection, with an incidence up to 3%, is a particularly concerning complication as management generally necessitates device removal. This can result in significant cost burden, requiring inpatient admission, return to operative room and extensive postoperative care. One important risk factor for IPP infection is operative time, with the suggestion that increased operative time facilitates a colonization of microbes from the skin flora and ambient air within the operating room (referred to as the aerobiome). Objective To evaluate whether increased exposure to the operating room (OR) aerobiome results in increased microbial colonization of IPPs. Methods We performed an ex vivo study focusing on the reservoir and tips of Coloplast Titan IPP. Conditions of an IPP surgery were attempted to be closely replicated. Setup included a dedicated table within the same institutional OR where IPPs are routinely performed, facilitating sample collection, and with standard intra-operative conditions-pressure 0.024”WC, temperature 66.80F, and humidity 49.2% RH-to emulate surgical conditions. Stringent surgical hygiene was observed to obtain samples in a sterile manner; this including surgical scrub, sterile field, and double-glove technique. A sterile swab was collected at 30-minute intervals over a total duration of 3 hours, from each individual component of the IPP, resulting in a total of 6 samples per component. To prevent any potential interference from previous samples, care was taken to collect each swab from distinct areas. The obtained swabs were subjected to quantitative polymerase chain reaction (qPCR) and next generation sequencing (NGS) analyses of the V12 16S rRNA conservative region using the MiSeq platform (Illumina, San Diego, CA) with 2x250 paired read chemistry. Subsequent bioinformatic processing was carried out utilizing a clustering-based method with operational taxonomic units set at a 97% similarity threshold, and taxonomic assignment was accomplished using an internally maintained taxonomic classifier. Results The results of the study, obtained through both standard culture and next-generation sequencing (NGS) analyses, demonstrated consistent and significant findings. Through rigorous examination, it was determined that no microbial growth was detected on any component of the inflatable penile prostheses (IPPs) throughout the entire duration of the experiment, which lasted up to 3 hours. This dual approach of standard culture and NGS provided comprehensive and robust evidence of the absence of microbial colonization on the IPP devices. Conclusions These findings suggest that the duration of exposure to the OR aerobiome alone does not appear to increase the risk of microbial colonization on IPP devices. Further ex vivo studies are needed to support these findings and evaluate whether factors such as time of skin-to-IPP contact or changes in OR conditions contribute to risk of IPP microbial colonization. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Coloplast, Boston Scientific.

Therapeutic effects of rehabilitation technologies in patients with functional asthenia

Relevance: determining the therapeutic effects of a complex of pathogenetically determined rehabilitation technologies in patients with functional asthenia is an urgent scientific and practical task. The aim of the study was to determine the therapeutic effects of combinations of rehabilitation technologies in patients with functional asthenia. Methods: 24 patients aged 29.3 (21.5–35.0) years with functional asthenia (ICD-10 code: R53) were studied. The patients were prescribed a set of physical exercises, a course of audiovisual polysensory relaxation, carbon dioxide baths, climatotherapy, clinical nutrition, and psychotherapy. The total duration of the course was 30 days. Clinical, instrumental, psychophysical, and integral methods of assessing the condition of patients were used. Results: an improvement in clinical status indicators and a decrease in signs of asthenia with an improvement in mood, well-being, cheerfulness, and self-confidence were noted. The rehabilitation course caused a pronounced oxygen capacity of tissues, an increase in adaptation reserves, an improvement in vegetative regulation and the level of somatic health, and a significant increase in physical performance in patients with functional asthenia. Conclusion: а complex of physical exercises, audiovisual polysensory relaxation, carbon dioxide baths, climatotherapy, clinical nutrition, and psychotherapy forms pronounced actoprotective and psychocorrective therapeutic effects in patients with functional asthenia.

Embolization of the middle meningeal artery for the prevention of chronic subdural hematoma recurrence in high-risk patients: a randomized controlled trial—the EMPROTECT study protocol

BackgroundMiddle meningeal artery (MMA) embolization has been proposed as a treatment of chronic subdural hematoma (CSDH). The benefit of the procedure has yet to be demonstrated in a randomized controlled...

Real-world evidence of heparin and citrate use in extracorporeal photopheresis: A hypothesis-generating data review of device settings and performance.

Extracorporeal photopheresis (ECP) is widely used for the treatment of cutaneous T-cell lymphoma, graft-vs-host disease, and other immune-related conditions. To avoid clotting during treatment, the ECP system used must be effectively primed with an anticoagulant. Heparin is the recommended anticoagulant for the THERAKOS CELLEX System, but acid citrate dextrose-A (ACDA) is often used. We compared system performance between these two anticoagulants for this ECP system. Deidentified data for ECP device performance were obtained at each treatment session, from automatically logged Smart Cards or labels completed by device operators. We compared the effects of ACDA or heparin on overall treatment duration, buffy coat (leukocyte) collection time, photoactivation time and the number of alarms and warnings. The variability in these parameters was also assessed. Data from 23 334 treat sessions were analyzed; ACDA was used in 34.4% and heparin in 65.6%. Overall, the ECP procedure duration, buffy coat collection time and photoactivation time were numerically similar regardless of whether ACDA or heparin was used, and regardless of needle mode. Photoactivation time variability was lower with ACDA compared with heparin in all needle modes. Among treatments that were completed automatically without any operator intervention, total treatment duration and photoactivation time were significantly reduced with ACDA use in both the double- and single-needle modes. The data presented indicate that, in both double- and single-needle modes, the THERAKOS® CELLEX® integrated ECP system performed similarly with ACDA compared to heparin, although ACDA demonstrated potential benefits in reducing variability in photoactivation time.

Shorter total sleep duration and lower sleep efficiency are associated with higher beta amyloid deposition in precuneus and cortical regions in cognitively normal older adults

Shorter total sleep duration and lower sleep efficiency are associated with higher beta amyloid deposition in precuneus and cortical regions in cognitively normal older adults

Sprint resisted swimming training effect on the swimmer’s hand orientation angles

The current study aimed to determine the effect of an 11-week sprint resisted swimming training programme on the swimming performance and the orientation angles of the hand. Fourteen young female swimmers were divided into two equivalent groups and were trained with specific sprint training sets. The experimental group performed these sets using a swimming parachute. For the evaluation of the intervention, before and at the end of the 11 weeks period both groups performed 50 m front crawl with maximal intensity and their underwater motion was recorded using four cameras. Their underwater movements were manually digitised using the Ariel Performance Analysis System and the statistical treatment of the data revealed a significant increase of the mean swimming velocity (3.76 ± 0.04 %) and stroke rate (3.09 ± 0.08 %) only in the experimental group. Moreover, a significant reduction of the total stroke duration (−4.26 ± 0.09 %) and the relative duration of the non-propulsive phases (−12.70 ± 0.23 %) was also observed only in the experimental group. The resultant velocity of the hand, and the pitch and sweepback angles of the hand remained unaffected in both groups during the pull and push phases. However, a significant decrease of the pitch angle (−47.44 ± 3.37 %) during the entry & catch phase was observed only in the experimental group. The increased performance and the higher mean swimming velocity after the current sprint resisted training programme was mainly due to the temporal modifications of the stroke, along with the pitch angle reduction during the entry & catch phase.

Cardiorespiratory patterns of male South American sea lions (Otaria flavescens) resting on land.

The goal of this study was to characterize the cardiorespiratory patterns of male South American sea lions (SASLs, Otaria flavescens) resting on land. We recorded respiratory and heart rate (n = 360 individuals studied) by observing the nostrils, chest movements and the impact of the heart on the thoracic wall. The sea lions breathe apneustically with a pause on inspiration, representing 74% of the respiratory cycle. The mean breathing frequency was 3.2 ± 1.0breathsmin-1, with a breathing cycle presenting periods of bradypneas, tachypneas, and long-term post-inspiratory pauses. The normal heart rate (nHR) was 73.4 ± 14.5beats min-1 and no significant differences were observed between age classes. All animals showed variability in HR in relation to respiratory phases (Inspiration: 101.2 ± 18.4beatsmin-1; post-inspiratory pause: 73.4 ± 14.5beatsmin-1; expiration: 64.6 ± 17.7beatsmin-1), consistent with respiratory sinus arrhythmia (RSA). The mean HR (measured during all respiratory phases) was 79.9 ± 22.7beatsmin-1, and was significantly different between age classes. The total duration of respiratory cycle, and duration of both inspiration and expiration, decreased with an increment in ambient temperature, with no variation in the pause duration. Heart rate during pause and expiration was significantly higher during high temperatures. Similar changes in cardiorespiratory patterns have been reported in other pinnipeds. Our results showed ontogenetic differences in development and typical variations with environmental and behavioral variables.

Eat-Radar: Continuous Fine-Grained Intake Gesture Detection Using FMCW Radar and 3D Temporal Convolutional Network With Attention.

Unhealthy dietary habits are considered as the primary cause of various chronic diseases, including obesity and diabetes. The automatic food intake monitoring system has the potential to improve the quality of life (QoL) of people with diet-related diseases through dietary assessment. In this work, we propose a novel contactless radar-based approach for food intake monitoring. Specifically, a Frequency Modulated Continuous Wave (FMCW) radar sensor is employed to recognize fine-grained eating and drinking gestures. The fine-grained eating/drinking gesture contains a series of movements from raising the hand to the mouth until putting away the hand from the mouth. A 3D temporal convolutional network with self-attention (3D-TCN-Att) is developed to detect and segment eating and drinking gestures in meal sessions by processing the Range-Doppler Cube (RD Cube). Unlike previous radar-based research, this work collects data in continuous meal sessions (more realistic scenarios). We create a public dataset comprising 70 meal sessions (4,132 eating gestures and 893 drinking gestures) from 70 participants with a total duration of 1,155 minutes. Four eating styles (fork & knife, chopsticks, spoon, hand) are included in this dataset. To validate the performance of the proposed approach, seven-fold cross-validation method is applied. The 3D-TCN-Att model achieves a segmental F1-score of 0.896 and 0.868 for eating and drinking gestures, respectively. The results of the proposed approach indicate the feasibility of using radar for fine-grained eating and drinking gesture detection and segmentation in meal sessions.

Delayed action leads to faster turning of fish by interaction with neighbor

Schooling fish exhibit captivating biological behaviors that have garnered interest from both biologists and engineers. While the undulatory motion of fish in schools has been extensively studied, rapid turning within these schools remains underexplored. This paper presents a three-dimensional computational fluid dynamics (CFD) model of a fast-start scenario involving two fish to investigate the influence of spatial and phase differences on swimming performance. Our findings indicate that, by leveraging the wake of the upstream fish, a downstream fish can enhance its travel distance by up to 34.4% and its rotational angle by up to 41.6%. The optimal travel distance is achieved when the starting jet of the front fish aligns with the center of mass (COM) of the downstream fish. Conversely, the largest rotational angle is observed when this jet precedes the center of mass. The research further identifies a vortex phase matching phenomenon in fish schools during rapid turns. The phase difference, or the downstream fish's delayed response, allows it to harness the wake for improved transitional and rotational movement. However, this approach might decrease the average angular velocity, which represents the rotational angle divided by the total duration of turning and waiting. Our study concludes that, with a specific phase difference, this delayed action facilitates faster fish turns by utilizing the wake created by the neighboring fish.

The MW5.5 earthquake on August 6, 2023, in Pingyuan, Shandong, China: A rupture on a buried fault

On August 6, 2023, a magnitude MW5.5 earthquake struck Pingyuan County, Dezhou City, Shandong Province, China. This event was significant as no large earthquakes had been recorded in the region for over a century, and no active fault had been previously identified. This study collects 1309 P-wave arrival times and 866 S-wave arrival times from 74 seismic stations less than 200 km to the epicenter to constrain the spatial distribution of the mainshock and its 125 early aftershocks by the double difference earthquake relocation method, and selects 864 P-waveforms from 288 stations located within 800 km of the epicenter to constrain the focal mechanism solution of the mainshock through centroid moment tensor inversion. The relocation and the inversion indicate, the Pingyuan MW5.5 earthquake was caused by a rupture on a buried fault, likely an extensive segment of the Gaotang fault. This buried fault exhibited a dip of approximately 75° to the northwest, with a strike of 222°, similar to the Gaotang fault. The rupture initiated at the depth of 18.6 km and propagated upward and northeastward. However, the ground surface was not broken. The total duration of the rupture was ∼6.0 s, releasing the scalar moment of 2.5895 × 1017 N·m, equivalent to MW5.54. The moment rate reached the maximum only 1.4 seconds after the rupture initiation, and the 90% scalar moment was released in the first 4.6 s. In the first 1.4 seconds of the rupture process, the rupture velocity was estimated to be 2.6 km/s, slower than the local S-wave velocity. As the rupture neared its end, the rupture velocity decreased significantly. This study provides valuable insights into the seismic characteristics of the Pingyuan MW5.5 earthquake, shedding light on the previously unidentified buried fault responsible for the seismic activity in the region. Understanding the behavior of such faults is crucial for assessing seismic hazards and enhancing earthquake preparedness in the future.

Caged Zn2+ Photolysis in Zebrafish Whole Brains Reveals Subsecond Modulation of Dopamine Uptake.

Free, ionic zinc (Zn2+) modulates neurotransmitter dynamics in the brain. However, the sub-s effects of transient concentration changes of Zn2+ on neurotransmitter release and uptake are not well understood. To address this lack of knowledge, we have combined the photolysis of the novel caged Zn2+ compound [Zn(DPAdeCageOMe)]+ with fast scan cyclic voltammetry (FSCV) at carbon fiber microelectrodes in live, whole brain preparations from zebrafish (Danio rerio). After treating the brain with [Zn(DPAdeCageOMe)]+, Zn2+ was released by application of light that was gated through a computer-controlled shutter synchronized with the FSCV measurements and delivered through a 1 mm fiber optic cable. We systematically optimized the photocage concentration and light application parameters, including the total duration and light-to-electrical stimulation delay time. While sub-s Zn2+ application with this method inhibited DA reuptake, assessed by the first-order rate constant (k) and half-life (t1/2), it had no effect on the electrically stimulated DA overflow ([DA]STIM). Increasing the photocage concentration and light duration progressively inhibited uptake, with maximal effects occurring at 100 μM and 800 ms, respectively. Furthermore, uptake was inhibited 200 ms after Zn2+ photorelease, but no measurable effect occurred after 800 ms. We expect that application of this method to the zebrafish whole brain and other preparations will help expand the current knowledge of how Zn2+ affects neurotransmitter release/uptake in select neurological disease states.

Impact of oral vancomycin treatment duration on rate of Clostridioides difficile recurrence in patients requiring concurrent systemic antibiotics.

There is a paucity of data guiding treatment duration of oral vancomycin for Clostridiodes difficile infection (CDI) in patients requiring concomitant systemic antibiotics. To evaluate prescribing practices of vancomycin for CDI in patients that required concurrent systemic antibiotics and to determine whether a prolonged duration of vancomycin (>14 days), compared to a standard duration (10-14 days), decreased CDI recurrence. In this retrospective cohort study, we evaluated adult hospitalized patients with an initial episode of CDI who were treated with vancomycin and who received overlapping systemic antibiotics for >72 hours. Outcomes of interest included CDI recurrence and isolation of vancomycin-resistant Enterococcus (VRE). Among the 218 patients included, 36% received a standard duration and 64% received a prolonged duration of treatment for a median of 13 days (11-14) and 20 days (16-26), respectively. Patients who received a prolonged duration had a longer median duration of systemic antibiotic overlap with vancomycin (11 vs 8 days; P < .001) and significantly more carbapenem use and infectious disease consultation. Recurrence at 8 weeks (12% standard duration vs 8% prolonged duration; P = .367), recurrence at 6 months (15% standard duration vs 10% prolonged duration; P = .240), and VRE isolation (3% standard duration vs 9% prolonged duration; P = .083) were not significantly different between groups. Discontinuation of vancomycin prior to completion of antibiotics was an independent predictor of 8-week recurrence on multivariable logistic regression (OR, 4.8; 95% CI, 1.3-18.1). Oral vancomycin prescribing relative to the systemic antibiotic end date may affect CDI recurrence to a greater extent than total vancomycin duration alone. Further studies are needed to confirm these findings.

Possible effects of cannabidiol (CBD) administration on the vocal activity of healthy domestic dogs upon their temporary separation from caregivers

Recent human clinical studies indicate that cannabidiol (CBD), the primary non-addictive component of cannabis, possesses considerable therapeutic potentials. The purpose of the present study was to explore the possibility of effects of CBD administration on behaviors of healthy domestic dogs. It is well-known that when temporarily separated from their caregivers, they may show an increase in vocalization. Here the effects of CBD administration upon such vocal activity were assessed. Ten 4- to 7-year-old healthy dogs experienced temporary separation from their caregivers twice, once following the administration of CBD at 2.0 mg/kg/day over a 2-week-period, and once following the administration of the same amount of olive oil as placebo over the same length of period. When the behavioral assessment was conducted by computing the total duration of any vocal activity exhibited by the dogs before the separation from their caregivers and after the separation, it was found that all of the 10 participant dogs vocalized more often when being left alone (after the separation) than when being with their caregivers (before the separation), whether they had received the administration of CBD or placebo. Following the CBD administration, however, the degree of such increase was significantly less robust than that following the placebo administration (p < 0.01). As one of the possible explanations for the results. the author hypothesizes anxiolytic effects of CBD in healthy domestic dogs, as has been reported in humans.

Physical Activity and Mental Health in Children and Adolescents With Neurodevelopmental Disorders

Children and adolescents with neurodevelopmental disorders experience mental health issues and are encouraged to be brought together in real-life treatment. However, physical activity, which is a promising method for boosting mental health, has only been examined in children and adolescents with certain types of neurodevelopmental disorders. To examine the association of physical activity interventions with mental health (ie, cognitive function, psychological well-being, internalizing, and externalizing problems) in children and adolescents with neurodevelopmental disorders and to identify possible moderators. Studies were searched from inception to May 2023 through Web of Science, PsycINFO, SPORTDiscus, MEDLINE, CINAHL, and ERIC. Randomized clinical trials or nonrandomized designs applying physical activity interventions and reporting at least 1 mental health outcome in children and adolescents aged 5 to 17 years with neurodevelopmental disorders were included. Two independent reviewers selected and assessed the studies. Random multilevel meta-analysis using Hedges g was performed. Data extraction and risk-of-bias assessment were conducted by multiple reviewers. Heterogeneity, publication bias, sensitivity analysis, and moderator analysis were examined to substantiate the results. The main outcomes were mental health related to cognitive function, psychological well-being, internalizing, or externalizing problems measured by neurocognitive tasks or subjective questionnaires. A total of 76 studies involving 3007 participants were included in systematic review, 59 of which were used for meta-analysis. The findings indicated that physical activity interventions were associated with significant benefits for overall mental health (g, 0.67; 95% CI, 0.50-0.85), cognitive function (g, 0.74; 95% CI, 0.53-0.95), psychological well-being (g, 0.56; 95% CI, 0.16-0.96), internalizing (g, 0.72; 95% CI, 0.34-1.10), and externalizing problems (g, 0.58; 95% CI, 0.28-0.89). Moderators were also identified: frequency, total sessions, and total duration for overall mental health; total sessions, and total duration for cognitive function; session duration and frequency for psychological well-being; physical activity type for internalizing problems; and session duration for externalizing problems. Moderator analyses showed that type of neurodevelopmental disorder did not modify the associations between physical activity and overall mental health or its subgroups. The findings in this study suggest that children and adolescents with different types of neurodevelopmental disorders may be grouped together when performing physical activity interventions, which were confirmed to be beneficial to overall mental health and its subgroups in this new diagnostic population, but that physical activity interventions should be tailored when targeting different mental health domains.

Normalized stability time analysis within the boundaries between adults with and without fear of falling

BackgroundThe unilateral stance test, measured by the center of pressure (COP), has been widely used to identify balance deficits. However, there is a critical gap in understanding the specific COP thresholds on postural stability in adults with a fear of falling (FOF).AimsTo investigate the normalized stability time, which was defined as the ratio of time spent within stability boundaries to the total test duration, under different visual conditions and specific thresholds between adults with and without FOF.MethodsTwenty-one older adults with FOF and 22 control subjects completed the unilateral limb standing test in eyes-open and eyes-closed conditions. Normalized stability times were computed based on five pre-determined COP sway range thresholds: 10 mm, 15 mm, 20 mm, 25 mm, and 30 mm.ResultsReceiver operating characteristic analysis determined the diagnostic accuracy of FOF. There were significant differences in the effects of both visual conditions (F = 46.88, p = 0.001) and threshold settings (F = 119.38, p = 0.001) on stability time between groups. The FOF group significantly reduced normalized stability time at the 10 mm COP threshold under eyes-closed conditions (t = – 1.95, p = 0.03).DiscussionThe findings highlight the heightened sensitivity of the 10 mm COP threshold in identifying group variances in postural stability when eyes are closed. Moreover, the FOF group displayed a marked reduction in stability duration based on visual scenarios and normalized thresholds.ConclusionThe study highlights the need to account for both COP boundaries and visual conditions in adults with FOF. When assessing postural control during unilateral stances, clinicians must also give attention to non-visual cues.

Low-dose sugammadex reverses moderate rocuronium-induced neuromuscular block in horses.

Neuromuscular block (NMB) during general anaesthesia has an implicit risk of inadvertent residual NMB during recovery. Reversal of NMB is commonly encouraged to decrease this risk, and has historically been performed with neostigmine/atropine, two agents with important cardiac and gastrointestinal side effects. Sugammadex is a new selective relaxant binding agent that can reverse rocuronium-induced NMB efficiently and without these complications. Recommended doses are possibly cost-prohibitive. To measure the recovery time from rocuronium-NMB after administration of low-dose sugammadex, compared with spontaneous recovery. Nonrandomised in vivo experiments. Fourteen adult horses undergoing different research procedures were anaesthetised with detomidine and isoflurane. All horses received NMB with rocuronium 0.3 mg/kg IV. Neuromuscular function was measured with acceleromyographic train-of-four (TOF) ratio. Recovery occurred spontaneously in five horses weighing (median [range]) 548 (413-594) kg and was enhanced with sugammadex 200 mg (total dose) in nine horses (433 [362-515]) kg. Recovery time from moderate NMB to a TOF ratio 1.0, and total duration of NMB were compared between groups. Cases of recurarisation (decrease in the TOF ratio <0.9 after recovery) were identified within 30 min after sugammadex. The dose of sugammadex was 0.46 (0.39-0.55) mg/kg. The recovery period lasted 21 (17-39) minutes for spontaneous and 4 (3-7) minutes for sugammadex. Total duration of NMB was 58 (41-70) minutes for spontaneous and 36 (21-43) for sugammadex (both p ≤ 0.003). There were no instances of recurarisation. Small sample size. A dose of sugammadex of approximately 0.5 mg/kg substantially shortened the recovery period from rocuronium-induced NMB from a median of 21 to 4 min, when given at a moderate depth of NMB. No recurarisation was observed within the next 30 min.

In vitro and in vivo antitrypanosomal activity of the fresh leaves of Ranunculus Multifidus Forsk and its major compound anemonin against Trypanosoma congolense field isolate

BackgroundAnimal trypanosomiasis is a major livestock problem due to its socioeconomic impacts in tropical countries. Currently used trypanocides are toxic, expensive, and the parasites have developed resistance to the existing drugs, which calls for an urgent need of new effective and safe chemotherapeutic agents from alternative sources such as medicinal plants. In Ethiopian traditional medicine fresh leaves of Ranunculus multifidus Forsk, are used for the treatment of animal trypanosomiasis. The present study aimed to evaluate the antitrypanosomal activity of the fresh leaves of R. multifidus and its major compound anemonin against Trypanosoma congolense field isolate.MethodsFresh leaves of R. multifidus were extracted by maceration with 80% methanol and hydro-distillation to obtain the corresponding extracts. Anemonin was isolated from the hydro-distilled extract by preparative TLC. For the in vitro assay, 0.1, 0.4, 2 and 4 mg/ml of the test substances were incubated with parasites and cessation or drop in motility of the parasites was monitored for a total duration of 1 h. In the in vivo assay, the test substances were administered intraperitoneally daily for 7 days to mice infected with Trypanosoma congolense. Diminazene aceturate and 1% dimethylsulfoxide (DMSO) were used as positive and negative controls, respectively.ResultsBoth extracts showed antitrypanosomal activity although the hydro-distilled extract demonstrated superior activity compared to the hydroalcoholic extract. At a concentration of 4 mg/ml, the hydro-distilled extract drastically reduced motility of trypanosomes within 20 min. Similarly, anemonin at the same concentration completely immobilized trypanosomes within 5 min of incubation, while diminazene aceturate (28.00 mg/kg/day) immobilized the parasites within 10 min. In the in vivo antitrypanosomal assay, anemonin eliminates parasites at all the tested doses (8.75, 17.00 and 35.00 mg/kg/day) and prevented relapse, while in diminazene aceturate-treated mice the parasites reappeared on days 12 to 14.ConclusionsThe current study demonstrated that the fresh leaves of R. multifidus possess genuine antitrypanosomal activity supporting the use of the plant for the treatment of animal trypanosomiasis in traditional medicine. Furthermore, anemonin appears to be responsible for the activity suggesting its potential as a scaffold for the development of safe and cost effective antitrypanosomal agent.

Effectiveness of low-intensity aerobic exercise with assisted bicycle exercises on quality of life and lung functions in du-chenne muscular dystrophy

Background: Duchenne muscular dystrophy (DMD) is an X-linked recessive disorder caused by abnormalities in the dystrophin gene that affects one in every 3,500 males. In India, approximately 0.8 million were involved. Management is usually multidirectional and more focused on improving the quality of life (QOL), not mortality. Physiotherapy and exercise are an integral part of the management of DMD. Since there were no recommended exercises for DMD, there is a need to create an exercise protocol that improves the QOL. Low-intensity aerobic exercises are highly recommended for older people and are found effective. Objective: The study aimed to identify the effectiveness of low-intensity aerobic exercise with assisted bicycle exercises on QOL and lung functions in DMD. Methods: A randomized controlled trial was conducted at the Institute of Muscular Dystrophy and Research Centre, Jeevan Foundation, Veeravanalur, Tirunelveli Dist. Tamil Nadu, India. The institute has around 200 children with DMD. This study selected 34 children based on the criteria. I, the children, were provided with low-intensity aerobic exercise for seventeen children. Group II provided the children with assisted bicycle exercises for seventeen children. Both groups received exercises for 60 minutes and deep diaphragmatic breathing for 10 minutes. All are given a home program to the children. The total study duration is ten weeks. Results: Data were analysed following the assessment of Quality of life using DMD QoL and the Lung function using a spirometer (FVC, FEV1, FEV1/VC). All the data were collected on day 1, every two months. Parametric tests were used to compare the outcome measures. The student t value for the DMD QOL is 9.66 with p &lt;0.001, the spirometry values of FEV1 are 7.67 with p&lt; 0.001, and FVC is 14.78 with p &lt; 0.001, respectively, and FEV1/VC is 10.81 with p &lt; 0.001. Conclusion: This study concluded that low-intensity aerobic exercises and assisted bicycle training improve the QOL and lung functions. On comparing the interventions, it was found that low-intensity aerobic exercises are better improved than the assisted bicycle group.

How explicit consumer credit information affects intent to purchase on credit: an experiment

PurposeConsumer culture is promoting immediate gratification, and the rise of digital financial services is increasing the risk of indebtedness while debt reduces well-being and affects mental health. The authors assess the effects of consumer information provision, debt literacy, chronic debt and attitudes toward debt on the intent to purchase on credit.Design/methodology/approachAn online survey including an experiment with a credit offer vignette was conducted in a representative sample of Estonia (n = 1204). Treatment conditions depicted either the total cost and duration of the credit agreement or the annual percentage rate.FindingsReceiving modified information resulted in a 26 to 30 percentage points decrease in propensity to purchase on credit. Purchasing on credit was associated with attitudes towards credit and chronic debt, but not with debt literacy.Research limitations/implicationsThe findings reveal large effects of information provision and highlight the limited effects of debt literacy on credit decisions. Limitations may emerge from differences in financial regulation across countries.Practical implicationsThe authors' results highlight the importance of applying behavioural insights in consumer credit information provision, both in the financial sector and policy. Testing the messages allows having evidence-based solutions that promote responsible purchasing on credit.Originality/valueThe findings call for changes in credit information provision requirements. Their effect is significantly larger compared to the literature, emphasizing the role of credit information provision in less regulated online markets.

Ketamine for Primary Analgosedation in Critically Ill Surgery and Trauma Patients Requiring Mechanical Ventilation.

Evaluate effectiveness and safety outcomes associated with the use of ketamine for primary analgosedation in the surgical/trauma ICU setting. Retrospective cohort study. Academic medical center in Minnesota. Patients admitted to the surgical ICU between 2015 and 2019 requiring mechanical ventilation and meeting one of three definitions for ketamine primary analgosedation were included: 1) no concomitant opioid infusion, 2) ketamine monotherapy for greater than or equal to 6 hours with subsequent opioid infusion, or 3) ketamine initiated concomitantly or within 4 hours of opioid and total opioid duration less than 4 hours. None. Use of ketamine, analgesics, and sedatives were evaluated. Pain, sedation, and delirium assessments immediately before and during ketamine infusion were collected and compared with reported goals. Concomitant analgesics, sedatives, and psychotropics were recorded. Reported failures due to ineffectiveness and toxicity were collected. Of 164 included patients, 88% never received a concomitant opioid infusion (primary analgosedation definition 1), 12% met alternative criteria for primary analgosedation (definitions 2 and 3). A majority, 68%, were surgical admissions and mean Acute Physiology and Chronic Health Evaluation III score was 90 (± 30). Median mechanical ventilation duration was 2.5 days (1.1-4.5) and ICU length of stay of 4.9 days (3-8). The median ketamine infusion dose and duration were 0.18 mg/kg/hr (0.1-0.3) and 30 hours (15.1-51.8). Concomitant infusions of propofol and dexmedetomidine were administered in 49% and 29% of patients, respectively. During ketamine infusion, the median percent of total pain scores at goal was 62% (33-96%), while 64% (37-91%) of Richmond Agitation Sedation Scale scores were at goal, and 47% of patients were Confusion Assessment Method-ICU positive during the ketamine infusion. Hallucinations were documented in 14% of patients and ketamine failure occurred in 11% of patients. Ketamine may be an effective primary analgosedation option in intubated surgical ICU patients, but prospective randomized studies are needed to evaluate this strategy.