Two-hour Period Research Articles

Value of focused lung ultrasound in diagnosing and monitoring pneumothorax after CT-guided lung biopsy.

Pneumothorax is a common complication after CT-guided transthoracic lung biopsy. Pneumothorax is most often diagnosed with a conventional chest X-ray after a two-hour observation period. Ultrasound has been shown to be superior to conventional X-rays in diagnosing pneumothorax in some settings and it can be repeated without radiation exposure. The aim of the study was firstly to explore the sensitivity and specificity of thoracic ultrasound compared to conventional chest x-ray following CT-guided transthoracic lung biopsy, and secondly to investigate the dynamic changes of pneumothorax size using ultrasound. This prospective study was conducted at Odense University Hospital in the Department of Radiology. Adult patients undergoing CT-guided lung biopsy were eligible for inclusion. A total of 26 patients were included in the study and were scanned five times in sitting upright and supine positions during the two-hour observation time using the FLUS Protocol. Pneumothorax was diagnosed via chest x-ray in 11 (42%) patients. With the patient in an upright position, the ultrasound had a sensitivity of 63.6% and a specificity of 93.3%. These numbers rose to 72.3% and 100% in the supine position. Monitoring the pneumothoraces showed a slight increase in size during the two hours. Ultrasound can be used to diagnose pneumothorax after CT-guided lung biopsy. All pneumothoraxes that were identified by ultrasound were detected within the first 30min. The dynamic changes of pneumothoraxes showed that the size of the pneumothorax did not increase to a level where the patient needed intervention or admittance.

Optimization of citrulline production from a Bacillus subtilis BH-01 isolated from raw buffalo milk

The main purpose of this study was to optimize the L-citrulline production process using Plackett-Burman and Box-Behnken designs. L-citrulline-producing bacterium BH-01 was isolated from raw buffalo milk. The isolate was tested for probiotic activities such as tolerance to simulated gastric and intestinal juices, antagonistic activity against six antibiotic-resistant bacteria, and temperature tolerance. L-citrulline production and arginine deiminase (ADI) activity were optimized using statistical designs. The bacterial isolate was molecularly identified as Bacillus subtilis strain AUMC B-498 (accession number PP574248.1). The strain exhibited resistance at pH 2.0 and bile salt 0.5% for a two-hour exposure period. It could inhibit the growth of Escherichia coli, Klebsiella pneumonia, Serratia sp., Staphylococcus aureus, methicillin-resistant Staphylococcus aureus (MRSA), and Streptococcus pneumoniae. From the results of statistical optimization, the Plackett-Burman design identified temperature, L-arginine, incubation period, and peptone as the most effective factors among the eight selected variables. Based on these, the Box-Behnken design was used to optimize the factors required to maximize citrulline production. The maximum L-citrulline was 632.5 µg/L, and ADI activity was 1.42 U/mL. Therefore, BH-01 isolated from Buffalo milk might be a promising candidate in food, biotechnological, and pharmaceutical applications due to its dual functionality for citrulline production and probiotic characteristics.

Experimental Study on Surfactant–Polymer Flooding After Viscosity Reduction for Heavy Oil in Matured Reservoir

An advanced enhanced oil recovery (EOR) method was investigated, employing a surfactant–polymer (SP) system in combination with a viscosity reducer for application in a heavy oil reservoir within the Haiwaihe Block, Liaohe Oilfield, in China. Significant advantages were observed through the combination of LPS-3 (an anionic surfactant) and OAB (a betaine surfactant) in reducing interfacial tension and enhancing emulsion stability, with the optimal results achieved at the ratio of 9:1. The BRH-325 polymer was found to exhibit superior viscosity enhancement, temperature resistance, and long-term stability. Graphene nanowedges were utilized as a viscosity reducer, leading to a viscosity reduction in heavy oil of 97.43%, while stability was maintained over a two-hour period. The efficacy of the combined system was validated through core flooding experiments, resulting in a recovery efficiency improvement of up to 32.7%. It is suggested that the integration of viscosity reduction and SP flooding could serve as a promising approach for improving recovery in mature heavy oil reservoirs, supporting a transition toward environmentally sustainable, non-thermal recovery methods.

Integrated Solution Combining Low-Frequency Forced Oscillation Technique and Continuous Equivital Sensor Monitoring for Assessment of Non-Invasive Ambulatory Respiratory Mechanics

Early assessment of respiratory mechanics is crucial for early-stage diagnosing and managing lung diseases, leading to greater patient outcomes. Traditional methods like spirometry are limited in continuous monitoring and patient compliance as they require forced maneuvers with significant patient cooperation, which may not be available in fragile individuals. The Forced Oscillation Technique (FOT) is a non-invasive measurement method, only based on the tidal breathing at rest from the patient for a limited time period. The proposed solution integrates low-frequency FOT with continuous monitoring using Equivital (EQV) sensors to enhance respiratory mechanics information with heart rate variability. Data were collected over a two-hour period from six healthy volunteers, measuring respiratory impedance every 7 min and continuously recording physiological parameters. The best-fitting fractional-order models for impedance data were identified using genetic algorithms. This study also explores the correlation between impedance model parameters and EQV data, discussing the potential of AI tools for forecasting respiratory properties. Our findings indicate that combined monitoring techniques and AI analysis provides additional complementary information, subsequently aiding the improved evaluation of respiratory function and tissue mechanics. The proposed protocol allows for ambulatory assessment and can be easily performed in normal breathing conditions.

Experimental investigation on slope runoff, sediment, and hydraulic parameters under different underlying surface

This study utilizes a rainfall simulator to conduct an experimental investigation of slope and rainfall on various underlying surfaces. This study aimed to determine the relationship between various hydraulic factors and sediment concentration by estimating runoff, sediment concentration generation, and hydraulic parameters on various underlying surfaces. The flow velocity, flow depth, shear stress, and unit stream power are the hydraulic parameters in this experiment. The soil sample will be set up appropriately in the rainfall simulator with a slope of 20º and subjected to a rainfall event for two hours on four trays with various underlying surface types. The rainfall intensity of 10 Lmin⁻¹ was designated for the rainfall simulator. Throughout a two-hour period, the runoff flow was collected at intervals of 30, 60, 90, and 120 minutes. The measured sediment concentration using Total Suspended Solid (TSS). Then measurements were conducted of the sediment concentration, runoff discharge, and hydraulic parameters. According to the results, the stream power of the four covers is higher for the dried leaves (0.004606 ms-3), grass cover (0.003274 ms-3), gravel (0.00232 ms-³), and bare soil cover (0.00081 ms-³). But bare soil produces the maximum concentration of sediment and surface runoff, which is then followed by grass, gravel, and leaves. In general, the generation of sediment began with the bare surface, gravel, dry leaves, and grass in descending sequence. Research has shown that rain-induced plant cover can be used as a low-cost strategy to reduce soil erosion on construction slope sites.

Detection of antimicrobial-induced survival/dead bacteria via mEos4b photoconversion: a preliminary study

The escalating prevalence of hospital-acquired infections poses a critical challenge for healthcare systems worldwide. Effective management requires rapid identification of pathogens and their antibiotic resistance profiles. In this study, we utilized the photoconvertible mEos4b protein, which transitions from green to red fluorescence upon blue light exposure, to distinguish live from dead bacteria. The mEos4b gene was cloned into a prokaryotic vector and expressed inEscherichia coliBL21. The Minimum Inhibitory Concentration (MIC) of the transgenic bacteria was determined for five antibiotics, followed by a post-antibiotic effect assessment over a two-hour exposure period. The optimal photoconversion time for mEos4b was established as 90 s, and confocal microscopy was used to visualize live (green) and dead (red) cells post-exposure. The mEos4b-TR system proved highly specific, accurately distinguishing live and dead bacteria without producing false positives, even in control groups, which is a common issue in commercial live-dead kits. By relying on cellular metabolic activity rather than dyes, this system minimizes nonspecific interactions and contamination, making it more reliable than traditional methods prone to false readings. These results highlight the potential of the mEos4b-TR system as a superior alternative for rapid, precise bacterial viability assessments, particularly in determining antibiotic susceptibility. This preliminary study demonstrates the system's differentiation of viable and non-viable cells, suggesting its potential application in future studies involving novel antibacterial agents to refine antibiotic sensitivity testing.

Acclimation Strategies for the Black Sea Diatom Algae Ditylum brightwellii to High Intensity of Light

In cells of a culture of the large diatom Ditylum brightwellii (T. West) Grunow acclimated to weak light (17 μmol photons/(m2 × s)), numerous chloroplasts were evenly distributed throughout the cell cytoplasm. After 10 min of exposure of algae to extremely high illumination (1100 μmol photons/(m2 × s)), their aggregates gradually formed in the center of the cell, which continued until the end of the two-hour exposure period. At light intensities of 510–935 µmol/(photons/(m2 × s) during short-term photoacclimation, chloroplast aggregation was noted for 20–60 min, after which their reverse movement and uniform distribution in the cytoplasm were revealed by the end of the second hour. Under conditions of a longer culture stay at a light intensity of 1100 μmol photons/(m2 × s), the algae retained their viability for only six hours. Long-term photoacclimation of this species, which ended by the end of the second day, was detected when the light weakened by about 2 times. It was expressed as an increase in cell volume and C/Chl a ratio, increased aggregation of chloroplasts in the center of the cell, and a decrease in a number of fluorescent parameters reflecting the efficiency of photosystem II and culture viability.

High extinction ratio multi-polarization states preparation based on SOI integrated chips

High extinction ratio multi-polarization states preparation based on SOI integrated chips

Adult Sports Participation and Physical Activity: How About Curling?

Despite its well-documented physical and psychosocial benefits, sport remains the least engaged form of physical activity (PA) among adults. Many adults may lack the skills needed to play or continue to play sports and aging adults are more likely to avoid participation for fear of poor performance or injury. A sport that shows great promise for adults seeking new sports participation outlets is curling. Curling is a team sport comprised of four interchangeable positions working collectively to deliver granite stones across a sheet of ice in an effort to outscore the opponent team. While it seems reasonable that walking on ice, “throwing” a 44 lb granite stone across a sheet of ice, and periodically sweeping while walking on ice over a two-hour period would generate at least a moderate amount of physical activity, research to date is quite limited. Therefore, the purpose of this study was to objectively measure the amount and intensity of PA achieved by average recreational curling participants during a typical curling match. Methods Members of a curling club in NC were asked to wear Actigraph Accelerometers (model GT3X) while they participated in their regularly scheduled curling match. All participants had at least one year of curling experience. Curling matches lasted between 90 and 120 minutes. Participants were asked to indicate their age, gender, and curling position during the match (lead, second, vice, skip) which were matched with accelerometer data. Results Overall, 110 participants (37 female, 73 male, avg. age 50 yrs) spent most of their curling time in light or moderate-intensity activity (18.1% Sedentary; 49.5% light; 32.4% moderate; .03% vigorous). In terms of minutes, the average participant spent 35.9 minutes engaged in Moderate-to-Vigorous PA (MVPA) per curling experience. This represents 23.9% of the weekly 150min of MVPA suggested by the CDC. The second position had the highest percentage of moderate activity level and a small percentage of vigorous activity. No other position reached a vigorous level. The skip position had the highest amount of sedentary activity as well as light activity. Females had a higher level of moderate activity in comparison to males. However, males reached a small amount of vigorous activity. The age group of 18 - 36 had the highest amount of moderate activity and the lowest amount of sedentary activity. This age group reached an average of 41.0 minutes of MVPA per curling experience. The age group of > 58 had the highest amount of sedentary activity and the lowest amount of moderate activity. Conclusions Curling may be a good sports participation option for adults looking for alternatives to meet recommended weekly amounts of MVPA. Participants should consider playing in one of the first three positions to maximize the amount and intensity of PA achieved while playing. Furthermore, since curling also requires balance, coordination, muscular strength, multitasking, strategic reasoning, and can cater to most physical challenges without compromising the integrity of the game, it may be an ideal sport to promote for adults of all ages and sport abilities. Implications for Practice and Policy Findings should be used to inform strategies for promoting curling as an opportunity for team sport involvement that has the added value of contributing to daily physical activity. However, , access and opportunities to play, especially for underserved populations, are limited. Given that most curling clubs in America are private and require a membership to play. Partnership arrangements between existing clubs and public parks and recreation departments could increase both access and opportunities to play.

Influence of Nanofluid Types on the Enhancements of Solar Collector Performance

Nowadays, solar energy is attracting a great deal of research interest. Optimizing solar collectors by incorporating nanoparticles into the base fluid is one area of current research focus. This study investigates how the types of nanoparticles affect the performance of solar collector. We investigated the effects of various nanoparticles types on performance of solar collector. Nanofluid 1 (alumina nanoparticles; Al2O3) and nanofluid 2 (silicon dioxide nanoparticles; SiO2) were combined with water. Nanofluids are made with a constant nanoparticle concentration of 0.5 vol. %. Data collection was conducted under Iraqi environments during the three-month study period (January, February, and March) from 9 a.m. to 3 p.m. In particular, the data for every two-hour period is displayed. The results demonstrated the collector’s efficiency significantly influenced by nanoparticles’ type. At 1 p.m. in February, nanofluid 1 was 4.8% in front of nanofluid 2. The significance of nanoparticle materials in enhancing solar collector efficiency is highlighted by this outcome. When water-based fluid in the solar collector was compared to nanofluids 2 and 1, the latter demonstrated a typically better efficiency. Nanoparticle owns higher thermal conductivity which is one of the reasons behind the increments of the nanofluid's overall conductivity.

Is a two-hour monitoring period sufficient and safe for patients undergoing ultrasound-guided percutaneous liver mass biopsy?: A prospective and multicenter experience.

To investigate whether patients undergoing percutaneous liver mass biopsy (PLMB) can be safely discharged following a two-hour monitoring period. A multi-center prospective analysis was conducted for 375 patients (196 males and 179 females), mean age 63 ± 12.45 years (range 37-89) who underwent PLMB between August 2023 and March 2024. Patients were monitored for 24 h, and complications were classified as minor or major. The timing of complications was categorized into three groups: within the first two hours, between the 2nd and 24th hours, and within 1 week after 24 hours. Minor complications occurred in 18.93% (71/375) and major complications in 2.13% (8/375). Most minor complications (80.2%, 57/71) appeared within the first two hours, 12.7% (9/71) between 2 and 24 h, and 7.1% (5/71) after 24 h. All major complications (62.5%, 5/8) except late-onset cases, occurred within the first two hours. No major complications occurred between 2 and 24 h. Late-onset major complications occurred in 37.5% (3/8) after 24 h. The two-hour monitoring period did not adversely impact patient management regarding minor complications and is safe for identifying all major complications except for late-onset ones. Extending the post-biopsy recovery period does not significantly improve patient care.

An engineered lactate oxidase based electrochemical sensor for continuous detection of biomarker lactic acid in human sweat and serum

An engineered lactate oxidase based electrochemical sensor for continuous detection of biomarker lactic acid in human sweat and serum

239-OR: CGM Has a Specific Effect on the Reduction of Nocturnal Hypoglycemia in People with Type 1 Diabetes on an MDI Treatment Regimen

MDI users with type 1 diabetes may be less able to respond to circadian changes in insulin demand than CSII or AID users, which may increase the risk of nocturnal hypoglycemia. Therefore, we re-analyzed data from the HYPO.DE RCT to evaluate the effect of CGM on the percentage of low glucose levels < 70 mg/dl (% < 70 mg/dl) and < 54 mg/dl (% < 54 mg/dl) during 12 two-hour periods throughout the day. We compared 4-week baseline data from 141 participants using spot glucose monitoring (SMBG) with 4-week outcome data after a 6-month follow-up period in which the control group (n=66) remained on SMBG and the intervention group (n=75) used CGM (Dexcom G5). At baseline without CGM, there were significantly higher proportions of %<70 mg/dl or %54 mg/dl during the night (00:00 am - 06:00 am) than during the day (8.5 ±1.0% vs. 6.5 ±0.6%, p<0.001 respectively 4.0 ±0.6% vs. 2.4 ±0.3%, p<0.001). CGM had a greater effect on nocturnal hypoglycemia than on daytime hypoglycemia (see Figure 1). The greatest reduction in favor of the CGM users was between 04:00 a.m. and 06:00 a.m., with a between-group difference of -8.5% (95% CI -10.4% to -6.7%, p<.001) for %<70 mg/dl and -5.5% (95% CI 4.4 - 6.6%, p<.001) for %<54 mg/dl. The data suggest that CGM provides benefits to MDI users with type 1 diabetes in preventing nocturnal hypoglycemia, potentially compensating for lack of responsiveness to a circadian changing insulin demand. Disclosure N. Hermanns: Speaker's Bureau; Berlin-Chemie AG, Sanofi-Aventis Deutschland GmbH. Research Support; Sanofi-Aventis Deutschland GmbH. Speaker's Bureau; Roche Diabetes Care. Research Support; Roche Diabetes Care. Speaker's Bureau; Dexcom, Inc. Advisory Panel; Abbott Diagnostics, Ypsomed AG. D. Ehrmann: Advisory Panel; Dexcom, Inc. Speaker's Bureau; Dexcom, Inc., Sanofi-Aventis Deutschland GmbH. Advisory Panel; Roche Diabetes Care. Speaker's Bureau; Roche Diabetes Care, Berlin-Chemie AG. B. Kulzer: Advisory Panel; Abbott Diagnostics, Berlin-Chemie AG, Dexcom, Inc., Sanofi, embecta, Novo Nordisk, Roche Diabetes Care. Speaker's Bureau; Bayer Inc., Insulet Corporation, Lilly Diabetes. G. Freckmann: Advisory Panel; Abbott. Research Support; Ascensia Diabetes Care. Advisory Panel; Boydsense, Dexcom, Inc., Lilly Diabetes. Speaker's Bureau; Novo Nordisk. Advisory Panel; Perfood, PharmaSens. Consultant; Roche Diabetes Care. Research Support; Roche Diabetes Care. Consultant; Sinocare. Speaker's Bureau; Terumo Corporation. Consultant; Ypsomed AG. L. Heinemann: Stock/Shareholder; Science Consulting in Diabetes GmbH, Profil Institut für Stoffwechselforschung GmbH. Advisory Panel; embecta. Board Member; Lifecare A/S. Stock/Shareholder; diateam GmbH. Funding The HYPO.DE study was funded by Dexcom, San Diego

Study on blood pressure rhythm in hypertensive patients withdeficiency syndrome and a random forest model for predicting hypertension withdeficiency syndrome.

Study on blood pressure rhythm in hypertensive patients withdeficiency syndrome and a random forest model for predicting hypertension withdeficiency syndrome.

Hey Google, Let’s Write

Writing involves more than attention to form (e.g., orthography, grammar), since it requires attention to text type, content, and genre. However, most students of English as a second language (L2) tend to prioritize linguistic accuracy in their writing, to the detriment of the content of their texts. Automatic speech recognition (ASR) has the potential to mitigate this, as it reduces the cognitive burden of writing by facilitating the text input process (using a skill most humans possess—speaking), offering assistance in spelling, and allowing a focus on other aspects of the task (e.g., cohesion, content). Automatic speech recognition is not only accessible and free, but it also fulfills Chapelle’s (2001) criteria of an effective computer-assisted language learning tool (e.g., authenticity, learner fit). Despite these affordances, there is a dearth of studies examining the possible affordances of ASR for writing. This mixed methods, one-shot study examines L2 writers’ perceptions of using ASR to write using the technology acceptance model (TAM). Seventeen (N = 17) undergraduate students at a Canadian university were provided with training on Google Voice Typing (Google Docs) and carried out a series of ASR-based writing tasks over a two-hour period. In order to measure their perceptions of the target criteria, participants filled in a TAM-informed survey consisting of statements about their experience with ASR scored on a 7-point Likert scale. To further explore the participants’ perceptions, semi-structured interviews followed. Findings indicate positive perceptions of ASR’s usefulness in terms of language learning and its ease of use due to the user-friendly voice commands. This suggests that ASR has pedagogical potential, thus requiring further examination to determine its optimal use for L2 writing.

A novel approach to heavy metal immobilization in municipal solid waste incineration fly ash: Investigating the use of chicken eggshell waste and CaO addition

A novel approach to heavy metal immobilization in municipal solid waste incineration fly ash: Investigating the use of chicken eggshell waste and CaO addition

Comparing the Contributions of Cutaneous and Respiratory Evaporative Water Loss to Cooling in Anna’s Hummingbirds (Calypte anna) Under Fasted and Fed Conditions

During high-temperature periods, endothermic animals evaporate water from the body surface to cool down. The two primary routes of evaporative water loss are: (1) evaporating water from the skin; and (2) evaporation from the respiratory surfaces during breathing and panting. In smaller avian species like Anna's hummingbirds ( Calypte anna), the higher cutaneous surface area to volume ratio presents an opportunity for the skin to become an important avenue for evaporative cooling, possibly becoming a major site. Additionally, hummingbirds feed on water-rich nectar. As a result, they eliminate surplus water through urination, but significant evaporation can also occur through their skin and respiratory system. Thus, total evaporative water loss could rise significantly for these animals when in a hydrated state. Here, this study investigates the relative importance of the two evaporative water loss routes (cutaneous and respiratory) of Anna's hummingbirds in fed and fasted states. We hypothesize that cutaneous evaporation has a high contribution to total evaporation. Moreover, we predict that evaporative water loss rates are higher under the fed (hydrated) condition relative to fasted states. Metabolic and evaporation rates from the head and the body were measured separately in a partitioned chamber at 30°C. Birds were fed immediately prior to entry into respirometry, and the transition from fed to fasted states was recorded over a two-hour period. Total evaporative water loss nearly doubled in the fed versus fasted condition (1.75 ± 0.85 mg H2O/min and 0.97 ± 0.28 mg H2O/min, respectively), with respiratory water loss being significantly higher in the fed compared to the fasted condition (0.87 ± 0.38 mg H2O/min versus 0.42 ± 0.12 mg H2O/min, respectively). On the other hand, the body had a large, but non-significant, difference in evaporative water loss rates between the fed and fasted conditions (0.88 ± 0.55 mg H2O/min and 0.57 ± 0.17 mg H2O/min, respectively). Importantly, cutaneous evaporative water loss made up half of the total evaporation in both the fed and fasted conditions. These results demonstrate that evaporative water loss is modulated by hydration status at both the respiratory and cutaneous surfaces. Furthermore, cutaneous evaporation makes up approximately the same proportion of total evaporation to other birds at thermoneutral temperatures. Future work manipulating ambient temperature in conjunction with hydration status will further our understanding of the relative importance of cutaneous evaporation for these small-bodied birds. Funded by the Genentech Foundations Scholarship, CSUPERB New Investigator Grant, and San Francisco State University. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Opioid-free anesthesia using a combination of ketamine and dexmedetomidine in patients undergoing laparoscopic cholecystectomy: a randomized controlled trial.

Opioids administered as bolus doses or continuous infusions are widely used for major and daycare surgeries. Opioid-free anesthesia is multimodal anesthesia and analgesia that does not use opioids, benefiting patients from opioid-related adverse effects. We compared the postoperative analgesic requirements of patients scheduled for elective laparoscopic cholecystectomy under opioid-free and opioid-based anesthesia. Study included 88 patients aged 18-60 years with American Society of Anesthesiologists physical status 1 and 2 who underwent elective laparoscopic cholecystectomy. Participants were randomly divided into two groups with 44 in each. The opioid-free group was administered an intravenous bolus of ketamine and dexmedetomidine, whereas fentanyl was used in opioid group. Primary outcome was to compare the total amount of fentanyl consumed by both groups during 6 h postoperative period. Episodes of postoperative nausea and vomiting (PONV) and vital signs were noted throughout the postoperative period to analyze the secondary outcomes. Both groups had similar demographic characteristics. The opioid-free group required lesser analgesia within the first 2 h (61.4 ± 17.4 vs. 79.0 ± 19.4 of fentanyl, P < 0.001), which was statistically significant. However, fentanyl consumption was comparable between the groups at 6 h (152 ± 28.2 vs. 164 ± 33.4, P = 0.061). Compared with 4.5% of the participants in the opioid-free group, 34% of those in the opioid-based group developed moderate PONV. Opioid-free anesthesia in patients undergoing laparoscopic cholecystectomy reduced the requirement of analgesia in first two-hour postoperative period and was associated with decreased PONV.

P144 Extended examination of post-challenge rewarming in patients with systemic sclerosis, as assessed by thermography

Abstract Background/Aims Clinical trials of systemic sclerosis (SSc)-related Raynaud’s phenomenon require better objective outcome measures. Thermography-monitored cold-challenge is a validated imaging technique. Cold-challenge is monitored for 15-minutes during rewarming, however, patients often do not fully rewarm. Knowing rewarming time enables better planning of daily trial protocols (e.g. challenges before and after treatment). The aim of this study was to test the hypotheses that 15-minute rewarming measurements are predictive of two-hour rewarming and that patients rewarm within a two-hour period. Methods Baseline thermography of the hands and cold-challenge was performed (1 minute, 15oC water, gloved hands submerged). Post-cold challenge, images were taken every 15s (to 15 minutes), every 5 minutes (to 30 minutes), every 10 minutes (to 60 minutes) and every 15 minutes (to 120 minutes). Baseline finger temperature (average, eight fingers, Tbase) and distal dorsal difference (DDD, temperature difference between dorsum ofthe hand and distal finger) were calculated from baseline images. Mean finger temperature difference (post-cold challenge-baseline, Tdiff), time to 25% (t25%), 50% (t50%), 100% (t100%) rewarming, maximum temperature achieved (Tmax), time to Tmax (tmax), area under the rewarming curve (AUC), and final temperature (Tf) were calculated. Cox regression assessed associations between Tbase, Tmax, Tf, DDD and AUC. Results Twenty patients with SSc were recruited; median (interquartile range) age 62 (53-69), duration of RP 16 (7-26) years. Fourteen patients (70%) rewarmed within two hours. Data, Table 1. Cox regression showed positive relationship between AUC and t25%, t50% and t100% and a negative relationship between Tbase, t50% and t100%. In the non-rewarming subset, 3/6 and 1/6 achieved t25%, t50% in 15 minutes. 13/14 patients that rewarmed achieved t25% and 11/14 achieved t50% within 15 minutes. Results suggest that the likelihood of longer-term rewarming is predicted the initial 15-minute rewarming. Conclusion Tbase was reached by the majority of patients with SSc in a two-hour window, therefore, a second or third cold challenge could be incorporated into early Phase II study protocols within a study day. Patients reaching t50% within 15 minutes were highly likely to rewarm fully over two hours; thus 15-minute rewarming may aid screening to identify patients who will fully rewarm. Disclosure A. Ndosi: None. G. Dinsdale: None. J. Manning: None. M. Mandzuk: None. S. Wilkinson: None. A. Herrick: None. A. Murray: None.

An Effective Methodology for Scoring to Assist Emergency Physicians in Identifying Overcrowding in an Academic Emergency Department in Thailand

BackgroundEmergency Department (ED) overcrowding is a global concern, with tools like NEDOCS, READI, and Work Score used as predictors. These tools aid healthcare professionals in identifying overcrowding and preventing negative patient outcomes. However, there’s no agreed-upon method to define ED overcrowding. Most studies on this topic are U.S.-based, limiting their applicability in EDs without waiting rooms or ambulance diversion roles. Additionally, the intricate calculations required for these scores, with multiple variables, make them impractical for use in developing nations.ObjectiveThis study sought to examine the relationship between prevalent ED overcrowding scores such as EDWIN, occupancy rate, and Work Score, and a modified version of EDWIN newly introduced by the authors, in comparison to the real-time perspectives of emergency physicians. Additionally, the study explored the links between these overcrowding scores and adverse events related to ED code activations as secondary outcomes.MethodThe method described in the provided text is a correlational study. The study aims to examine the relationship between various Emergency Department (ED) overcrowding scores and the real-time perceptions of emergency physicians in every two-hour period. Additionally, it seeks to explore the associations between these scores and adverse events related to ED code activations.ResultsThe study analyzed 459 periods, with 5.2% having Likert scores of 5–6. EDOR had the highest correlation coefficient (0.69, p < 0.001) and an AUC of 0.864. Only EDOR significantly correlated with adverse events (p = 0.033).ConclusionEDOR shows the most robust link with ‘emergency physicians’ views on overcrowding. Additionally, elevated EDOR scores correlate with a rise in adverse events. Emergency physicians’ perceptionof overcrowding could hint at possible adverse events. Notably, all overcrowding scores have high negative predictive values, efficiently negating the likelihood of adverse incidents.