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Context: By delivering the drug to the intended cell location, the use of nanomaterials in the drug delivery system may influence how the patient receives the medication and may assist in mitigating severe side effects. Density functional theory was used to assess the use of boron carbon nitride nanocages (BNCNCs), boron nitride (BNNSs), and boron carbon nitride nanosheets (BNCNSs) as melphalan (Mln) drug carriers in both the gaseous and fluid phases. We systematically examined the dipole moment, density of states, frontier molecular orbital, and optimal adsorption energy to understand the targeted drug delivery potential of these nanostructures. Adsorption energy analysis revealed that in both gas and water media, Mln drug adsorption takes place spontaneously on all the conjugated structures. The occurrence of adsorption energy as physisorbed energy suggests that the process is reversible, and desorption can take place with a much lower energy input. This physical contact is appropriate for the unquestionable unloading of Mln medications to the intended location. The reactivity is higher in BNNSs and BNCNSs, while the stability is higher in BNCNCs. The recovery time shows a shorter time for BNNSs and BNCNSs, while BNCNC shows a potential desorption time in higher temperature. These conclusions are corroborated by the results of the quantum theory of atoms in molecules (QTAIM). After the interaction analysis, it was observed that the BNCNCs can act as potential carriers for the melphalan. From dipole moment analysis, all three nanostructures show a high hydrophilic nature but quite higher in BNCNCs after doping in both media. Overall, all the structures show the potential carrier for melphalan drug., Methods: The quantum mechanical approach, or DFT, has been used to study the fundamental structural, electrical, thermodynamic, and other aspects of proposed structures to develop an acceptable Mln drug detector. The adsorbate and all adsorbents were optimized via the hybrid B3LYP functional and the 6-311G +  + (2d, p) basis set approach prior to the adsorption process. The Gaussian 09 package was used at 298 K as the constant temperature and 1 atm as the constant pressure. The structures are examined using the same functional models for solvation analysis-6-311 G +  + (2d, p) and B3LYP-as well as the polarized continuum model (PCM) model as the foundation set. Density of states was studied using GaussSum 3.0 software. The interaction studies QTAIM and RDG were studied using VMD and Multiwfn software., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Graphene has great potential to be used for humidity sensing due to its ultrahigh surface area and conductivity. However, the impact of different atomic layers of graphene on the SiO 2 /Si substrate on humidity sensing has not been studied yet. In this paper, we fabricated three types of humidity sensors on the SiO 2 /Si substrate based on one to three atomic layers of graphene, in which the sensing areas of graphene are 75 μm × 72 μm and 45 μm × 72 μm, respectively. We studied the impact of both the number of atomic layers of graphene and the sensing areas of graphene on the responsivity and response/recovery time of the prepared graphene-based humidity sensors. We found that the relative resistance change of the prepared devices decreased with the increase of number of atomic layers of graphene under the same change of relative humidity. Further, devices based on tri-layer graphene showed the fastest response/recovery time, while devices based on double-layer graphene showed the slowest response/recovery time. Finally, we chose devices based on double-layer graphene that have relatively good responsivity and stability for application in respiration monitoring and contact-free finger monitoring.

Paroxysmal atrial fibrillation is a common arrhythmia, and its development process and prediction of the degree of atrial fibrosis are of great significance for treatment and management. Optical imaging technology provides a new means for non-invasive observation of atrial electrical activity. The aim of this study is to investigate the predictive effect of sinus node recovery time on the degree of atrial fibrosis in patients with paroxysmal atrial fibrillation, and to provide a basis for the application of optical imaging technology in the study of atrial fibrosis. The study collected clinical and optical imaging data from a group of patients with paroxysmal atrial fibrillation, and used statistical analysis methods to investigate the relationship between sinus node recovery time and the degree of atrial fibrosis. The research results indicate that there is a significant correlation between the recovery time of the sinus node and the degree of atrial fibrosis, that is, there is a positive correlation between the prolonged recovery time of the sinus node and the aggravation of atrial fibrosis. SNRT can serve as an effective indicator for evaluating atrial matrix and can be applied to predict recurrence after catheter ablation of paroxysmal atrial fibrillation. Shortening SNRT through catheter ablation can become an important predictor of effective catheter ablation., Competing Interests: Declaration of competing interest The authors declare no competing interests., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Introduction: The type of admission to the Intensive Care Unit (ICU) influences the prognosis of patients with severe pneumonia and, in the case of patients with COVID-19 pneumonia, this is still unexplored. The objective of this study was to determine the differences between early and late ICU admission., Methodology: A retrospective cohort study of patients with COVID-19 pneumonia at two high-complexity hospitals in Colombia. Early ICU admission (EICUA) was defined as direct admission from the emergency department or within the first 24 hours of admission. Late ICU admission (LICUA) was defined as admission from the hospitalization service after 24 hours of arrival. A robust Cox regression was performed for the variable recovery time, to determine the impact of the ICU admission type in the hazard rate., Results: 68.2% were EICUA patients and 31.8% were LICUA patients. Recovery and duration of hospital stay were significantly lower in EICUA than in LICUA (9 vs 15 days, p = 0.0001, and 10 vs 15.5 days, p < 0.0001, respectively). However, the duration of ICU stay (7 vs 9 days, p = 0.131) and the invasive mechanical ventilation requirement (48.9% vs 54.9%, p = 0.374) were not statistically significant. The 30-day follow-up showed no difference between the EICUA and LICUA (alive 97% vs 94.6%, p = 0.705)., Conclusions: Mortality between EICUA and LICUA patients with COVID-19 pneumonia showed no statistically significant differences. However, the recovery time, the probability intensity of instant recovery, and the duration of hospital stay were better in EICUA than in LICUA. Neither EICUA nor LICUA affects the final status (death) of patients., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2024 Miguel Alejandro Pinzón, Santiago Ortiz, Henry Laniado, Nelson Fonseca, Juan Felipe Betancur, Héctor Holguín, Pablo Montoya, Bernardo Javier Muñoz, Beatriz Ramírez, Carolina Arias Arias, Isabel Potes, Luz Maribel Toro, Julian Quiceno.)

Introduction: Cataracts have been considered as one of the major causes for reducing the vision-related quality of life and increasing the risk of comorbidities and mortality among the general population., Aim: This study aimed to assess the importance of grading cataracts in predicting recovery time and final visual outcomes after cataract surgery., Method: A retrospective consecutive case review of elective cataract surgeries performed in a tertiary care hospital during a three-year period from 2019 to 2021 was studied. The postoperative visual status was correlated with grading., Results: The reports of this study implicate the fact that 16.4% of the patients had grade 1 anterior segment cataracts. Visual acuity of perfect vision (6/6P) was obtained in 24% of patients, and 41.2% of patients had grade 1 anterior segment cataract surgery on day 1 (p<0.005) . Perfect vision at 6/6 visual acuity was obtained in 24% of patients, and 27.5% of patients had grade 2 anterior segment cataract surgery in week 1 (p<0.05) ., Conclusion: The study shows that patients with grade 1 anterior segment cataract surgery had a better visual recovery time and visual outcome. The grading system of cataracts has further shown improvement in the vision care of the patients, along with showing reliability and monitoring of cataract formation., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Institutional Review Board, Saveetha Medical College & Hospital, Chennai, India issued approval (SMC/IEC/2021/06/146). Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, A et al.)

Background: Malnutrition is a public health problem that affects physical and psychosocial well-being. It manifests as a rapid deterioration in nutritional status and bilateral edema due to inadequate food intake or illness., Methods: This study is a retrospective cohort of 1208 children with severe acute malnutrition (SAM) in Sofala Province from 2018 to 2022. It includes hospitalized children aged 6-59 months with SAM and related complications. The dependent variable is recovery, and the independent variables include age, sex of the child, vomiting, dehydration, hypoglycemia, nutritional edema and anthropometry. Survival curves were plotted using the Kaplan-Meier method, and bivariable and multivariable Cox regression analyses were performed., Results: The crude analysis revealed significant factors for nutritional recovery in children with SAM, including age, weight, height, malaria, diarrhea and dehydration. Children under 24 months had a 28% lower likelihood of recovery. Weight below 6.16 kg decreased the likelihood by 2%, and height above 71.1 cm decreased it by 20%. Conversely, malaria, diarrhea and dehydration increased the likelihood of recovery. However, after adjustment, only diarrhea remained a significant predictor of nutritional recovery., Conclusion: This study found that diarrhea is a predictor of nutritional recovery in children with SAM., (© The Author(s) 2024. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

This study aimed to determine COVID-19 recovery time and identify predictors among hospitalized patients in the Dhanusha District of Madhesh Province, Nepal. This hospital-based longitudinal study involved 507 COVID-19 patients admitted to three distinct medical facilities for therapeutic intervention between April and October 2021. Data were collected for patient demography, symptoms, vital signs, oxygen saturation levels, temperatures, heart rates, respiratory rates, blood pressure measurements, and other health-related conditions. Kaplan-Meier survival curves estimated the recovery time, and a Cox proportional hazard model was used to identify the predictors of recovery time. For the total participants, mean age was 51.1 (SD = 14.9) years, 68.0% were males. Of the total patients, 49.5% recovered, and 16.8% died. The median for patient recovery was 26 days (95% CI: 25.1-26.7). Patients with severe or critical conditions were less likely to recover compared to those with milder conditions (hazard ratio (HR) = 0.34, 95% CI: 0.15-0.79; p = 0.012). In addition, an increase in oxygen saturation was associated with an elevated likelihood of recovery (HR = 1.09, 95% CI = 1.01-1.17, p = 0.018). This study underscores the need for early admission to hospital and emphasizes the targeted interventions in severe cases. Additionally, the results highlight the importance of optimizing oxygen levels in COVID-19 patient care.

The increasing use of the zebrafish ( Danio rerio ) in scientific experiments has made it necessary to implement anesthesia protocols guaranteeing minimum pain and suffering for these animals and ensuring the reliability of the results obtained from their research. Therefore, we aimed to compare the effectiveness of two anesthetics, eugenol and MS-222, in consecutive administrations and evaluate the zebrafish behaviour after repeated anesthesia. Thus, several zebrafish were anaesthetized with eugenol, MS-222, and buffered MS-222 three times repeatedly with a 24-h interval between each exposure. The induction and recovery periods were also timed. Their swimming frequency was determined after each exposure to assess their behaviour after the anesthesia. Anesthesia induction was quicker with eugenol compared to MS-222. However, eugenol presented longer recovery times, which were prolonged after each exposure. Also, the swimming frequency was reduced after each anesthesia with eugenol. The buffered version of MS-222 was more efficacious than the non-buffered one. Both versions of MS-222 did not affect the swimming frequency. Based on these findings, we recommend the utilization of MS-222 buffered rather than eugenol when repeated, brief-duration anesthesia is necessitated for a study.

Compound hot-dry events cause more severe impacts on terrestrial ecosystems than dry events, while the differences in recovery time (ΔRT) between hot-dry and dry events and their contributing factors remain unclear. Both remote sensing observations and eddy covariance measurements reveal that hot-dry events prolong the recovery time compared with dry events, with greater prolongation of recovery time in drylands than in humid regions. Random forest regression modeling demonstrates that the difference in vapor pressure deficit between hot-dry and dry events, with an importance score of 35%, is the major factor contributing to ΔRT. The severity of stomatal restriction exceeds that of non-stomatal limitation, which restricts the vegetation productivity that is necessary for the recovery process. These results emphasize the negative effect of vapor pressure deficit on vegetation recovery during hot-dry events and project an extension of drought recovery time considering elevated vapor pressure deficit in a warming world., (© The Author(s) 2024. Published by Oxford University Press on behalf of China Science Publishing & Media Ltd.)

Background: Neonatal asphyxia is a leading cause of early neonatal mortality, accounting for approximately 900,000 deaths each year. Assessing survival rates, recovery time and predictors of mortality among asphyxiated neonates can help policymakers design, implement, and evaluate programs to achieve the sustainable development goal of reducing neonatal mortality to 12/1,000 live births by 2030. The current study sought to ascertain the survival status, recovery time, and predictors of neonatal asphyxia., Methods: A retrospective follow-up study conducted in Debre Berhan Comprehensive Specialized Hospital, which carried out from May 20th to June 20th, 2023 using records of asphyxiated babies in NICUs from January 1st, 2020 to December 31st, 2022, involving a sample size of 330. Pre-structured questionnaires created in Google Form were used to collect data, and STATA Version 14.0 was utilized for data entry and analysis, respectively. The Kaplan-Meier survival curve, log rank test, and median time were calculated. A multivariable Cox proportional hazards regression model was fitted in order to determine the predictors of time to recovery. Variables were statistically significant if their p-value was less than 0.05., Results: Three hundred thirty admitted asphyxiated neonates were followed a total of 2706 neonate -days with a minimum of 1 day to 18 days. The overall incidence density rate of survival was 9.9 per 100 neonates' days of observation (95% CI: 8.85-11.24) with a median recovery time of 9 days (95% CI: 0.82-0.93). Prolonged labor (Adjusted hazard ratio (AHR: 0.42,95%CI:0.21-0.81), normal birth weight (AHR:2.21,95% CI: 1.30-3.70),non-altered consciousness (AHR:2.52,CI:1.50-4.24),non-depressed moro reflex of the newborn (AHR:2.40,95%CI: 1.03-5.61), stage I HIE (AHR: 5.11,95% CI: 1.98-13.19),and direct oxygen administration via the nose (AHR: 4.18,95% CI: 2.21-7.89) were found to be independent predictors of time to recovery of asphyxiated neonates.., Conclusion: In the current findings, the recovery time was prolonged compared to other findings. This implies early diagnosis, strict monitoring and provision of appropriate measures timely is necessary before the babies complicated into the highest stage of hypoxic -ischemic encephalopathy(HIE) and managing complications are the recommended to hasten recovery time and increase the survival of neonates., (© 2024. The Author(s).)

Context: Carbon monoxide, also known as the "silent killer," is a colorless, odorless, tasteless, and non-irritable gas that, when inhaled, enters the bloodstream and lungs, binds with the hemoglobin, and blocks oxygen from reaching tissues and cells. In this work, the monolayer MoSe 2 -based CO gas sensors were designed using density functional theory calculation with several dopants including Al, Au, Pd, Ni, Cu, and P. Here, Cu and P were found to be the best dopants, with adsorption energies of -0.67 eV (Cu) and -0.54 eV (P) and recovery times of 1.66 s and 13.8 ms respectively. Cu conductivity for CO adsorption was found to be 2.74 times that of CO 2 adsorption in the 1.0-2.26 eV range. P displayed the highest selectivity, followed by Pd and Ni. The dopants, Pd and Ni, were found suitable for building CO gas scavengers due to their high recovery times of 9.76 × 10 20 s and 2.47 × 10 11 s. Similarly, the adsorption of CO 2 on doped monolayer MoSe 2 was also investigated. In this study, it is found that monolayer MoSe 2 could be employed to create high-performance CO sensors in a CO 2 -rich environment., Method: The electrical characteristics of all doped MoSe 2 monolayers are obtained using a DFT calculation with the PBE-GGA method from the Quantum ESPRESSO package. The self-consistent field (SCF) computations were performed using a 7 × 7 × 1 k-point grid and a norm-conserving pseudo potential (NCPP) file. To determine electrical conductivity, the semi-classical version of Boltzmann transport theory, implemented in the Boltz Trap code, was used., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Unidirectional displacement flow (UDF) ventilation systems in operating rooms are characterized by a uniformity of velocity ≥80% and protect patients and operating room personnel against exposure to hazardous substances. However, the air below the surgical lights and in the surrounding zone is turbulent, which impairs the ventilation system's effect., Aim: We first used the recovery time (RT) as specified in International Organization for Standardization 14644 to determine the particle reduction capacity in the turbulent spaces of an operating room with a UDF system., Methods: The uniformity of velocity was analyzed by comfort-level probe grid measurements in the protected area below a hemispherical closed-shaped and a semi-open column-shaped surgical light (tilt angles: 0°/15°/30°) and in the surrounding zone of a research operating room. Thereafter, RTs were calculated., Results: At a supply air volume of 10,500 m 3 /h, the velocity, reported as average uniformity ± standard deviation, was uniform in the protected area without lights (95.8% ± 1.7%), but locally turbulent below the hemispherical closed-shaped (69.3% ± 14.6%), the semi-open column-shaped light (66.9% ± 10.9%), and in the surrounding zone (51.5% ± 17.6%). The RTs ranged between 1.1 and 1.7 min below the lights and 3.5 ± 0.28 min in the surrounding zone and depended exponentially on the volume flow rate., Conclusions: Compared to an RT of ≤20 min as required for operating rooms with mixed dilution flow, particles here were eliminated 12-18 times more quickly from below the surgical lights and 5.7 times from the surrounding zone. Thus, the effect of the lights was negligible and the UDF's retained its strong protective effect., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Aim: Difficulty understanding speech following concussion is likely caused by auditory processing impairments. We hypothesized that concussion disrupts pitch and phonetic processing of a sound, cues in understanding a talker., Patients & Methods/results: We obtained frequency following responses to a syllable from 120 concussed and 120 control. Encoding of the fundamental frequency (F0), a pitch cue and the first formant (F1), a phonetic cue, was poorer in concussed children. The F0 reduction was greater in the children assessed within 2 weeks of their injuries., Conclusion: Concussions affect auditory processing. Results strengthen evidence of reduced F0 encoding in children with concussion and call for longitudinal study aimed at monitoring the recovery course with respect to the auditory system., Competing Interests: The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.Competing interests disclosure The authors have no competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties., (© 2024 Future Medicine Ltd.)

It has been demonstrated that isoflurane-induced anesthesia can increase the blood glucose level, leading to hyperglycemia and several adverse effects. The administration of a mix of ketone diester (KE) and medium-chain triglyceride (MCT) oil, named KEMCT, abolished the isoflurane-anesthesia-induced increase in blood glucose level and prolonged the recovery time from isoflurane anesthesia in a male preclinical rodent model, Wistar Albino Glaxo/Rijswijk (WAG/Rij) rats. While most preclinical studies use exclusively male animals, our previous study on blood glucose changes in response to KEMCT administration showed that the results can be sex-dependent. Thus, in this study, we investigated female WAG/Rij rats, whether KEMCT gavage (3 g/kg/day for 7 days) can change the isoflurane (3%)-anesthesia-induced increase in blood glucose level and the recovery time from isoflurane-evoked anesthesia using the righting reflex. Moreover, KEMCT-induced ketosis may enhance both the extracellular level of adenosine and the activity of adenosine A1 receptors (A1Rs). To obtain information on the putative A1R mechanism of action, the effects of an A1R antagonist, DPCPX (1,3-dipropyl-8-cyclopentylxanthine; intraperitoneal/i.p. 0.2 mg/kg), on KEMCT-generated influences were also investigated. Our results show that KEMCT supplementation abolished the isoflurane-anesthesia-induced increase in blood glucose level, and this was abrogated by the co-administration of DPCPX. Nevertheless, KEMCT gavage did not change the recovery time from isoflurane-induced anesthesia. We can conclude that intragastric gavage of exogenous ketone supplements (EKSs), such as KEMCT, can abolish the isoflurane-anesthesia-induced increase in blood glucose level in both sexes likely through A1Rs in WAG/Rij rats, while recovery time was not affected in females, unlike in males. These results suggest that the administration of EKSs as an adjuvant therapy may be effective in mitigating metabolic side effects of isoflurane, such as hyperglycemia, in both sexes.

Background: Recovery time is a crucial factor in ensuring the safety and effectiveness of both patients and endoscopy centers. Propofol is often preferred due to its fast onset and minimal side effects. Remimazolam is a new intravenous sedative agent, characterized by its rapid onset of action, quick recovery and organ-independent metabolism. Importantly, its effect can be specifically antagonized by flumazenil. The primary goal of this study is to compare the recovery time of remimazolam besylate and propofol anesthesia during endoscopic procedures in elderly patients. Methods: 60 patients aged 65-95 years who underwent gastrointestinal endoscopy were randomly and equally assigned to two groups: the remimazolam group (Group R) and the propofol group (Group P). The primary measure was the recovery time, defined as the time from discontinuing remimazolam or propofol until reaching an Observer's Assessment of Alertness and Sedation scale (OAA/S) score of 5 (responds readily to name spoken in normal tone). The time required to achieve an OAA/S score of 3 (responds after name spoken loudly or repeatedly along with glazed marked ptosis) was also recorded and compared. Results: The recovery time for Group R (2.6 ± 1.6 min) was significantly shorter than that for Group P (10.8 ± 3.0 min), with a 95% confidence interval (CI): 6.949-9.431 min, p <0.001. Similarly, the time to attain an OAA/S score of 3 was significantly less in Group R (1.6 ± 0.9 min) compared to Group P (9.6 ± 2.6 min), with a 95% CI: 6.930-8.957 min, p <0.001. Conclusion: Our study demonstrated that remimazolam anesthesia combined with flumazenil antagonism causes a shorter recovery time for elderly patients undergoing gastrointestinal endoscopy compared to propofol. Remimazolam followed by flumazenil antagonism provides a promising alternative to propofol for geriatric patients, particularly during gastrointestinal endoscopy., Competing Interests: Competing Interests: The authors have declared that no competing interest exists., (© The author(s).)

Spatial aspects of visual performance are usually evaluated through visual acuity charts and contrast sensitivity (CS) tests. CS tests are generated by vanishing the contrast level of the visual charts. However, the quality of retinal images can be affected by both ocular aberrations and scattering effects and none of those factors are incorporated as parameters in visual tests in clinical practice. We propose a new computational methodology to generate visual acuity charts affected by ocular scattering effects. The generation of glare effects on the visual tests is reached by combining an ocular straylight meter methodology with the Commission Internationale de l'Eclairage's (CIE) general disability glare formula. A new function for retinal contrast assessment is proposed, the subjective straylight function (SSF), which provides the maximum tolerance to the perception of straylight in an observed visual acuity test. Once the SSF is obtained, the subjective straylight index (SSI) is defined as the area under the SSF curve. Results report the normal values of the SSI in a population of 30 young healthy subjects (19 ± 1 years old), a peak centered at SSI = 0.46 of a normal distribution was found. SSI was also evaluated as a function of both spatial and temporal aspects of vision. Ocular wavefront measures revealed a statistical correlation of the SSI with defocus and trefoil terms. In addition, the time recovery (TR) after induced total disability glare and the SSI were related; in particular, the higher the RT, the greater the SSI value for high- and mid-contrast levels of the visual test. No relationships were found for low contrast visual targets. To conclude, a new computational method for retinal contrast assessment as a function of ocular straylight was proposed as a complementary subjective test for visual function performance.

Background: Individuals receiving hemodialysis often experience concurrent symptoms during treatment and frequently report feeling unwell after dialysis. The degree to which intradialytic symptoms are related, and which specific symptoms may impair health-related quality of life (HRQoL) is uncertain., Objectives: To explore intradialytic symptoms clusters, and the relationship between intradialytic symptom clusters with dialysis treatment recovery time and HRQoL., Design/setting: We conducted a post hoc analysis of a prospective cohort study of 118 prevalent patients receiving hemodialysis in two centers in Calgary, Alberta and Hamilton, Ontario, Canada., Participants: Adults receiving hemodialysis treatment for at least 3 months, not scheduled for a modality change within 6 weeks of study commencement, who could provide informed consent and were able to complete English questionnaires independently or with assistance., Methods: Participants self-reported the presence (1 = none to 5 = very much ) of 10 symptoms during each dialysis treatment, the time it took to recover from each treatment, and weekly Kidney Disease Quality of Life 36-Item-Short Form (KDQoL-36) assessments. Principal component analysis identified clusters of intradialytic symptoms. Mixed-effects, ordinal and linear regression examined the association between symptom clusters and recovery time (categorized as 0, >0 to 2, >2 to 6, or >6 hours), and the physical component and mental component scores (PCS and MCS) of the KDQoL-36., Results: One hundred sixteen participants completed 901 intradialytic symptom questionnaires. The most common symptom was lack of energy (56% of treatments). Two intradialytic symptom clusters explained 39% of the total variance of available symptom data. The first cluster included bone or joint pain, muscle cramps, muscle soreness, feeling nervous, and lack of energy. The second cluster included nausea/vomiting, diarrhea and chest pain, and headache. The first cluster (median score: -0.56, 25th to 75th percentile: -1.18 to 0.55) was independently associated with longer recovery time (odds ratio [OR] 1.62 per unit difference in score, 95% confidence interval [CI]: 1.23-2.12) and decreased PCS (-0.72 per unit difference in score, 95% CI: -1.29 to -0.15) and MCS scores (-0.82 per unit difference in score, 95% CI: -1.48 to -0.16), whereas the second cluster was not (OR 1.24, 95% CI: 0.97-1.58; PCS 0.19, 95% CI -0.46 to 0.83; MCS -0.72, 95% CI: -1.50 to 0.06)., Limitations: This was an exploratory analysis of a small data set from 2 centers. Further work is needed to externally validate these findings to confirm intradialytic symptom clusters and the generalizability of our findings., Conclusions: Intradialytic symptoms are correlated. The presence of select intradialytic symptoms may prolong the time it takes for a patient to recover from a dialysis treatment and impair HRQoL., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Overfishing, capture mortality, and consequences following the release of surviving animals represent severe threats to chondrichthyans. Although holocephalans are common bycaught and discarded species, other than postrelease mortality, little is known of fishing capture stress impacts. The stress response elicited after capture, essential to increase survival chances, is energetically demanding and affects the amount of energy available for other biological activities, with potential long-term impairments. We measured the effect of 30-min simulated gillnet capture on oxygen uptake rate (ṀO 2 ), a proxy for metabolic rate and energy use, on recovery pattern, and on swimming activity of elephant fish (Callorhinchus milii). Immediately after simulated capture, Active and Inactive ṀO 2 , measured during swimming and resting periods, respectively, were 27.5% and 43.1% lower than precapture values. This metabolic decline is likely an adaptation for reducing the energy allocated to non-essential activities, thus preserving it to sustain the stress response and processes essential for immediate survival. Supporting this, after gillnet capture, animals decreased their swimming time by 26.6%, probably due to a reduction in the energy allocated to movement. After 7 days, swimming activity and both Inactive ṀO 2 and Active ṀO 2 returned to precapture values. Although metabolic decline may enhance survival chances, the associated decreased swimming activity might increase predation risk and slow the physiological recovery after a fishing event. Moreover, some of the activities involved in Inactive ṀO 2 are fundamental for life maintenance and therefore its depression after a capture event might have long-term repercussions for life sustenance and health., (© 2023 The Authors. Journal of Experimental Zoology Part A: Ecological and Integrative Physiology published by Wiley Periodicals LLC.)

Background: Granulomatous lobular mastitis (GLM) is a chronic inflammatory breast condition characterized by an unclear etiology and an undefined therapeutic approach. Surgical intervention is considered an alternative modality for managing GLM. Staged operation is the predominant and characteristic surgical approach in the treatment of GLM in our center; therefore, we evaluated the efficacy of staged operative techniques in this cohort study., Methods: We retrospectively reviewed 212 patients with GLM who underwent staged operation between August 2020 and July 2022 in the inpatient department of our institute. Their clinical history information, clinic complaints, treatment details, surgical outcomes, follow-up results, and scores on the satisfaction questionnaire were analyzed. The patients were called for follow-up and consultation with a deadline of August 2023., Results: The median follow-up time was 27 months (range, 14-37 months). In total, 212 patients were treated with three different staged procedures according to the individual assessment and patient willingness, including 168 patients who underwent one-stage debridement operation and two-stage suture operation (DO + SO), 25 patients who underwent one-stage debridement operation without suture (DO), and 19 patients who underwent one-stage debridement and simultaneous suture operation (DSO). The median recovery time was 29 days (range, 14-60 days). A minority of patients developed postoperative complications, including effusion (1.89%), flap ischemia (0.94%), areola-nipple ischemia (0.94%) and sinus tract formation (2.36%). The scores of the satisfaction questionnaire were 43.10±3.09, and 186 patients (87.74%) gave high scores for postoperative breast appearance. Only 5 of 212 patients (2.36%) developed recurrence., Conclusions: Staged operation performed in our institute is an effective and safe surgical therapy in patients with GLM, yielding a short recovery time, low recurrence and good cosmetic results., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://gs.amegroups.com/article/view/10.21037/gs-23-386/coif). The authors have no conflicts of interest to declare., (2024 Gland Surgery. All rights reserved.)

Objective: Facial nerve paralysis is the most problematic complication of surgery for parotid tumors. This study aimed to examine the progress of recovery from postoperative transient facial nerve paralysis (POFNP)., Methods: Participants were 203 patients who developed POFNP after benign parotid surgery. A Kaplan-Meier showed the progress of recovery from paralysis. Factors involved in recovery were examined. For factors for which a significant difference was found, recovery from paralysis was examined over time., Results: Rates of recovery from paralysis were as follows: 28.6% of patients at 1 month, 58.3% at 3 months, 85.9% at 6 months, and 95.1% at 12 months after surgery. Deep lobe tumors were shown to be significantly associated with delayed recovery from paralysis. The relationship between tumor location and the time of recovery from was that deep lobe tumors had a significantly worse recovery from paralysis at 4 and 5 months after surgery., Conclusion: Patients who develop POFNP must be informed about the progress of recovery and factors involved in recovery from paralysis. We believe that the results of the present study are a useful reference to that end., Competing Interests: Declaration of Competing Interest The authors declare no conflicts of interest., (Copyright © 2023. Published by Elsevier B.V.)

Purpose: The new ultra-short-acting benzodiazepine, remimazolam, offers a pharmacokinetic and pharmacodynamic advantage over commonly used procedural sedation medication. This retrospective study explored the real-world utilization of remimazolam during procedural sedation to support the development of a nurse sedation protocol. The primary outcome was to identify associations between recovery time, adverse reactions, and dose-response in expanded patient populations., Methods: This study reviewed charts of 292 adult patients from 3 hospitals within one institution who received remimazolam during procedural sedation between June 1, 2021 and December 31, 2021. Data were analyzed using logistic and linear regression., Findings: The median time to alert in patients receiving remimazolam alone was 12 minutes (interquartile range 10, 17) and increased when additional sedation medications were utilized. Receiving additional sedative medication significantly increased the odds of hypoxia (OR 2.77, 95% CI 1.30-5.91, P = 0.008) after adjusting for body mass index (BMI), American Society of Anesthesiologists physical status (ASA-PS), and total remimazolam dose. There was a 25% increase in odds of experiencing hypoxia for every 5 kg/m2 increase in BMI (95% CI 1.01-1.54, P = 0.037)., Implications: Remimazolam presents as a promising option for nurse procedural sedation, offering minimal impact on hemodynamics and respirations, quick recovery, and no residual sedative effects., Competing Interests: Declaration of Competing Interest This work was supported through funding by the Mayo Clinic Department of Pharmacy for the statistical analysis and interpretation of data., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Background: Sedation with continuous dexmedetomidine and bolus midazolam administration provides a lower incidence of unacceptable patient movement during procedures but requires a longer recovery time. The authors aimed to compare recovery time and unacceptable patient movement during sedation with initial loading of dexmedetomidine followed by continuous propofol infusion with those during sedation with continuous dexmedetomidine and bolus midazolam administration., Methods: In this prospective randomized controlled trial, 54 patients undergoing dental surgery and requiring intravenous sedation were assigned to either the dexmedetomidine and propofol group (n = 27, dexmedetomidine administered at 6 μg/kg/h for 5 minutes, followed by continuous propofol infusion using a target-controlled infusion) or the dexmedetomidine and midazolam group (n = 27, dexmedetomidine administered at 0.2-0.7 μg/kg/h continuously after the same initial loading dose with bolus midazolam). A bispectral index of 70 through 80 was maintained during the procedure. Patient movement that interfered with the procedure and time from the end of sedation to achieving a negative Romberg sign were assessed., Results: Times from the end of sedation to achieving a negative Romberg sign in the dexmedetomidine and propofol group (median, 14 minutes [interquartile range, 12-15 minutes]) were significantly shorter (P < .001) than in the dexmedetomidine and midazolam group (median, 22 minutes [interquartile range, 17.5-30.5 minutes]). The incidence of unacceptable patient movement was comparable between groups (n = 3 in the dexmedetomidine and propofol group, n = 4 in the dexmedetomidine and midazolam group; P = .999)., Conclusions: Sedation with a single loading dose of dexmedetomidine followed by continuous propofol infusion can prevent delayed recovery without increasing unacceptable patient movement., Practical Implications: The combination of dexmedetomidine and propofol may provide high-quality sedation for ambulatory dental practice. This clinical trial was registered in the University Hospital Medical Information Network Clinical Trials Registry. The registration number is UMIN000039668., (Copyright © 2023 American Dental Association. Published by Elsevier Inc. All rights reserved.)

Clinical trials demonstrated the role of vaccines and antiviral treatments against SARS-CoV-2 in reducing the likelihood of disease progression and death. However, there are limited data available regarding the time to negativity of people who received these treatments. Further, several comorbidities and risk factors might affect the impact of vaccines and antiviral treatments. To this end, we aimed to evaluate and disentangle the impact of anti-SARS-CoV-2 treatments and that of underlying clinical factors associated with a shortened length of SARS-CoV-2 infection. Hence, we recorded the timeframe of positive nasopharyngeal swab in people infected while being hospitalized for reasons other than SARS-CoV-2 infection. All patients who died or were discharged with a positive swab were excluded from the study. A total of 175 patients were included in this study. Clinical conditions encompass malignancies, immunological disorders, cardiovascular, metabolic, neurodegenerative, and chronic kidney disease. Most of the participants (91.4%) were vaccinated before admission to the hospital, and 65.1% received antiviral treatment within three days after the symptom's onset. Unvaccinated patients had a longer median time to negativity than people who received at least two doses of vaccine (18 vs. 10 days). Concerning the clinical conditions of all patients, multivariate analysis highlighted a lower probability of 14-day conversion of antigenic test positivity in patients with hematological malignancy, including those vaccinated and those exposed to antiviral therapies. In conclusion, our data showed that prompt administration of antiviral treatments accelerates the clearance of SARS-CoV-2. Further, in the elderly patients under study, previous vaccination and antiviral treatment synergize to reduce time to negativity. This translates into a shorter hospitalization time and a lower risk of transmission through patients and connected healthcare workers in a hospital ward setting, with considerable improvement in cost-effective care management.

Objective: The aim was to evaluate the difference in recovery when comparing total intravenous anesthesia (TIVA) to inhalational gas anesthesia in patients receiving rhinoplasty., Study Design: Retrospective review., Setting: Postoperative anesthesia care unit (PACU)., Methods: Patients who received a functional or cosmetic rhinoplasty at a single academic institution between April 2017 and November 2020 were included. Inhalational gas anesthesia was in the form of sevoflurane. Phase I recovery time, which was defined as the time it took a patient to reach ≥9/10 on the Aldrete scoring system was recorded, as well as the usage of pain medication in the PACU. The postoperative course and incidence of postoperative nausea and vomiting (PONV) were also collected., Results: Two hundred and two patients were identified with 149 (73.76%) who received TIVA and 53 (26.24%) who received sevoflurane. For the patients who received TIVA, the average recovery time was 101.44 minutes (standard deviation [SD]: 34.64) compared to an average recovery time of 121.09 minutes (SD: 50.19) for patients who received sevoflurane leading to a difference of 19.65 minutes (p = 0.002). Patients who received TIVA experienced less PONV (p = 0.001). There were no differences in the postoperative course including surgical or anesthesia complications, postoperative complications, hospital or Emergency Department admissions, or administration of pain medication (p > 0.05 for all)., Conclusion: When utilizing TIVA over inhalational anesthesia, patients undergoing rhinoplasty had significantly increased benefits in terms of reduced phase I recovery times and decreased incidence of PONV. TIVA was demonstrated to be a safe and efficacious method of anesthesia for this patient population., (© 2023 American Academy of Otolaryngology-Head and Neck Surgery Foundation.)

Introduction: Despite the significant economic impact of occupational injuries on companies and society, studies focused on analyzing the determinants of workdays lost due to sick leave remain scarce and incomplete. This paper contributes to this issue by (a) analyzing the drivers of sick leave duration, distinguishing factors that explain the health recovery time from those that could lead workers to a voluntary extension of the absence period, and (b) formulating and empirically testing the effect of gender, citizenship, temporary work, job tenure, amount of disability benefit, and size of the injured worker's firm on the number of days the employee is off work after the injury., Method: Hypotheses are tested on a comprehensive dataset that includes all nonfatal occupational injuries causing sick leave that occurred in the manufacturing sector in Spain during 2015-2019, with more than 400,000 injuries. We conduct ordinary least squares and count data regression models in which the number of days off work is regressed on employees and work characteristics while accounting for a set of variables to control the injury's nature and severity., Results: The results show that after considering the intrinsic characteristics of the injury and the severity of the worker's injuries, women, native workers, workers with more seniority, workers with higher salaries, and those working in larger companies have longer periods of sick leave. The results suggest that moral hazard considerations significantly impact the time to return to work after an occupational injury., Practical Applications: Based on the findings, several insights for company managers and public decision-makers are discussed. Specifically, interventions aimed at improving the organization of work and the working conditions of workers in manufacturing industries are highlighted, as well as the need to improve control and supervision mechanisms during the recovery process of injured workers., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Two-dimensional materials have attracted a great deal of interest in developing nanodevices for gas-sensing applications over the years. The 2D BeN 4 monolayer, a recently synthesized single-layered Dirac semimetal, has the potential to function as a gas sensor. This study analyzes the NH 3 sensing capacity of the pristine and vacancy-induced BeN 4 monolayers using first-principles density functional theory (DFT) calculations. As per the results, the NH 3 molecule is physisorbed on the pristine BeN 4 via weak Van der Waals interaction with a poor adsorption energy of -0.41 eV and negligible charge transfer. Introducing Be vacancy in BeN 4 increased the NH 3 adsorption energy to -0.83 eV due to the improved charge transfer (0.044 e) from the defective monolayer to the NH 3 molecule. The structural stability, sufficient recovery time (74 s) at room temperature, and superior work function sensitivity promise the potential application of defective BeN 4 as an NH 3 sensor. This research will be a theoretical groundwork for creating innovative BeN 4 -based NH 3 gas sensors., (© 2023 IOP Publishing Ltd.)

Introduction: First-principles calculations were used to study the adsorption behavior of environmentally significant gases CO, CO 2 , NO, NO 2 , SO, and SO 2 on pure buckled aluminene (b-Al) for gas sensing applications. Therefore, structural, electronic, and adsorption properties including adsorption energy values and recovery time have been calculated and discussed., Methods: All the structures were optimized using Amsterdam Density Functional (ADF) code BAND. In addition, triple zeta polarization basis with slater-type orbitals were utilized., Results: For every gas analyzed, we observed favorable adsorption energy values and charge transfer occurring between the gas molecule and b-Al. In the valance band, there was a strong hybridization between the p orbitals of gas and b-Al, this led to enhanced conductivity in the density of states (DOS). The recovery time suggested that the adsorption of NO, NO 2 , SO, and SO 2 gases on b-Al is good for the application of reversible gas sensors. The recovery time indicated that the b-Al material is very sensitive to NO, NO 2 , SO, and SO 2 gas molecules., Conclusion: The conclusion in light of all these results is that b-Al based materials can appear as a probable candidate for high gas sensing performance., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: The presence of volatile organic compounds (VOCs) in the exhaled breath of lung cancer patients is the only available source for detecting the disease at its initial stage. Exhaled breath analysis depends purely on the performance of the biosensors. The interaction between VOCs and pristine MoS 2 is repulsive in nature. Therefore, modifying MoS 2 via surficial adsorption of the transition metal nickel is of prime importance. The surficial interaction of six VOCs with Ni-doped MoS 2 led to substantial variations in the structural and optoelectronic properties compared to those of the pristine monolayer. The remarkable improvement in the conductivity, thermostability, good sensing response, and recovery time of the sensor exposed to six VOCs revealed that a Ni-doped MoS 2 exhibits impressive properties for the detection of exhaled gases. Different temperatures have a significant impact on the recovery time. Humidity has no effect on the detection of exhaled gases upon exposure to VOCs. The obtained results may encourage the use of exhaled breath sensors by experimentalists and oncologists to enable potential advancements in lung cancer detection., Methods: The surface adsorption of transition metal and its interaction with volatile organic compounds on a MoS 2 surface was studied by using Spanish Initiative for Electronic Simulations with Thousands of Atoms (SIESTA). The pseudopotentials used in the SIESTA calculations are norm-conserving in their fully nonlocal forms. The atomic orbitals with finite support were used as a basis set, allowing unlimited multiple-zeta and angular momenta, polarization, and off-site orbitals. These basis sets are the key for calculating the Hamiltonian and overlap matrices in O(N) operations. The present hybrid density functional theory (DFT) is a combination of PW92 and RPBE methods. Additionally, the DFT+U approach was employed to accurately ascertain the coulombic repulsion in the transition elements., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: The therapeutic feeding unit (TFU) provides comprehensive inpatient clinical care for children suffering from severe acute malnutrition (SAM) in three stages: stabilization, transition, and rehabilitation. During the transitional and rehabilitation phases, children receive either F-100 or ready-to-use therapeutic food (RUTF). Although both promote weight gain, RUTF is more energy dense than F-100. There is limited and contrasting evidence regarding their effect on recovery time. Therefore, this study aimed to assess the effect of RUTF on time to recovery among SAM children aged 6-59 months admitted to the TFU in Ethiopia., Methods: Health Facility-based prospective cohort study was conducted among 476 children treated in three hospitals and four health centers in the Sidama region from September 2021 to January 2022. A structured questionnaire adopted from the Ethiopian national protocol for the management of SAM was used for data collection. Data were entered into EpiData version 3.1 and exported to SPSS version 20 for analysis. The Kaplan-Meir curve and log-rank test were used to compare time to recovery between children who received RUTF and F-100. Multivariable Cox proportional hazard analysis was conducted to assess the association between time to recovery and the type of therapeutic food, controlling for the confounding variables., Results: The median recovery time was significantly shorter in children receiving RUTF (7 days; 95% CI: 6.62-7.38) compared to F-100 (10 days; 95% CI: 8.94-11.06). Children below 24 months (AHR = 0.54, 95% CI: 0.42-0.69), dehydrated (AHR = 1.34, 95% CI: 1.07-1.75), edematous malnutrition (AHR = 1.29, 95% CI: 1.03-1.61), and anemic (AHR = 2.57, 95% CI: 1.90-3.48) during admission were associated with time to recovery., Conclusions: Children who received RUTF recovered faster than children who received F-100. Administering RUTF to children below 24 months, who present with anemia and dehydration can improve their recovery rate and shorten their stay in the health facility., (© 2023. The Author(s).)

Recovery time, the time it takes for ecosystems to return to normal states after experiencing droughts, is critical for assessing the response of ecosystems to droughts; however, the spatial dominant factors determining recovery time are poorly understood. We identify the global patterns of terrestrial ecosystem recovery time based on remote sensed vegetation indices, analyse the affecting factors of recovery time using random forest regression model, and determine the spatial distribution of the dominant factors of recovery time based on partial correlation. The results show that the global average recovery time is approximately 3.3 months, and that the longest recovery time occurs in mid-latitude drylands. Analysis of affecting factors of recovery time suggests that the most important environmental factor affecting recovery time is soil moisture during the recovery period, followed by temperature and vapour pressure deficit (VPD). Recovery time shortens with increasing soil moisture and prolongs with increasing VPD; however, the response of recovery time to temperature is nonmonotonic, with colder or hotter temperatures leading to longer recovery time. Soil moisture dominates the drought recovery time over 58.4% of the assessed land area, mostly in the mid-latitudes. The concern is that soil moisture is projected to decline in more than 65% regions in the future, which will lengthen the drought recovery time and exacerbate drought impacts on terrestrial ecosystems, especially in southwestern United States, the Mediterranean region and southern Africa. Our research provides methodological insights for quantifying recovery time and spatially identifies dominant factors of recovery time, improving our understanding of ecosystem response to drought., (© 2023 John Wiley & Sons Ltd.)

Because nanomaterials are highly reactive and electronically sensitive towards a variety of drug molecules, they are thought of as efficient drug sensors. In the present research study, an aluminum carbide (C 3 Al) monolayer is employed and its interaction is examined with cyclophosphamide (CP) by performing DFT computations. The C 3 Al monolayer is highly reactive and sensitive towards CP according to the computations. CP interacts with the C 3 Al monolayer with the adsorption energy of -31.39 kcal/mol. A considerable charge transfer (CT) indicates an enhancement in the conductivity. Also, the charge density is explained based on the electron density differences (EDD). The decrease in CP/C 3 Al energy gap (E g ) by approximately 52.91% is due to the remarkable effect of adsorption on the LUMO and the HOMO levels. Therefore, due to the decrease in E g which can generate an electrical signal, the electrical conductivity is considerably increased. These results suggest that the C 3 Al monolayer can be employed as a proper electronic drug sensor for CP. Also, the recovery time for the desorption process of CP form the surface of C 3 Al is 351 s at 598 K., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Ketamine is administered in the perioperative period for its benefits in analgesia, anti-agitation and anti-depression when administered at a small dose. However, it is not clear whether the intra-operative administration of ketamine would affect emergence under sevoflurane anesthesia. To investigate this effect, we designed this trial., Methods: In this randomized, double-blind, placebo-controlled study, we enrolled 44 female patients aged 18-60 who were scheduled to elective laparoscopic gynecological surgeries. All patients were randomly assigned to saline or s-ketamine group. In s-ketamine group, patients received 0.125 mg/kg s-ketamine 30 min after the start of surgery. In saline group, patients were administered the same volume of saline. Sevoflurane and remifentanil were used to maintain general anesthesia. The primary outcome was emergence time. We also assessed postoperative agitation, cognitive function, and delirium. In addition, we collected and analyzed prefrontal electroencephalogram (EEG) during and after general anesthesia., Results: There were no significant differences in emergence time between s-ketamine group and saline group (10.80 ± 3.77 min vs. 10.00 ± 2.78 min, P = 0.457). Neither postoperative agitation (4 [3, 4] vs. 4 [3, 4], P = 0.835) nor cognitive function (25.84 ± 2.69 vs. 25.55 ± 2.19, P = 0.412) differed between groups. No postoperative delirium was observed in either group. Subanesthetic s-ketamine resulted in active EEG with decreased power of slow (-0.35 ± 1.13 dB vs. -1.63 ± 1.03 dB, P = 0.003), delta (-0.22 ± 1.11 dB vs. -1.32 ± 1.09 dB, P = 0.011) and alpha (-0.31 ± 0.71 dB vs. -1.71 ± 1.34 dB, P = 0.0003) waves and increased power of beta-gamma bands (-0.30 ± 0.89 dB vs. 4.20 ± 2.08 dB, P < 0.0001) during sevoflurane anesthesia, as well as an increased alpha peak frequency (-0.16 ± 0.48 Hz vs. 0.31 ± 0.73 Hz, P = 0.026). EEG patterns did not differ during the recovery period after emergence between groups., Conclusion: Ketamine administered during sevoflurane anesthesia had no apparent influence on emergence time in young and middle-aged female patients undergoing laparoscopic surgery. Subanesthetic s-ketamine induced an active prefrontal EEG pattern during sevoflurane anesthesia but did not raise neurological side effects after surgery., Trial Registration: Chinese Clinical Trial Registry, ChiCTR2100046479 (date: 16/05/2021)., (© 2023. The Author(s).)

Introduction: To determine if there is a recovery time difference between patients with and without obstructive sleep apnea (OSA) when using total intravenous anesthesia (TIVA) compared to volatile gas inhalational anesthesia., Patients and Methods: OSA and Non-OSA patients were identified at a tertiary institution between January 2019 and November 2020. Non-OSA patients were defined as those who have not been formerly diagnosed with OSA. A modified STOP-BANG score (MSBS) was performed to screen Non-OSA patients for OSA. Recovery was measured by Phase I recovery time, or time it took a patient to reach ≥9/10 on the Aldrete scoring system., Results: A total of 334 patients were included with 142 in the OSA cohort (59 TIVA, 83 inhalational anesthesia) and 192 in the Non-OSA cohort (119 TIVA, 73 inhalational anesthesia). In OSA patients, there was a 41.29-minute recovery time reduction when using TIVA versus sevoflurane ( P  < .0001). Non-OSA patients recovered faster than OSA patients when undergoing inhalational anesthesia by 46.76 minutes and TIVA by 18.58 minutes ( P  < .0001 and P  = .0907, respectively). Non-OSA patients with a MSBS < 3 and ≥3 had a shorter recovery time compared to OSA patients when both underwent sevoflurane anesthesia (57.27 minutes, P  < .0001 and 56.23 minutes, P  = .040, respectively). Non-OSA patients with a MSBS of <3 had a decrease in recovery time of 26.68 minutes when compared to OSA patients who underwent TIVA ( P  = .0004)., Conclusions: When utilizing TIVA over inhalational anesthesia, patients with OSA have significantly increased benefit in terms of reduced Phase I recovery times as compared to Non-OSA patients.

Objective: Specific guidelines regarding an optimal general anesthesia (GA) approach to obstructive sleep apnea (OSA) patients remain undefined. Literature comparing the efficacy of total intravenous anesthesia (TIVA) and inhalational anesthesia in this population is sparse. We hypothesize that OSA patients receiving TIVA will experience reduced recovery times and other improved post-surgical outcomes., Study Design: Randomized controlled trial., Methods: Adult OSA patients undergoing upper airway surgery (hypoglossal nerve stimulation [HNS], nasal, or palate surgery) from February 2020-December 2020 were included. A post-anesthesia care unit (PACU) nursing survey documented patients' alertness, pain, oxygen supplementation, and postoperative nausea and vomiting from PACU arrival to 2 hours. Perioperative timepoints from the electronic medical record (EMR) and a nurse-estimated Phase I recovery time were collected., Results: One hundred eleven patients were included (46 TIVA and 65 inhalational anesthesia). Per EMR-recorded timepoints, TIVA patients undergoing HNS and palate surgery experienced Phase I Time reductions of 12.5 min (p = 0.042) and 27.5 min (p = 0.016), respectively. Per the PACU survey, TIVA patients undergoing any surgery, HNS, or palate surgery experienced nurse-estimated Phase I Time reductions of 16.5 min (p = 0.004), 12.5 min (p = 0.031), and 38.5 min (p = 0.024), respectively. Overall, TIVA patients experienced higher alertness and pain ratings, and lower oxygen supplementation requirements from PACU arrival to 30 min (p < 0.05)., Conclusion: Patients with OSA receiving TIVA for GA maintenance during upper airway procedures experienced reduced recovery times and oxygen supplementation requirements, and a more rapid return to alertness. Future work toward developing optimized anesthetic guidelines for OSA patients is merited., Level of Evidence: 3 Laryngoscope, 133:984-992, 2023., (© 2022 The American Laryngological, Rhinological and Otological Society, Inc.)

With the increasing use of virtual reality (VR) devices, interest in reducing their negative effects, such as VR sickness, is also increasing. This study used electroencephalography (EEG) to investigate participants' VR sickness recovery time after watching a VR video. We tested 40 participants in advance using a motion sickness susceptibility questionnaire (MSSQ). We classified the participants into two groups (sensitive group/non-sensitive group) depending on their MSSQ scores. We used a simulator sickness questionnaire (SSQ) and EEG to evaluate VR sickness. The SSQ score increased significantly after watching the VR sickness-inducing video (VR video) in both groups (p < 0.001). The recovery time based on the SSQ was 11.3 ± 6.6 min for the sensitive group and 9.1 ± 5.2 min for the non-sensitive group. The difference in recovery time between the two groups was not significant (p > 0.05). EEG results showed that recovery time took an average of 11.5 ± 7.1 min in both groups. The EEG data showed that the delta wave increased significantly across all brain areas (p < 0.01). There was no statistical difference between groups in recovering VR sickness depending on individual characteristics. However, we confirmed that subjective and objective VR recovery required at least 11.5 min. This finding can inform recommendations regarding the VR sickness recovery times., (© 2023 The Authors.)

Objective: The spinal accessory nerve (SAN) is commonly used as a donor nerve for reinnervation of elbow flexors in brachial plexus injury (BPI) reconstruction. However, no study has compared the postoperative outcomes between SAN-to-musculocutaneous nerve (MCN) transfer and SAN-to-nerve to biceps (NTB) transfer. Thus, this study aimed to compare the postoperative time to recovery of elbow flexors between the two groups., Methods: A total of 748 patients who underwent surgical treatment for BPI between 1999 and 2017 were retrospectively reviewed. Among them, 233 patients were treated with nerve transfer for elbow flexion. Two techniques were used to harvest the recipient nerve: the standard dissection technique and the proximal dissection technique. The postoperative motor power of elbow flexion was assessed every month for 24 months using the Medical Research Council (MRC) grading system. Survival and Cox regression analyses were used to compare the time to recovery (MRC grade ≥ 3) between the two groups., Results: Of the 233 patients who underwent nerve transfer surgery, there were 162 patients in the MCN group and 71 patients in the NTB group. At 24 months after surgery, the MCN group had a success rate of 74.1%, and the NTB group had a success rate of 81.7% (p = 0.208). When compared with the MCN group, the NTB group had a significantly shorter median time to recovery (19 months vs 21 months, p = 0.013). Only 11.1% of patients in the MCN group regained MRC grade 4 or 5 motor power 24 months after nerve transfer surgery compared with 39.4% patients in the NTB group (p < 0.001). Cox regression analysis showed that the SAN-to-NTB transfer in combination with the proximal dissection technique was the only significant factor affecting time to recovery (HR 2.33, 95% CI 1.46-3.72; p < 0.001)., Conclusions: SAN-to-NTB transfer in combination with the proximal dissection technique is the preferred nerve transfer option for restoration of elbow flexion in traumatic pan-plexus palsy.

Background: Severe acute malnutrition (SAM) among children under five years of age remains a huge public health and economic burden in Sub-Saharan Africa. We investigated time to recovery and its predictors among children aged 6 to 59 months admitted into Community-based Management of Acute Malnutrition (CMAM) stabilisation centres for complicated severe acute malnutrition and whether the outcomes met the minimum Sphere standards., Methods: The study was a retrospective cross sectional quantitative review of data recorded in six CMAM stabilization centres registers in four Local Government Areas, Katsina state, Nigeria from September 2010 to November 2016. Records of 6925 children, aged 6-59 months with complicated SAM were reviewed. Descriptive analysis was used to compare performance indicators with Sphere project reference standards. Cox proportional hazard regression analysis was used to estimate the predictors of recovery rate at p < 0.05 and Kaplan-Meier curve to predict the probability of surviving different forms of SAM., Results: Marasmus was the most common form of severe acute malnutrition (86%). Overall, the outcomes met the minimum sphere standards for inpatient management of SAM. Children with oedematous SAM (13.9%) had the lowest survival rate on Kaplan-Meier graph. The mortality rate was significantly higher during the 'lean season'-May to August (Adjusted Hazard Ratio (AHR) = 0.491, 95% CI = 0.288-0.838). MUAC at Exit (AHR = 0.521, 95% CI = 0.306-0.890), marasmus (AHR = 2.144, 95% CI = 1.079-4.260), transfers from OTP (AHR = 1.105, 95% CI = 0.558-2.190) and average weight gain (AHR = 0.239, 95% CI = 0.169-0.340) were found to be significant predictors of time-to-recovery with p values < 0.05., Conclusion: The study showed that, despite a high turnover of complicated SAM cases in the stabilization centres, the community approach to inpatient management of acute malnutrition enabled early detection and reduced delays in access to care of complicated SAM cases. In the face of health workforce shortage in rural communities to provide pediatric specialist care for SAM children, we recommend task shifting to community health care workers through in service training could bridge the gap and save more lives of children dying from the complication of SAM in rural communities in Nigeria., (© 2023. The Author(s).)

Catechol is a toxic biomolecule due to its low degradability to the ecosystem and unpredictable impact on human health. In this work, we have investigated the catechol sensing properties of pristine and transition metal (Ag, Au, Pd, and Ti) decorated γ -graphyne (GY) systems by employing the density functional theory and first-principles molecular dynamics approach. Simulation results revealed that Pd and Ti atom is more suitable than Ag and Au atom for the decoration of the GY structure with a large charge transfer of 0.29e and 1.54e from valence d-orbitals of the Pd/Ti atom to the carbon-2p orbitals of GY. The GY + Ti system offers excellent electrochemical sensing towards catechol with charge donation of 0.14e from catechol O-p orbitals to Ti-d orbitals, while the catechol molecule is physisorbed to pristine GY with only 0.04e of charge transfer. There exists an energy barrier of 5.19 eV for the diffusion of the Ti atom, which prevents the system from metal-metal clustering. To verify the thermal stability of the sensing material, we have conducted the molecular dynamics simulations at 300 K. We have reported feasible recovery times of 2.05 × 10 -5 s and 4.7 × 10 2 s for sensing substrate GY + Pd and GY + Ti, respectively, at 500 K of UV light., (© 2023 IOP Publishing Ltd.)

Background: It has been suggested that administration of exogenous ketone supplements (EKSs) not only increases blood ketone body levels but also decreases blood glucose level and modulates isoflurane-induced anesthesia in different rodents, such as Wistar Albino Glaxo Rijswijk (WAG/Rij) rats. Thus, we investigated whether administration of EKSs can modulate the isoflurane anesthesia-generated increase in blood glucose level and the time required to recover from isoflurane-induced anesthesia., Methods: To investigate the effect of EKSs on isoflurane anesthesia-induced changes in blood glucose and R-β-hydroxybutyrate (R-βHB) level as well as recovery time from anesthesia, we used KEMCT (mix of ketone ester/KE and medium chain triglyceride/MCT oil in a 1:1 ratio) in WAG/Rij rats. First, to accustom the animals to the method, water gavage was carried out for 5 days (adaptation period). After adaptation period, rats of first group (group 1) were gavaged by water (3 g/kg), whereas, in the case of second group (group 2), the diet of animals was supplemented by KEMCT (3 g/kg, gavage) once per day for 7 days. One hour after the last gavage, isoflurane (3%) anesthesia was induced for 20 min (group 1 and group 2) and the time required for recovery from anesthesia was measured by using righting reflex. Subsequently, blood levels of both R-βHB and glucose were also evaluated. Changes in blood glucose and R-βHB levels were compared to control, which control glucose and R-βHB levels were measured on the last day of the adaptation period (group 1 and group 2). Time required for recovery from isoflurane anesthesia, which was detected after 7 th KEMCT gavage (group 2), was compared to recovery time measured after 7 th water gavage (group 1)., Results: The KEMCT maintained the normal glucose level under isoflurane anesthesia-evoked circumstances preventing the glucose level elevating effect of isoflurane. Thus, we demonstrated that administration of KEMCT not only increased blood level of R-βHB but also abolished the isoflurane anesthesia-generated increase in blood glucose level. Moreover, the time required for recovery from isoflurane-evoked anesthesia increased significantly in KEMCT treated animals., Conclusions: Putative influence of elevated blood ketone body level on isoflurane-evoked effects, such as modulation of blood glucose level and recovery time from anesthesia, should be considered by anesthesiologists., (© 2023. The Author(s).)

Background: Optimum procedural sedation is very essential for conducting non-operating room procedures such as endoscopic retrograde cholangiopancreatography (ERCP). The combination of ketamine and dexmedetomidine (KD) is expected to balance out the undesirable effects of either drug and provide smooth sedation. Together ketamine and propofol (KP) also provide synergistic sedation with stable hemodynamics. This prospective, single-blinded randomized study aimed to compare the effect of both the combinations during ERCP in terms of oxygen desaturation, respiratory depression, hemodynamic parameters, analgesia, recovery time, and ease with which the endoscopist could perform the endoscopy., Methods: This prospective, single-blinded randomized study (CTRI/2019/08/020625) was conducted on 84, ASA (American Society of Anesthesiologists) physical status I or II patients, of age 18-65 years presenting for ERCP in a tertiary care center. They were randomized to receive either KD (n=42) or KP (n=42) combination during ERCP. Mean SPO 2 at the end of the procedure was compared between the groups. Apart from these periprocedural hemodynamic and respiratory parameters, pain scores on arrival in the recovery room (t0), 15 minutes (t15), and 30 minutes (t30), recovery time, and endoscopist's satisfaction as per a Likert's scale were recorded., Results: The mean SpO 2 (SpO 2 recorded every minute during the procedure and averaged over procedure time in minutes) in group KP (97.7 [96.1-98.6]) was significantly lower than group KD (98.5 [98.1-98.8]) (p=0.005). The post-procedure pain scores measured at t0 and t15 were higher in group KP (p<0.001 and p=0.043), and comparable at t30 in both the groups (p=0.711). The time to achieve Modified Aldrete score (MAS) ≥ 9 was significantly more in group KD (p<0.001). The lowest mean arterial pressure and heart rate in group KD were significantly lower than in group KP (p<0.001, p=0.006, respectively). The overall endoscopist satisfaction was better in group KP compared to group KD (p= 0.011)., Conclusions: The combination of ketamine-dexmedetomidine for procedural sedation during ERCP is a safe alternative to ketamine-propofol with a better respiratory profile., Clinical Trial Number and Registry Url: CTRI/2019/08/020625 ( www.ctri.nic.in )., (© 2022. Indian Society of Gastroenterology.)

Understanding population responses to discrete 'pulsed' environmental disturbances is essential to conservation and adaptive management. Populations of concern can be driven to low levels by disturbance, and understanding interspecific differences in recovery trajectories is necessary for evaluating management options. We analysed single-species models to investigate the demographic and management factors determining the two components of population 'resilience': the magnitude of initial impact on population abundance, and duration of the recovery time. We simulated age-structured populations with density-dependent recruitment, subjected to a pulse disturbance consisting of a period of increased mortality of either the juvenile age class or all age classes, and calculated both impact and return time. For illustration, we used demographic parameters from a suite of 16 fish species. We formulated the model as a renewal equation, allowing us to describe disturbance impacts mathematically as a convolution. We also included nonlinear dynamics, representing populations that recover to a steady state; this is more realistic (in most cases) than prior analyses of resilience in linear models without density-dependence. When the disturbance affected only one or a few young age-classes, longevity was the major life-history determinant of impact and recovery time. Shorter-lived species endured greater impacts when disturbed because each age class is a greater proportion of the population. However, shorter-lived species also had faster recovery times, for the same reason. When disturbance affected adult age-classes, the impact was more immediate and no longer affected by species' longevity, though the effect of longevity on recovery time remained. These results improve our understanding of interspecific differences in resilience and increase our ability to make predictions for adaptive management. Additionally, formulating the problem as a renewal equation and using mathematical convolutions allows us to quantify how disturbances with different time courses (not just an immediate, constant level of disturbance but gradually increasing or decreasing levels of disturbance) would have different effects on population resilience: delayed responses for species in which biomass is concentrated in older age classes, and for disturbances that become progressively more severe., (© 2022 The Authors. Journal of Animal Ecology © 2022 British Ecological Society.)

Background: The aim of this study was to assess the effect of intradialytic cycling exercise on quality of life (QOL) and recovery time in patients who underwent hemodialysis., Materials and Methods: Hemodialysis patients were recruited from the referral dialysis centers affiliated with Isfahan University of Medical Sciences, Isfahan, Iran. Patients were randomly assigned into the intervention and the control groups. Patients in the intervention group exercised on a stationary bike for 12 weeks (3 times per week for 30 min); however, patients in the control group received usual hemodialysis. The kidney disease QOL (KDQOL)-short-form version 1.3 was used to assess QOL. Patients were asked to answer the question "How long does it take to recover from a dialysis session?" to assess recovery time., Results: A total of 110 hemodialysis patients, including 60 in the intervention group and 50 in the control group were analyzed. A significant increase was observed in the generic (mean difference ± SE: 1.50 ± 0.44, P = 0.001), kidney disease (mean difference ± SE: 0.84 ± 0.28, P = 0.004), and overall QOL (mean difference ± SE: 1.18 ± 0.33, P = 0.001) scores after 12 weeks of intradialytic cycling exercise in the intervention group. Furthermore, a significant difference was noted between the intervention and the control group regarding the mean difference of all QOL scores after the intervention ( P < 0.05). We also found a significant difference in the mean difference of recovery time between the intervention and the control group after the intervention ( P < 0.001)., Conclusion: KDQOL and recovery time could improve in hemodialysis patients after 12-week intradialytic exercise., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Research in Medical Sciences.)

Aim: Prolonged diaper dermatitis may increase the risk of atopic dermatitis or infections. This prospective observational study aimed to investigate the prevalence, symptoms, areas, and recovery time of diaper dermatitis in infants aged 1 month and identify the factors related to recovery time., Methods: Diaper dermatitis was defined as the presence of erythema, papules, dryness, erosion, or ulceration in the diapered area. Recovery time was days between infant's 1-month medical check-up and disappearance of symptoms. Survival analysis was performed using the Kaplan-Meier method, and the log-rank test was used to identify the factors related to recovery time., Results: Among 113 infants, 66 (58.4%) had diaper dermatitis, with erythema at the perianal area being the most common symptom. The median recovery time was 10 days. Four infants (6.1%) had diaper dermatitis for >5 weeks. Severity was not related to recovery time., Conclusions: A frequency of diaper changing of ≤10 times per day was a risk factor for recovery time. Our data showed recovery in approximately 10 days, regardless of severity at study enrollment. Health care professionals could inform parents of recovery time and recommended diaper changing frequency., (© 2022 Japan Academy of Nursing Science.)

Objective: Given the human and economic cost of the COVID-19 pandemic, protecting healthcare workers (HCW) and ensuring continuity of care is critical. The aim of this study is to evaluate the cost-effectiveness of different strategies to ascertain COVID-19 recovery in HCWs., Methods: Data were collected from the hospital health surveillance program on HCWs at the University Hospital of Verona between 29/02/2020 and 14/04/2021. The diagnosis of SARS-CoV-2 infection and the assessment of the recovery were made through RT-PCR on oro-nasopharyngeal swab-sample. Recovery time and probability were estimated through Kaplan-Meier estimate. For each recovery assessment strategy costs (laboratory diagnostics and human resources), expressed in local currency (euro-€), and working days saved (WDS-effectiveness) were estimated. A decision-tree was created where each knot was a time point scheduled by the different recovery assessment strategies. A Monte Carlo simulation method was used, and probabilistic sensitivity analysis assessed the effect of input uncertainty., Results: In the study period 916 (9.9%) HCWs tested positive. Recovery time through symptom-based strategy (21 days 0.95 CI 16-24) was significantly lower compared to swab-based one (25 days 0.95 CI 23-28, p < 0.001). The swab-based strategy was dominated by all symptoms-based ones. Symptoms-based with a swab on days 14 and 17 had an ICER of 2 €/WDS and 27 €/WDS compared to the one scheduled on days 10 and 17 and with only one swab on the 17th day., Conclusions: Scheduling swabs on days 14 and 17 in a symptom-based strategy was the most cost-effective, saving 7.5 more working days than the standard one with swabs on days 10 and 17., (© 2022. The Author(s).)

Herbivore distributions and abundance are shifting because of climate change, leading to intensified grazing pressure on foundation species such as seagrasses. This, combined with rapidly increasing magnitudes of change in estuarine ecosystems, may affect seagrass resilience. While the overall resilience of seagrasses is generally well-studied, the timeframes of recovery has received comparatively little attention, particularly in temperate estuaries. We investigated how the recovery time (RT) of seagrass is affected by simulated grazing in a southwestern Australian estuary. Whilst excluding swans, we simulated different grazing intensities (25, 50, 75, and 100% removal from 1 m 2 plots) at four locations in the Swan-Canning Estuary, Western Australia during summer and tracked the recovery of seagrass over 3 months, using seagrass cover as the main measure of recovery. We found that seagrass recovered within 4-6 weeks from the lower grazing intensities (25 and 50%) and 7-19 weeks from the higher grazing intensities (75 and 100%) across the estuary. Increased grazing intensity led to not only longer recovery times (RTs), but also greater variability in the RT among experimental locations. The RT from the higher grazing intensities at one location in particular was more than double other locations. Seagrass recovery was through vegetative mechanisms and not through sexual reproduction. There was a significant grazing treatment effect on seagrass meadow characteristics, particularly belowground biomass which had not recovered 3 months following grazing. As the pressure of climate change on estuarine environments increases, these quantified RTs for seagrass provide a baseline for understanding grazing pressure as a singular disturbance. Future work can now examine how grazing and other potentially interacting pressures in our changing climate could impact seagrass recovery even further., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 O’Dea, Lavery, Webster and McMahon.)

(1) Background: To explore the influence on post-activation potentiation (PAP) when combining different degrees of blood flow restriction (BFR) with multi-levels of resistance training intensity of activation. (2) Purpose: To provide competitive athletes with a more efficient and feasible warm-up program. (3) Study Design: The same batch of subjects performed the vertical jump test of the warm-up procedure under different conditions, one traditional and six BFR procedures. (4) Methods: Participants performed seven counter movement jump (CMJ) tests in random order, including 90% one repetition maximum (1RM) without BFR (CON), and three levels of BFR (30%, 50%, 70%) combined with (30% and 50% 1RM) (BFR-30-30, BFR-30-50, BFR-50-30, BFR-50-50, BFR-70-30 and BFR-70-50). Jump height (H), mean power output (P), peak vertical ground reaction force (vGRF), and the mean rate of force development (RFD) were recorded and measured. (5) Results: Significantly increasing results were observed in: jump height: CON (8 min), BFR-30-30 (0, 4 min), BFR-30-50 (4, 8 min), BFR-50-30 (8 min), BFR-50-50 (4, 8 min), BFR-70-30 (8 min), ( p < 0.05); and power output: CON (8 min), BFR-30-30 (0, 4 min), BFR-30-50 (4 min), BFR-50-30 (8 min), BFR-50-50 (4, 8 min) ( p < 0.05); vGRF: CON (8 min), BFR-30-30 (0, 4 min), BFR-30-50 (4, 8 min), BFR-50-30 (4 min), BFR-50-50 (4, 8 min) ( p < 0.05); RFD: CON (8 min), BFR-30-30 (0, 4 min), BFR-30-50 (4 min), BFR-50-30 (4 min), BFR-50-50 (4 min) ( p < 0.05). (5) Conclusions: low to moderate degrees of BFR procedures produced a similar PAP to traditional activation. Additionally, BFR-30-30, BFR-30-50, and BFR-50-50 were longer at PAP duration in comparison with CON.

Response and recovery times are among the most important parameters for gas sensors. Their optimization has been pursued through several strategies, including the control over the morphology of the sensitive material. The effectiveness of these approaches is typically proven by comparing different sensors studied in the same paper under the same conditions. Additionally, tables comparing the results of the considered paper with those available in the literature are often reported. This is fundamental to frame the results of individual papers in a more general context; nonetheless, it suffers from the many differences occurring at the experimental level between different research groups. To face this issue, in the present paper, we adopt a statistical approach to analyze the response and recovery times reported in the literature for chemiresistors based on pure SnO 2 for ethanol detection, which was chosen as a case study owing to its available statistic. The adopted experimental setup (of the static or dynamic type) emerges as the most important parameter. Once the statistic is split into these categories, morphological and sensor-layout effects also emerge. The observed results are discussed in terms of different diffusion phenomena whose balance depends on the testing conditions adopted in different papers.

Background: Magnetic resonance imaging (MRI) under sedation requires faster recovery for early discharge and feeding resumption in children with neuropsychiatric disorders. The use of dexmedetomidine alone results in delayed recovery. Propofol, when used alone, can cause hypotension and respiratory depression. A new regimen for sedation was evaluated by exploiting the properties of these drugs, to allow faster recovery with minimal adverse events., Materials and Methods: One hundred and fifty children aged 2-12 years requiring MRI were randomly allocated to these three groups. Group P ( n = 50) received propofol bolus at 2 mg.kg -1 over 10 min followed by infusion at 100 μg.kg -1 .min -1 . Group D ( n = 50) received dexmedetomidine bolus of 2 μg.kg -1 over 10 min followed by infusion at 1 μg.kg -1 .h -1 . Group PD ( n = 50) received propofol bolus at 2 mg.kg -1 over 10 min followed by dexmedetomidine infusion at 1 μg.kg -1 .h -1 . Recovery characteristics were noted., Results: Recovery following sedation in Group PD (15 ± 7.0 min) and Group P (17.35 ± 7.4 min) were comparable and significantly ( P = 0.03) lesser than Group D (27.58 ± 8.09 min). Emergence delirium scores were significantly less in Group PD (5 ± 1.08) and Group D (5.6 ± 2.4), unlike scores in Group P (9 ± 2.43). About 79.5% (39/49) of children in Group P, 88.2% (45/51) of children in Group D, and 86% (43/50) of children in Group PD completed MRI without any movement. Seven (14.58%) in Group P, 2 (4%) in Group D, and 5 (10.20%) in Group PD required rescue sedation., Conclusion: The regimen with propofol bolus and dexmedetomidine infusion provided adequate sedation and better recovery characteristics in children aged 2-12 years without systemic complications, as compared to the use of either agent alone., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Anesthesia: Essays and Researches.)

Objective: Many studies have identified factors associated with increased symptom burden and prolonged recovery after pediatric and adolescent concussion. Few have systematically examined the effects of prior concussion on these outcomes in patients with concussion due to any mechanism. An improved understanding of the short- and long-term effects of a multiple concussion history will improve counseling and management of this subgroup of patients., Methods: A retrospective review of adolescent and young adult acute concussion patients presenting to the multidisciplinary concussion clinic between 2018 and 2019 was conducted at a single center. Patient demographic data, medical history including prior concussion, initial symptom severity score (SSS), injury mechanisms, and recovery times were collected. Univariate and multivariable analyses were conducted to identify associations of history of prior concussion and patient and injury characteristics with symptom score and recovery time., Results: A total of 266 patients with an average age of 15.4 years (age range 13-27 years) were included. Prior concussion was reported in 35% of patients. The number of prior concussions per patient was not significantly associated with presenting symptom severity, recovery time, or recovery within 28 days. Male sex and sports-related concussion (SRC) were associated with lower presenting SSS and shorter recovery time on univariate but not multivariable analysis. However, compared to non-sport concussion mechanisms, SRC was associated with 2.3 times higher odds of recovery within 28 days (p = 0.04). A history of psychiatric disorders was associated with higher SSS in univariate analysis and longer recovery time in univariate and multivariable analyses. Multivariable log-linear regression also demonstrated 5 times lower odds of recovery within 28 days for those with a psychiatric history., Conclusions: The results of this study demonstrated that an increasing number of prior concussions was associated with a trend toward higher presenting SSS after youth acute concussion but did not show a significant association with recovery time or delayed (> 28 days) recovery. Presence of psychiatric history was found to be significantly associated with longer recovery and lower odds of early (≤ 28 days) recovery. Future prospective, long-term, and systematic study is necessary to determine the optimal counseling and management of adolescent and young adult patients with a history of multiple concussions.

Objective: This study aimed to evaluate potential predictors for recovery time in pregnant patients with moderate to severe ovarian hyperstimulation syndrome (OHSS)., Methods: A total of 424 pregnant patients with moderate to severe OHSS who underwent in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) were retrospectively identified. The clinical features and laboratory findings within 24 h after admission were collected. Treatment for OHSS was carried out according to standard procedures, including fluid replacement therapy, human albumin, aspirin, low-molecular-weight heparin, and paracentesis, when necessary. Patients were discharged from the hospital when the tmorning hematocrit was <40% and no obvious clinically relevant symptoms existed, such as abdominal distension, abdominal pain, and shortness of breath. Meanwhile, ultrasound indicating little pleural or abdominal effusion and biochemical abnormalities returning to normal were required. Spearman's correlation analysis was used to assess the association between the blood-related parameters and recovery time. Multiple linear regression models were used to assess the relationship between the clinical or laboratory parameters and recovery time., Results: The median recovery time of these patients was 11 days. In Spearman's correlation test, leukocytes, hemoglobin, platelets, hematocrit, creatinine, prothrombin time (PT), fibrinogen (Fib), D-dimer, and fibrinogen degradation products (FDPs) were positively correlated with recovery time. On the other hand, albumin and thrombin time (TT) were negatively correlated with recovery time. Multiple linear regression analysis showed that polycystic ovary syndrome (PCOS), hemoglobin, platelets, albumin, and Fib were significantly associated with the recovery time of patients with OHSS ( p  = 0.023, p  < 0.001, p  = 0.007, p  < 0.001, and p  = 0.019, respectively)., Conclusions: In pregnant patients with OHSS, PCOS and hypoalbuminemia were associated with a significantly longer recovery time. Meanwhile, the recovery time was longer when patients have high levels of hemoglobin, platelets, and Fib., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Huang, Shi, Chen, Shi and Zhai.)