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The purpose of this study is to investigate if an orally administered combination of aspirin and ketamine will provide better analgesia than a ketamine alone in adult patients presenting to the Emergency Department (ED) with acute musculoskeletal pain.We conducted a prospective, randomized, open-label trial of ED patients aged 18 and older presenting with moderate to severe acute musculoskeletal pain as defined by an 11-point numeric rating scale (NRS) with an initial score of ≥5. Patients were randomized to receive either 324 mg of VTS-Aspirin™ and 0.5 mg/kg of oral ketamine (AOK) that is directly swallowed or 0.5 mg/kg of oral ketamine (OK) alone that is swished first and then swallowed. Patients were assessed at baseline, 30, 60, 90, and 120 min. The primary outcome was a difference in pain scores between the two groups at 60 min post-administration. Secondary outcomes included adverse events and the need for rescue analgesia.We enrolled 60 patients in the study (30 per group). The difference in mean pain scores at 60 min between the AOK and OK groups was 2.6 [95% CI: 1.38-3.77] showing a lower mean pain score in the OK group. At 60 min, the AOK group had a change in mean pain score from 8.4 to 6.3 (difference 2.1; 95% CI: 1.35-3.00). The OK group had a change in mean pain score from 7.8 to 3.7 (difference 4.1, 95% CI: 3.25-4.90). No clinically concerning changes in vital signs were observed. No serious adverse events occurred in either group. The most commonly reported adverse effects were dizziness and fatigue. None of the participants required rescue analgesia at 60 min post-medications administration.The administration of an oral combination of VTS-Aspirin ™ and ketamine resulted in less analgesia compared to oral ketamine alone, for the short-term treatment of moderate to severe acute musculoskeletal pain in the ED.govRegistration: NCT04860804.

In the last few decades, individuals and communities worldwide have increasingly experienced feelings of anger, anxiety, and frustration concerning environmental issues such as climate change, sustainability, or pollution, and the Covid-19 pandemic has further exacerbated such social fears on a global scale. In this context, popular environmentalist movements, together with other influential individuals, are giving voice to those feelings, offering a safe space for sharing negative emotions, and supporting people with guidance and information through social media. The present study focuses on the discursive construction of negative feelings in social media posts by environmental organisations and eco-conscious people. The term ‘eco-anxiety’ and other relevant keywords are used to assess the presence of eco-anxiety topics in online discourses by looking at recurrent verbal elements and language patterns. While qualitative Critical Discourse Analysis is the privileged methodology, the analysis adopts the Hogg’s scale for eco-anxiety measurement to investigate the sense of urgency and negativity shared by social media users. The analysis is reinforced by data obtained through the corpus analysis tool Sketch Engine outlining points of contact among keywords and collocations, and validating hypotheses on eco-anxiety as a discursive theme., Anglistica AION: An Intersciplinary Journal, Vol 25 No 2 (2021): Living in the Age of Anger. Representing ‘Negative Solidarities’ in Contemporary Global Culture

Background The goal of antimicrobial stewardship is to optimize antimicrobial therapy and clinical outcomes while minimizing the unintended consequences of antimicrobial use. With the majority of antibiotics prescribed in the outpatient setting, optimizing antimicrobial prescribing across the care continuum is necessary. We aimed to evaluate the effect of antimicrobial stewardship interventions on the rate of inappropriate antibiotic prescribing in three adult primary care clinics affiliated with a tertiary care hospital. Methods Antibiotic prescriptions were identified by filtering common antibiotics prescribed prior to and post intervention. Prescriptions were excluded if they were prescribed pre-procedure or if the patient had a recent hospitalization within 30 days of the outpatient visit. Appropriateness of antibiotics was determined by indication, agent, dose and duration. Institutional guidelines were created for most common infections treated in the pre-intervention period. Education to outpatient providers was completed in two in-person visits. Results A total of 258 prescriptions were reviewed between the pre- and post-intervention periods. The majority of patients were female (73-76%) and the median age was similar between both cohorts. The most common infection treated during the pre-intervention period was urinary tract infection, whereas skin and soft tissue infection was most common in the post-intervention period. During the baseline period, the inappropriate prescribing rate was 61%. After intervention, the rate was reduced to 55%. Conclusion The use of outpatient antimicrobial stewardship guidelines and provider education to reinforce knowledge demonstrated reductions in inappropriate antibiotic prescribing. Disclosures All Authors: No reported disclosures.

RESUMEN Objetivo Conocer las propiedades curativas de las hojas de la planta medicinal de uso ancestral pacha-muña (Hedeoma mandoniana Wedd) a través de los saberes de los pobladores del área rural de Antajirca y Bomboncocha, del departamento de Huánuco, Perú, y caracterizar su composición química. Métodos Estudio con enfoque mixto, de corte cualitativo mediante entrevistas orales no estructuradas sobre el uso y propiedades curativas de la pacha-muña a 10 mujeres trabajadoras informales, de los poblados rurales de Antajirca y Bomboncocha, distrito de Churubamba. El estudio tuvo un enfoque cuantitativo: se recolectaron plantas silvestres para someter sus hojas a extracción con etanol, y exponer el extracto a ensayos cualitativos como Shinoda, cloruro férrico, prueba de espumas, de Fehling, entre otros. Se aplicó también la técnica de destilación por arrastre con vapor, para extraer el aceite esencial, el cual se sometió a cromatografía de gases acoplada a espectrometría de masas. Resultados La pacha-muña, planta ampliamente utilizada por los pobladores de la región, es consumida en infusión para sanar problemas digestivos (diarreas, acidez estomacal, halitosis, indigestión, cólicos), enfermedades respiratorias (gripes, bronquitis, asma), entre otras. Se encontró que las hojas están compuestas principalmente por flavonoides, taninos, fenoles y pulegone. Conclusión La pacha-muña, es una hierba aromática ampliamente utilizada por los pobladores de Huánuco, como una herencia cultural de alto valor medicinal, con efectos curativos explicados por la presencia de flavonoides, taninos, fenoles y pulegone. RESUMEN Objective To learn about the healing properties of the leaves of the medicinal plant of ancestral use pacha-muña (Hedeoma mandoniana Wedd) through the knowledge of the inhabitants of the rural area of Antajirca and Bomboncocha, in the department of Huánuco, Peru, and to characterize its chemical composition. Methods Study with a mixed approach, of a qualitative nature, by conducting oral, unstructured interviews on the use and curative properties of the pachamuña to 10 informal women workers, from the rural villages of Antajirca and Bomboncocha, district of Churubamba. And with a quantitative approach, since wild plants were collected, to submit their leaves to ethanol extraction, and expose the extract to qualitative tests such as: Shinoda, ferric chloride, foam test, by Fehling; among others. The technique of steam distillation was also applied to extract the essential oil, which was subjected to gas chromatography coupled with mass spectrometry. Results Pacha-muña, a plant widely used by the inhabitants of the region, is consumed as an infusion to cure digestive problems (diarrhea, heartburn, halitosis, indigestion, colic), respiratory diseases (flu, bronchitis, asthma), among others. It was found that the leaves are mainly composed by: flavonoids, tannins, phenols and pulegone. Conclusion Pacha-muña is an aromatic herb widely used by the inhabitants of Huánuco as a cultural inheritance of high medicinal value, with healing effects explained by the presence of flavonoids, tannins, phenols and pulegone.

El estudio de investigación tuvo el propósito de evaluar el grado de relación que existe entre la formación profesional y su relación con los procesos pedagógicos en el Instituto Superior Pedagógico Privado “Esteban Pavletich” Huánuco -2020. Se identificó la relación que existe entre el aprendizaje del estudiante, y se determinó la relación que existe entre el propósito de formación profesional y los procesos pedagógicos además el aprendizaje del estudiante; así mismo la naturaleza de su formación profesional la finalidad de interpretar resultados se utilizó el diseño correlacional con el muestro no probabilístico con un total de 75 estudiantes 32 estudiantes del VI semestre, 30 estudiantes del VIII 13 estudiantes del X semestre todos estudiantes de Educación Física del instituto. Al grupo en estudio se aplicó un cuestionario de 16 preguntas sobre la formación profesional y su relación con los procesos pedagógicos. Para medir la correlación se realizó la estadística descriptiva y para la contracción de la hipótesis se aplicó la prueba de correlación, de las dos variables cuantitativas que con llevan a los valores de ambas variables, relación entre dos variables no implica por si misma ninguna relación de origen. Se ha demostrado, de la encuesta aplicada a 75 estudiantes del total de porcentaje al 100% Válido deficiente 1,3% regular 10,7% bueno 37,3% excelente 50,7% esto demuestra la existencia de relación entre formación profesional y su relación con los procesos pedagógicos.

Traumatic spinal cord injury (SCI) leads to the disruption of neural pathways, causing loss of neural cells, with subsequent reactive gliosis and tissue scarring that limit endogenous repair. One potential therapeutic strategy to address this is to target reactive scar-forming astrocytes with direct cellular reprogramming to convert them into neurons, by overexpression of neurogenic transcription factors. Here we used lentiviral constructs to overexpress Ascl1 or a combination of microRNAs (miRs) miR124, miR9/9* and NeuroD1 transfected into cultured and in vivo astrocytes . In vitro experiments revealed cortically-derived astrocytes display a higher efficiency (70%) of reprogramming to neurons than spinal cord-derived astrocytes. In a rat cervical SCI model, the same strategy induced only limited reprogramming of astrocytes. Delivery of reprogramming factors did not significantly affect patterns of breathing under baseline and hypoxic conditions, but significant differences in average diaphragm amplitude were seen in the reprogrammed groups during eupneic breathing, hypoxic, and hypercapnic challenges. These results show that while cellular reprogramming can be readily achieved in carefully controlled in vitro conditions, achieving a similar degree of successful reprogramming in vivo is challenging and may require additional steps., Competing Interests: Declaration of interests The authors declare no competing interests.