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Haibin Zou,1 Fangfang Xi,1 Yuanyuan Fu,1 Jinhui Xu,1 Ping Zhang,1 Dongge Li,2 Heguo Luo1 1Department of Anesthesiology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, 330006, People’s Republic of China; 2The Third Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, 330006, People’s Republic of ChinaCorrespondence: Heguo Luo, Department of Anesthesiology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, 330006, People’s Republic of China, Tel +86 13807035516, Email ddjy121@163.comPurpose: Ciprofol, a new sedative anesthetic developed in China, offers rapid onset and recovery, reduced injection pain, and stable circulation. However, its effect on blood pressure during anesthesia induction in older adults remains unclear. To compare the effects of propofol and ciprofol on hypotension induced by general anesthesia in older adults.Patients and Methods: This prospective, single-center, double-blind, randomized, controlled clinical study enrolled 117 older adults undergoing surgery. Patients in the ciprofol group (group C) received an intravenous injection of ciprofol (0.3 mg/kg, n=57), while the propofol group (group P) received an intravenous injection of propofol (1.5 mg/kg, n=58). The primary outcome was the incidence of hypotension (mean arterial pressure (MAP) decreased by > 30% from baseline or MAP< 65 mmHg). Secondary outcomes included induction success rate (bispectral index (BIS) value ≤ 60 and Modified Observer’s Assessment of Alertness/Sedation Scale (MOAA/S) score ≤ 1), injection pain, number of drug additions, time to BIS 60, time to eyelash reflex disappearance, blood pressure changes, incidence of hypertension, tachycardia and BIS values before and after administration.Results: The incidence of induced hypotension was 26.3% (15/57) in group C and 48.3% (28/58) in group P (OR=0.383, 95% CI:175– 0.837, P =0.015). Group C had significantly lower injection pain incidence (5.3% vs 20.7%, OR=0.213, 95% CI: 0.057– 0.801, p=0.014). Both groups had a 100% induction success rate, with no significant difference in the number of additional doses. Post-intubation hypertension and tachycardia incidence were not significantly different. Group C showed less blood pressure decrease during induction and a deeper anesthesia level.Conclusion: Compared to propofol, ciprofol reduces the incidence of induced hypotension in older adults and maintains more stable blood pressure during induction. Additionally, ciprofol reduces injection pain and provides a good depth of anesthesia, making it a safe and effective option for anesthesia induction in older adults.Trial Registration ClinicalTrials.gov Identifier: ChiCTR2200066053.Keywords: ciprofol, propofol, bispectral index, BIS, hypotension

Background: Breast cancer-related lymphedema (BCRL) profoundly impacts patients' quality of life, causing heightened depression, anxiety, and physical limitations. Surgical removal of the axillary nodes, combined with radiation therapy, is a significant risk factor for BCRL. Smarter axillary surgery, coupled with early detection and fostering lymphedema education, significantly improves BCRL management, promoting timely diagnosis and treatment. A lymphedema prevention program encompassing all these factors can significantly aid in preventing, treating, and reducing the severity of BCRL cases. Therefore, our study aims to share our insights and experiences gained from implementing a lymphedema prevention program at our institution. Methods & Results: At our institution, axillary reverse mapping (ARM) is performed on all patients undergoing axillary surgery. We surveil these patients with pre- and postoperative SOZO® measurements using bioimpedance spectroscopy to detect sub-clinical lymphedema. Concerning education, we use a 3-pronged approach with surgeons, nurse practitioners, and video representation for patients. We have had 212 patients undergo the ARM procedure since 2019, with three (1.41%) developing persistent lymphedema. Conclusion: Our study underscores the significance of a comprehensive lymphedema prevention program, integrating smarter axillary surgery, early detection, and patient education. The lymphedema rate of 1.41% not only validates the success rate of these interventions but also advocates for their widespread adoption to enhance the holistic care of breast cancer survivors. As we continue to refine and expand our program, further research, and long-term follow-up are crucial to improve prevention strategies continually and enhance the overall well-being of individuals at risk of BCRL. [ABSTRACT FROM AUTHOR]

This study investigates the incorporation of accounting and informatics in contemporary company management, with a specific emphasis on the influence of information technology on corporate governance and its effects on firm management. This evaluates the significance of ICT in business and the function of economic information systems in corporate management. The study used a qualitative methodology, using academic literature, industry reports, and case studies. The studies seek to improve comprehension of the correlation between accounting and informatics in contemporary corporate management. The study highlights the pivotal significance of information technologies in creating corporate settings and promoting innovation.

Objective: The course of sedation during drug‐induced sleep endoscopy (DISE) depends on the application pattern of the sedative drug. The depth of sedation should imitate light and deep sleep as well. Moreover, there should be as many breathing cycles as possible available for observation during light and deep sedation. The aim of the study was to evaluate different rates of propofol application with respect to the achieved depth and length of the course of sedation. Methods: Sixty‐three consecutive patients with obstructive sleep apnea and/or snoring undergoing DISE were randomly sedated by propofol perfusion at seven different application patterns: 14, 16, 18, 19, 20, 22 mg/kg/h (0.233, 0.267, 0.3, 0.317, 0.333, 0.367 mg/kg/min) per perfusor and individual bolus application 10 mg each. Sedation depth was monitored by BiSpectral Index™ (BIS). The influence of baseline parameters and the courses of sedation were analyzed. Results: The application rate was the only factor that influenced the depth of sedation. Basic parameters (gender, age, body mass index, apnea‐hypopnea index) had no influence on the depth of sedation. The sedation depth was dependent on the rate of propofol application. Regimes at 14 and 16 mg/kg/h as well as bolus application did not reach BIS levels below 50 representing deep sleep. Propofol doses of more than 20 mg/kg/h led to rapid decreases of sedation levels below deep sleep niveau. Propofol rates between 18 and 20 mg/kg/h enable BIS levels below 50 representing deep sleep and providing enough breathing cycles for observation. Conclusion: Lower application rates of propofol provide slower courses of sedation and shallower depths of sedation. A rate of 14 mg/kg/h might be appropriate to reach a sedation plateau at light sleep. A rate of 18 mg/kg/h leads to a sedation, corresponding to deep sleep. The combination of both rates might be a suitable pattern for performing sedation‐controlled DISE. Level of evidence: 2: Randomized trial.Establishment of a dose–response relationship between applied sedative and achieved sedation during sleep endoscopy. And proposal to perform a sedation‐depth guided sleep endoscopy. [ABSTRACT FROM AUTHOR]

BackgroundBreast cancer-related lymphedema (BCRL) profoundly impacts patients’ quality of life, causing heightened depression, anxiety, and physical limitations. Surgical removal of the axillary nodes, combined with radiation therapy, is a significant risk factor for BCRL. Smarter axillary surgery, coupled with early detection and fostering lymphedema education, significantly improves BCRL management, promoting timely diagnosis and treatment. A lymphedema prevention program encompassing all these factors can significantly aid in preventing, treating, and reducing the severity of BCRL cases. Therefore, our study aims to share our insights and experiences gained from implementing a lymphedema prevention program at our institution.Methods & ResultsAt our institution, axillary reverse mapping (ARM) is performed on all patients undergoing axillary surgery. We surveil these patients with pre- and postoperative SOZO® measurements using bioimpedance spectroscopy to detect sub-clinical lymphedema. Concerning education, we use a 3-pronged approach with surgeons, nurse practitioners, and video representation for patients. We have had 212 patients undergo the ARM procedure since 2019, with three (1.41%) developing persistent lymphedema.ConclusionOur study underscores the significance of a comprehensive lymphedema prevention program, integrating smarter axillary surgery, early detection, and patient education. The lymphedema rate of 1.41% not only validates the success rate of these interventions but also advocates for their widespread adoption to enhance the holistic care of breast cancer survivors. As we continue to refine and expand our program, further research, and long-term follow-up are crucial to improve prevention strategies continually and enhance the overall well-being of individuals at risk of BCRL.

Abstract Background Clinical insight (i.e., impaired insight into illness) is increasingly recognized by the scientific community as a significant contributor to an array of psychological and clinical outcomes in schizophrenia. Therefore, its assessment using a reliable, rapid, easy and economic tool is important for clinical practice. This study proposes to investigate the psychometric properties of an Arabic translation of the Birchwood Insight Scale (BIS) in Arabic-speaking chronic patients with schizophrenia. Our objectives were to identify the most adequate factor structure of the BIS among the several measurement models previously proposed in the literature, verify the reliability and measurement invariance of the BIS across sex groups, and explore the concurrent validity of the BIS through examining its patterns of correlations with psychotic symptoms. Method One hundred seventeen Arabic-speaking chronic, remitted patients with schizophrenia took part in this study. An Arabic translated version of the BIS and the Positive and Negative Syndrome Scale (PANSS) were administered to participants. Results Confirmatory factor analyses (CFA) showed that, after omitting two items with low loadings (items 1 and 2), the unidimensional factor model of the BIS showed good fit indices and a reliability of α = 0.68 and ω = 0.68. However, analyses failed to show good fit for the full-length one-, two-, and three-factor models of the BIS in its Arabic version. Measurement invariance of the Arabic 6-item one-factor BIS was established between males and females at the configural, metric and scalar levels; no statistically significant difference between males and females was found in terms of BIS scores. Finally, BIS scores correlated significantly with the PANSS scores in our sample, thus demonstrating adequate concurrent validity. Conclusion This study offers valuable additional psychometric information about the BIS based on results of CFA and other analyses in schizophrenia from a non-Western cultural environment. We believe that making the BIS available in Arabic might benefit clinicians working with Arabic-speaking patients with schizophrenia, open new avenues of research and gain a better knowledge into the nature of clinical insight and its relevance to psychopathology.

This study investigates the incorporation of accounting and informatics in contemporary company management, with a specific emphasis on the influence of information technology on corporate governance and its effects on firm management. This evaluates the significance of ICT in business and the function of economic information systems in corporate management. The study used a qualitative methodology, using academic literature, industry reports, and case studies. The studies seek to improve comprehension of the correlation between accounting and informatics in contemporary corporate management. The study highlights the pivotal significance of information technologies in creating corporate settings and promoting innovation. [ABSTRACT FROM AUTHOR]

Overhydration (OH) is a prevalent medical problem that occurs in patients with kidney failure, but a specific marker has still not been found. Patients requiring kidney replacement therapy suffer from a water imbalance, which is correlated with mortality rates in this population. Currently, clinicians employ techniques such as bioimpedance spectroscopy (BIS) and ultrasound (USG) markers of overhydration or markers of heart and kidney function, namely NT-pro-BNP, GFR, or creatinine levels. New serum markers, including but not limited to Ca-125, galectin-3 (Gal-3), adrenomedullin (AMD), and urocortin-2 (UCN-2), are presently under research and have displayed promising results. Ca-125, which is a protein mainly used in ovarian cancer diagnoses, holds great potential to become an OH marker. It is currently being investigated by cardiologists as it corresponds to the volume status in heart failure (HF) and ventricular hypertrophy, which are also associated with OH. The need to ascertain a more precise marker of overhydration is urgent mainly because physical examinations are exceptionally inaccurate. The signs and symptoms of overhydration, such as edema or a gradual increase in body mass, are not always present, notably in patients with chronic kidney disease. Metabolic disruptions and cachexia can give a false picture of the hydration status. This review paper summarizes the existing knowledge on the assessment of a patient's hydration status, focusing specifically on kidney diseases and the role of Ca-125. [ABSTRACT FROM AUTHOR]

Abstract Objective The course of sedation during drug‐induced sleep endoscopy (DISE) depends on the application pattern of the sedative drug. The depth of sedation should imitate light and deep sleep as well. Moreover, there should be as many breathing cycles as possible available for observation during light and deep sedation. The aim of the study was to evaluate different rates of propofol application with respect to the achieved depth and length of the course of sedation. Methods Sixty‐three consecutive patients with obstructive sleep apnea and/or snoring undergoing DISE were randomly sedated by propofol perfusion at seven different application patterns: 14, 16, 18, 19, 20, 22 mg/kg/h (0.233, 0.267, 0.3, 0.317, 0.333, 0.367 mg/kg/min) per perfusor and individual bolus application 10 mg each. Sedation depth was monitored by BiSpectral Index™ (BIS). The influence of baseline parameters and the courses of sedation were analyzed. Results The application rate was the only factor that influenced the depth of sedation. Basic parameters (gender, age, body mass index, apnea‐hypopnea index) had no influence on the depth of sedation. The sedation depth was dependent on the rate of propofol application. Regimes at 14 and 16 mg/kg/h as well as bolus application did not reach BIS levels below 50 representing deep sleep. Propofol doses of more than 20 mg/kg/h led to rapid decreases of sedation levels below deep sleep niveau. Propofol rates between 18 and 20 mg/kg/h enable BIS levels below 50 representing deep sleep and providing enough breathing cycles for observation. Conclusion Lower application rates of propofol provide slower courses of sedation and shallower depths of sedation. A rate of 14 mg/kg/h might be appropriate to reach a sedation plateau at light sleep. A rate of 18 mg/kg/h leads to a sedation, corresponding to deep sleep. The combination of both rates might be a suitable pattern for performing sedation‐controlled DISE. Level of evidence 2: Randomized trial.

Abstract Background Postoperative delirium (POD) is an important complication for older patients and recent randomised controlled trials have showed a conflicting result of the effect of deep and light anesthesia. Methods We included randomised controlled trials including older adults that evaluated the effect of anesthetic depth on postoperative delirium from PubMed, Embase, Web of Science and Cochrane Library. We considered deep anesthesia as observer’s assessment of the alertness/ sedation scale (OAA/S) of 0–2 or targeted bispectral (BIS) 50. The primary outcome was incidence of POD within 7 days after surgery. And the secondary outcomes were mortality and cognitive function 3 months or more after surgery. The quality of evidence was assessed via the grading of recommendations assessment, development, and evaluation approach. Results We included 6 studies represented 7736 patients aged 60 years and older. We observed that the deep anesthesia would not increase incidence of POD when compared with the light anesthesia when 4 related studies were pooled (OR, 1.40; 95% CI, 0.63–3.08, P = 0.41, I2 = 82%, low certainty). And no significant was found in mortality (OR, 1.12; 95% CI, 0.93–1.35, P = 0.23, I2 = 0%, high certainty) and cognitive function (OR, 1.13; 95% CI, 0.67–1.91, P = 0.64, I2 = 13%, high certainty) 3 months or more after surgery between deep anesthesia and light anesthesia. Conclusions Low-quality evidence suggests that light general anesthesia was not associated with lower POD incidence than deep general anesthesia. And High-quality evidence showed that anesthetic depth did not affect the long-term mortality and cognitive function. Systematic review registration CRD42022300829 (PROSPERO).

Variability is high in predicted propofol concentrations during clinical anaesthesia titrated by target-controlled infusion (TCI) to maintain a processed EEG parameter (bispectral index [BIS]) within a specified range. We have shown that the potential for improving the pharmacokinetic model is minimal. The drug titration paradox revealed that titration challenges the classical relationship between drug dose and effect in both individuals and the population. We hypothesised that dynamic factors during surgery beyond the static genetic, epigenetic, and other factors such as age, height, and weight affect the necessary dose. We compared the variability of measured end-tidal sevoflurane concentrations with predicted effect-site propofol concentrations when titrated to a BIS range of 40–60, with the hypothesis that the variability in measured sevoflurane concentrations would not be less than the variability in estimated propofol concentrations. Clinical data from 2280 surgical procedures >1 h in duration were included in the analysis. Anaesthesia with sevoflurane or propofol was based on an institutional protocol. The titration performance for both drugs was assessed by comparing BIS values 30 min after skin incision. The variability of the required concentrations at the same time point was calculated and compared. The achieved 30-min post-incision BIS ranges were not significantly different for sevoflurane or propofol TCI (30 [99% CI: 28–33] and 31 [99% CI: 27–36], respectively). The variability of sevoflurane concentrations was not significantly different from measured predicted propofol concentrations during BIS-guided anaesthesia (normalized concentration range of 0.89 [99% CI: 0.78–0.99] and 0.93 [99% CI 0.87–1.02). Improvements in prediction accuracy of pharmacokinetic models beyond that of those already in clinical use are unlikely to reduce variability in target anaesthetic concentrations across patients in clinical practice. [ABSTRACT FROM AUTHOR]

Abstract Background The Bispectral Index (BIS) and the Patient State Index (PSI) are commonly used measures to assess intraoperative sedation depth. However, model differences lead to different results, which in turn interferes with clinicians’ judgment on the depth of anesthesia. Remimazolam tosilate (RT) for injection is a new benzodiazepine used in sedation. In its clinical application, there are few effective indicators for sedation depth monitoring. To close this gap, this study aims to compare BIS and PSI in measuring the sensitivity and specificity of intraoperative RT and to explore the safety of RT for intraspinal anesthesia in elderly patients. Methods This study included 40 patients undergoing elective electro-prostatectomy with intraspinal anesthesia, who were monitored by BIS and PSI simultaneously during operation. Remimazolam tosylate 0.1 mg/kg was intravenously administered after the intraspinal anesthesia when patients were in a completely painless status. Then BIS, PSI, the Modified Observer’s Assessment of Alertness and Sedation (MOAA/S) scores and vital signs were observed and recorded per minute for 10 min. Pearson’s correlation analysis and linear regression model were used to compare BIS and PSI sedation scores, and to test their associations with the MOAA/S score, respectively. ROC curves were drawn to compare the sensitivity and specificity of BIS and PSI. Changes of vital signs were presented as mean ± standard deviation. Perioperative liver and kidney function indicators were analyzed using a paired t-test to evaluate the safety of RT for intraspinal anesthesia in the elderly patients. Results According to Pearson’s correlation analysis, a significant (P

The article examines the current state of implementation of one of the largest regulatory projects in to examine the role of international cross-border payment regulation in the context of global financial architecture and to see how a modernized national payment infrastructure could be optimally embedded in the global payment infrastructure. To achieve this purpose, this article systematizes the standard setting documents and analyzes doctrinal sources. Special attention is paid to BIS Innovation Hub projects. The study analyses area E of the G20 Roadmap, which covers the development of new means of payment, including CBDCs and stablecoins. In particular, the paper provides an overview of analytics and specific projects pertaining to the introduction of central bank digital currencies (CBDC). The article also analyzes how the issuance of CBDCs relates to the international framework being created for regulating crypto assets. The authors conclude that global financial regulation is becoming more payment-centric since the issue of regulating cross-border payments lies at the intersection of several important policies and international legal regimes. In particular, this involves international policies pertaining to the regulation of financial services, macroprudential regulation, regulation of the global monetary system, regulation of crypto assets, countering illicit financial flows in the global economy, and ESG regulation. The article systematizes the features and risks of the payment-centric model for global financial regulation. It concludes that international cooperation and coordination are necessary if cross-border projects related to payments are to be successfully implemented.

Background: Insomnia is a very common and yet challenging condition encountered in clinical practice. Clinical evaluation, often with the help of questionnaires is used to diagnose and quantify this condition. However, the questionnaires are highly heterogeneous in their scope and outlook and give varying information on different aspects of insomnia. Research questionnaires on insomnia abound in clinical literature but are not useful in the clinical setting to help in therapeutic decision-making. This paper is a review of the scope and limitations of some of the commonly used questionnaires in the diagnosis and evaluation of insomnia in the clinical setting. Methods: A thorough literature search of studies evaluating diagnosis and evaluation of insomnia were included. The studies were selected on basis of their utility in clinical settings and the quality of the research reporting the results of their use. The usefulness and scope of the questionnaire and voids in their utility were discussed. Out of a total of 3872 articles, a final of 11 studies were taken up for final study as per the guidelines of reporting of systematic reviews PRISMA statement, 2020. Results: The included articles showed great heterogeneity in their scope as well as outcome measures. The older studies were of low methodological quality and limited clinical utility. Administration in a clinical setting was difficult for many while scoring questionnaires was complex and cumbersome. Conclusion: There is an unmet need for a holistic and easily administrable assessment measure of insomnia remains.

Background and Aims: The return of consciousness (ROC) after general anesthesia (GA) is by stopping the administration of anesthetic agents. At present, no drug is given to reverse the loss of consciousness produced by general anesthetic agents. This study is conducted to find whether caffeine and aminophylline hasten the ROC. Material and Methods: This study was conducted on 75 American Society of Anesthesiologists (ASA) I and II female patients undergoing laparoscopic hysterectomy, aged between 18 and 60 years. The patients were divided into three equal groups (Group C: caffeine citrate, Group A: aminophylline, and Group S: saline) of 25 each by a computer-generated random number table. GA was induced with propofol, fentanyl, and maintained with propofol infusion. On completion of the surgery, the neuromuscular blocking agent was reversed and then the infusion of propofol was stopped. The study drug was administered intravenously when the BIS 60 was achieved. Time to achieve BIS 90, return of first gag reflex, eye-opening on verbal command, and extubation after study drug administration were noted. Hemodynamic parameters and SpO2 were also monitored. Results: The time for BIS 60 to 90 was 10 (4.25) min in the caffeine group, 13 (4.25) min in the aminophylline group, and 26 (9.0) min in the saline group. The time to return of gag reflex and time to extubation were shorter in the caffeine and aminophylline group compared to the saline group. The time to eye-opening on verbal command was shorter in the aminophylline group compared to the saline group. Hemodynamic parameters after infusion of the study drug were comparable in all three groups. Conclusion: Caffeine hastens the recovery from total intravenous anesthesia with propofol and fentanyl in laparoscopic hysterectomy as effectively as aminophylline. [ABSTRACT FROM AUTHOR]

Background: Postoperative delirium (POD) is the most common postoperative complication in elderly patients, especially in older aged patients (aged 75 years or over). The development of electroencephalography analysis could provide indicators for early detection, intervention, and evaluation. If there are pathophysiological changes in the brain, the BIS value will also change accordingly. In this study, we investigated the predictive value of the preoperative bispectral (BIS) index in POD for patients aged over 75 years. Methods: In this prospective study, patients (≥ 75 years) undergoing elective non-neurosurgery and non-cardiac surgery under general anesthesia were included (n = 308). Informed consent was obtained from all involved patients. Before the operation and during the first 5 postoperative days, delirium was assessed with the confusion assessment method by trained researchers twice every day. Thereafter, the preoperative bedside BIS of each patient was dynamically acquired by the BIS VISTA monitoring system and the BIS monitoring of electrodes. A series of evaluation scales were assessed before and after surgery. A preoperative predictive score was generated according to the results of multivariable logistic regression. The receiver operating characteristic curves were drawn and the area under the curves was estimated to evaluate the perioperative diagnostic values of BIS and preoperative predictive score for POD. The specificity, sensitivity, positive predictive value (PPV), and negative predictive (NPV) value were calculated. Results: Delirium occurred in 50 of 308 (16.2%) patients. The median BIS of delirious patients was 86.7 (interquartile range [IQR] 80.0–94.0), lower than that of the non-delirious 91.9 (IQR 89.7–95.4, P < 0.001). According to the ROC curve of the BIS index, the optimal cut-off value was 84, with a sensitivity of 48%, specificity of 87%, PPV 43%, NPV 89% for forecasting POD and the area under curves was 0.67. While integrating BIS, mini-mental state examination, anemia, activities of daily living, and blood urea nitrogen, the model had a sensitivity of 78%, specificity of 74%, PPV of 0.37%, and NPV of 95% for forecasting POD, and the area under curves was 0.83. Conclusions: Preoperative bedside BIS in delirium patients was lower than that in non-delirium patients when undergoing non-neurosurgery and non-cardiac surgery in patients aged over 75. The model of integrating BIS, mini-mental state examination, anemia, activities of daily living, and blood urea nitrogen is a promising tool for predicting postoperative delirium in patients aged over 75. [ABSTRACT FROM AUTHOR]

The domain of SEPs is highly engrossed with multitude of issues, as it is generally understood. Most of the issues come from patent holders' anti-competitive behavior, which includes unilateral rejection to license, patent ambushes, patent holdups, strategic injunctive relief, royalty staking, and breach of F/RAND Commitments, both inside and outside of SSOs (national & international). One of the key tenets of standards is that they be universally recognized and applied once they have been approved. Suppliers view standards as a way to meet consumer needs while also offering a chance to pave the way for innovation through compatibility, complementarily and interoperability. Standards thus have an impact on both innovation and the dissemination of technology since they create a technological infrastructure with a significant public benefit component. The previous article provided the readers with a comprehensive introduction to SEPs and their implications in the modern intellectual property landscape. This issue of this yearlong series will take the baton further to dwell on the issues circumventing around this domain of SEPs. [ABSTRACT FROM AUTHOR]

Ping Wang,1,2 Lei Zhao,1 Tianlong Wang,1 Wei Mei,3 Jingsheng Li,1 Yi An,1 Lixia Li,1 Zhongjia Li1 1Department of Anesthesiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, People’s Republic of China; 2Department of Anesthesiology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210000, People’s Republic of China; 3Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430000, People’s Republic of ChinaCorrespondence: Lei Zhao, Email zhaoalei@sina.comObjective: This study aimed to compare the half-effective concentration (EC50) of propofol required for the bispectral index (BIS) 50 in patients with Parkinson’s disease (PD) and non-PD (NPD) during induction by the Dixon’s improved sequential method.Methods: This prospective study recruited 20 patients with PD undergoing deep brain stimulation and 20 patients with NPD accompanied by meningioma or glioma undergoing intracranial surgery from March 2018 to March 2019. The patients were induced by propofol via target-controlled infusion. The target effect-site concentration of propofol was determined by the Dixon’s improved sequential method. The results of the pilot experiment showed that the target effect-site concentration for the first patient with PD and NPD was 3.5 μg/mL and 2.8 μg/mL, respectively. BIS values were recorded after achieving a constant effect-site concentration of propofol. The increment or decrement of the target effect-site concentration of the next patient was 0.1 μg/mL.Results: Demographic data, general physical condition, and hemodynamic values were similar between the PD and the NPD groups. The target effect-site concentration of propofol induction doses was significantly higher in the PD group than in the NPD group. The EC50 of propofol required for BIS 50 was 3.213 μg/mL [95% confidence interval (CI), 3.085– 3.287 μg/mL] in the PD group and 2.77 μg/mL (95% CI, 2.568– 2.977 μg/mL) in the NPD group.Conclusion: The EC50 of propofol required for BIS 50 was higher in patients with PD than in patients with NPD.Keywords: BIS, effect-site concentration, Parkinson’s disease, propofol, sequential method, TCI

Background and Aims: The return of consciousness (ROC) after general anesthesia (GA) is by stopping the administration of anesthetic agents. At present, no drug is given to reverse the loss of consciousness produced by general anesthetic agents. This study is conducted to find whether caffeine and aminophylline hasten the ROC. Material and Methods: This study was conducted on 75 American Society of Anesthesiologists (ASA) I and II female patients undergoing laparoscopic hysterectomy, aged between 18 and 60 years. The patients were divided into three equal groups (Group C: caffeine citrate, Group A: aminophylline, and Group S: saline) of 25 each by a computer-generated random number table. GA was induced with propofol, fentanyl, and maintained with propofol infusion. On completion of the surgery, the neuromuscular blocking agent was reversed and then the infusion of propofol was stopped. The study drug was administered intravenously when the BIS 60 was achieved. Time to achieve BIS 90, return of first gag reflex, eye-opening on verbal command, and extubation after study drug administration were noted. Hemodynamic parameters and SpO2 were also monitored. Results: The time for BIS 60 to 90 was 10 (4.25) min in the caffeine group, 13 (4.25) min in the aminophylline group, and 26 (9.0) min in the saline group. The time to return of gag reflex and time to extubation were shorter in the caffeine and aminophylline group compared to the saline group. The time to eye-opening on verbal command was shorter in the aminophylline group compared to the saline group. Hemodynamic parameters after infusion of the study drug were comparable in all three groups. Conclusion: Caffeine hastens the recovery from total intravenous anesthesia with propofol and fentanyl in laparoscopic hysterectomy as effectively as aminophylline.

This study re-examines the relationships between the five mindfulness facets of observing, describing, acting-with-awareness, non-judging, and non-reactivity, and the affective personality measures inspired by the revised Reinforcement Sensitivity Theory (rRST). The rRST measures assess behavioural inhibition sensitivity, fight-flight-freeze sensitivity, and the behavioural approach sensitivity components of reward interest, goal-drive-persistence, reward reactivity, and impulsivity. Research has suggested that relationships exist between specific mindfulness facets and specific rRST constructs. However, some non-significant relationships were reported, possibly due to the small sample used. Also included in the analyses is (self-reported) attentional control, a variable that has not been accounted for in rRST and mindfulness research, but is inter-correlated with mindfulness and anxiety. In a sample of 641 participants, behavioral inhibition sensitivity shared a negative relationship with the describing, acting with awareness, non-judging, and non-reactivity components of mindfulness, and the impulsivity component of behavioural approach sensitivity shared a negative relationship with the acting with awareness facet of mindfulness. This is consistent with previous research. Attentional control shared a positive relationship with the describing, acting with awareness. and non-judging facets of mindfulness. In conclusion, specific reinforcement sensitivity personality constructs and attentional control relate to specific mindfulness components. Trait mindfulness and/or the efficacy of mindfulness interventions could be affected by variations in reinforcement sensitivity and attentional control ability.

Background: The Bispectral Index (BIS) and the Patient State Index (PSI) are commonly used measures to assess intraoperative sedation depth. However, model differences lead to different results, which in turn interferes with clinicians' judgment on the depth of anesthesia. Remimazolam tosilate (RT) for injection is a new benzodiazepine used in sedation. In its clinical application, there are few effective indicators for sedation depth monitoring. To close this gap, this study aims to compare BIS and PSI in measuring the sensitivity and specificity of intraoperative RT and to explore the safety of RT for intraspinal anesthesia in elderly patients. Methods: This study included 40 patients undergoing elective electro-prostatectomy with intraspinal anesthesia, who were monitored by BIS and PSI simultaneously during operation. Remimazolam tosylate 0.1 mg/kg was intravenously administered after the intraspinal anesthesia when patients were in a completely painless status. Then BIS, PSI, the Modified Observer's Assessment of Alertness and Sedation (MOAA/S) scores and vital signs were observed and recorded per minute for 10 min. Pearson's correlation analysis and linear regression model were used to compare BIS and PSI sedation scores, and to test their associations with the MOAA/S score, respectively. ROC curves were drawn to compare the sensitivity and specificity of BIS and PSI. Changes of vital signs were presented as mean ± standard deviation. Perioperative liver and kidney function indicators were analyzed using a paired t-test to evaluate the safety of RT for intraspinal anesthesia in the elderly patients. Results: According to Pearson's correlation analysis, a significant (P < 0.01) correlation between BIS and PSI was found when used to monitor intraoperative sedation of RT (r = 0.796). Significant associations between BIS and MOAA/S (r = 0.568, P < 0.01), and between PSI and MOAA/S (r = 0.390, P < 0.01) were also found. The areas under the ROC curves of BIS and PSI were 0.801 ± 0.022 and 0.734 ± 0.026, respectively, suggesting that both measures may predict patients' state of consciousness and BIS was more accurate than PSI. Vital signs remained stable throughout the study. No abnormal changes of clinical significance were found based on laboratory test results of liver and kidney function. Conclusion: BIS and PSI are strongly associated for monitoring the sedation of RT intraoperatively. Both methods can accurately reflect sedation depth. According to correlation analyses with MOAA/S scale and ROC curves, BIS is more accurate than PSI during such intraoperative monitoring. In addition, RT can be safely used in elderly patients under intraspinal anesthesia for supportive sedation, with stable vital signs and sound kidney and liver safety profiles. Trial registration: http://www.chictr.org.cn (ChiCTR2100051912). [ABSTRACT FROM AUTHOR]

'Depth of anaesthesia' monitors claim to measure hypnotic depth during general anaesthesia from the EEG, and clinicians could reasonably expect agreement between monitors if presented with the same EEG signal. We took 52 EEG signals showing intraoperative patterns of diminished anaesthesia, similar to those that occur during emergence (after surgery) and subjected them to analysis by five commercially available monitors. We compared five monitors (BIS, Entropy-SE, Narcotrend, qCON, and Sedline) to see if index values remained within, or moved out of, each monitors' recommended index range for general anaesthesia for at least 2 min during a period of supposed lighter anaesthesia, as observed by changes in the EEG spectrogram obtained in a previous study. Of the 52 cases, 27 (52%) had at least one monitor warning of potentially inadequate hypnosis (index above range) and 16 of the 52 cases (31%) had at least one monitor signifying excessive hypnotic depth (index below clinical range). Of the 52 cases, only 16 (31%) showed concordance between all five monitors. Nineteen cases (36%) had one monitor discordant compared with the remaining four, and 17 cases (33%) had two monitors in disagreement with the remaining three. Many clinical providers still rely on index values and manufacturer's recommended ranges for titration decision making. That two-thirds of cases showed discordant recommendations given identical EEG data, and that one-third signified excessive hypnotic depth where the EEG would suggest a lighter hypnotic state, emphasizes the importance of personalised EEG interpretation as an essential clinical skill. [ABSTRACT FROM AUTHOR]

Impulsive personality traits are complex heritable traits that are governed by frontal-subcortical circuits and are associated with numerous neuropsychiatric disorders, particularly drug abuse and attention-deficit/hyperactivity disorder (ADHD). In collaboration with the genetics company 23andMe, we performed 10 genome-wide association studies on measures of impulsive personality traits [the short version of the UPPS-P Impulsive Behavior Scale, and the Barratt Impulsiveness Scale (BIS-11)] and drug experimentation (the number of drug classes an individual had tried in their lifetime) in up to 22,861 male and female adult human research participants of European ancestry. Impulsive personality traits and drug experimentation showed single nucleotide polymorphism heritabilities that ranged from 5 to 11%. Genetic variants in the CADM2 locus were significantly associated with UPPS-P Sensation Seeking (p = 8.3 × 10-9, rs139528938) and showed a suggestive association with Drug Experimentation (p = 3.0 × 10-7, rs2163971; r2 = 0.68 with rs139528938). Furthermore, genetic variants in the CACNA1I locus were significantly associated with UPPS-P Negative Urgency (p = 3.8 × 10-8; rs199694726). The role of these genes was supported by single variant, gene- and transcriptome-based analyses. Multiple subscales from both UPPS-P and BIS showed strong genetic correlations (>0.5) with Drug Experimentation and other substance use traits measured in independent cohorts, including smoking initiation, and lifetime cannabis use. Several UPPS-P and BIS subscales were genetically correlated with ADHD (rg = 0.30-0.51), supporting their validity as endophenotypes. Our findings demonstrate a role for common genetic contributions to individual differences in impulsivity. Furthermore, our study is the first to provide a genetic dissection of the relationship between different types of impulsive personality traits and various psychiatric disorders.SIGNIFICANCE STATEMENT Impulsive personality traits (IPTs) are heritable traits that are governed by frontal-subcortical circuits and are associated with neuropsychiatric disorders, particularly substance use disorders. We have performed genome-wide association studies of IPTs to identify regions and genes that account for this heritable variation. IPTs and drug experimentation were modestly heritable (5-11%). We identified an association between single nucleotide polymorphisms in CADM2 and both sensation seeking and drug experimentation; and between variants in CACNA1I and negative urgency. The role of these genes was supported by single variant, gene- and transcriptome-based analyses. This study provides evidence that impulsivity can be genetically separated into distinct components. We showed that IPT are genetically associated with substance use and ADHD, suggesting impulsivity is an endophenotype contributing to these psychiatric conditions.

Structural equation modelling (SEM) is a statistical technique used in the field of Information Systems amongst others. The technique has been paid attention thanks to its flexibility and predictive power. However, there is a paucity of guidelines in the application of the technique in the field of Behavioural Information Security. Hence, this paper aims to provide a comprehensive guide of using PLS-SEM in disclosure and privacy studies on Social Network Sites (SNSs). Data has been gathered using papers (n=21) published between 2006 and 2022 from scholarly databases such as Google Scholar, Association for Information Systems eLibrary (AISeL), IEEE Xplore and Science Direct. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA 2020) was used to analyse and synthesize the status of the field. Our systematic review covers data characteristics, reasons for using PLS-SEM, the evaluation of measurement models, the evaluation of the structural model and reporting best practices. The review proposed guidelines for the use of PLS-SEM in the discipline of Behavioural Information Security with a focus on disclosure and privacy on SNSs studies and other fields as well.

The crosslinked polyethylene (XLPE) cable safety is affected by environmental factors and artificial defects during operation. This work proposes an improved locating method based on broadband impedance spectrum (BIS) to locate local defects in XLPE cables. The calculation process of the algorithm has been analyzed. The selection of the incident Gaussian signal and the peak recognition method have been discussed, where the pulse width of the Gaussian signal was found to be determined primarily by the upper limit frequency of the traveling wave transmitting in the cable. The centroid and function fitting methods were established to reduce the peak recognition error caused by the test sampling rate. This work verified the accuracy of the algorithm through experiments. A vector network analyzer (VNA) was used to test the BIS of the cable. A 20 m-long cable containing abrasion and an inserted nail with different depths was measured in the BIS test. It was found that the abrasion and the nail could be located. The locating deviation of abrasion was within ±1%, and the centroid and function fitting methods could effectively reduce the locating deviation. The locating deviation was within ±1% when the depth of the nail inserted into the cable accounted for less than 50% of the insulation thickness. When the depth exceeded 75% of the insulation thickness, the deviation of each method was more significant, and the maximum absolute value of the deviation was 4%. [ABSTRACT FROM AUTHOR]

Introduction: Allergic rhinitis (AR) is an IgE-mediated reaction to inhaled allergens, and is a prominent health concern affecting approximately 400 million people worldwide. A comprehensive understanding of AR's pathophysiology is imperative for developing novel therapies, especially considering its frequent co-morbidity with asthma and conjunctivitis. The escalating prevalence of AR is correlated with increased urbanization and environmental pollutants, recognized as prominent contributing factors. Dysregulation in immune networks, Th1/Th2 cytokine imbalance, activation of mast cells and eosinophils are implicated in AR progression. Classic AR symptoms include nasal congestion, nasal itching, rhinorrhea, and sneezing which significantly impact the quality of life, social interactions, and workplace productivity., Methods: This randomized, double-blind, placebo-controlled, three-arm, three-sequence study was aimed to assess the efficacy of supplementation of a co-delivery form of turmeric extract with ashwagandha extract (CQAB) in comparison with a bioavailable curcumin (CGM) and placebo in alleviating AR symptoms and enhancing the quality of life in individuals with mild AR. Participants received either placebo, CGM, or CQAB twice/day for 28 days, and subjective measures were recorded at the baseline and at the end of study., Results: CQAB supplementation demonstrated a significant ( P  < 0.05) improvement in Total Nasal Symptom Score (TNSS) compared to placebo and CGM. Furthermore, CQAB administration resulted in enhanced sleep quality ( P  < 0.05) as evaluated by the BIS questionnaire, heightened energy levels, and decreased fatigue and overall mood disturbance (POMS-SF) compared to both placebo and CGM., Conclusion: The results suggests that CQAB has the potential to be used as a dietary supplement in alleviating AR discomforts., Clinical Trial Registration: https://ctri.nic.in/Clinicaltrials/login.php; Identifier CTRI/2021/01/030355., Competing Interests: The authors declare that this study received funding from Akay Natural Ingredients. PP, JM, SD and KIM were employed by Akay Natural Ingredients. The remaining 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., (© 2024 K, Aryan, Prabhakaran, Mulakal, Das S, IM and Parameswara Panicker.)

Abstract Background Impulsivity is associated with several psychiatric disorders, including substance use disorders (SUD) and attention deficit hyperactivity disorder (ADHD). A widely used questionnaire to assess impulsivity is the Barratt Impulsiveness Scale (BIS), and the aim of the current study was to evaluate the psychometric properties of the Swedish version of the BIS (swe-BIS). Methods The original BIS was translated to Swedish and back-translated by an authorized translator. The swe-BIS was administered to healthy controls (n = 113), patients with alcohol use disorder (n = 97), amphetamine use disorder (n = 37) and attention deficit hyperactive disorder (ADHD; n = 26). A subset of subjects (n = 62) completed the swe-BIS twice within 1 week. Psychometric evaluation of the swe-BIS included assessment of different indices of reliability (internal consistency, test-retest and agreement) and validity (response processess, divergent and convergent). Confirmatory factor analyses (CFA) were performed to assess several indices of model fit in five different models based on previously suggested subscales. Results Cronbach’s alpha for all swe-BIS items in the full sample was 0.89, ranging from 0.78–0.87 within the different subgroups. The Pearson test-retest correlation for total score was 0.78 (p

Abstract The main emphasis of this study was to assess the status of drinking water quality from four different water sources available in and around an institutional campus of Lumami, Nagaland University, with special reference to the detection of trace heavy metal elements. The results of the physico-chemical parameters of the water show that values of DO, BOD5 and free CO2 at S3 are beyond the permissible limit set by WHO and BIS. The values of DO in all the three stations (S1, S2 and S4) are near the maximum permissible limit of drinking water, indicating the deterioration of water quality, whereas the rests of the parameters are below the permissible limit of WHO and BIS. The detection of Hg in all stations along with alarmingly high concentrations of Fe and others such as Cu, Zn, Mn and Se is perceived as a matter of concern. On the other hand, As and Pb were not detected in any station. The detection of Hg and Fe in all the four types of water sources is an indication of contaminant hazards and needs drinking water treatment practices in these areas which in turn have implications on human health.

Abstract Background This study compared the effects of premedication with different doses of aminophylline on the recovery profile after general anaesthesia. Methods Forty-five patients scheduled for pelvic-abdominal surgeries were divided into 3 groups: Group C: the patients received 100 ml of IV normal saline, Group A1: the patients received 2 mg/kg IV aminophylline, and Group A2: the patients received 4 mg/kg IV aminophylline 30 min before induction of general anaesthesia. The following data were recorded: demographic data, ASA physical status, duration of anaesthesia and surgery, heart rate, mean arterial blood pressure, propofol dose, fentanyl dose, times to reach BIS (48 ± 2) after induction of anaesthesia and to reach a value of 80 after discontinuation of sevoflurane anaesthesia, time to recovery of consciousness and to tracheal extubation and to discharge from the post-anaesthesia care unit, and side effects of aminophylline. Results The time to reach a BIS of 48 ± 2 was significantly lower for the control group than group A2 (70.67 ± 22.50 and 106.67 ± 34.77 s for groups C and A2, respectively, p -value =0.01). The time to reach a BIS of 80 was significantly longer for the control group than group A1 andA2 (5.6 ± 1.40,3.5 ± 1.93and 2.53 ± 1.72 min for groups C,A1 and A2, respectively, p -value

Intra-operative awareness is very rare yet represents a serious complication of general anaesthesia. The ongoing consequences of such an event may cause significant distress and long-term effects such as insomnia, depression, anxiety and post-traumatic stress disorder (PTSD). To provide safer anaesthesia, it is critical to identify contributing factors related to both the patient and the anaesthesia to prevent intra-operative awareness in at-risk patients. It is also vital to provide education to Post Anaesthesia Care Unit (PACU) nurses and surgical ward nurses about the appropriate way to manage a situation when a patient reports intra-operative awareness following anaesthesia. General anaesthesia with neuromuscular blockade is still considered the highest risk factor for intra-operative awareness. Depth of anaesthesia monitoring has come under the spotlight to try and address this complication; however, there is yet to be a device or technique that provides 100 per cent accuracy in measuring depth of anaesthesia. It is the collective responsibility of all perioperative staff to identify patients at high risk of intra-operative awareness, manage the intra-operative complexities and offer support and expert counselling post-operatively when intra-operative awareness is reported. [ABSTRACT FROM AUTHOR]

Background: Rapid recovery after anesthesia is critical and is associated with the anesthetic agents used. The bispectral index (BIS) monitoring to guide anesthetic agents' doses may play a significant role in the recovery time. This study compared recovery time after Target Controlled Infusion (TCI) of propofol with sevoflurane anesthesia by using BIS monitoring during vitrectomy surgery. Methodology: This was a prospective observational, randomized study on 40 patients aged 18-65 y, physical status ASA I-II, body mass index (BMI) 18-30 kg/m2, who underwent vitrectomy surgery. Subjects were randomly assigned into two groups, Group P - the TCI propofol group, and Group S - the sevoflurane group. Subjects in the Group P received TCI propofol (Schnider), and subjects in the Group S received sevoflurane for anesthesia maintenance, with a targeted BIS score of 40-60. Inj. fentanyl 1 µg/kg was administered if there was an increase in blood pressure, heart rate and/or BIS that could not be overcome by increasing the dose of TCI propofol or sevoflurane. Recovery time was calculated from when the maintenance regimen was stopped until the patient was able to obey simple commands. Recovery time, fentanyl consumption, postoperative agitation, nausea and vomiting incidence were noted and analyzed with SPSS v21.0 for Windows. T-Test or Mann-Whitney U test was performed to analyze the data. Result: Recovery time in the Group P [11.5 (5-25) min)] was not significantly different from the Group S [9 (4-18) min, p = 0.139]. Total fentanyl consumption was higher in the Group P than in the Group S (1.765 vs. 1.428 µg/kg). The frequency of agitation during recovery was higher in the Group S than in the Group P (30% vs. 20%) Conclusion: There was no significant difference in recovery time between TCI propofol and sevoflurane anesthesia using BIS monitoring in vitrectomy. Total fentanyl consumption was higher in the propofol group than in the sevoflurane group. The impact of these anesthetic regimens on postoperative agitation needs further investigation. [ABSTRACT FROM AUTHOR]

The crosslinked polyethylene (XLPE) cable safety is affected by environmental factors and artificial defects during operation. This work proposes an improved locating method based on broadband impedance spectrum (BIS) to locate local defects in XLPE cables. The calculation process of the algorithm has been analyzed. The selection of the incident Gaussian signal and the peak recognition method have been discussed, where the pulse width of the Gaussian signal was found to be determined primarily by the upper limit frequency of the traveling wave transmitting in the cable. The centroid and function fitting methods were established to reduce the peak recognition error caused by the test sampling rate. This work verified the accuracy of the algorithm through experiments. A vector network analyzer (VNA) was used to test the BIS of the cable. A 20 m-long cable containing abrasion and an inserted nail with different depths was measured in the BIS test. It was found that the abrasion and the nail could be located. The locating deviation of abrasion was within ±1%, and the centroid and function fitting methods could effectively reduce the locating deviation. The locating deviation was within ±1% when the depth of the nail inserted into the cable accounted for less than 50% of the insulation thickness. When the depth exceeded 75% of the insulation thickness, the deviation of each method was more significant, and the maximum absolute value of the deviation was 4%.

Background: Impulsivity is associated with several psychiatric disorders, including substance use disorders (SUD) and attention deficit hyperactivity disorder (ADHD). A widely used questionnaire to assess impulsivity is the Barratt Impulsiveness Scale (BIS), and the aim of the current study was to evaluate the psychometric properties of the Swedish version of the BIS (swe-BIS). Methods: The original BIS was translated to Swedish and back-translated by an authorized translator. The swe-BIS was administered to healthy controls (n = 113), patients with alcohol use disorder (n = 97), amphetamine use disorder (n = 37) and attention deficit hyperactive disorder (ADHD; n = 26). A subset of subjects (n = 62) completed the swe-BIS twice within 1 week. Psychometric evaluation of the swe-BIS included assessment of different indices of reliability (internal consistency, test-retest and agreement) and validity (response processess, divergent and convergent). Confirmatory factor analyses (CFA) were performed to assess several indices of model fit in five different models based on previously suggested subscales. Results: Cronbach's alpha for all swe-BIS items in the full sample was 0.89, ranging from 0.78–0.87 within the different subgroups. The Pearson test-retest correlation for total score was 0.78 (p < 0.001), with greater test-retest correlations within compared to across different subscales. The Bland-Altman plot indicated high level of agreement between test and retest. The healthy individuals had lower swe-BIS score compared to the patients (t(267.3) = − 8.6; p < 0.001), and the swe-BIS total score was also significantly different between each of the four participant groups (p < 0.01 for all group comparisons). Furthermore, swe-BIS had greater correlations with impulsivity related scales compared to non-impulsivity related scales. The CFA analyses indicated that while no suggested model showed an optimal fit, the best model fit indices was found for the 3-factor model. Conclusions: The swe-BIS was found to have good to excellent psychometric properties with respect to the assessed indices of reliability and validity, supporting use of the scale in clinical research in both healthy individuals and patients with SUD and ADHD. [ABSTRACT FROM AUTHOR]

Introduction: In this study, it is aimed to assess the validity and reliability of Reinforcement Sensitivity Questionnaire (RSQ) which was developed on the basis of revised Reinforcement Sensitivity Theory (rRST) in Turkish community sample. Methods: The sample of study was consisted of 528 participants, 314 (59.5%) female and 214 (40.5%) male, in the range of 18-69 years. Data was collected by using online data collection tools via snowball method. Within the scope of the reliability study, test-retest application, split-half method and internal consistency analysis; within the scope of the validity study, explanatory factor analysis and confirmatory factor analysis were performed. For criterion-related validity Behavioral Inhibition System / Behavioral Activation System Scale (BIS/BAS), Eysenck Personality Questionnaire Revised-Abbreviated Form (EPQR-A) and State-Trait Anxiety Inventory (STAI-II) were applied. Results: At the result of reliability analysis, the Cronbach Alpha internal consistency coefficient values of RSQ subscales were determined between 0.71 and 0.82. At the result of criterion-related validity, statistically significant correlations between subscales of RSQ and the similar subscales of BIS/BAS, EPQR-A and STAI-II were found. In explanatory factor analysis, a five-factor construct that has eigenvalues above 1, accounting for 49.96% of the total variance was found and it was seen that the questionnaire items loaded on their expected subscales consistent with the original questionnaire. In confirmatory factor analysis, CFI value was below the acceptable value of 0.90 at the first analysis. After eliminating two items and applying the recommended modifications, the fit indices reached the acceptable levels. Conclusion: According to the results of analysis, it was determined that Turkish version of RSQ is a valid and reliable evaluation tool for Turkish population. [ABSTRACT FROM AUTHOR]

Introduction Body attitudes may serve as both vulnerability and protective factors for various forms of emotional and behavioral disorders, including suicidal and self-harm behaviors in adolescent and youth populations. Body Investment Scale (BIS, Orbach & Mikulincer, 1998) is an instrument specially designed to account for body attitudes in suicide assessment. Objectives The study was aimed to provide a preliminary evidence for using the BIS translation in the assessment of suicide risk factors in Russian-speaking student population in Azerbaijan. Methods The common recommendations for test translation were used. The factor structure, inter-item consistency of scales, and retest reliability were assessed. The participants were 100 students (18-23 years, 40 females, 60 males), 50 of them completed the retest. Results The exploratory factor analysis with fixed number of factors reveals a homologous structure to the original BIS scales, explaining 48.2% of variance (in comparison to 55% of original measure). Inter-item reliability coefficients were lower: .989 for Body attitude, .696 for comfort with touch, .65 for Care and .61 for Protection scales. Pearson’s r for retest reliability (in a month) were above 0.9. Three items that could be excluded for enhancing the consistency of scales address physical contact and self-harm issues and might be culturally inappropriate. Conclusions BIS is a promising instrument due to its grounded factor structure, but refinement of some items of the Russian translation is desired, as well as further study of applicability for adolescent population. BIS could fill the gap in scarcity of instruments for suicide assessment for Russian speaking population. Disclosure No significant relationships.

Background: This study compared the effects of premedication with different doses of aminophylline on the recovery profile after general anaesthesia. Methods: Forty-five patients scheduled for pelvic-abdominal surgeries were divided into 3 groups: Group C: the patients received 100 ml of IV normal saline, Group A1: the patients received 2 mg/kg IV aminophylline, and Group A2: the patients received 4 mg/kg IV aminophylline 30 min before induction of general anaesthesia. The following data were recorded: demographic data, ASA physical status, duration of anaesthesia and surgery, heart rate, mean arterial blood pressure, propofol dose, fentanyl dose, times to reach BIS (48 ± 2) after induction of anaesthesia and to reach a value of 80 after discontinuation of sevoflurane anaesthesia, time to recovery of consciousness and to tracheal extubation and to discharge from the post-anaesthesia care unit, and side effects of aminophylline. Results: The time to reach a BIS of 48 ± 2 was significantly lower for the control group than group A2 (70.67 ± 22.50 and 106.67 ± 34.77 s for groups C and A2, respectively, p -value =0.01). The time to reach a BIS of 80 was significantly longer for the control group than group A1 andA2 (5.6 ± 1.40,3.5 ± 1.93and 2.53 ± 1.72 min for groups C,A1 and A2, respectively, p -value < 0.01). The time to ROC was significantly longer for the control group than groups A1 and A2 (8.93 ± 0.92, 5.6 ± 2.47 and 4.53 ± 3.33 min for groups C, A1 and A2, respectively; p -value < 0.01). The extubation time was significantly longer for the control group than groups A1 and A2 (12.4 ± 1.08, 7.87 ± 3.27 and 6.6 ± 2.47 min for groups C, A1 and A2, respectively; p -value < 0.01). Conclusion: Premedication with aminophylline enhanced the recovery profile after pelvic-abdominal surgeries under general anaesthesia without cardiovascular complications. Clinical trial registration: Name of the registry: Register@ClinicalTrials.gov Trial registration number: ClinicalTrials.gov Identifier: NCT04151381. Date of registration, November 5, 2019, 'Retrospectively registered'. [ABSTRACT FROM AUTHOR]

The main emphasis of this study was to assess the status of drinking water quality from four different water sources available in and around an institutional campus of Lumami, Nagaland University, with special reference to the detection of trace heavy metal elements. The results of the physico-chemical parameters of the water show that values of DO, BOD5 and free CO2 at S3 are beyond the permissible limit set by WHO and BIS. The values of DO in all the three stations (S1, S2 and S4) are near the maximum permissible limit of drinking water, indicating the deterioration of water quality, whereas the rests of the parameters are below the permissible limit of WHO and BIS. The detection of Hg in all stations along with alarmingly high concentrations of Fe and others such as Cu, Zn, Mn and Se is perceived as a matter of concern. On the other hand, As and Pb were not detected in any station. The detection of Hg and Fe in all the four types of water sources is an indication of contaminant hazards and needs drinking water treatment practices in these areas which in turn have implications on human health. [ABSTRACT FROM AUTHOR]

Background and Aims: Internet Gaming Disorder (IGD), which is an underlying symptom classified as a behavioral addiction disorder, has many related social problems that have garnered the bulk of attention in recent research. However, its psychological/behavioral mechanism is still unclear. The purpose of the current study was to explore the relationship between IGD and impulsivity which is regulated by behavioral inhibition and activation among different age groups.Methods: A total of 1,525 students completed Young's Internet Addiction Test (IAT), Online Game Addiction Questionnaire, the Behavioral Inhibition System/Behavioral Activation System (BIS/BAS) scales, and the Barratt Impulsiveness Scale-11 (BIS-11).Results: (1) The prevalence of IGD in different ages students was 10.3%. (2) BIS, BAS-Fun seeking (BAS-F), and BIS-11 scores indicated that there were significant differences between IGD and non-IGD individuals. (3) BIS showed significant differences in different grades (i.e., between undergraduates and middle school students with IGD; F = 3.10, p < 0.05). (4) The IAT scores demonstrated a significant positive correlation with BIS scores (r = 0.375, p < 0.05) among undergraduates with IGD; IAT scores of high school students with IGD were negatively correlated with BAS-Reward (BAS-R) (r = −0.28, p < 0.05).5)BIS and BIS-11 together could explain 14.9% variance of IGD among the college group; BAS-R and BAS-F together could explain 16.7% variance of IGD among the high school group (p < 0.05).Conclusions: The relationships between IGD and BIS, BAS-F, BAS-D, BIS-11 scores differed due to the age group of individuals tested.

In the heart, Na/K-ATPase regulates intracellular Na(+) and Ca(2+) (via NCX), thereby preventing Na(+) and Ca(2+) overload and arrhythmias. Here, we test the hypothesis that nitric oxide (NO) regulates cardiac intracellular Na(+) and Ca(2+) and investigate mechanisms and physiological consequences involved. Effects of both exogenous NO (via NO-donors) and endogenously synthesized NO (via field-stimulation of ventricular myocytes) were assessed in this study. Field stimulation of rat ventricular myocytes significantly increased endogenous NO (18 ± 2 μM), PKCε activation (82 ± 12%), phospholemman phosphorylation (at Ser-63 and Ser-68) and Na/K-ATPase activity (measured by DAF-FM dye, western-blotting and biochemical assay, respectively; p

Background and Aims: Internet Gaming Disorder (IGD), which is an underlying symptom classified as a behavioral addiction disorder, has many related social problems that have garnered the bulk of attention in recent research. However, its psychological/behavioral mechanism is still unclear. The purpose of the current study was to explore the relationship between IGD and impulsivity which is regulated by behavioral inhibition and activation among different age groups. Methods: A total of 1,525 students completed Young's Internet Addiction Test (IAT), Online Game Addiction Questionnaire, the Behavioral Inhibition System/Behavioral Activation System (BIS/BAS) scales, and the Barratt Impulsiveness Scale-11 (BIS-11). Results: (1) The prevalence of IGD in different ages students was 10.3%. (2) BIS, BAS-Fun seeking (BAS-F), and BIS-11 scores indicated that there were significant differences between IGD and non-IGD individuals. (3) BIS showed significant differences in different grades (i.e., between undergraduates and middle school students with IGD; F = 3.10, p < 0.05). (4) The IAT scores demonstrated a significant positive correlation with BIS scores (r = 0.375, p < 0.05) among undergraduates with IGD; IAT scores of high school students with IGD were negatively correlated with BAS-Reward (BAS-R) (r = −0.28, p < 0.05).5)BIS and BIS-11 together could explain 14.9% variance of IGD among the college group; BAS-R and BAS-F together could explain 16.7% variance of IGD among the high school group (p < 0.05). Conclusions: The relationships between IGD and BIS, BAS-F, BAS-D, BIS-11 scores differed due to the age group of individuals tested. [ABSTRACT FROM AUTHOR]

Introduction Endoscopic retrograde cholangiopancreatography (ERCP) is vital for diagnosing and treating biliary and pancreatic diseases, necessitating deep sedation typically achieved through total intravenous anesthesia. Propofol, with its favorable pharmacokinetic profile, is the preferred sedative, but conventional administration methods of mg/kg boluses or infusion rates pose challenges. Target-controlled infusion (TCI) systems offer a solution that ensures precise dose delivery of propofol. Despite its widespread use, the literature lacks specific guidance on the target plasma concentration (Cp) of propofol for sedation in patients undergoing ERCP. Methods A prospective interventional study was conducted at the Institute of Liver and Biliary Sciences, Delhi, India to determine the target Cp of propofol for sedation during ERCP. The study enrolled 86 American Society of Anesthesiologists (ASA) grade I and II patients aged 18-70 years. The primary objective was to establish the optimal propofol concentration for sedation as guided by a bispectral index (BIS) value of 60-70. Secondary outcomes included induction time, recovery time, total propofol consumption, and the occurrence of adverse events (if any). The Marsh pharmacokinetic model guided the TCI pump, adjusting Cp until the target sedation was achieved. Results The mean Cp of propofol to maintain the BIS value 60-70 was 2.21 ± 0.42 µg/ml. Age-wise analysis revealed variations, emphasizing the need for individualized dosing. Induction time was 4.21 ± 0.68 minutes; recovery times were seven minutes (median, IQR: 5-10 minutes) for BIS >80 and seven minutes (median, IQR: 5-10 minutes) for achieving a Modified Observer's Assessment of Alertness/Sedation score of ≥5. The mean propofol consumption was 6.24 mg/kg/hr. Side effects were minimal, with 1.16% experiencing transient hypoxia and hypotension. Conclusion The study establishes a mean target propofol concentration of 2.21 ± 0.42 µg/ml for sedation in ASA I and II patients undergoing ERCP., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Institutional Ethics Committee, Institute of Liver and Biliary Sciences issued approval IEC/2023/102/MA07. 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, S et al.)

Aim: This study aimed to synthesize and characterize a novel Bis -GMA analog, termed P- Bis -GMA, through structural modification by replacing hydroxyl (-OH) groups with phosphonooxy [-O-P(=O)(OH) 2 ] groups and to evaluate and compare its viscosity with Bis -GMA., Materials and Methods: Bis -GMA, triethylamine, dichloromethane, and phosphoryl chloride were utilized for the synthesis of P- Bis -GMA through phosphorylation. Fourier discerned the chemical structure of the synthesized P- Bis -GMA transform infrared spectroscopy (FTIR), and its viscosity was assessed by rheometry in oscillatory shear mode over a frequency sweep range of 0.1-100 (ω, rad/s) at 25°C with a 25 mm parallel plate design and a 0.5 mm gap. The data was recorded and statistically analyzed., Results: The FTIR analysis confirmed the successful synthesis of P- Bis -GMA, evidenced by the disappearance of hydroxyl (-OH) peaks and the emergence of phosphonooxy [-O-P(=O)(OH) 2 ] peaks in the P- Bis -GMA. Rheological testing demonstrated a notable reduction in viscosity for P- Bis -GMA (436.62 Pa.s) when compared to conventional Bis -GMA (1089.02 Pa.s), indicating improved handling characteristics., Conclusion: P- Bis -GMA was successfully synthesized by phosphorylation reaction where the -OH groups responsible for the high viscosity in the Bis -GMA were replaced with the [-O-P(=O)(OH) 2 ] groups with significantly reduced viscosity., Clinical Significance: The development of P- Bis -GMA holds promise for simplifying dental procedures by reducing chairside time with uncooperative children. The P-Bis -GMA-based composites possess self-adhering properties thereby eschewing the etching and bonding procedures with reduced moisture contamination of the restoration during bonding. This ultimately leads to better clinical outcomes and improved patient experiences by reducing technical vulnerabilities. How to cite this article: Ajay R, Selvabalaji A, Muthamilselvi M, et al. Synthesis and Characterization of a Chemico-structurally Modified Bis-GMA Analog for Dental Applications. J Contemp Dent Pract 2024;25(6):588-592.

Background: Gray’s revised Reinforcement Sensitivity Theory (r-RST) is a neuropsychological explanation of personality that has been broadly used in substance use disorders. Although the Behavioral Approach System (BAS) is strongly related to nicotine dependence, findings in Behavioral Inhibition System (BIS) are controversial and there is little information about the role of the Fight/Flight/Freeze System (FFFS) in nicotine dependence. The purpose of the present study was to evaluate the mediating role of Risky Decision Making (RDM) in this relationship to clarify the controversy and fill the gap. Methods: The final sample of this correlation study comprised of 347 university students (age, Mean±SD 23.2±6.7) who completed two self-report measures, including the Fagerstrom Test For Nicotine Dependence (FTND), Jackson-5 questionnaire of r-RST, and a computerized Iowa Gambling Task (IGT) to measure RDM. Pearson correlation and a path analysis framework were used to determine the simple, direct, and indirect effects of r-RST systems on nicotine dependence severity through RDM. Results: Using Amos, path analyses demonstrated significant direct and indirect effects of BAS and FFFS/BIS on tobacco use. Also, the relationship between BAS/FFFS/BIS and tobacco use was shown to be mediated by RDM. Conclusion: It was demonstrated that the relationship among BAS /FFFS/BIS and tobacco use can be partly explained using maladaptive RDM strategies, suggesting that decreasing reliance on decision-making in risky situations, while increasing the use of decision-making skills educations in risky situations, and increasing the use of alternative sensation and fun seeking by smoking and emotion regulation and mindfulness-based therapies

Approach and avoidance represent two fundamental behavioral traits that develop early in life. Previous studies have examined the neural correlates of approach and avoidance traits in adults and adolescents. Here, using the data set of the Adolescent Brain Cognition Development project, we investigated the structural cerebral bases of behavioral activation system (BAS) and behavioral inhibition system (BIS) in children. We employed voxel-based morphometry to examine how gray matter volumes (GMV) related specifically to BAS and BIS traits in 11,542 children (5491 girls, age 9–10 years) with 648 and 2697 identified as monozygotic twins (MZ) and dizygotic twins/siblings (DZ), respectively. After accounting for the BIS score, higher BAS scores (residuals) were positively correlated with the GMV of the ventral striatum (VS), and the correlation was stronger in MZ than in DZ and unrelated children, with a heritability (h2) of 0.8463. Higher BAS scores were negatively correlated with the GMV of bilateral visual, lateral orbitofrontal, temporal, and inferior frontal cortex, as well as the precuneus. Higher BIS (after accounting for BAS) scores were negatively correlated with the GMVs of the ventral caudate and bilateral putamen/pallidum, hypothalamus, and right anterior insula, and the correlation was stronger in MZ than in DZ and unrelated children, with a heritability of 0.8848. A cluster in the VS showed positive and negative correlation with the BAS and BIS scores, respectively. These findings suggest shared and distinct cerebral volumetric bases of the BAS and BIS traits in children. Whereas both traits have a strong genetic basis, the BAS relative to BIS appears to be more amenable to environmental influences. These findings add to the literature of developmental neuroscience and may help identify genetic risk factors of externalizing and internalizing psychopathology.

According to literature, students’ attitudes toward peers with disabilities are crucial for the social inclusion of students with disabilities. Therefore, knowledge about students’ behavioral intention to interact with peers with intellectual disability (ID) can help improve the social inclusion of students with ID. This study aimed to examine the psychometric properties of the Arabic version of the Behavioral Intention to Interact with Peers with Intellectual Disability Scale (BIS). Data were collected from 887 elementary school students (591 girls and 296 boys) from third to sixth grades in Saudi Arabia. Psychometric properties of the BIS were examined with a confirmatory factor analysis, measurement invariance analysis (across gender), and reliability scales (internal consistency). Good indicators were obtained for the construct and the convergent validity of the BIS. The results supported the two-dimensional structure of the BIS. The internal consistency of the BIS and each of its subscales was good. Furthermore, no measurement variance was found for boys and girls students. The Arabic version of the scale showed good psychometric properties and therefore can be recommended to measure students’ behavioral intention to interact with peers with intellectual disability.