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• Lower values of PhA were related with lower z-score values for functional fitness composite. • Higher values of PhA are related with a better physical function. • PhA predicts body strength, agility and dynamic balance in healthy older adults. Phase angle (PhA) is recognized as an indicator of cellular health and may be a useful marker of physical functions in geriatric populations. We aim to analyse the ability of the Phase angle (PhA) to predict the physical function in older adults. 113 healthy older adults (67 female and 46 male) performed physical tests using the Fullerton Battery – Senior Fitness Test , to assess their physical fitness. Bioelectrical impedance spectroscopy was used to determine PhA at 50KHz and dual-energy x-ray absorptiometry to assess body composition. PhA was positively associated with functional fitness composite, chair stand, arm curl and 6 min walk test and negatively related with chair sit-and-reach and 8-foot and go (p < 0.05). Even after adjusting for potential confounding variables such as age, sex and appendicular lean soft tissue, PhA showed an association with arm curl (ß = 0.23,p = 0.038), and 8-foot and go (ß=-0.214,p = 0.042). Higher values of PhA are related with a better physical function. Regardless of sex, age, and skeletal muscle, PhA predicts body strength, agility and dynamic balance in healthy older adults. [ABSTRACT FROM AUTHOR]

The exposure of infants and children to volatile anesthetics, such as sevoflurane, has been a topic of concern with respect to the potential risk for long term neurocognitive effects. The primary objective of this study was to determine whether the perioperative utilization of Bispectral Index (BIS) monitoring alters the sevoflurane delivery and exposure to children. This is a prospective randomized trial of two groups of healthy ambulatory day surgery patients (2 to 12 years). The patients in both groups had the BIS applied soon after the induction of general anesthesia, but only the anesthesiologists in the group randomized to BIS visible were able to see the BIS values. All of the patients received general anesthesia with sevoflurane. This study found no difference in the overall exposure to sevoflurane between both groups (mean end-tidal sevoflurane level of 1.8 in both groups, P = 084). The duration of time in the recovery room, the time to meet discharge criteria, the Pediatric Agitation Emergence Delirium (PAED) scores and the Face, Legs, Activity, Cry, Consolability (FLACC) scores were not statistically different between the groups. The application and utilization of intraoperative BIS monitoring does not alter the sevoflurane administration nor the discharge readiness nor the recovery profile in healthy ambulatory children. [ABSTRACT FROM AUTHOR]

Groundwater is a vital source of freshwater in both urban and rural regions of the world. However, its injudicious abstraction and rapidly increasing contamination are posing a severe threat for sustainable water supply worldwide. Geographical Information System (GIS)-based groundwater quality evaluation using Groundwater Quality Index (GQI) has been proved to be a cost-effective tool for assessing groundwater quality and its variability at a larger scale. However, the conventional GQI approach is unable to deal with uncertainties involved in the assessment of environmental problems. To overcome this limitation, a novel hybrid framework integrating Fuzzy Logic with the GIS-based GQI is proposed in this study for assessing groundwater quality and its spatial variability. The proposed hybrid framework is demonstrated through a case study in a hard-rock terrain of Southern India using ten prominent groundwater-quality parameters measured during pre-monsoon and post-monsoon seasons. Two conventional GIS-based GQI models GQI-10 (using all the ten groundwater-quality parameters) and GQI-7 (using seven 'concerned/critical' groundwater-quality parameters) as well as hybrid Fuzzy-GIS-based GQI (FGQI) models (using seven critical parameters) were developed for the two seasons and the results were compared. The Trapezoidal membership functions classified the model input parameters into 'desirable' , 'acceptable' and 'unacceptable' classes based on the experts' knowledge and water quality standards for drinking purposes. The concentrations of Ca2+, Mg2+, and SO 4 2− in groundwater were found within the WHO desirable limits for drinking water throughout the year, while the concentrations of seven parameters (TDS, NO 3 −-N, Na+, Cl−, K+, F− and Hardness) exceed their permissible limits during pre-monsoon and post-monsoon seasons. A comparative evaluation of GQI models revealed that the FGQI model predicts groundwater quality better than the conventional GQI-10 and GQI-7 models. GQI modeling results suggest that the groundwater of most of eastern and southern parts (∼60% in pre-monsoon season; ∼90% in post-monsoon season) of the study area is unsuitable for drinking. Further, the groundwater quality deteriorates during post-monsoon seasons compared to pre-monsoon seasons, which indicates an increased influx of contaminants from different industries, mining areas, waste disposal sites and agricultural fields during monsoon seasons. This finding calls for the strict enforcement of regulations for proper handling of effluents from various contamination sources in the study area. It is concluded that the fuzzy logic-based decision-making approach (FGQI) is more reliable and pragmatic for groundwater-quality assessment and analysis at a larger scale. It can serve as a useful tool for the water planners and decision makers in efficiently monitoring and managing groundwater quality at watershed or basin scales. Image 1 • Novel hybrid framework integrating Fuzzy Logic with GIS-based GQI is developed. • FGQI is more reliable and useful for water-quality evaluation at larger scales. • Groundwater polluted zones are in eastern and southern parts of the study area. • Groundwater quality in post-monsoon seasons is worse than in pre-monsoon seasons. • Comprehensive strategies for sustainable groundwater management are urgently needed. [ABSTRACT FROM AUTHOR]

Introduction: The prediction of seizure thresholds in electroconvulsive therapy (ECT) remains problematic. There are two common ways to calculate stimulus charge at first ETC session. One is based in progressive titration of anesthesia and the other one from patient's age. Both methods assume certain percentage of ineffective inductions. Drugs used in anaesthetic induction can modify seizure threshold. Monitor depth of anesthesia by BIS can be useful to reduce the number of ineffective induction. Objectives: Compare seizure duration, stimulus charge and propofol dose in sessions where BIS was used and with sessions where it wasn't to analyzed if BIS use optimizes ETC method by getting more theoretical effectiveness. Methods: Data were analyzed retrospectively in ETC sessions in Hospital Navarra for the last 4 years. Seizure duration, stimulus charge and propofol dose were compared with sessions where BIS was used and with sessions where it wasn't. Results: A total of 2636 ETC sessions of 113 patients were analyzed. Statistically significant differences were obtained for clinical seizure duration (BIS group 19,47 VS NOBIS group 15,72), stimulus charge used (379 VS 306 mcombs) and propofol dose needed for anaesthetic induction (1,27 VS 1,46 mg/kg). Number of ineffective seizure inductions was 11.4% in NOBIS group VS 5.2% in BIS group. Conclusions: BIS is a useful tool that optimizes ETC method to get more theoretical effectiveness. Using BIS, dose adjustment of anesthesics drugs improves and lower stimulus charges are needed, decreasing cognitive side effects. [ABSTRACT FROM AUTHOR]

Introduction: In ETC, the seizure induction moment is crucial in seizure quality. Depth anesthesia monitoring allows a better drug adjustment and precise identification of the optimum moment to cause seizure. Objectives: To analyze the relation between depth anesthesia, monitored by BIS, and clinical seizure duration to improve ETC technique by identify optimal seizure induction moment. Methods: Data were analyzed retrospectively. 648 ETC sessions were analyzed, also the relation between depth anesthesia and clinical seizure duration. A partial correlation analysis was made (controlling for age, sex, stimulus charge -mcombs-, propofol dose, succinilcolina dose and lidocaine dose) Results: Positive correlation statistically significant was found between depth anesthesia and seizure duration (R: 0,331: p<0.005) Conclusions: BIS number in seizure induction moment is a useful measure to reach better seizure quality. BIS number is a good predictor of ETC efficiency in clinical practice because it allows identification of optimal seizure induction moment. [ABSTRACT FROM AUTHOR]

A series of ten novel 2,5-bis(indolyl)-1,3,4-oxadiazoles were designed and synthesized. All these compounds were evaluated for their cytotoxicity against four cancer cell lines namely A549, MDA-MB-231, MCF-7 and HeLa using MTT reduced assay. Among them, compound 12e exhibited good cytotoxicity on MCF-7 cell line with IC 50 value of 1.8 μM and it was identified as a promising drug lead when compared to the standard drug doxorubicin (IC 50 value 0.98 μM). Compound, 12h exhibited better antitumor activity against three cancer cell lines i.e., lung (A549), breast (MCF-7) and cervical (HeLa) with IC 50 values of 3.3 μM, 2.6 μM and 6.34 μM respectively. The impact of these compounds on colchicine binding site of tubulin polymer was carefully investigated using molecular docking studies and interpretations between actives and inactive were explained. Image 1 • We have design and synthesized a new series of 2,5-Bis(indolyl)-1,3,4-oxadiazoles, Nortopsentin analogues. • All these analogues are screened for their cytotoxicities against A549, MDA-MB-231, MCF-7 and HeLa cancer cell lines. • Compounds 12e and 12h showed potent cytotoxicity against MCF-7 cell with IC 50 values of 1.8 ± 0.9 μM and 2.6 ± 0.89 μM. • It is important to note that all derivatives exhibited no cytotoxicity on the normal human embryonic kidney cells, HEK-293. • The impact of derivatives on colchicine binding site of tubulin polymer was carefully investigated using docking studies. [ABSTRACT FROM AUTHOR]

The objective of our study was to assess the efficacy and safety of dexmedetomidine given in a small dose for a 1-h infusion as an adjuvant to local analgesia in ophthalmic operations. The study was double-blind prospective, randomized, and placebo controlled. We studied the effects of a small dose of dexmedetomidine (0.5 µ·kg−1·h−1 for 10 min followed by 0.2 µ·kg−1·h−1 for 50 min. Patients were divided randomly into two groups with 20 patients in each: group A was the study group and group B was the placebo group. Heart rate, systolic blood pressure, and diastolic blood pressure were significantly lower in the dexmedetomidine group than the placebo group. Bispectral index values were significantly lower in the dexmedetomidine group than the placebo group. Also, intraocular pressure significantly decreased in the dexmedetomidine group compared to the placebo group. The study revealed that dexmedetomidine in the studied dose has a sedative effect, provides safe control of heart rate and blood pressure, and also decreases intraocular pressure during ophthalmic surgery under local anesthesia. [ABSTRACT FROM AUTHOR]

Comments on a study focusing on the use of the bispectral index (BIS) for monitoring the level of sedation in patients in the intensive care unit. Correlation between the BIS and subjective monitoring scales; Factors affecting the reliability of the BIS monitor; Reaction to the data suggesting that monitoring sedation with the BIS may reduce the frequency of patient awareness during neuromuscular blockade.

Purpose: Drug induced sedation endoscopy (DISE) is performed to investigate patterns and sites of obstruction in patients with sleep-disordered breathing (SDB). During DISE the patients are sedated to obtain a muscular relaxation of the upper airway which mimics the relaxation during natural sleep. Different sleep stages are intended to be simulated by drug induced sedation, and it is helpful to measure the depth of sedation. The BiSpectral Index® (BIS) is often used for this procedure. Besides the BIS, other means of sedation depth monitoring exist in anaesthesiology but have not yet been investigated with respect to DISE. Monitoring of the Cerebral State Index® (CSI) is one of these methods. The aim of the study was to compare the BIS and CSI for sedation depth monitoring during DISE., Methods: Sixty patients underwent DISE monitored by the BIS and CSI in parallel. The BIS and CSI values were compared using the Bland-Altman analysis., Results: The BIS and CSI values differed during the course of sedation during DISE by a mean of - 6.07. At light sedation (BIS 60-80), lower values by 10 scale points of CSI compared with BIS were detectable. At deeper sedation levels (BIS 40-50), the CSI turned to present equal and even higher values compared with the BIS., Conclusion: Sedation depth measurement during DISE can be performed by the BIS or CSI, but the differences should be interpreted carefully as comparable data for sleep stages in natural sleep are available only for BIS.

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'.

Objective: To compare the accuracy, correlation and agreement between the bispectral index (BIS) and BISpro during propofol anaesthesia., Methods: The BIS, BISpro, heart rate, target-concentration of propofol and Observer's Assessment of Alertness and Sedation (OAA/S) score were recorded every 30 s in female patients scheduled for hysteroscopic surgery. Propofol anaesthesia was induced by an initial target-controlled concentration (1.0 μg/ml) followed by a stepwise increase (0.5 μg/ml) until the patient was unresponsive. Spearman's correlation coefficient and prediction probability were calculated for the association between sedation levels and the above parameters. The ability of investigated parameters to distinguish between OAA/S scores was analysed. Bland-Altman analysis was used to compare the agreement between BIS and BISpro. The BIS and BISpro cut-off values for lost response were also determined., Results: Out of 30 patients in total, a high correlation was found between BIS and BISpro, and both correlated well with OAA/S score. Only BIS was able to distinguish all investigated OAA/S states accurately, but the ability to predict OAA/S score 5 to loss of response was comparable between BIS and BISpro. The calculated cut-off values were 68 for BIS and 70 for BISpro., Conclusion: BISpro and BIS are reliable monitors of general anaesthesia during sedation. Trial registration number : Chinese Clinical Trial Registry (URL: www.chictr.org.cn): ChiCTR1900024037 (retrospectively registered).

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., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Xiang, Tian, Zhou, Chen, Potenza and Zhang.)

Purpose: Nontruncating variants in SMARCA2, encoding a catalytic subunit of SWI/SNF chromatin remodeling complex, cause Nicolaides-Baraitser syndrome (NCBRS), a condition with intellectual disability and multiple congenital anomalies. Other disorders due to SMARCA2 are unknown., Methods: By next-generation sequencing, we identified candidate variants in SMARCA2 in 20 individuals from 18 families with a syndromic neurodevelopmental disorder not consistent with NCBRS. To stratify variant interpretation, we functionally analyzed SMARCA2 variants in yeasts and performed transcriptomic and genome methylation analyses on blood leukocytes., Results: Of 20 individuals, 14 showed a recognizable phenotype with recurrent features including epicanthal folds, blepharophimosis, and downturned nasal tip along with variable degree of intellectual disability (or blepharophimosis intellectual disability syndrome [BIS]). In contrast to most NCBRS variants, all SMARCA2 variants associated with BIS are localized outside the helicase domains. Yeast phenotype assays differentiated NCBRS from non-NCBRS SMARCA2 variants. Transcriptomic and DNA methylation signatures differentiated NCBRS from BIS and those with nonspecific phenotype. In the remaining six individuals with nonspecific dysmorphic features, clinical and molecular data did not permit variant reclassification., Conclusion: We identified a novel recognizable syndrome named BIS associated with clustered de novo SMARCA2 variants outside the helicase domains, phenotypically and molecularly distinct from NCBRS.

The current situation around coronavirus disease 2019 (COVID-19) portrays a threat to us in several ways: It imposes uncertainty and a lack of control and reminds us of our own mortality. People around the world have reacted to these threats in seemingly unrelated ways: From stockpiling yeast and toilet paper to favoring nationalist ideas or endorsing conspiratorial beliefs. According to the General Process Model of Threat and Defense , the confrontation with a threat - a discrepant experience - makes humans react with both proximal and distal threat responses. While the proximal response manifests in behavioral inhibition that leads to heightened anxious arousal and vigilance, distal responses seek to lower behavioral inhibition and the associated state of anxiety and vigilance through engaging in distal defenses. In the present research, we propose that the reactions to COVID-19 may represent distal defense strategies to the pandemic and, therefore, can be explained and forecasted by the model. Thus, we hypothesized increased perceived COVID-19 threat to lead to a proximal threat response in the form of heightened behavioral inhibition. This, in return, should enhance the use of distal defenses (i.e., several ingroup biases, system justification, and conspiratorial beliefs) overlapping with the reactions observed as a response to COVID-19. This hypothesized mediated effect of increased perceived COVID-19 threat on distal defenses was tested in two preregistered studies: In Study 1 ( N = 358), results showed perceived COVID-19 threat to be related to behavioral inhibition and, in turn, to be associated with increased distal defenses (i.e., higher entitativity, control restoration motivation, passive party support). In Study 2 ( N = 348), we manipulated COVID-19 threat salience and found results suggesting the distal defenses of ingroup entitativity, system justification, and conspiratorial beliefs to be mediated by the proximal threat response. The results of the present research hint toward a common mechanism through which the seemingly unrelated reactions to COVID-19 can be explained. The results might help to predict future behavior during the COVID-19 pandemic and to design measures to counteract the detrimental effects of the pandemic., (Copyright © 2020 Jutzi, Willardt, Schmid and Jonas.)

B cell leukemia/lymphoma-2 (Bcl-2)-interacting death suppressor (BIS), also identified as Bcl-2-associated athanogene 3 (BAG3), has been reported to be upregulated in reactive astrocytes after brain insults. The present study was designed to further substantiate the involvement of BIS protein in the astroglial reaction in the striatum of rats treated with the mitochondrial toxin, 3-nitropropionic acid. Weak constitutive immunoreactivity for BIS was observed in astrocytes in the control striatum, whereas its expression was upregulated, along with that of nestin, in the lesioned striatum. In the lesion core, where astrocytes are virtually absent, BIS/nestin double-labeled cells were associated with the vasculature and were identified as perivascular adventitial fibroblasts. By contrast, BIS/nestin double-labeled cells in the perilesional area were reactive astrocytes, which were confined to the border zone contributing to the formation of the astroglial scar; this was evident 3 days post-lesion and increased thereafter progressively throughout the 28-day experimental period. At the ultrastructural level, BIS protein was diffusely localized throughout the cytoplasm within the stained cells. Collectively, our results demonstrate the phenotypic and functional heterogeneity of BIS-positive cells in the lesioned striatum, suggesting the involvement of BIS in the formation of astroglial scar and its potential role in the development of fibrotic scar after brain insults.

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., (Copyright © 2020 Alnahdi and Schwab.)

Digoxin, a compound of the cardiac glycoside family, was originally prescribed for heart failure but has recently been rediscovered for its potent antitumor activity. However, it has a narrow therapeutic margin due to its cardiotoxicity, limiting its safe use as an antitumor agent in clinical practice. To widen its therapeutic margin, we investigated whether the antitumor effect of digoxin is potentiated by the depletion of BCL-2-interacting cell death suppressor (BIS) in A549 lung cancer cells. BIS is a multifunctional protein that is frequently overexpressed in most human cancers including lung cancer. Our results demonstrated that the inhibitory potential of digoxin on the migratory behavior of A549 cells is significantly enhanced by BIS depletion as assessed by transwell assay and collagen-incorporated 3D spheroid culture. Western blotting revealed that combination treatment significantly reduces p-STAT3 expression. In addition, a STAT3 inhibitor substantially suppressed the aggressive phenotypes of A549 cells. Thus, our results suggest that loss of STAT3 activity is a possible molecular mechanism for the synergistic effect of digoxin and BIS depletion. Our findings suggest the sensitizing role of BIS silencing to reduce the dose of digoxin for treatment of lung cancer with a high metastatic potential., Competing Interests: Declaration of competing interest The authors declare no potential financial interests., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Vagal nerve stimulation (VNS) is an established adjunctive treatment for patients with refractory epilepsy. VNS is effective in many cases, but few patients achieve complete elimination of seizures. Furthermore, VNS can cause respiratory complications, such as obstructive sleep apnea. This report describes the successful anesthetic management of a 28-year-old woman with a VNS device who underwent dental treatment under general anesthesia. She was morbidly obese and had undergone placement of a VNS device secondary to drug-resistant epilepsy 2 years prior but continued to experience daily epileptic seizures. Because of concerns about the risk of perioperative epileptic seizures and apneic events, use of the dedicated VNS device magnet was planned if such complications occurred. Total intravenous anesthesia was induced with propofol and remifentanil and a bispectral index sensor was used to help monitor brain wave activity for evidence of seizures along with the depth of anesthesia. Postoperatively, the patient received positional therapy and supplemental oxygen while being closely monitored in recovery. The anesthetic course was completed uneventfully without need of the VNS magnet. A thorough understanding of the mechanics of a VNS device, including proper use of the VNS magnet, is critical for an anesthesiologist during the perioperative period.

The depth of anesthesia is commonly assessed in clinical practice by the patient's clinical signs. However, during cardiopulmonary bypass and hypothermia, common symptoms of nociception such as tachycardia, hypertension, sweating, or movement have low sensitivity and specificity in the description of the patient nociception and hypnosis, in particular, detecting nociceptive stimuli. Better monitoring of the depth of analgesia during hypothermia under cardiopulmonary bypass will avoid underdosage or overdosage of analgesia, especially opioids. Induced hypothermia has a multifactorial effect on the level of analgesia and hypnosis. Thermoregulatory processes appear essential for the activation of analgesic mechanisms, ranging from a physiological strong negative affiliation between nerve conduction velocity and temperature, until significant repercussions on the pharmacological dynamics of the analgesic drugs, the latter decreasing the clearance rate with a subsequent increase in the effect-site concentrations. Under the hypothesis that deep hypothermia induces massive effects on the analgesia and hypnosis levels of the patient, we studied whether hypothermia effects were mirrored by several neuromonitoring indices: two hypnosis indices, consciousness index and bispectral index, and a novel nociception index designed to evaluate the analgesic depth. In this clinical trial, 39 patients were monitored during general anesthesia with coronary atherosclerosis cardiopathy who were elective for on-pump coronary artery bypass graft surgery under hypothermia. The changes and correlation between the consciousness index, bispectral index, and nociception index with respect to the temperature were compared in different timepoints at basic state, during cardiopulmonary bypass and after cardiopulmonary bypass. While the three neuromonitoring indices showed significant correlations with respect to the temperature, the nociception index and consciousness index showed the strongest sensitivities, indicating that these two indices could be an important means of intraoperative neuromonitoring during induced hypothermia under cardiopulmonary bypass.

Prior research shows that North Americans and Western Europeans react to threats with defensive strategies based on behavioral approach vs. inhibition systems (BAS/BIS)-i.e., a desire to approach a goal or to avoid a threat. In the present research, we explored whether this phenomenon is more pronounced in tight cultures (e.g., Germany) as compared to loose cultures (e.g., Russia), testing how Germans and Russians respond to societal threats. We expected that due to the higher levels of cultural tightness, Germans would show stronger defensive reactions to threats than Russians. Additionally, we investigated the role of need for tightness (i.e., need for strict regulation of social order) in threat management processes. In Study 1, Germans recalling violations of societal norms produced stronger rightward bias on the line bisection task than Russians, indicative of greater BAS activation in Germans than in Russians. In Study 2, we used frontal alpha asymmetry, providing the first cross-cultural test of BIS-BAS reactions utilizing neuronal markers. In this study, presentation of societal threat in a video portraying Islamic immigration as a large-scale violation of social norms led to higher BIS activation among Germans than among Russians, if their need for tightness was high. We discuss the role of tightness, need for tightness, and type of threat for cross-cultural particularities of threat-induced motivational shifts., (© The Author(s) 2018.)

Purpose of Review: Processed electroencephalography (pEEG) is widely used in clinical practice. Few clinicians utilize the full potential of these devices. This brief review will address the improvements in patient management available from the utilization of all pEEG data., Recent Findings: Anesthesiologists easily learn to recognize raw pEEG patterns that are consistent with an appropriate level of hypnotic effect. Power distribution within the waveform can be displayed in a visual format that identifies signatures of the principal anesthetic hypnotics. Opinion on the benefit of pEEG data in the mitigation of postoperative neurological impairment remains divided., Summary: Looking beyond the index number can aid clinical decision making and improve confidence in the benefits of this monitoring modality., Competing Interests: Conflict of InterestDavid A. Mulvey has received honoraria for teaching activities on behalf of Gwenagen Ltd., the UK distributor of the Narcotrend pEEG device, and is the President of the UK Society for Intravenous Anaesthesia. Peter Klepsch declares that he has no conflict of interest., (© Springer Science+Business Media, LLC, part of Springer Nature 2020.)

Whole-body bioelectrical impedance analysis for measuring body composition has been well-explored but may not be sensitive enough to changes in the trunk compared to changes in the limbs. Measuring individual body segments can address this issue. A segmental bioelectrical impedance spectroscopy device (SBISD) was designed for body composition measurement and a prototype was implemented. Compensation was performed to adjust the measured values to correct for a phase difference at high frequencies and to counteract the hook effect when measuring the human body. The SBISD was used to measure five subjects and was compared against three existing analyzers. For most segmental measurements, the SBISD was within 10% of the R0 and R∞ values determined with a Bodystat Multiscan 5000 and an Impedimed SFB7. The impedance values from the third reference device, a Seca 514, differed significantly due to its eight-electrode measuring technique, meaning impedance measurements could not be compared directly. [ABSTRACT FROM AUTHOR]