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Reduced vagally mediated heart rate variability (VmHRV) has been reported in patients with chronic pain. In healthy persons, breathing with longer expiration relative to inspiration increases VmHRV at 12 breaths per minute. The present study aimed to determine the immediate effect of breathing with longer expiration relative to inspiration on VmHRV and mood states in patients with chronic pain. Fifty patients with chronic pain aged between 20 and 67 years were prospectively randomized as two groups with an allocation ratio of 1:1. The interventional group practiced breathing with metronome based visual cues, maintaining an inspiration to expiration ratio of 28:72 (i/e ratio, 0.38) at a breath rate of 12 breaths per minute. The average i/e ratio they attained based on strain gauge respiration recording was 0.685 (SD 0.48). The control group, which looked at the metronome without conscious breath modification had an average i/e ratio of 0.745 (SD 0.69). The VmHRV, respiration and self-reported mood states (using the Brief Mood Introspection Scale (BMIS)) were assessed. There was a significant increase in HF-HRV and RMSSD during low i/e breathing (repeated measures ANCOVA, Bonferroni adjusted post-hoc test, p < 0.05; in all cases). Self-reported mood states changed as follows: (i) following low i/e breathing positive-mood states increased while the aroused mood state decreased whereas (ii) following the control intervention the aroused mood state increased (repeated measure ANOVA, p < 0.05; in all cases). Hence breathing with prolonged expiration is possibly useful to increase VmHRV and improve self- reported mood states in patients with chronic pain. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Babylon Center for Humanities Studies is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Nodes in socially aware networks (SANs) may act selfishly on individual bases due to resource constraints and socially selfish behavior arising from the social preferences of nodes. In response to such selfish behaviors exhibited by nodes, this paper proposes a social trust confirmation-based selfish node detection algorithm (STCDA). This algorithm first utilizes a subjective forwarding willingness detection mechanism to discern selfishness. If a node's energy is insufficient or its message rejection rate is too high—that is, the node cannot or is unwilling to forward messages—it indicates that the node is selfish. Otherwise, it is evaluated more thoroughly through the node's social trust detection mechanisms. It calculates the social trust level of nodes based on the benefits of forwarding messages, thereby distinguishing between individually selfish nodes and socially selfish nodes in the network. If further evaluation is needed, the final judgment will be made using the message confirmation feedback detection mechanism. This checks the message information forwarded by nodes in the network. If nodes fail to forward messages after receiving them—excluding reasons such as message expiration or temporary insufficient cache space—it indicates that the nodes are selfish. Results from experimental simulations show that this algorithm performs better than traditional algorithms. Under conditions of 80% selfish nodes, a message TTL of 300 min, and 10 MB of cache space, it improves the message delivery rate by 5.87% and reduces the average delay by 6.2% compared to the existing comprehensive confirmation-based selfish node detection algorithm. [ABSTRACT FROM AUTHOR]

Background: This study aims to compare resource utilization and staff satisfaction between the point-of-care (POC) activated system and the traditional intravenous piggyback (PB) system in hospital pharmacy settings. Methods: Employing a pre-post quasi-experimental design from November 2019 to April 2020, the study assessed resource requirements for both the POC activated system and the traditional PB system. Additionally, a staff satisfaction survey was conducted, focusing on staff experiences related to the pharmacy preparation process and the subsequent activation of the system by nurses. Results: The POC activated system required significantly fewer full-time equivalents (FTEs) per month compared to the PB system (0.36 ± 0.05 vs. 1.56 ± 0.07; p < 0.0001). Using POC in automated dispensing cabinets (ADCs) reduced medication administration time and returns (6.41% vs. 1.75%; p < 0.0001). The staff satisfaction survey revealed greater satisfaction with the POC activated system. A subsequent analysis showed the POC activated system had a low expiration rate of 0.1% and a cost of 39 Saudi riyal, while the traditional system had higher expiration rates and cost of 46,260 SR. Conclusions: The POC activated system reduced FTEs, decreased returned medications, and enhanced staff satisfaction compared to the PB system. [ABSTRACT FROM AUTHOR]

Copyright of Majalat Monazaat Al-Aamal is the property of Majalat Monazaat Al-Aamal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Majalat Monazaat Al-Aamal is the property of Majalat Monazaat Al-Aamal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The Budgetary Enforcement Act of 1990 (BEA90), in effect from 1992 to 2002, is frequently held up as an example of a congressional control that constrained U.S. federal spending. This paper provides a formal test of this conventional wisdom using synthetic control on federal non-defense discretionary expenditures, which is the category of spending BEA90 was considered the most binding. A BEA90-retaining Synthetic United States generated from a lasso regression on a large panel of donors high-income national economic and government finance indicators ultimately reach 2006 at about the same level as the actual United States despite temporarily showing some more restraint immediately upon expiration. We conclude that BEA90 effect on federal non-defense discretionary spending was small, short-lived, statistically likely to have emerged from chance, and more generally did not bend the curve of federal expenditure growth. [ABSTRACT FROM AUTHOR]

Objective: Parenteral nutrition constitutes a crucial advance in intensive care, it is used when the gastrointestinal system is not functional. Parenteral nutrients include macronutrients and micronutrients, delivered via two-in-one or all-in-one systems. Stability is crucial and is assessed by physicochemical, microbiological and galenic stability. This study aims to analyze the galenic stability of a parenteral lipid emulsion after expiration. Methods: 156 expired parenteral nutrition sachets were donated. During the 6 months of expiry, the analysis of galenic stability included: visual verification, droplet size, polydispersity index as well as Zeta potential. Results: During the 6 months of studies after expiration, the visual appearance of the emulsion did not change. Droplet sizes (102 nm to 397.05 nm) and Zeta potential (-23.73 mV to -20.05 mV) also remained within standards. Conclusion: The galenic stability of certain parenteral nutrition formulations can extend beyond the expiration date indicated by the manufacturers. This discovery opens up new prospects for the use of drugs in intensive care units, particularly in resource-limited settings where wastage of medical products is a major concern. The use of parenteral nutrition solutions beyond their expiration date could lead to substantial savings, by reducing waste and optimizing stock utilization. [ABSTRACT FROM AUTHOR]

Introduction The United States Army has shifted doctrine to focus on large-scale combat operations against peer to near-peer adversaries. Future conflicts could result in a limited supply chain, leaving medical providers with only expired blood products for treatment of hemorrhagic shock. This study evaluated quality, function, and safety metrics of whole blood stored for 1 week past regulated expiration (i.e. 35 days, in CPDA-1). Materials and Methods Whole blood units (n  = 6) were collected in citrate phosphate dextrose adenine-1 (CPDA-1) anticoagulant and stored refrigerated for up to 42 days. Units were sampled on days 35, 37, 39, and 42 of storage and evaluated for the following: complete blood count, blood metabolism and chemistries, clotting dynamics, and presence of bacteria. Results The majority of evaluated parameters fell outside of normal clinical ranges beginning at day 35 of storage. At 42 days, blood pH was 6.58 ± 0.038, hemolysis was significantly increased (P  = .037 vs day 35), and bacterial contamination was not evident. Glucose levels continuously dropped during extended storage. K+ was significantly increased at day 42 compared to day 35 (P  = .010). A significant reduction in clot strength, factor V activity, and factor VIII activity was evident beginning at day 39 of storage. Conclusions Storage of whole blood out to 42 days results in a continuous decline in function, but further in vivo safety studies should be performed to determine if the benefits of expired blood outweigh the risks. Other methods to safely extend storage of whole blood that maintain hemostatic function and preserve safety should be investigated, with emphasis placed on methods that reduce potassium leak and/or hemolysis. [ABSTRACT FROM AUTHOR]

In expeditionary environments, the consistent availability of blood for casualty care is imperative yet challenging. Responding to evidence and the specific needs of its expeditionary context, the US Central Command (USCENTCOM) prioritized supplying stored low titer O whole blood (LTOWB) to its units from March, 2023 onward. A strategy was devised to set minimal LTOWB on-hand supply benchmarks, determined by the number of operating beds and point of injury teams. This transition led to a 54% reduction in orders for packed red blood cells. As a countermove, the Armed Services Blood Program (ASBP) enhanced LTOWB production at a conversion rate 2:1 from packed red blood cell to LTOWB. Consequently, there was a decline in expired blood products, and fulfillment rates for blood requests are projected to reach 100% consistently. This paper delves into the intricacies of the expeditionary blood supply, the rationale behind the LTOWB transition, the devised allocation strategy, and the subsequent impacts of this change. [ABSTRACT FROM AUTHOR]

Copyright of Journal of South-Central Minzu University (Natural Science Edition) is the property of Journal of South-Central Minzu University (Natural Science Edition) Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Seismocardiographic (SCG) signals are chest wall vibrations induced by cardiac activity and are potentially useful for cardiac monitoring and diagnosis. SCG waveform is observed to vary with respiration, but the mechanism of these changes is poorly understood as alterations in autonomic tone, lung volume, heart location and intrathoracic pressure are all varying during the respiratory cycle. Understanding SCG variability and its sources may help reduce variability and increase SCG clinical utility. This study investigated SCG variability during breath holding (BH) at two different lung volumes (i.e., end inspiration and end expiration) and five airway pressures (i.e., 0, ± 2–4, and ± 15–20 cm H2O). Variability during normal breathing was also studied with and without grouping SCG beats into two clusters of similar waveform morphologies (performed using the K-medoid algorithm in an unsupervised machine learning fashion). The study included 15 healthy subjects (11 Females and 4 males, Age: 21 ± 2 y) where SCG, ECG, and spirometry were simultaneously acquired. SCG waveform variability was calculated at each experimental state (i.e., lung volume and airway pressure). Results showed that breath holding was more effective in reducing the intra-state variability of SCG than clustering normal breathing data. For the BH states, the intra-state variability increased as the airway pressure deviated from zero. The subaudible-to-audible energy ratio of the BH states increased as the airway pressure decreased below zero which may be related to the effect of the intrathoracic pressure on cardiac afterload and blood ejection. When combining the BH waveforms at end inspiration and end expiration states (at the same airway pressures) into one group, the intra-state variability increased, which suggests that the lung volume and associated change in heart location were a significant source of variability. The linear trend between airway pressure and waveform changes was found to be statistically significant for BH at end expiration. To confirm these findings, more studies are needed with a larger number of airway pressure levels and larger number of subjects. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To investigate the effects of FLow-controlled EXpiration (FLEX) ventilation expiration time and speed on respiratory and pulmonary mechanics in anesthetized horses in dorsal recumbency. ANIMALS: 6 healthy adult research horses. METHODS: In this randomized crossover experimental study, horses were anesthetized 3 times and were ventilated each time for 60 minutes using conventional volume-controlled ventilation (VCV), linear emptying of the lung over 50% of the expiratory time (FLEX50), or linear emptying of the lung over 100% of the expiratory time (FLEX100) in a randomized order. The primary outcome variables were dynamic compliance (Cdyn), hysteresis, and alveolar dead space. The data was analyzed using two-factor ANOVA. Significance was set to P < .05. RESULTS: Horses ventilated using FLEX50 and FLEX100 showed significantly higher Cdyn and significantly lower hysteresis values compared to horses ventilated using VCV. Horses ventilated using FLEX50 had significantly lower alveolar dead space compared to horses ventilated using FLEX100 or VCV. Horses ventilated using FLEX100 had significantly lower alveolar dead space compared to VCV horses. [ABSTRACT FROM AUTHOR]

Effective medications will be required to maintain human health for long-duration space operations. Previous studies have explored the stability and potency of several of the medications used on the International Space Station (ISS). This study is a comprehensive analysis of the expected terrestrial shelf-lives of the entire 2023 ISS formulary using 4 international registries. Of the 106 medications in the ISS formulary, shelf-life data was found in at least 1 of the registries for 91 (86%) medications. Of these 91 medications, 54 have an estimated terrestrial shelf-life of ≤36 months when stored in their original packaging. 14 will expire in less than 24 months. The results of this study provide operational insight to supplying a pharmacy for an exploration mission, optimize therapeutic outcomes, and prevent diseases associated with extended spaceflight operations. Ultimately, those responsible for the health of spaceflight crews will have to find ways to extend the expiration of medications to the complete mission duration or accept the elevated risk associated with administration of an expired medication. [ABSTRACT FROM AUTHOR]

The lateral parafacial area (pFL) is a crucial region involved in respiratory control, particularly in generating active expiration through an expiratory oscillatory network. Active expiration involves rhythmic abdominal (ABD) muscle contractions during late-expiration, increasing ventilation during elevated respiratory demands. The precise anatomical location of the expiratory oscillator within the ventral medulla's rostro-caudal axis is debated. While some studies point to the caudal tip of the facial nucleus (VIIc) as the oscillator's core, others suggest more rostral areas. Our study employed bicuculline (a γ-aminobutyric acid type A [GABA-A] receptor antagonist) injections at various pFL sites (-0.2 mm to +0.8 mm from VIIc) to investigate the impact of GABAergic disinhibition on respiration. These injections consistently elicited ABD recruitment, but the response strength varied along the rostro-caudal zone. Remarkably, the most robust and enduring changes in tidal volume, minute ventilation, and combined respiratory responses occurred at more rostral pFL locations (+0.6/+0.8 mm from VIIc). Multivariate analysis of the respiratory cycle further differentiated between locations, revealing the core site for active expiration generation with this experimental approach. Our study advances our understanding of neural mechanisms governing active expiration and emphasizes the significance of investigating the rostral pFL region. [ABSTRACT FROM AUTHOR]

The Food and Drug Administration has mandated that all pharmaceutical products should have an expiration date (or shelf life), mentioned directly on the container label since 1979. The notion of shelf life was introduced to Ayurveda, Siddha, and Unani medications in the year 2005. In view of this, a number of research works have been published regarding the shelf life assessment of varied Ayurvedic formulations and their modified dosage forms. However, lots of variations have been observed in the estimated shelf life of the same dosage form in the different studies undertaken. Owing to this, the presented article aims to compile and critically appraise both published and unpublished literature on shelf life, considering both classical and scientific concepts. An extensive search was performed in various online databases, websites as well as search engines including Google Scholar, PubMed, ScopeMed, Dhara Online, etc., to screen the available published literature. The search criterion was using the words shelf life, Saveeryata avadhi, stability study, real-time stability study, and expiry date in relation to the Ayurvedic formulations. On reviewing the accessible literature, it was found that only 49 researches are there that reported the shelf life of Ayurvedic formulations, corresponding with the norms laid down in the recent version of the 2016 gazette notification while a majority of the studies do not comply. The calculated shelf life was found less in 54.68 % and more in 35.93 % and exact equal in only 4.68 % formulations in comparison to the prescribed values. Upon reviewing the available literature, the authors believe that determining shelf life for Ayurvedic formulations is a challenging task. Limiting shelf life to certain duration in absence of a range may be misleading. Although this current attempt is a preliminary one, more in-depth research is needed to determine the changes in stability periods and the underlying rationale for these changes due to different attributes. Moreover, there is a lack of indistinct specifications for the shelf life of many dosage forms. Hence, estimation, validation, and then incorporation of the shelf life of new dosage forms to gazette are also the need of the moment. [ABSTRACT FROM AUTHOR]

Purpose: Low values of heart rate deceleration capacity (DC) and heart rate asymmetry (HRA) are associated with cardiovascular risks. Slow respiration has been proven to enhance the magnitudes of these indexes, but individual inspiratory (TI) and expiratory (TE) durations were not controlled in most studies. This study aims to examine whether the effects of TI and TE on these indexes would be the same and, if not, how to adjust TI and TE to maximize the effect of slow respiration. Methods: We evaluated 14 seated healthy young adults who randomly controlled their breathing to nine combinations of TI and TE, each chosen respectively from 2, 4, and 6 s. A 5-min R-R interval time series was obtained from each study period for further analysis. Results: The magnitude of DC increased when TI or TE increased, while that of acceleration capacity (AC) remained almost unchanged by TI. We further defined a new index as 100 × DC2/(DC2 + AC2) and found it to be correlated with conventional Guzik's (r = 0.94) and Porta's (r = 0.99) indexes of HRA during different combinations of TI and TE. Increasing TI and increasing TE both enhanced the magnitudes of HRA indexes, with TI taking effect when ≤ 4 s, and TE taking effect when > 4 s. DC and HRA indexes were maximized with a TI of 4 s and a TE of 6 s. Conclusion: We suggest that a TI of 3–4 s with a TE of 7–6 s is an appropriate standard for slow respiration. [ABSTRACT FROM AUTHOR]

Accelerations and decelerations of heart rate are nonsymmetrical in the magnitude and number of beat-to-beat changes. The asymmetric features of heart rate variability are related to respiratory durations. To explore the link between respiration and heart rate asymmetry (HRA), we evaluated 14 seated, healthy young adults who breathed with nine combinations of inspiration duration (TI) and expiration duration (TE), chosen respectively from 2, 4, and 6 s. A 5-min R-R interval (RRI) time series was obtained from each study period to construct an averaged pattern waveform relative to the respiratory cycle. We observed that the time interval between inspiration onset and RRI minimum progressively lengthened as TI and TE increased. The time interval between expiration onset and RRI maximum also lengthened when TE increased but shortened when TI increased. Consequently, TI and TE had different effects on the acceleration time (AT; from RRI maximum to RRI minimum) and deceleration time (DT; from RRI minimum to RRI maximum). The percentage of AT within the respiratory cycle showed a strong correlation with traditional Guzik's (r = 0.862, P < 0.001) and Porta's (r = 0.878, P < 0.001) indexes of HRA assessed in a Poincaré plot analysis. These findings suggest that, in addition to considering the magnitude and number of beat-to-beat changes, HRA can also be assessed based on another aspect: the duration of consecutive changes. The stepwise link between the duration of heart rate change and respiratory duration provides insight into the mechanisms connecting respiration to HRA. NEW & NOTEWORTHY: In healthy adults who regulated their breathing across nine combinations of inspiration and expiration durations, we used averaged pattern waveform technique to quantify the durations of heart rate acceleration and deceleration within the respiratory cycle. The percent duration of acceleration showed a strong correlation with traditional heart rate asymmetry indexes, which evaluate the magnitude and number of beat-to-beat changes. This new approach opens a window to explore the asymmetric features of heart rate variability. [ABSTRACT FROM AUTHOR]

Copyright of Revista Crítica de Relaciones de Trabajo, Laborum is the property of Ediciones Laborum S.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Babylon Center for Humanities Studies is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Economics & Environment / Ekonomia i Środowisko is the property of Fundacja Ekonomistow Srodowiska i Zasobow Naturalnych and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

An editorial is presented which expresses the views on the risks of endotracheal intubation in critically ill patients and the ongoing debate surrounding the use of etomidate versus ketamine for induction. Topics include the association between etomidate and increased mortality, the need for safer alternatives, and strategies to mitigate hemodynamic instability during intubation.

Background: Timing is critical when determining if a patient can be successfully extubated. The criteria for obtaining the optimal time for extubation are bare minimum and subject to variability. There are not many studies that are done to use diaphragm function or diaphragm thickness (Tdi) to have any role in extubation outcome as success or failure. Aims and Objectives: The aims and objectives of the study are to apply diaphragmatic ultrasound as a predictor of extubation to reduce morbidity and mortality in these patients. Materials and Methods: This study was conducted as a prospective single-blind study among patients admitted in post-anesthesia care unit and surgical intensive care unit, Department of Anesthesiology at Trauma care Centre during the study period of June 2019–November 2021. The ultrasonographer was informed of the intensivist’s decision to start weaning. Tdi is measured at end expiration and end inspiration. The percent change in Tdi between end expiration and end inspiration (ΔTdi%) was calculated as (Tdi end inspiration–Tdi end expiration/Tdi end expiration) ×100. Results: Mean age was 46.2±15.2 years, ranging from 18 to 66 years. Tdi was above 30 in 64% cases, whereas Tdi% at end of expiration was above 0.17 cm in 62% cases. Weaning was successful in 78% cases whereas weaning failed in 22% cases. Weaning success rate was significantly associated with higher Tdi at end expiration (≥0.17 cm) (P

Introduction This study investigated the efficacy and safety of neoadjuvant chemotherapy for locally advance penile squamous cell carcinoma for which current evidence is lacking. Methods Included patients had locally advanced penile squamous cell carcinoma with clinical lymph node metastasis treated with at least 1 dose of neoadjuvant chemotherapy prior to planned consolidative lymphadenectomy. Objective response rates were assessed using Response Evaluation Criteria in Solid Tumors v1.1. The primary and secondary outcomes were overall survival and progression-free survival, estimated by the Kaplan–Meier method. Treatment-related adverse events were graded per the Common Terminology Criteria for Adverse Events v5.0. Results A total of 209 patients received neoadjuvant chemotherapy for locally advanced and clinically node-positive penile squamous cell carcinoma. The study population consisted of 7% of patients with stage II disease, 48% with stage III, and 45% with stage IV. Grade 2 treatment-related adverse events occurred in 35 (17%) patients, and no treatment-related mortality was observed. Of the patients, 201 (97%) completed planned consolidative lymphadenectomy. During follow-up, 106 (52.7%) patients expired, with a median overall survival of 37.0 months (95% confidence interval [CI] = 23.8 to 50.1 months) and median progression-free survival of 26.0 months (95% CI = 11.7 to 40.2 months). Objective response rate was 57.2%, with 87 (43.2%) having partial response and 28 (13.9%) having a complete response. Patients with objective response to neoadjuvant chemotherapy had a longer median overall survival (73.0 vs 17.0 months, P  < .01) compared with those who did not. The lymph node pathologic complete response rate was 24.8% in the cohort. Conclusion Neoadjuvant chemotherapy with lymphadenectomy for locally advanced penile squamous cell carcinoma is well tolerated and active to reduce the disease burden and improve long-term survival outcomes. [ABSTRACT FROM AUTHOR]

Recordings from pre-Bötzinger complex neurons responsible for the inspiratory phase of the respiratory rhythm reveal a ramping burst pattern, starting around the time that the transition from expiration to inspiration begins, in which the spike rate gradually rises until a transition into a high-frequency burst occurs. The spike rate increase along the burst is accompanied by a gradual depolarization of the plateau potential that underlies the spikes. These effects may be functionally important for inducing the onset of inspiration and hence maintaining effective respiration; however, most mathematical models for inspiratory bursting do not capture this activity pattern. Here, we study how the modulation of spike height and afterhyperpolarization via the slow inactivation of an inward current can support various activity patterns including ramping bursts. We use dynamical systems methods designed for multiple timescale systems, such as bifurcation analysis based on timescale decomposition and averaging over fast oscillations, to generate an understanding of and predictions about the specific dynamic effects that lead to ramping bursts. We also analyze how transitions between ramping and other activity patterns may occur with parameter changes, which could be associated with experimental manipulations, environmental conditions, and/or development. [ABSTRACT FROM AUTHOR]

Objective: The study aimed to enhance medication management efficiency by introducing a systematic approach to redistributing medications to high-utilization zones, thereby mitigating the volume and expenses associated with non-returnable expired medications. Methods: This quality improvement initiative encompassed 2 key phases. Initially, a standardized workflow for managing expiring medications was implemented across 2 satellite pharmacy areas. Subsequently, the impact of these interventions was assessed by comparing pre-implementation and post-implementation data on the quantity and monetary value of expired medications. Baseline data were derived from expired medication records spanning January 1, 2022, to December 31, 2022. The new workflow was established in December 2022, and post-implementation data were collected from January 1, 2023, to March 31, 2023. The process rollout involved devising workflow protocols, creating supportive documentation, and delivering training to pharmacy personnel. Data collection encompassed medication identifiers, stock locations, date medications were received, expiration dates, along with wholesale acquisition cost for each item. Descriptive statistical methods were employed for analysis. Results: Comparative analysis of pre-implementation and post-implementation data revealed substantial reductions in the annual estimated quantity of expired medications (284 fewer items, representing a 13.6% decrease) and corresponding wholesale acquisition costs ($5075 USD reduction, translating to a 19.7% decrease) within the satellite areas during the study period. Moreover, a comparison of post-implementation quarter one data with the corresponding data from the previous year highlighted even more significant reductions in the quantity of expired medications (203 fewer items, reflecting a 31.1% decrease) and associated wholesale acquisition costs ($2548 USD reduction, signifying a 33.0% decrease) within the satellite areas. Conclusions: This study underscores the potential advantages of employing a standardized process to proactively reallocate medications prior to their expiration, thereby enabling their utilization in other hospital sections. Future endeavors could concentrate on the wider implementation of similar workflows throughout different hospital locations and the broader enterprise. [ABSTRACT FROM AUTHOR]

The aim of this study is to investigate a joint replenishment and preservation technology investment problem for non-instantaneous deteriorating items in which preservation technology investment affects not only the deterioration rate but also the length of the non-deterioration period. Regarding efforts towards delaying the deterioration process, the longer these items are kept in storage, the higher is the holding cost. Therefore, we consider the holding cost as a linearly increasing function of storage period. Along these lines, the retailer needs to balance the cost of investment in the preservation technology to reduce the deterioration rate and the increased total profit due to the decreased deterioration rate. This study discusses the scenario where the supplier offers the retailer the option to prepay a predefined percentage of the purchase cost if their order quantity exceeds or equals the minimum order quantity. Otherwise, the retailer takes a loan from a bank to prepay the entire purchasing cost. The main purpose of this study is to provide the best combined replenishment strategies and preservation technology investment under the abovementioned scenario by ensuring the maximum profit. A solution procedure is developed to determine the optimal solutions, and an algorithm is created by combining all theoretical results derived from the analytical study. Numerical examples are used to verify the theoretical results. Sensitivity analysis revealed some useful managerial insights. Results reveal that the retailer places orders under the conditions of a higher frequency with smaller order quantities to avoid excessive shortage costs when the holding cost is a linearly increasing function of the storage period. [ABSTRACT FROM AUTHOR]

Respiratory diseases, including the cronic obstructive pulmonary disease (COPD) are among the leading causes of death worldwide. To date, there is no physical examination procedure that can quantify important parameters within a specific lesion area inside the lung. In this study, we propose a novel sensor probe system consisting of a basket forceps and 2 pressure sensors to simultaneously measure the expiratory airflow and the static pressure inside the pulmonary airway. A Pitot tube mechanism using 2 pressure sensors is introduced in the system for measuring both the physical quantities. Small fiber‐optic pressure sensors with 0.3 mm diameter were utilized, and both the airflow rate and the static pressure characteristics were evaluated for obtaining the calibration curves. Finally, the proposed sensor system was implemented to measure both the airflow and pressure in an artificial ventilator and an experimental animal. The measurement of expired airflow and static pressure inside the airway of a rat with the diameter of 1.8 mm were demonstrated. © 2024 Institute of Electrical Engineer of Japan and Wiley Periodicals LLC. [ABSTRACT FROM AUTHOR]

The criteria for obtaining the optimal time for extubation are bare minimum and subject to variability. There are not many studies that are done to use diaphragm function or diaphragm thickness (Tdi) to have any role in extubation outcome as success or failure. Aims and Objectives: The aims and objectives of the study are to apply diaphragmatic ultrasound as a predictor of extubation to reduce morbidity and mortality in these patients. Materials and Methods: This study was conducted as a prospective single-blind study among patients admitted in post-anesthesia care unit and surgical intensive care unit, Department of Anesthesiology at Trauma care Centre during the study period of June 2019-November 2021. The ultrasonographer was informed of the intensivist's decision to start weaning. Tdi is measured at end expiration and end inspiration. The percent change in Tdi between end expiration and end inspiration (ΔTdi%) was calculated as (Tdi end inspiration-Tdi end expiration/Tdi end expiration) ×100. Results: Mean age was 46.2±15.2 years, ranging from 18 to 66 years. Tdi was above 30 in 64% cases, whereas Tdi% at end of expiration was above 0.17 cm in 62% cases. Weaning was successful in 78% cases whereas weaning failed in 22% cases. Weaning success rate was significantly associated with higher Tdi at end expiration (≥0.17 cm) (P<0.05). Conclusions: Timely weaning off is very important. Delayed weaning may lead to further infection and complications. Diaphragmatic ultrasound plays a vital role in extubating the patient. Ultrasound-guided Tdi and diaphragm motion can be used as a predictor for timely extubation. Diaphragmatic thickness reflects the strength of diaphragm and hence would help us to estimate a successful extubation. [ABSTRACT FROM AUTHOR]

Copyright of FinanzRundschau is the property of De Gruyter and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

We currently have multiple blood components that meet the highest quality and safety standards. However, we still have unmet needs, especially in operation areas, prehospital care situations and in disasters with mass casualties. Blood and its derivatives continue to be a scarce commodity, which in our environment depends on the altruistic donation of citizens and has limitations for its conservation, transportation and expiration. [ABSTRACT FROM AUTHOR]

This study was conducted to examine the microbiological quality indicators (total bacterial count and coliform count) and physicochemical quality indicators (pH, redness, volatile basic nitrogen [VBN] content) of meat according to various storage temperatures (-20~15°C) and packaging methods (wrap, vacuum). Based on these results, we proposed a safe consumption period. Redness, pH, and VBN content were not considered appropriate for setting the expiration date, as the redness and pH of the meat after spoilage were better than the standard values for both vacuum and wrap packaging (p<0.05). Additionally, the VBN content at 2 and 4°C increased slightly (fresh level) until the initial time of spoilage (1.0×106 colony-forming unit [CFU]/cm²) and then increased rapidly thereafter. Therefore, the results were not consistent with microbial spoilage. When the decay point was evaluated based on the presence of microorganisms, vacuum packaging extended the storage period approximately 2.5-fold when compared with wrap packaging, and the meat could be stored at 2 or 4°C for 40 or 23 days, respectively. Therefore, to evaluate meat quality, microbial indicators should be considered first. The microbiological standards proposed in this study can be used for safety management during the distribution of meat. However, to ensure meat safety, additional investigations of appropriate indicators of freshness must be conducted. [ABSTRACT FROM AUTHOR]

This paper documents that short-term options achieve significantly lower returns during months with 4 versus 5 weeks between expiration dates. The average return differential ranges from 16 to 29 basis points per week for delta-hedged portfolios, and from 101 to 187 basis points per week for straddles, over 1996–2017. Evidence based on earnings announcements and institutional holdings suggests that investor inattention to exact expiration date rather than underlying risk exposures or transaction costs can explain the mispricing. Market makers seem to adjust prices accordingly, and tend to over-trade mispriced options against less sophisticated investors. [ABSTRACT FROM AUTHOR]

This research turns the spotlight to the deregulation of once publicly funded affordable housing. Through a microsimulation that follows the conversion from affordable to market-rate units on Roosevelt Island New York, we estimate the expected demographic changes each year between 1976 and 2070. The simulation combines information from the American Community Survey, the island's masterplan, the privatization agreements, and interviews with residents, to produce interactive graphs at three urban scales: the neighborhood, the project, and the building. We found that while the households of market-rate units are gradually becoming younger and more affluent, the households of affordable units are becoming older and more impoverished. Despite an individual agreement for each building, the demographic changes are similar, and that, those changes will affect low-income buildings first. Moreover, upon expiration, 30 percent of the existing protected tenants will be over 65 and at risk of being displaced. The simulation is available at http://ridigitaltwin.pythonanywhere.com/. [ABSTRACT FROM AUTHOR]

OBJECTIVE To investigate the mechanisms underlying the improved arterial oxygenation described with flow-limited expiration (FLEX) ventilation in anesthetized horses. ANIMALS 5 healthy adult research horses. METHODS Horses underwent volume-controlled ventilation for 60 minutes (VCV1), followed by 60 minutes of FLEX, and 30 minutes of VCV (VCV2). Main outcomes included the arterial partial pressure of oxygen-to-Fio2 (PF) ratio and electrical impedance tomography (EIT)-derived functional indices at the end of each phase. The EIT data were used to create regional maps of relative lung ventilation and perfusion as well as regional maps of ventilation/perfusion (V/Q) ratios. Ventilation indices derived from EIT included the fraction of expired volume in 1 second (FEV1; %) and the time it took for the EIT signal to drop to 50% of the peak signal at end-inspiration (TClose50; seconds). Data were analyzed with 2-way ANOVA for repeated measures. P < .05 was considered significant. RESULTS The PF ratio increased significantly with FLEX compared to both VCV1 and VCV2 (P < .01). There were no differences in the relative distribution of ventilation nor perfusion between ventilation strategies. However, when ventilation and perfusion were superimposed and V/Q ratio maps were constructed, FLEX had a homogenizing effect toward values of 1.0. The FEV1 was shorter (P < .01) and the TClose50 was longer (P < .001) in all regions during FLEX compared to both VCV1 and VCV2. CLINICAL RELEVANCE Our findings suggest that FLEX ventilation in anesthetized horses enhances regional V/Q matching, likely by prolonging expiratory aeration and reducing airway closure. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Anbar University for Law & Political Sciences is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Implementing machine learning algorithms in the non-conducive environment of the vehicular network requires some adaptations due to the high computational complexity of these algorithms. K-clustering algorithms are simplistic, with fast performance and relative accuracy. However, their implementation depends on the initial selection of clusters number (K), the initial clusters' centers, and the clustering metric. This paper investigated using Scott's histogram formula to estimate the K number and the Link Expiration Time (LET) as a clustering metric. Realistic traffic flows were considered for three maps, namely Highway, Traffic Light junction, and Roundabout junction, to study the effect of road layout on estimating the K number. A fast version of the PAM algorithm was used for clustering with a modification to reduce time complexity. The Affinity propagation algorithm sets the baseline for the estimated K number, and the Medoid Silhouette method is used to quantify the clustering. OMNET++, Veins, and SUMO were used to simulate the traffic, while the related algorithms were implemented in Python. The Scott's formula estimation of the K number only matched the baseline when the road layout was simple. Moreover, the clustering algorithm required one iteration on average to converge when used with LET. [ABSTRACT FROM AUTHOR]

Haila described Singapore as a laboratory for a social scientist given the multiple ways land is used, managed or treated as a source of public revenue. Phang explains how housing has given the bottom 50 per cent of households, wealth equating to the level advocated in Piketty's 'ideal society'. As fixed‐term leases expire, people who own apartments on public land will see their values fall to zero. Inequality will return, challenging the otherwise stable polity. Using both qualitative and quantitative methods, this paper explores how and why this unique land regime was created, and expose how theoretically inconsistent policies and their ad hoc, pragmatic application has created several rent leakages to a minority of the population who continue to hold freehold land. It offers some alternative strategies better informed by land rent theory, that might be adopted to preserve the benefits enjoyed for now. [ABSTRACT FROM AUTHOR]

A 48-year-old woman presented to the ED with a nonproductive cough, shortness of breath, and stridor. She was otherwise healthy and had never used tobacco. The patient was mildly tachycardic but otherwise hemodynamically stable, afebrile, and saturating well on room air. She did not display any signs of increased work of breathing at rest. Although auscultation of her thorax indicated good air entry bilaterally without any adventitious sounds, stridor was elicited with forced expiration. [ABSTRACT FROM AUTHOR]

Private interests might occasionally influence the decisions of troop-providers when contributing to UN peacekeeping missions. However, the pursuit of private benefits impacts how the mandates of peacekeeping missions are fulfilled. Drawing upon the conflict-of-interest theory, I argue that the effectiveness of UN peacekeeping operations is compromised when troop-providers lack ideational commitment to the principles of UN peacekeeping. This article explores the impact of troop-providers' ideational commitment to UN peacekeeping on the duration of UN missions. To achieve this, a duration analysis is conducted over all completed and ongoing peacekeeping operations from April 1991 to December 2019. The results reveal that conflicting interests within peacekeeping operations lead to an increased time required for concluding UN missions. In essence, by establishing a connection between the raison d'^etre of troop-providers and the duration of missions, this article outlines significant policy implications for the United Nations. [ABSTRACT FROM AUTHOR]

Breathing is a natural daily action that one cannot do without, and it sensitively and intensely changes under various situations. What if this essential act of breathing can impact our overall well-being? Recent studies have demonstrated that breathing oscillations couple with higher brain functions, i.e., perception, motor actions, and cognition. Moreover, the timing of breathing, a phase transition from exhalation to inhalation, modulates specific cortical activity and accuracy in cognitive tasks. To determine possible respiratory roles in attentional and memory processes and functional neural networks, we discussed how breathing interacts with the brain that are measured by electrophysiology and functional neuroimaging: (i) respiration-dependent modulation of mental health and cognition; (ii) respiratory rhythm generation and respiratory pontomedullary networks in the brainstem; (iii) respiration-dependent effects on specific brainstem regions and functional neural networks (e.g., glutamatergic PreBötzinger complex neurons, GABAergic parafacial neurons, adrenergic C1 neurons, parabrachial nucleus, locus coeruleus, temporoparietal junction, default-mode network, ventral attention network, and cingulo-opercular salience network); and (iv) a potential application of breathing manipulation in mental health care. These outlines and considerations of "brain–breath" interactions lead to a better understanding of the interoceptive and cognitive mechanisms that underlie brain–body interactions in health conditions and in stress-related and neuropsychiatric disorders. [ABSTRACT FROM AUTHOR]

Copyright of Letras (0326-3363) is the property of Pontificia Universidad Catolica Argentina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Derecho Fiscal is the property of Revista de Derecho Fiscal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of ZARCH: Journal of Interdisciplinary Studies in Architecture & Urbanism is the property of Universidad de Zaragoza and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Técnica Tributaria is the property of Asociacion Espanola de Asesores Fiscales and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Cultural heritage is one of Indonesia's wealth that must be maintained and preserved by all components of the nation. Law Number 11 of 2010 concerning Cultural Heritage strengthens efforts to protect and preserve cultural heritage by regulating criminal offences committed against cultural heritage, including cultural heritage destruction. However, investigating criminal offences of destroying cultural heritage sites is inseparable from various problems that can slow down its completion. Therefore, regulating the expiration of the investigation period for cultural heritage destruction is necessary. This research is normative-empirical, in which data is obtained through a literature study and interviews with investigators from the Region X Cultural Preservation Centre. From the research results, it was found that the investigation of the cultural heritage sites destruction still has many obstacles faced. In addition, the expiration of the cultural heritage sites destruction does not yet have a particular regulation and still refers to the Criminal Code. How to cite item: Sofyani, Shannon Galice and Benedict Matteew. “Expiration Regulation of the Investigation of Cultural Heritage Destruction.” Jurnal Cakrawala Hukum 14 no. 3 (2023): 346-362. DOI: 10.26905/idjch.v14i3.11279.

Objective To analyze the blood dispatching of hospitals in Shijiazhuang area, in order to provide reference for blood dispatching policy of hospitals and ensure clinical blood supply. Methods The hospital blood dispatching data from 2018 to 2021 were queried through the blood center information management system (SHINOW9.5) and TMIS system, and the blood dispatching volume, frequency, variety and blood type distribution of hospitals at all levels were analyzed by SPSS statistical software. Results From 2018 to 2021, there were 1 196 times of blood dispatching in hospitals with a total volume of 4 648.5 U, showing a downward and then upward trend two years before and after the outbreak of COVID-19. As the main blood dispatching product, erythrocyte dispatching was 3 988 U, accounting for 85.79% of the total dispatching volume, with a dispatching rate of 2.99‰. The dispatching volume of red blood cells in secondary hospitals accounted for 86.13%.The dispatching rate of erythrocyte in secondary and tertiary hospitals was 1.03% and 0.06%, respectively, with significant difference(P