Gauze versus solid skin barrier for tracheostomy care: a crossover randomized clinical trial.

PURPOSE: The aim of this study was to compare gauze and a solid pectin-based skin barrier to evaluate clinical outcomes and cost-effectiveness of care for tracheostomy wounds. METHODS: A randomized clinical trial with crossover design was conducted to compare gauze to a solid skin barrier for management of patients with tracheostomies. The main study outcomes were skin integrity, dressing change frequency, time required for dressing changes, product costs, and nurses' satisfaction. SETTING AND SUBJECTS: A convenience sample was recruited from 2 medical centers in Taiwan. Using permuted block randomization, patients undergoing tracheostomy were randomly allocated to 1 of 2 groups. One group received tracheostomy care with gauze for the first 6 days and a solid pectin-based skin barrier for the following 6 days. This regimen was reversed in the second group. RESULTS: Skin integrity was significantly better among patients managed with a solid skin barrier as compared to management with gauze (Z=-2.75, P= .006). No significant differences in dressing change frequency, time required for dressing changes, or product costs between the 2 groups were found. Nurses' satisfaction was significantly higher for the solid skin barrier as compared to gauze (Z=-2.31, P= .021, for group 1, and T=-1.97, P= .048, for group 2). CONCLUSIONS: The use of a solid skin barrier for tracheostomy care was associated with lower occurrences of impaired skin integrity and higher satisfaction among nurses when compared to gauze.

[Effects of vegetation on river flow: a review].

Vegetation is a component of the natural river. To understand the interaction between vegetation and water flow is of scientific and practical significance for the protection of wildlife habitats, the control of water body eutrophication, the ecological restoration of rivers and lakes, and the management of riverways. This paper reviewed the researches about the interaction between vegetation and water flow in riverways, summarized the research progress in the effects of the vegetation on the resistance coefficient and water flow structure, and introduced the applications of numerical simulation in this research field. Based on the previous studies, the effects of river section shape, plant individual form, and vegetation distribution pattern on the flow regime of water flow in vegetation section were analyzed. For further study, the importance of deeply understanding the hydraulics mechanisms of the interaction between vegetation and water flow in terms of the diversity of river morphology, the vegetation variation at different spatiotemporal scales, the water flow distribution in vegetation section, and the three dimensional turbulent simulation was expatiated.

Pumpkin (Cucurbita moschata) fruit extract improves physical fatigue and exercise performance in mice.

Pumpkin (Cucurbita moschata) is a popular and nutritious vegetable consumed worldwide. The overall purpose of this study was to evaluate the effects of C. moschata fruit extract (CME) on anti-fatigue and ergogenic functions following physiological challenges. Male ICR mice from four groups designated vehicle, CME-50, CME-100 and CME-250, respectively (n = 8 per group in each test) were orally administered CME for 14 days at 0, 50, 100 and 250 mg/kg/day. The anti-fatigue activity and exercise performance were evaluated using exhaustive swimming time, forelimb grip strength, as well as levels of plasma lactate, ammonia, glucose, and creatine kinase after an acute swimming exercise. The resting muscular and hepatic glycogen was also analyzed after 14-day supplementation with CME. Trend analysis revealed that CME treatments increased grip strength. CME dose-dependently increased 5% body weight loaded swimming time, blood glucose, and muscular and hepatic glycogen levels. CME dose-dependently decreased plasma lactate and ammonia levels and creatine kinase activity after a 15-min swimming test. The mechanism was relevant to the increase in energy storage (as glycogen) and release (as blood glucose), and the decrease of plasma levels of lactate, ammonia, and creatine kinase. Therefore, CME may be potential for the pharmacological effect of anti-fatigue.