Gamma (60 Hz) auditory stimulation improves intrusions but not recall and working memory in healthy adults.

Gamma-band (> 30 Hz) brain oscillations (γ) play a crucial role in memory and long-term potentiation, and their disruptions have been consistently documented in patients with Alzheimer's Disease (AD). Gamma-band oscillation entrainment through 60 Hz transcranial alternating stimulation (tACS) and 40 Hz tACS/sensory stimulation has been shown to enhance memory performance in healthy adults and patients with AD, respectively. However, the impact of gamma auditory stimulation on healthy adults' memory remains uncertain. In this balanced crossover study, 36 healthy subjects (27 Females) underwent three auditory stimulation conditions: no auditory stimulation (NO_AS), 40 Hz, and 60 Hz. Long-term verbal memory (LTM) and verbal working memory (WM) were assessed using, respectively, the Ray Auditory Verbal Test (RAVLT) and Digit Span Backward test (DS-B). We hypothesized that 60 Hz would improve LTM (as compared to NO_AS), but not WM; no specific effects were hypothesized for 40 Hz. We found that gamma-band auditory stimulation (40 Hz and 60 Hz) did not significantly affect RAVLT recall or WM. However, 60 Hz stimulation reduced RAVLT immediate recall intrusion; this outcome negatively correlated with DS-B performance, suggesting a positive impact of 60 Hz on executive functions. In summary, gamma-band auditory stimulation did not enhance memory in healthy adults, but 60 Hz stimulation potentially benefits executive functions. Further investigation is needed to understand gamma oscillation's role in cognitive processes for both healthy and clinical populations.

Improvement of mnemonic discrimination with acute light exercise is mediated by pupil-linked arousal in healthy older adults.

Physical exercise has positive impacts on hippocampal memory decline with aging. One of the postulated neurobiological mechanisms of the decline is reduced catecholaminergic projections from the locus coeruleus to the hippocampus. Recent human studies revealed that very light exercise rapidly enhances memory and pupil diameter, which suggests that light exercise may improve memory via neural circuits involved in the ascending arousal system, including the locus coeruleus, even in older adults. Thus, we aimed to clarify the effects of a single bout of light-intensity exercise (60% ventilatory threshold) on mnemonic discrimination performance, an index of hippocampal memory function, in healthy older adults using a randomized crossover design. Pupil diameter was measured during exercise as a physiological marker of the ascending arousal system. Discrimination of highly similar stimuli to the targets improved after exercise when compared to the resting control performance. Importantly, causal mediation analysis showed that pupil dilation during exercise mediated the memory improvement. These results suggest that brief light exercise rapidly enhances memory, possibly by upregulating the ascending arousal system.

Effects of a passive shoulder exoskeleton on muscle activity among Danish slaughterhouse workers.

AIM: To evaluate the effect of a shoulder exoskeleton on muscle activity and to compare the effect with a lifting glove among slaughterhouse workers in occupational settings. MATERIALS AND METHODS: We conducted a crossover study of 26 workers measured during two work days with and without the use of a passive shoulder exoskeleton and a lifting glove at a Danish slaughterhouse. Electromyography sensors were placed bilateral on 5 shoulder muscles. The 10th, 50th, and 90th percentiles of muscle activity normalized by maximal voluntary contractions were measured and analyzed using mixed effect models. RESULTS: For the 50th percentiles of the agonist muscles, the exoskeleton reduced muscle activity bilaterally for deltoid anterior with up to 29.47%, deltoid middle with 10.22%, and upper trapezius with 22.21%. The lifting glove only reduced muscle activity for right deltoid anterior (36.59%) and upper trapezius (7.11%), but generally increased left muscle activity with up to 15.58%. DISCUSSION: The exoskeleton showed larger reductions in muscle activity compared to the lifting glove.

Short-term effects of ambient oxidation, and its interaction with fine particles on first-ever stroke: A national case-crossover study in China.

Stroke is a significant global cause of disability and death, and its burden has been on the rise, while ambient air pollution has been conclusively linked to stroke incidence. However, knowledge about effects of atmospheric oxidation on stroke and its interactions with fine particles (PM2.5) are still limited. In this study, we investigated the short-term effects of ambient NO2, O3, and their combined oxidation (Owt) on first-ever stroke, based on data from the China National Stroke Screening Survey (CNSSS) conducted from 2013 to 2015. We found significant association between ambient NO2 exposure at lag0 day with first-ever stroke, with a 13.1 % (95 % CI: 3.5 %, 23.6 %) increase in the first-ever stroke risk per 10 µg/m3 exposure. We also found a significant interaction between NO2 and PM2.5 (p < 0.05): first-ever stroke risk increased 23.8 % (95 % CI: 9.6 %, 39.8 %) per 10 µg/m3 NO2 exposure in population exposed to higher PM2.5 concentrations, while no significant association was found in population exposed to lower PM2.5 concentrations. The results of stratified analyses indicated that physical inactivity enhanced the detrimental effects of O3 and Owt exposure, while smoking and transient ischemic attack (TIA) history enhanced the detrimental effects of NO2 exposure. However, TIA history appeared to mitigate the adverse effects of O3 exposure. This study is helpful to better understand the impact of ambient oxidation on stroke, as well as its interaction with PM2.5, and has implications for policies and standards for atmospheric protection and governance.

Comparative Bioavailability and Benefits on Mental Functions of Novel Extended-Release Caffeine Capsules against Immediate-Release Caffeine Capsules: An Open-Label, Randomized, Cross-over, Single-Dose Two-Way Crossover Study.

Present study aimed compared pharmacokinetic profile of sustained-release CaffXtend® capsules (SR-Caffeine) with immediate-release caffeine capsules (IR-Caffeine), and the effect of SR-caffeine on memory, motivation, concentration, and attention. This open-label, randomized, single-dose, two-treatment, two-sequence, two-period, two-way crossover oral bioavailability study block randomized (1:1) healthy subjects (N = 15) to receive SR-Caffeine (200 mg) and IR-Caffeine (200 mg). Blood samples were collected at 0.25, 0.50, 0.75, 1, 1.5, 2, 3, 4, 5, 6, 8, 10, 12, 24, 36 and 48 h in each period. Primary study outcome included comparing relative bioavailability of SR-Caffeine 200 mg and IR-Caffeine 200 mg under fasting conditions, and changes in caffeine research visual analogue scale (Caff-VAS) scores ('relaxed', 'alert', 'jittery', 'tired', 'tense', 'headache', 'overall mood' and 'mentally fatigued') were also evaluated. Fifteen subjects completed the study. Mean tmax was 4.08 ± 2.13h for SR-Caffeine compared to 0.83 ± 0.39h for IR-Caffeine, (p < 0.0001). Similarly, mean t½ was 7.07 ± 3.48h for SR-Caffeine compared to 5.78 ± 2.11h for IR-Caffeine (p = 0.04189). However, total exposure was similar for SR-Caffeine and IR-Caffeine (90% CI: 89.89-120.50% to 94.49-123.82% for geometric least square mean of ln-transformed AUC0-t and AUC0-∞). In the Caff-VAS evaluation, the SR-Caffeine group showed significantly better scores for 'jitteriness', 'tiredness', 'alertness' and 'overall mood' for 8-12 h than the IR-Caffeine group. No adverse events were reported. Results demonstrated sustained release of caffeine over 24 h from SR-Caffeine as compared to IR-Caffeine, which showed significant improvements in the scores for 'relaxed', 'alertness' and 'overall mood' and significantly lower scores for the parameters-'jittery' and 'tired' for extended period.Clinical trial registration: CTRI/2021/06/034185.

Evaluation of N95 respirators on fit rate, real-time leakage, and usability among Chinese healthcare workers: study protocol of a randomized crossover trial.

Background: N95 respirators are used to limit the transmission of respiratory viruses in clinical settings. There are two to three major types of N95 available for all healthcare workers in Hong Kong. However, after the coronavirus outbreak and the consequent shortage of many commonly used respirators, several new N95 respirators were adopted temporarily in clinical settings without evaluation. Prior literature indicates that traditional N95 respirators used in hospitals in Hong Kong are not fit for Chinese people and have fit rates ranging from 50 to 60%. This study aims to investigate and compare the fit rate, real-time leakage, and mask usability of traditional and new N95 respirators among Chinese healthcare workers. Methods: This study will employ two sequential phases. Phase 1 has a cross-sectional exploratory design used to investigate the fit rate and mask usability of three types of respirators. Phase 2 will examine the effectiveness of respiratory protection by comparing traditional and new N95 respirators by a randomized crossover trial. Eligible participants will be randomly allocated through a controlled crossover experiment to either a traditional or new respirator group (n = 100 in each arm) for performing standard clinical procedures. The primary outcome (real-time leakage) will be recorded at 30 s intervals during nasopharyngeal suctioning and cardiopulmonary resuscitation. The secondary outcomes are the fit rate and mask usability. After a 2 min suctioning (15 s twice) and 4 min one-person CPR, the fit rate (assessed by standard N95 fit testing) and mask usability (measured by self-reported mask usability scale) will be recorded as data of post-procedure. After 10 min rest, measurement of real-time leakage (i.e., crossover), fit test, and usability will be repeated. Discussion: The result of real-time leakage will be a vital indicator of the respiratory protection of Chinese healthcare workers while performing prevalent clinical procedures, such as resuscitation. The fit rate and usability result will serve as an essential reference for consumable purchase policy in clinical settings.Trial registration: ISRCTN registry: ISRCTN40115047. Retrospectively registered on May 9, 2023. https://www.isrctn.com/ISRCTN40115047.

Development and Validation a UPLC-MS/MS Method for Quantification of Pentoxifylline in Beagle Plasma: Application for Pharmacokinetic Study of Food Effect.

Purpose: To develop an UPLC-MS/MS method for the quantitative analysis of pentoxifylline in beagle dog plasma and apply it to a pharmacokinetic study of food effect. Methods: Sample separation was achieved using a Kinetex Phenyl-Hexyl column (50 × 2.1 mm, 1.7 µm) with a gradient elution program in 5.5 min after a simple protein precipitation with methanol. Using the mobile phase that made up by 0.2% formic acid and 5mM ammonium formate water (A) and methanol (B). Quantitation was carried out using the positive ionization mode with multiple reaction monitoring (MRM). A randomized, single-dose, two-period crossover study was conducted in six fasted or fed beagles that received 400 mg pentoxifylline sustained-release tablets (Brand name: Shuanling™, CSPC Pharmaceutical Group). WinNonlin® software was used to calculate pharmacokinetic parameters. Results: The linear calibration range was 2-1000 ng/mL (r2> 0.99). Both intra- and inter-batch precision were less than 6.27%, and the accuracy ranged from 88.65% to 97.18%. Pentoxifylline was readily absorbed in fasted and fed dogs administered a dose of 400 mg (tmax:1.54h vs 1.83h). Compared to the fasted group, the AUC0→t and Cmax in the fed group increased by 1.71-fold and 1.30-fold, respectively. In the fasted group, the AUC0→t and Cmax values were 4684.08 h•ng/mL and 2402.33 ng/mL, respectively. In the fed group, these values were 8027.75 h•ng/mL and 3119.67 ng/mL. The difference in AUC0-t between the fed and fasted group was statistically significant. Conclusion: The novel optimized UPLC-MS/MS assay is an effective tool for the determination of pentoxifylline and has been successfully applied in pharmacokinetic studies of pentoxifylline in beagle dogs. The administration of pentoxifylline sustained-release tablets with food significantly increased the area under the time curve, and it is recommended that they should be administered during or shortly after feeding.

Montgomery Salivary Bypass Tube vs Self-Expandable Metal Stents for the treatment of esophageal strictures after total laryngectomy: a crossover study.

Objectives: Dysphagia affects 16% of patients undergoing total laryngectomy; of these, a third is due to pharyngoesophageal stenosis. Currently, the treatment is cyclic dilation of the stricture and Montgomery Salivary Bypass Tube (MSBT) application. The aim of this study is to assess whether using Self-Expandable Metal Stent (SEMS) may give better results after a non-durable response to repeated dilatation and application of MSBT. Materials and Methods: We verified whether using SEMS after at least 3 cyclic dilations and application of MSBT results in a longer dysphagia-free time in laryngectomized patients with pharyngolesopha-geal stenosis. Secondary outcomes were the duration of the procedures, radiation exposure and complications. Results: We enrolled 6 patients with a median age of 65 years (QR 62.5 - 75.75), of which 50% had undergone radiotherapy. Friedman's test for the duration of the dysphagia-free period did not show a statistically significant difference between the two groups (Friedman chi-squared = 2.6667, df = 1, p-value = 0.1025). The time required to implant the MSBT was significantly less than that required to implant the SEMS (Friedman chi-squared = 6, df = 1, p-value = 0.01431). Radiation exposure was absent for MSBT, while SEMS implant required an exposure to X-rays during the procedure and after 48 hours for placement verification. Two patients experienced short-term complications after SEMS implantation and one after two weeks from MSBT implantation; none of them had any health consequences. Conclusion: In patients who are already undergoing cyclic dilations and application of MSBT, switching to SEMS is not beneficial. Furthermore, MSBT has a significantly shorter implant procedure, does not expose the patient to X-rays, and, in the absence of complications, has a longer duration before removal.

Slow Digestible Starch in Native Pea Starch (Pisum sativum L.) Lowers Glycemic Response with No Adverse Effects on Gastrointestinal Symptoms in Healthy Adults.

Diabetes prevalence achieved 470B in 2021. Diabetics are looking for foods that allow them to better manage the postprandial glycemia. Owing to its large amylose fraction, pea starch may contribute to formulate recipes with a lower glycemic index (GI). This study measured the rapidly, slowly digested and resistant fractions in pea starch and in a powder mix recipe. Starch fractions were determined according to the Englyst methodology. A nonblind repeat measure crossover design trial in healthy humans was used to study the GI of pea starch and maltodextrin powder mix recipes against glucose. Gastrointestinal symptoms were measured. Thirteen healthy volunteers aged 18-60 years with body mass index <30 kg/m2 and fasting blood glucose <6.1 mmol/L participated in the study. They consumed 25 g available carbohydrate portions of the test products. Blood glucose was measured at -5 and 0 min before consumption till 180 min after starting to eat. The slow digestible starch (SDS) content of native pea starch was 30% of the total starch content. The pea-based powder mix recipe contained 25% SDS in comparison with 9% for the maltodextrin-based recipe. The glucose response after pea starch was significantly lower compared with maltodextrin. The glucose response after pea starch recipe was significantly lower compared with maltodextrin recipe. There was no significant difference in mean scores for well-being and gastrointestinal symptoms after consumption of pea starch and maltodextrin or between the two recipes. In conclusion, this study has demonstrated the presence of high SDS content in pea starch, which reduced postprandial glycemic response compared with maltodextrin. The pea starch recipe did not induce any negative gastrointestinal symptoms. Pea starch may, therefore, prove to be a beneficial ingredient in developing food products for improving glycemic control without undesirable side effects.

Effects of air pollution on emergency visits for acute otitis media among children: a case-crossover study in Chongqing, China.

Background: Many epidemiological studies have demonstrated the short-term effects of air pollution on acute otitis media (AOM) in children, but few studies have explored the association between AOM and air pollution in Chinese children. This study aimed to analyze the effects of air pollution on emergency visits for AOM among children through a time-stratified case-crossover design in Chongqing, China. Methods: The outpatient medical records of children from nine main urban districts who presented with AOM between December 22, 2018 and December 21, 2021 were collected from the Children's Hospital of Chongqing Medical University. Data for air pollution variables, including the air quality index (AQI), particulate matter ≤ 10 µm (PM10), PM2.5, SO2, CO, NO2 and O3 from 17 monitoring sites were collected. Data for meteorological factors as confounding variables also were collected. Conditional logistic regression was used to analyze the data with single-pollutant models, multi-pollutant models, and stratified analyses. Results: Increases in AQI, PM10, PM2.5, SO2, CO and NO2 were positively associated with emergency visits for AOM among children in single-pollutant models and stratified analyses. Increases in PM10, SO2, CO and NO2 were positively associated with emergency visits for AOM among children in multi-pollutant models. NO2 had the most statistically significant OR values in all models, whereas significant effects of O3 were observed only in seasonal stratification. In single-pollutant models, we found that the best lag periods were lag 0-7 for air pollution variables except for O3 and the largest OR values were 1.185 (95%CI: 1.129-1.245) for SO2 in single-pollutant models. In stratified analyses, there were no difference between groups in these statistically significant OR values through gender and age stratification, while the differences between seasons in these OR values of PM10, SO2, CO, NO2 and O3 were statistically significant. Children aged 0 years and 3-5 years represented the most susceptible population, and among the seasons, susceptibility was greater during Winter and Spring. Conclusion: Short-term exposure to air pollution can increase emergency visits for AOM among children in Chongqing, China.

Application of a new multi-element integrated teaching mode based on bite-sized teaching, flipped classroom, and MOOC in clinical teaching of obstetrics and gynaecology.

CONTEXT: Effective clinical medical student education includes attention to teaching approaches. This study assessed the impact of a new multi-element teaching mode that utilizes Bite-Sized Teaching, flipped classroom, and MOOC on learner perception in an Obstetrics and gynaecology clerkship. METHODS: A Two-stage crossover design study was conducted of a multi-element teaching mode compared to traditional teaching mode in an academic year. Participants included Ninety-six medical students practicing obstetrics and gynecology in our hospital, randomly divided into two groups respectively underwent multi-element teaching mode and traditional teaching mode. After each semester, a final test (including theoretical and clinical practical test) was conducted.When an academic year was completed, post intervention survey assessed learner perceptions of the intervention. RESULT: In order to comprehensively test students' performance after study, we take theoretical and practical examinations. The theoretical examination mainly tests students' grasp of basic knowledge points, while the practical examination focuses on the examination of students' diagnosis and treatment of diseases. There were statistically significant differences both in the theoretical and clinical practical scores between the new multi-element integrated teaching mode and the traditional teaching mode, specifically as follows: In the end of first semester, the theoretical scores of the two groups were respective 43.75 ± 3.42 vs. 42.07 ± 2.90, and clinic practical test scores were respective 44.93 ± 2.42 vs. 43.37 ± 2.52; In the end of second semester, the theoretical scores of the two groups were respective 44.30 ± 2.69 vs. 42.25 ± 3.39, and clinic practical test scores were respective 43.79 ± 2.25 vs. 41.93 ± 2.80.(p < 0.05). The results of questionnaires demonstrated that 80.21% of the students showed preference for the new multi-element integrated teaching mode comparing to traditional teaching methods. CONCLUSION: The new multi-element integrated teaching mode is well accepted by the students and can improve the students' mastery of knowledge, and can improve the students' clinical comprehensive ability. The new multi-element integrated teaching mode is shown more preference than traditional teaching mode in the teaching of Obstetrics and Gynaecology. Further long term study is needed carried out to consolidate our conclusion. The new multi-element integrated teaching mode may have positive effects on clinical teaching of Obstetrics and Gynaecology.

Impacts of short-term low-level exposure to air pollutants on hospital admissions for pulmonary sepsis in elderly patients.

BACKGROUND: Acute exposures to high levels of air pollutants are thought to be associated with hospitalization of patients with lung infection, while relatively little is known about the association between air pollutants and HOSPITAL ADMISSIONS FOR pulmonary sepsis. OBJECTIVES: To assess the correlation between low-level exposure to air pollutants and the hospitalizations for pulmonary sepsis in elderly patients. METHODS: A total of 249 elderly patients with pulmonary sepsis from January 2018 to December 2020 in Shenzhen people's hospital were included. The data regarding hospitalizations for pulmonary sepsis, meteorological factors, and daily average levels of air pollutants on single-day lags (Lag0 to Lag7) in Shenzhen were collected. Low-level exposure was defined as the annual means of air pollutants below the levels of the Ambient Air Quality Standard (AAQS) in China (NO. GB3095-2012) and/or Global Air Quality Guidelines (AQG). A time-stratified case-crossover study design approach was used to evaluate the associations between exposure to air pollutants and incidence of the disease, univariate and multivariate logistic regression analysis to analyze the association between levels of air pollutants and hospitalizations for pulmonary sepsis in elderly patients. RESULTS: Exposure to PM1(P = 0.007, Lag 2 day; P = 0.038, Lag6 day), PM2.5(P = 0.046, Lag2 day), PM10(P = 0.048, Lag4 day), and O3(P = 0.044, Lag6 day) was positively correlated with elevated risk of hospitalizations for pulmonary sepsis. In addition, logistic regression analysis revealed that exposure to PM1 (OR = 1.833, 95%CI:1.032 ~ 3.256, Lag6 day) and O3 (OR = 2.091, 95%CI:1.019 ~ 4.289, Lag6 day) were the independent risk factors of pulmonary sepsis in elderly patients. CONCLUSION: Our results demonstrate that short-term low-level exposure to PM1 and O3 could elevate the risk of hospitalizations for pulmonary sepsis in elderly patients in Shenzhen, providing evidence for developing early warning and screening systems for pulmonary sepsis.

Pharmacokinetics, Safety, and Tolerability of Once-Daily Darunavir With Cobicistat and Weekly Isoniazid/Rifapentine.

BACKGROUND: Once-weekly isoniazid with rifapentine (HP) for 3 months is a recommended treatment for latent tuberculosis infection in persons with HIV. HP reduces exposures of certain antiretroviral medications, resulting in limited options for the concomitant use of these therapies. Here, we examined the pharmacokinetics (PK), safety, and tolerability of darunavir/cobicistat with HP. METHODS: This was an open-label, fixed sequence, two-period crossover study in persons without HIV. Participants received darunavir 800 mg/cobicistat 150 mg once-daily alone for 4 days, then continued darunavir/cobicistat once-daily for days 5-19 with HP coadministration on days 5, 12, and 19. Intensive PK assessments were performed on days 4, 14, and 19. PK parameters were determined using noncompartmental methods. Geometric mean ratios with 90% confidence intervals (CIs) were calculated and compared between phases using mixed-effects models. RESULTS: Thirteen participants were enrolled. Two withdrew after day 4, and one withdrew after day 14. Of the 3 withdrawals, 2 were attributed to drug-related adverse events. Darunavir area under the concentration-time curve, maximum concentrations (Cmax), and concentrations at 24 hours postdose (C24h) were reduced by 71%, 41%, and 96% ∼48-72 hours after HP administration (day 14), respectively, and 36%, 17%, and 89% with simultaneous HP administration (day 19), respectively. On day 14, 45% of the predose and 73% of C24h concentrations were below the darunavir EC50 (0.055 µg/mL). CONCLUSIONS: Darunavir exposures were significantly decreased with HP coadministration. Temporal relationships between HP coadministration and the extent of induction or mixed inhibition/induction of darunavir metabolism were apparent. Coadministration of darunavir/cobicistat with 3HP should be avoided.

Early absorption sources of caffeine can be a useful strategy for improving female table tennis players-specific performance.

BACKGROUND: The consumption of fast absorption sources containing caffeine, such as caffeinated gum and coffee mouth rinsing, has been considered a practical nutritional strategy among athletes. Therefore, this study aimed to determine the effect of early absorption sources containing caffeine on the performance of female table tennis players. METHOD: Eighteen female table tennis players randomly participated in this randomized, double-blind, and crossover designed study. Before starting the test, the participants attended a familiarization session. In each test session, participants were randomly assigned to one of three conditions including chewing caffeinated gum (CG, n = 6), coffee mouth rinsing (CMR, n = 6) and placebo capsule (PLA, n = 6). All participants consumed caffeine with an average dose of ∼3 to 4.5 mg·kg-1. The one-week interval was considered a washout period for each condition. Each test session included measurement of functional, skill and cognitive tests. Skill tests included serve, forehand drive, backhand push and counter tests. The Cognitive function measured by color recognition test, and functional tests included agility, hand movement speed, the explosive power of the upper body and lower body, hand-eye coordination and hand grip strength tests. The collected data were analyzed (with SPSS Windows software) by repeated measure ANOVA analysis and Bonferroni post hoc test at P ≤ 0.05 level. RESULTS: The findings of the present study illustrated that CG and CMR increased significantly agility and reduced the amounts of errors in the cognitive test compared to PLA (p < 0.05), While there was no significant difference between CG and CMR (p > 0.05). Also, CG and CMR compared to PLA and CMR compared to CG rose significantly hand movement speed and movement speed (p < 0.05), and CMR compared to PLA increased significantly hand-eye coordination, isometric hand strength, service accuracy and forehand drive (p < 0.05). However, CG compared to PLA and CMR had no significant effect on hand-eye coordination, isometric hand strength, service accuracy and forehand drive (p > 0.05). In addition, CG and CMR enhanced significantly the explosive power of the lower body compared to PLA (p < 0.05), While there was no significant difference between CG and CMR (p > 0.05). Also, CG and CMR compared to PLA and CG compared to CMR had no significant effect on the explosive power of the upper body, backhand, and counter skills (p > 0.05). Furthermore, CG increased significantly accuracy in the service test compared to PLA (p < 0.05). CONCLUSION: According to the results, it seems that early absorption sources of caffeine (CMR and CG) are efficient strategies for improving the specific performance of female table tennis players. However, allegedly CMR and CG have a better effect on functional and cognitive tests compared to skill tests.

Functional profiling of gut microbial and immune responses toward different types of dietary fiber: a step toward personalized dietary interventions.

Dietary fiber plays a crucial role in maintaining gut and overall health. The objective of this study was to investigate whether different types of dietary fiber elicited specific changes in gut microbiota composition and the production of short-chain fatty acids. To test this, a longitudinal crossover study design was employed, in which healthy adult women consumed three distinct dietary fiber supplements: Inulin (fructo-oligosaccharide), Vitafiber (isomalto-oligosaccharide), and Fibremax (mixture of different fiber) during a one-week intervention period, followed by a 2-week washout period. A total of 15 g of soluble fiber was consumed daily for each supplement. Samples were collected before and after each intervention to analyze the composition of the gut microbiota by 16S rRNA sequencing and fecal levels of short-chain fatty acids measured using nuclear magnetic resonance. Phenotypic changes in peripheral blood mononuclear cells were studied in subsets of participants with higher SCFA levels post-intervention using spectral flow cytometry. The results revealed substantial stability and resilience of the overall gut bacterial community toward fiber-induced changes. However, each supplement had specific effects on gut bacterial alpha and beta diversity, SCFA production, and immune changes. Inulin consistently exerted the most pronounced effect across individuals and certain taxa were identified as potential indicators of SCFA production in response to inulin supplementation. This distinguishing feature was not observed for the other fiber supplements. Further large-scale studies are required to confirm these findings. Overall, our study implies that personalized dietary fiber intervention could be tailored to promote the growth of beneficial bacteria to maximize SCFA production and associated health benefits.

The Effects of Potato Presentation on Vegetable Intake in School-Aged Children: A Cross-Over Study.

Vegetables are an essential component of a healthy dietary pattern in children; however, their consumption is often insufficient due to lack of preference. To address this, the influence of combining vegetables (mixed peas and carrots-MPACs) with potatoes, a generally liked food, on overall vegetable consumption among children aged 7-13 years was explored. The research involved a cross-over study design with 65 participants who completed five lunchtime meal conditions, each with different combinations of MPACs and potatoes versus a control (MPACs with a wheat roll). The meals were provided in a cafeteria setting, and plate waste was used to measure vegetable consumption. Anthropometric data and other variables were also measured. Notably, self-reported hunger did not significantly differ between conditions. Meal condition was a significant predictor of MPACs (F = 5.20; p = 0.0005), with MPAC consumption highest when combined with shaped potato faces in the same bowl (+8.77 g compared to serving MPACs and shaped potato faces in separate bowls) and lowest when combined with diced potatoes in the same bowl (-2.85 g compared to serving MPACs and diced potatoes in separate bowls). The overall model for MPAC consumption was influenced by age, height z-score, body fat percentage z-score, and condition (likelihood ratio = 49.1; p < 0.0001). Age had the strongest correlation with vegetable consumption (r = 0.38), followed by male gender, height z-score (r = 0.30), and body fat z-score (r = -0.15). The results highlight the positive impact of combining potatoes with vegetables in school meals, particularly when using shaped potato faces. These findings emphasize the potential of potatoes as a valuable vegetable option in promoting healthier eating habits among children. Additionally, future research could explore the impact of different potato combinations and investigate other factors influencing meal consumption in school settings.

Effects of high-intensity gait training with and without soft robotic exosuits in people post-stroke: a development-of-concept pilot crossover trial.

INTRODUCTION: High-intensity gait training is widely recognized as an effective rehabilitation approach after stroke. Soft robotic exosuits that enhance post-stroke gait mechanics have the potential to improve the rehabilitative outcomes achieved by high-intensity gait training. The objective of this development-of-concept pilot crossover study was to evaluate the outcomes achieved by high-intensity gait training with versus without soft robotic exosuits. METHODS: In this 2-arm pilot crossover study, four individuals post-stroke completed twelve visits of speed-based, high-intensity gait training: six consecutive visits of Robotic Exosuit Augmented Locomotion (REAL) gait training and six consecutive visits without the exosuit (CONTROL). The intervention arms were counterbalanced across study participants and separated by 6 + weeks of washout. Walking function was evaluated before and after each intervention using 6-minute walk test (6MWT) distance and 10-m walk test (10mWT) speed. Moreover, 10mWT speeds were evaluated before each training visit, with the time-course of change in walking speed computed for each intervention arm. For each participant, changes in each outcome were compared to minimal clinically-important difference (MCID) thresholds. Secondary analyses focused on changes in propulsion mechanics and associated biomechanical metrics. RESULTS: Large between-group effects were observed for 6MWT distance (d = 1.41) and 10mWT speed (d = 1.14). REAL gait training resulted in an average pre-post change of 68 ± 27 m (p = 0.015) in 6MWT distance, compared to a pre-post change of 30 ± 16 m (p = 0.035) after CONTROL gait training. Similarly, REAL training resulted in a pre-post change of 0.08 ± 0.03 m/s (p = 0.012) in 10mWT speed, compared to a pre-post change of 0.01 ± 06 m/s (p = 0.76) after CONTROL. For both outcomes, 3 of 4 (75%) study participants surpassed MCIDs after REAL training, whereas 1 of 4 (25%) surpassed MCIDs after CONTROL training. Across the training visits, REAL training resulted in a 1.67 faster rate of improvement in walking speed. Similar patterns of improvement were observed for the secondary gait biomechanical outcomes, with REAL training resulting in significantly improved paretic propulsion for 3 of 4 study participants (p < 0.05) compared to 1 of 4 after CONTROL. CONCLUSION: Soft robotic exosuits have the potential to enhance the rehabilitative outcomes produced by high-intensity gait training after stroke. Findings of this development-of-concept pilot crossover trial motivate continued development and study of the REAL gait training program.

A comparison of tracheal intubation using intubrite laryngoscope and conventional MAC laryngoscope: An open, prospective, crossover manikin study.

BACKGROUND: New devices are more available in the pre-hospital environment operational theaters and emergency departments. One is an intubrite laryngoscope (INT) with Dual LED lighting that combines ultraviolet and white LED. The study aimed to compare the efficacy of endotracheal intubation using INT and conventional laryngoscope performed by inexperienced paramedics (paramedics students) and paramedics with experience in advanced airways management in full and limited accessibility settings. METHODS: It was an open, prospective, crossover manikin study. Sixty paramedics and paramedic students were recruited. Participants were divided into 2 equal groups depending on their experience (n = 30). Experienced participants were further randomly divided into 2 groups (n = 15). Inexperienced participants were also randomly divided into 2 groups (n = 15). The criterion of inexperience was 5 or fewer intubation by any laryngoscope. Inexperience participants were asked to perform tracheal intubation in standard pre-hospital settings (without limited access to manikin) (scenario A) and difficult pre-hospital settings (limited access to manikin - narrow space between benches) (scenario B). Experience participants were asked to intubate manikin in difficult pre-hospital settings. RESULTS: In the normal pre-hospital environment, the success rate after the first attempt was 56,7% for conventional laryngoscope and 66,7% for intubrite. However, the overall effectiveness of tracheal intubation using both laryngoscopes in 3 attempts was 90% for both devices. The successful rate of first attempt intubation in a difficult environment by inexperienced was 73,3% for INT and 50% for conventional laryngoscope. Overall effectiveness was 83,3% and 86,7% respectively. The successful rate of first attempt intubation in the experienced group was 86,7% with INT compared to 60% with a conventional laryngoscope in difficult settings. Overall effectiveness was 96,7% for both devices. CONCLUSION: Intubrite provided better working conditions and make up for deficiencies in successful tracheal intubation by inexperienced participants in a normal and difficult environment. Tracheal intubation with intubrite was more effective in the experienced group. Tracheal intubation effectiveness with intubrite was also higher in the experienced group.

Evaluation of Thermal Antinociceptive Effects of Intramuscular Hydromorphone Hydrochloride in Great Horned Owls (Bubo virginianus).

Across the Americas, great horned owls (Bubo virginianus) are often presented to veterinarians for conditions requiring pain management. Although recent studies have evaluated opioid drugs in raptor species, information in Strigiformes is lacking. The objective of this study was to evaluate the analgesic effect and duration of action of hydromorphone hydrochloride, a full µ-opioid receptor agonist, in great horned owls. In a randomized, blinded, balanced crossover study, 6 adult birds (5 females and 1 male) received hydromorphone (0.3 and 0.6 mg/kg) or saline (0.9% NaCl) solution (0.03 mL/kg; control) in the left pectoral muscle, with a 7-day washout interval between treatments. Each bird was assigned an agitation-sedation score, and the thermal foot withdrawal threshold (TFWT) was measured at predetermined times before (t = 0 hours) and after treatment administration (t = 0.5, 1.5, 3, and 6 hours). Measurements of the TFWT were obtained with a test box equipped with a thermal perch, which delivered a gradually increasing temperature 40-62°C (104-143.6°F) to the right plantar surface of the owl's foot. Compared with controls, hydromorphone at 0.3 mg/kg dose resulted in significantly higher mean TFWT at 0.5 hours (P < 0.001), 1.5 hours (P = 0.003), and 3 hours (P = 0.005), whereas the 0.6 mg/kg dose resulted in significantly higher mean TFWT from 0.5 hours (P = 0.035) to 1.5 hours (P = 0.001). Both hydromorphone doses were associated with a significant change in the agitation-sedation score (P = 0.001), consistent with mild to moderate sedation. Two owls were observed tremoring after administration of the 0.6 mg/kg dose, which was not noted after the 0.5-hour timepoint; no other adverse effects were identified. This study offers scientific evidence to support the use of a µ-opioid agonist in great horned owls for pain management. Pharmacokinetics and other pharmacodynamic studies of other pain models evaluating hydromorphone and other opioid drugs in this species are still needed.

Effects of Atorvastatin and Rosuvastatin on Blood Lipids in Quaker Parrots (Myiopsitta monachus).

Statin drugs are the most effective class of hypolipidemic and antiatherosclerotic drugs, with atorvastatin and rosuvastatin being the most effective. While the use of statins would be a tremendous asset in the treatment of dyslipidemia and lipid-accumulation disorders in birds, there are only limited data available regarding their use and effectiveness in psittacine species. Two consecutive randomized crossover trials on Quaker parrots (Myiopsitta monachus) were performed to study the effect of atorvastatin and rosuvastatin. Ten birds were used in an initial balanced crossover experiment with 5 oral treatments (control; atorvastatin 10 mg/kg q12h and q24h; rosuvastatin 10 mg/kg q12h and q24h) for 2 weeks each. Plasma lipidomics and lipoprotein profiling were performed after each treatment. Twelve birds were used in a second experiment consisting of 2 parallel crossover studies, each with 6 birds either fed their regular diet or a 0.3% cholesterol diet. In the 2 parallel crossover studies, the treatment group was administered atorvastatin 20 mg/kg orally q12h and the control group a placebo suspension orally q12h. Plasma lipidomics, lipoprotein profiles, and 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase activity were subsequently measured. Results were analyzed with serial linear mixed models and trends were assessed graphically. No statistically significant effect of any statin treatment was detected on plasma lipids, lipoproteins, creatinine kinase, or HMG-CoA reductase activity. In the first trial, all the rosuvastatin treatments led to some nonsignificant decreases in several triacylglycerol species, while in the second trial this was only observed in the birds on atorvastatin 20 mg/kg q12h being fed their regular diet. Quaker parrots may require much higher doses of statin drugs to show significant and clinically useful lipid-lowering effects.