Comparison between the recovery time of alfentanil and fentanyl in balanced propofol sedation for gastrointestinal and colonoscopy: a prospective, randomized study

BACKGROUND: There is increasing interest in balanced propofol sedation (BPS) titrated to moderate sedation (conscious sedation) for endoscopic procedures. However, few controlled studies on BPS targeted to deep sedation for diagnostic endoscopy were found. Alfentanil, a rapid and short-acting synthetic analog of fentanyl, appears to offer clinically significant advantages over fentanyl during outpatient anesthesia. It is reasonable to hypothesize that low dose of alfentanil used in BPS might also result in more rapid recovery as compared with fentanyl. METHODS: A prospective, randomized and double-blinded clinical trial of alfentanil, midazolam and propofol versus fentanyl, midazolam and propofol in 272 outpatients undergoing diagnostic esophagogastroduodenal endoscopy (EGD) and colonoscopy for health examination were enrolled. Randomization was achieved by using the computer-generated random sequence. Each combination regimen was titrated to deep sedation. The recovery time, patient satisfaction, safety and the efficacy and cost benefit between groups were compared. RESULTS: 260 participants were analyzed, 129 in alfentanil group and 131 in fentanyl group. There is no significant difference in sex, age, body weight, BMI and ASA distribution between two groups. Also, there is no significant difference in recovery time, satisfaction score from patients, propofol consumption, awake time from sedation, and sedation-related cardiopulmonary complications between two groups. Though deep sedation was targeted, all cardiopulmonary complications were minor and transient (10.8%, 28/260). No serious adverse events including the use of flumazenil, assisted ventilation, permanent injury or death, and temporary or permanent interruption of procedure were found in both groups. However, fentanyl is New Taiwan Dollar (NT$) 103 (approximate US$ 4) cheaper than alfentanil, leading to a significant difference in total cost between two groups. CONCLUSIONS: This randomized, double-blinded clinical trial showed that there is no significant difference in the recovery time, satisfaction score from patients, propofol consumption, awake time from sedation, and sedation-related cardiopulmonary complications between the two most common sedation regimens for EGD and colonoscopy in our hospital. However, fentanyl is NT$103 (US$ 4) cheaper than alfentanil in each case. TRIAL REGISTRATION: Institutional Review Board of Buddhist Tzu Chi General Hospital (IRB097-18) and Chinese Clinical Trial Registry (ChiCTR-TRC-12002575

Development of a palm olein oil-in-water (o/w) emulsion stabilized by a whey protein isolate nanofibrils-alginate complex

An oil-in-water (o/w) emulsion is a system where the oil droplets are dispersed within a watery phase. The most important function of emulsions is their ability to incorporate lipophilic components into food matrices. Thus, it is crucial to develop an emulsion that is highly stable. This work was aimed at developing a palm olein o/w emulsion stabilized by a whey protein isolate nanofibrils-alginate complex, as well as evaluating the influence of oil load and the homogenization process (both pressure and cycle) on the characteristics of the o/w emulsions. Emulsions were analyzed for droplet size, zeta potential, viscosity, creaming stability, and morphology. The results showed that an increase in oil load led to a larger droplet size, less negative zeta potential, and emulsions that were more viscous and less stable. On the other hand, increasing homogenization pressure and the number of homogenization cycles resulted in a smaller droplet size, more negative zeta potential, and emulsions that were less viscous and more stable. Emulsions with a smaller droplet size and better stability resulted from lower oil load, high homogenization pressure and more homogenization cycles

AMiBA: Broadband Heterodyne CMB Interferometry

The Y. T. Lee Array for Microwave Background (AMiBA) has reported the first science results on the detection of galaxy clusters via the Sunyaev Zel'dovich effect. The science objectives required small reflectors in order to sample large scale structures (20') while interferometry provided modest resolutions (2'). With these constraints, we designed for the best sensitivity by utilizing the maximum possible continuum bandwidth matched to the atmospheric window at 86-102GHz, with dual polarizations. A novel wide-band analog correlator was designed that is easily expandable for more interferometer elements. MMIC technology was used throughout as much as possible in order to miniaturize the components and to enhance mass production. These designs will find application in other upcoming astronomy projects. AMiBA is now in operations since 2006, and we are in the process to expand the array from 7 to 13 elements.Comment: 10 pages, 6 figures, ApJ in press; a version with high resolution figures available at http://www.asiaa.sinica.edu.tw/~keiichi/upfiles/AMiBA7/mtc_highreso.pd

AMiBA Wideband Analog Correlator

A wideband analog correlator has been constructed for the Yuan-Tseh Lee Array for Microwave Background Anisotropy. Lag correlators using analog multipliers provide large bandwidth and moderate frequency resolution. Broadband IF distribution, backend signal processing and control are described. Operating conditions for optimum sensitivity and linearity are discussed. From observations, a large effective bandwidth of around 10 GHz has been shown to provide sufficient sensitivity for detecting cosmic microwave background variations.Comment: 28 pages, 23 figures, ApJ in press

AMiBA: scaling relations between the integrated Compton-y and X-ray derived temperature, mass, and luminosity

We investigate the scaling relations between the X-ray and the thermal Sunyaev-Zel'dovich Effect (SZE) properties of clusters of galaxies, using data taken during 2007 by the Y.T. Lee Array for Microwave Background Anisotropy (AMiBA) at 94 GHz for the six clusters A1689, A1995, A2142, A2163, A2261, and A2390. The scaling relations relate the integrated Compton-y parameter Y_{2500} to the X-ray derived gas temperature T_{e}, total mass M_{2500}, and bolometric luminosity L_X within r_{2500}. Our results for the power-law index and normalization are both consistent with the self-similar model and other studies in the literature except for the Y_{2500}-L_X relation, for which a physical explanation is given though further investigation may be still needed. Our results not only provide confidence for the AMiBA project but also support our understanding of galaxy clusters.Comment: Accepted by ApJ; 8 pages, 3 figures, 5 table

Pendidikan kesihatan dan jasmani: satu pernyataan konsensus sejagat baru / Christopher R. Edginton, Ming-kai Chin and Eng Hoe Wee

Perubahan yang ketara di dalam pendidikan jasmani telah berlaku dalam masa 40 tahun dengan transisi daripada orentasi tradisional kemahiran sukan kepada penekanan yang lebih luas ke atas kecergasan berasaskan kesihatan dan aktiviti fizikal sepanjang hayat. (Bocarro et al., 2008; Jago et al., 2009; McKenzie & Kahan, 2008). Namun, di merata dunia, program-program pendidikan jasmani sedang dikurangkan, dihadkan dan/atau sewenang-wenangnya dihapuskan daripada kurikulum sekolah rendah dan menengah (Hardman & Marshall, 2009; Puhse & Gerber, 2005). Adalah bertambah jelas bahawa nilai program-program pendidikan jasmani sedang diuji di seluruh dunia

Implementation of Brain Breaks((R)) in the Classroom and Effects on Attitudes toward Physical Activity in a Macedonian School Setting

The purpose of this study was to explore the effects of Brain Break((R)) activities on interest and motivation for physical activity among schoolchildren and the contribution of such activities on learning for health and holistic development. The study sample was comprised of 283 participants, primary school students from 3rd to 5th grades from two public schools in the Republic of Macedonia. Six experimental and six control groups were included in the study. Interventions in classroom settingsbased Brain Break((R)) video exercises were introduced in the experimental group during a period of three months. Students\u27 attitudes toward physical activity were tested using a self-report survey instrument entitled Attitudes toward Physical Activity Scale (APAS) before and after intervention. Applied factor analyses were completed and the results of these analysis support APAS validity and the successful use of this application in the measurement of the learning experience, self-awareness, self-efficacy, and self-confidence in developing physical fitness. Learning was enhanced by using video exercises. Information presented in this paper is meaningful for the promotion of better exercise habits and the holistic approach to better health by using personal motivation and motivation provided by others. The results from repeated ANCOVA suggest positive effects of the applied Brain Break((R)) video exercises as an interventional program. The study confirms the effect of application of Brain Break((R)) video exercises on children\u27s attitudes for physical activity, motivation for PA, internalization of movement habits as personal good

AMiBA: Sunyaev-Zel'Dovich Effect-derived Properties and Scaling Relations of Massive Galaxy Clusters

99學年度劉國欽研究獎助論文 100學年度劉國欽升等參考著作[[abstract]]The Sunyaev-Zel'dovich Effect (SZE) has been observed toward six massive galaxy clusters, at redshifts 0.091 ≤ z ≤ 0.322 in the 86-102 GHz band with the Y. T. Lee Array for Microwave Background Anisotropy (AMiBA). We modify an iterative method, based on the isothermal β models, to derive the electron temperature T e, total mass M t, gas mass M g, and integrated Compton Y within r 2500, from the AMiBA SZE data. Non-isothermal universal temperature profile (UTP) β models are also considered in this paper. These results are in good agreement with those deduced from other observations. We also investigate the embedded scaling relations, due to the assumptions that have been made in the method we adopted, between these purely SZE-deduced T e, M t, M g, and Y. Our results suggest that cluster properties may be measurable with SZE observations alone. However, the assumptions built into the pure-SZE method bias the results of scaling relation estimations and need further study.[[journaltype]]國外[[incitationindex]]SCI[[booktype]]紙本[[booktype]]電子版[[countrycodes]]US