Effectiveness of Pulmonary Rehabilitation in Patients with COPD

Background: Pulmonary rehabilitation (PR) is beneficial for patients with COPD, with improvement in exercise capacity and health-related quality of life. Despite these overall benefits, the responses to PR vary significantly among different individuals. It is not clear if PR is beneficial for patients with COPD and normal exercise capacity. Although it is believed that longer pulmonary rehabilitation programs can provide better results, most of the evidence comes from short-term programs. Objective: The objective of this analysis was to determine the effectiveness of respiratory services provided in the hospital or community by respiratory therapists (RTs) in reducing health care utilization and improving patient outcomes. The aim was to evaluate the outcomes of a comprehensive pulmonary rehabilitation (PR) in chronic obstructive pulmonary disease. Methodology: All 65 Pakistani patients who met the inclusion criteria with ages between 40 to 65 years, including both male and female, with mild to severe COPD were enrolled in the study on the basis of convenient sampling. Informed consent was taken from each patient starting about the study and their rights to withdraw from study. A demographics detail (name, age, sex) was noted along with the necessary medical history. A questionnaire was made to see the effects of pulmonary rehabilitation in patients with COPD. All necessary tests were performed to evaluate the patient betterment completely. Results: The mean FEV1 in the subjects was 1.29 ± 0.47 L/min, 64.8 ± 23.0% of predicted. Clinically there is a little effect on CXR pattern, FEV1 and FEV1/FVC after pulmonary rehabilitation. But overall quality of life improved after pulmonary rehabilitation. Mainly improvement occurs in peak expiratory flow rate, BORG dyspnea scale, 6 mint walk test distance (meters) and Oxygen saturation after rehabilitation. Conclusion: These results showed that patients with COPD had benefited from a comprehensive PR program in an out-patient setting regardless of disease severity. Exercise training can result in significant improvement in health-related quality of life, exercise capacity, respiratory muscle strength, and exertional dyspnea in subjects with COPD and normal exercise capacity

Influence of Bilayer Thickness on Mechanical and Tribological Properties of (Ti-Al)N/MoN Nanostructured Hard Coatings Deposited by Cathodic Arc Ion Plating

Funding Information: This scientific work was supported by the National Natural Science Foundation of China under grant Nos. 12305328 and 12375285 and by the Shenzhen Municipal Committee on Science and Technology Innovation under grant No. JCYJ20220530140605011. Publisher Copyright: © 2023 by the authors.Deposition of (Ti-Al)N/MoN multilayered coatings was carried out through a cathodic ion-plating system in an argon and then nitrogen atmosphere. Bilayer thickness (Λ) of all the samples were achieved, from 22 to 104 nm, by organizing substrate holder rotational speed (SRS). To obtain the optimum properties of the (Ti-Al)N/MoN coatings, the Ti and Al ratio was maintained at a level of 1:1. X-ray diffraction (XRD), high-resolution transmission electron microscopy (HRTEM), X-ray photoelectron spectroscopy (XPS), and Raman spectroscopy were utilized to analyze the crystal structure and morphology of the coatings. Mechanical and tribological properties were examined by nanohardness and atomic force microscopy (AFM). The preferred orientation of the (Ti-Al)N/MoN nanoscale multilayer films was TiAlN (200) and MoN (200), which had face centered cubic (fcc) and hexagonal structures, respectively. The hardness increased with the decrease in Λ (104 nm to 26 nm), and then it increased. The highest hardness of 37 GPa was revealed at Λ = 26 nm, whereas the least wear rate of 8.09 × 10−7 mm3/N.m was attained at Λ = 22 nm. Wear rate, roughness, and coefficient of friction were decreased with decreasing bilayer period. EDS results showed that Al and Ti contents were almost the same in all samples, as per design of the experiment.publishersversionpublishe

COMPARATIVE EFFICACY OF HYPERTONIC SALINE AND NORMAL SALINE SOLUTIONS IN EXPERIMENTALLY INDUCED ENDOTOXIC SHOCK IN DOGS

This study was contemplated to determine the comparative beneficial effects of hypertonic saline solution and sterile saline solution in induced endotoxic shock in dogs. For this purpose, 12 healthy Mongrel dogs were randomly divided into two equal groups (A and B). All the animals were induced endotoxaemia by slow intravenous administration of Escherichia coli endotoxins 0111:B4. Group A was treated with normal saline solution @ 90 ml/kg BW, while group B was given hypertonic saline solution @ 4 ml/kg BW, followed by normal saline solution @ 10 ml/kg BW. Different parameters were observed for evaluation of these fluids including clinical and haematological parameters, serum electrolytes, mean arterial pressure, and blood gases at different time intervals up to 24 hours post treatments. After infusion of respective fluids, all parameters returned to baseline values in both the groups but group B showed better results than group A except bicarbonates, which better recovered in group A. Thus, it was concluded that a small-volume of hypertonic saline solution could be effectively used in reversing the endotoxaemia. Moreover, it provides a rapid and inexpensive resuscitation from endotoxic shock

Factors associated with financial security, food security and quality of daily lives of residents in Nigeria during the first wave of the COVID-19 pandemic

An online survey was conducted to identify factors associated with financial insecurity, food insecurity and poor quality of daily lives of adults in Nigeria during the first wave of the COVID-19 pandemic. The associations between the outcome (experience of financial loss, changes in food intake and impact of the pandemic on daily lives) and the explanatory (age, sex, education level, anxiety, depression, HIV status) variables were determined using logistic regression analysis. Of the 4439 respondents, 2487 (56.0%) were financially insecure, 907 (20.4%) decreased food intake and 4029 (90.8%) had their daily life negatively impacted. Males (AOR:0.84), people who felt depressed (AOR:0.62) and people living with HIV -PLHIV- (AOR:0.70) had significantly lower odds of financial insecurity. Older respondents (AOR:1.01) had significantly higher odds of financial insecurity. Those depressed (AOR:0.62) and PLHIV (AOR:0.55) had significantly lower odds of reporting decreased food intake. Respondents who felt anxious (AOR:0.07), depressed (AOR: 0.48) and who were PLHIV (AOR:0.68) had significantly lower odds of reporting a negative impact of the pandemic on their daily lives. We concluded the study findings may reflect a complex relationship between financial insecurity, food insecurity, poor quality of life, mental health, and socioeconomic status of adults living in Nigeria during the COVID-19 pandemic

Factors associated with COVID-19 pandemic induced post-traumatic stress symptoms among adults living with and without HIV in Nigeria: a cross-sectional study

Background: Nigeria is a country with high risk for traumatic incidences, now aggravated by the COVID-19 pandemic. This study aimed to identify differences in COVID-19 related post-traumatic stress symptoms (PTSS) among people living and not living with HIV; to assess whether PTSS were associated with COVID-19 pandemic-related anger, loneliness, social isolation, and social support; and to determine the association between PTSS and use of COVID-19 prevention strategies.Methods: The data of the 3761 respondents for this analysis was extracted from a cross-sectional online survey that collected information about mental health and wellness from a convenience sample of adults, 18 years and above, in Nigeria from July to December 2020. Information was collected on the study's dependent variable (PTSS), independent variables (self-reported COVID-19, HIV status, use of COVID-19 prevention strategies, perception of social isolation, access to emotional support, feelings of anger and loneliness), and potential confounder (age, sex at birth, employment status). A binary logistic regression model tested the associations between independent and dependent variables.Results: Nearly half (47.5%) of the respondents had PTSS. People who had symptoms but were not tested (AOR = 2.20), felt socially isolated (AOR = 1.16), angry (AOR = 2.64), or lonely (AOR = 2.19) had significantly greater odds of reporting PTSS (p p Conclusion: The present study identified some multifaceted relationships between post-traumatic stress, HIV status, facemask use, anger, loneliness, social isolation, and access to emotional support during this protracted COVID-19 pandemic. These findings have implications for the future health of those affected, particularly for individuals living in Nigeria. Public health education should be incorporated in programs targeting prevention and prompt diagnosis and treatment for post-traumatic stress disorder at the community level.</p

Effect of Physical Form and Level of Wheat Straw Inclusion on Growth Performance and Blood Metabolites of Fattening Goat

The inclusion of straw in high concentrate total mixed rations (TMRs) of male fattening goats can provide the necessary fiber to prevent ruminal acidosis and maintain growth. The objective of this study was to evaluate the effects of the physical form (PF) of the diet (pelleted vs. conventional) and the straw level (SL) of wheat straw (WS) (15% versus 25%) in total mixed rations on feed intake, growth, total tract digestibility, and blood metabolites of fattening goats. Thirty-two male Beetal goats (27.4 &plusmn; 0.28 kg body weight (BW)) were divided randomly into the following four dietary treatments with a 2 &times; 2 factorial arrangement (n = 8/treatment): (1) CTMR15 (conventional TMR containing 15% WS), (2) CTMR25 (conventional TMR containing 25% WS), (3) PTMR15 (pelleted TMR containing 15% WS), and (4) PTMR25 (pelleted TMR containing 25% WS). Both conventional and pelleted 15% WS TMR had 33.7% neutral detergent fiber (NDF) and 19.3% acid detergent fiber (ADF), whereas in 25% WS TMR the NDF and ADF contents were 38.7% and 22.9%, respectively. The experimental diets were formulated to be iso-nitrogenous (crude protein (CP) = 15%). The dry matter intake (DMI) (1.265 vs. 1.044 kg/day) and average daily gain (ADG) (0.176 vs. 0.143 kg/day) were higher (p &lt; 0.05) in pelleted vs. conventional TMR-fed goats. Irrespective of the PF of the TMR, the 15% WS-fed animals had greater (p &lt; 0.05) DMI (1.206 vs. 1.102 kg/day) and ADG (0.172 vs. 0.144 kg) when compared to those fed on 25% WS diets. Furthermore, feed-to-gain ratio (F:G) was higher (p &lt; 0.05) in the 25% WS-fed goats when compared with the 15% WS-fed animals. Digestibility coefficients, nitrogen balancing, hepatic enzymes, blood metabolites, and hematological parameters were similar (p &gt; 0.05) across all treatments. In conclusion, feeding pelleted TMR with WS improved DMI and growth performance as compared to those fed conventional TMR, and 15% WS performed better than 25% WS without exerting any adverse effects on blood metabolites, liver enzymes, or hematological parameters

Longitudinal course and predictors of depressive symptoms in atopic dermatitis

BACKGROUND: Atopic dermatitis (AD) is associated with eczematous lesions, pruritus, pain, and sleep disturbance, which may negatively impact mental health over time. OBJECTIVE: Determine the predictors and longitudinal course of depressive symptoms in adults with AD. METHODS: A prospective, dermatology practice-based study was performed (n=695). AD signs, symptoms and severity and Patient Health Questionnaire (PHQ)-9 were assessed. RESULTS: At baseline, 454 (65.32%) had minimal, 139 (20.00%) mild, 57 (8.20%) moderate, 27 (3.88%) moderately severe, and 8 (2.59%) had severe depression. Most had fluctuating levels of depressive symptoms. Feeling bad, thoughts of self-harm, difficulty concentrating, and slow movement were most persistent. Predictors of persistent depression included older age, non-white race, male sex, public or no insurance, more severe itch, skin pain, facial erythema, nipple eczema, sleep disturbance, and presence of pityriasis alba. LIMITATIONS: Single center study. CONCLUSION: Depressive symptoms are closely related to and fluctuate with AD severity over time. Improved control of AD signs and symptoms, particularly itch, may secondarily improve mental health